Background
In the United Kingdom, opioids used for pain relief, benzodiazepine tranquillisers used to treat conditions such as anxiety, insomnia and muscle spasms, and antidepressants used to treat depression, chronic pain and other (off label) conditions [British National Formulary, 2021], are more prescribed today than at any other time in history [Davis et al., 2019; Moore, 2019]. While some people are able to taper off them successfully with no symptoms, at least 50% who try to reduce or stop their antidepressants and up to approximately 80% discontinuing tranquillisers will experience psychological and physical withdrawal effects, with a significant number of cases persisting longer than six months [Ashton, 2002; Warner, et al., 2006; Kendrick 2015; Davis et al., 2019]. Similarly, in the case of opioids, UK drug treatment centres reported a 33% rise in patients with prescribed opioid dependency in 2018 and 2019 [Moore, 2019]. The withdrawal effects experienced when coming off prescribed drugs often surface in clusters and are referred to as a ‘withdrawal syndrome’ [Ashton, 2002; Kosten & George, 2002]. When symptoms persist for long periods, unemployment, job loss, financial problems, divorce and relationship break-ups are additional factors that can negatively impact a person’s life [Moncrieffe, 2014], thus making coping more difficult and adequate and appropriate support necessary.
Compassion-Based Approach
Gilbert [2009] defines compassion as a basic kindness and deep awareness of suffering and the desire and effort to relieve it. Compassion flows from oneself to others, from others to self, and from self to self [Gilbert, 2009; Neff, 2003b]. This website encourages the use of compassion and self-kindness in a non-judgemental, gentle way. As described by [Gilbert 2009], non-judgementally acknowledging one’s suffering, with a response that is self-motivated and self-directed, borne out of “kindness, concern and support.” It entails having a desire for one’s well-being and gently and patiently encouraging actions that result in “optimal functioning and health” [Neff, 2003a]. The coping resources offered on this website and in our Compassion Focused Healing group are rooted in this approach.
Mindfulness-Based Approach
Mindfulness is a state of being in awareness and paying attention to the present moment without judgement. One notices what is happening and responds through choice rather than being driven by habitual reactions [Kabat-Zinn, 2004; Burch, 2008]. Existing research supports mindfulness and mindfulness-based approaches such as Acceptance and Commitment Therapy (ACT) as being beneficial in managing anxiety, depression,
chronic pain and other chronic medical conditions [Graham, et al., 2016; Kuber & Weibflog, 2017].
Mindfulness-based practices can cultivate acceptance of chronic conditions, increase psychological flexibility and potentially also lead to better self- management [Graham, et al., 2016; Kuber & Weibflog, 2017; Simpson et al., 2018]. The goal is to change a person’s relationship with an adverse experience or condition, rather than change or get rid of it [Harris, 2009; Graham et al., 2017].
According to feedback from our site visitors and anecdotal evidence collated over the last 16 years by the founder of this website, a mindfulness-based approach has proven to be one of the most useful coping resources in dealing with withdrawal symptoms, and like compassion, it forms the basis of our work.
Research
Predominantly, the existing research in the areas of prescribed drug injury has focused on the disabling effects resulting from discontinuing long-term use of opioids, tranquillisers and antidepressants, and in the areas of mindfulness and self-compassion the focus has been on its benefits on other psychological and physiological conditions. The evidence clearly exists to conclude there are problematic issues associated with prescribed drug injury and withdrawal, and that both mindfulness and self-compassion can benefit anxiety, depression and many chronic illnesses.
However, literature reviews have confirmed there is no existing research investigating coping with these prescribed drug withdrawal syndromes, or the use of any compassion or mindfulness-based approach as a coping resource. Mindful and Compassionate Care will continue to explore the benefits of using mindfulness and compassion-based interventions and resources for people experiencing withdrawal reactions when discontinuing
prescribed opioids, tranquillisers and antidepressants. Through incorporating both approaches in our work with this client group, we are contributing to new knowledge and information in the fields of mindfulness, compassion and prescribed drug injury and withdrawal, which we hope will result in improvements in professional care and therapeutic practice.
References:
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