Mindfulness based stress reduction among substance abuse patients at de-addiction center

It is of interest to investigate the effectiveness of a mindfulness-based stress reduction program on stress and salivary cortisol among substance abuse patients. There were 60 drug addicts who were receiving treatment at the addiction centre. Samples are divided into 30 drug abuse patient experimental and 30 substance abuse patient control groups using the simple random sampling approach. Salivary cortisol, a pre-test stress biomarker, was measured and used to analyse the results. The MBSR programme was administered over thecourse of eight weeks, with two 1-hour sessions held each day, with a cap of 15 participants. The biomarker for stress (salivary cortisol) will be obtained once again at the end of the program to assess the post-test level of perceived stress and compare it to the results. Patients showed improvements in stress level (p < 0.05) following the 8-week MBSR program. The mean level of blood cortisol in the experimental group was 18.08 (3.62), which was dropped to 7.54 (1.29) before the intervention. The mean cortisol level in the experimental group differs by 10.54 (3.45) between pre and post intervention following the intervention (p value is < 0.005). Thus, there is a difference between the experimental conditions before and after the intervention. The mean serum cortisol level in the pre-test is 17.30 (2.34) and the mean serum cortisol level in the post test is 17.15 (2.31) in the control group (p value is > 0.005). Data shows that there is a significant difference between the groups. MBSR may be a beneficial intervention for reducing stress, in Patients taking treatment in de addiction centre.

addressing the stress of substance abuse patients at an addiction facility.Mindfulness concerns 'presence of mind' a receptive attentiveness to events and experiences occurring in the present moment, in contrast to a state of mind in which occurrences are habitually filtered through appraisals, evaluations, memories, and beliefs about events and experience [1].Over the last three decades, mindfulness-based interventions have been increasingly included into clinical interventions and wellness programmes to teach individuals how to better regulate stress-related thoughts, emotions, and behaviour.Mindfulness interventions fundamentally teach a generalizable approach to stress reduction that is, one can be adapted to a variety of stressful situations over time.

Mindfulness interventions have been shown to reduce a variety of psychological symptoms amongst health care providers [2],
The purpose of this RCT was to assess the efficacy of a mindfulnessbased intervention developed from the empirically supported mindfulness-based stress reduction (MBSR) program [3], for lowering stress and neuroendocrine stress markers, as well as lowering the likelihood of relapse and coping capacities to stop using the substances A glucocorticoid called cortisol is produced from cholesterol and released into the bloodstream by the adrenal cortex.Most cortisol in blood plasma (65%) binds to corticosteroid-binding globulin with high affinity but poor capacity (transcortin).A total of 30% of cortisol is bound to albumin, while the remaining 3-5% is still in its free, metabolically active state.[4,5].Therefore, by measuring the amount of cortisol in extracellular fluids, the HPA axis activity during a stress reaction may be identified (blood, urine, saliva).The most often utilised method, which involves measuring blood cortisol levels, has some drawbacks.Additional stress is experienced during the procedure of drawing blood samples from the vein, which might lead to falsely optimistic results [6].Another shortcoming is that cortisol measured from serum or plasma indicates total cortisol rather than free, physiologically active cortisol.Furthermore, several disorders and medications alter the levels of transcortin and albumin, which alters the level of total cortisol in proportion to free cortisol [7,8].Due to the aforementioned drawbacks, measuring salivary cortisol levels is receiving more attention today.As a result of diffusion via the basolateral membrane of the salivary gland acini, this hormone accounts for 70% of the non-bound blood cortisol that enters the saliva.Due to its low molecular weight and liposolubility, unbound cortisol diffuses easily through cell membranes

Method: Participants:
This pilot research examined at a mindfulness-based stress reduction program's feasibility and initial efficacy.There were 60 drug addicts who were receiving treatment at the addiction center.Samples are divided into 30 drug abuse patient experimental and 30 substance abuse patient control groups using the simple random sampling approach.The experimental group members gave their informed consent for the study after being fully informed about it.Salivary cortisol, a pre-test stress biomarker, was measured and used to analyse the results.The study excludessubstance abusers who have just been admitted, substance abusers with a history of seizure disease, serious physical sickness, aggressive conduct, hallucinations, or hostile behaviour.

Intervention and study materials:
The MBSR intervention is based on a programme created by Jon Kabat-Zinn and colleagues at the Massachusetts Medical Center's Stress Reduction and Relaxation Clinic.Being mindful is having the ability to give your present awareness your whole attention-not just your thoughts.A treatment programme called MBSR teaches participants how to self-regulate their arousal in response to stressful situations or symptoms [19,20].By practising meditation, the programme aims to help patients become more conscious of their thoughts and feelings.It also teaches them to pay attention to and monitor their thoughts and feelings in stressful situations to prevent emotional distress.
The MBSR programme was administered over the course of eight weeks, with two 1-hour sessions held each day, with a cap of 15 participants.The biomarker for stress (salivary cortisol) will be obtained once again at the end of the program to assess the posttest level of perceived stress and compare it to the results.Patients were asked to keep a diary of their practice time for activities like meditation, walking meditation, and body scans for six days a week for eight weeks after the orientation.Patients were instructed to formally practice for at least 15 to 45 minutes at the first session.
The patients went to a 2-hour session on the eighth week, which comprised a practice session and a discussion on nutrition based on the Kabat-Zinn programme.

Salivary cortisol:
Samples of saliva were collected both before and after the MBSR in both experimental and control group.Samples were obtained by placing synthetic Salivettes under the tongue for two minutes (Salimetrics, State College, PA).The returned samples were immediately frozen at 20 degrees Celsius until the entire sample assay was completed.Samples were then thawed and centrifuged for 15 min at 1500 £ g at 10 degrees C. Cortisol was assayed using the Salimetrics competitive immunoassay method.The inter-assay coefficient of variation (CV) was 6.69%_6.88%, the intra-assay CV was 3.88%_7.12%,and the sensitivity was <0.007 ug/dL.

Results:
Figure 1 reveals that Before the intervention, the mean level of blood cortisol in the experimental group was 18.08 (3.62), which was dropped to 7.54 (1.29),Following the intervention the mean cortisol level in the experimental group differs by 10.54 (3.45) between pre and post intervention.sinceP value is < 0.005 It is significant and indicates that there is a difference between the experimental conditions before and after the intervention.In the control group, the mean serum cortisol level in the pretest is 17.30 (2.34) and the mean serum cortisol level in the posttest is 17.15 (2.31).The control group's mean cortisol level varies between preand post-intervention by 0.14 (0.84),since the P value is greater than 0.005, the difference between pre and post intervention in the control group is not significant.The p value is less than 0.005 when comparing the posttest values of the experimental and control groups.Demonstrates that there is a significant difference between the groups [9,10].Under intense stress, cortisol output rises dramatically[11,12].The level of ©Biomedical Informatics secreted in such situations stands in correlation with the intensity of the stress[13].The precise central stress system components that will be engaged in cortisol control during a stressful experience rely on a variety of variables.The kind of stressor is the first of these variables.Physical, biological, and psychological stressors include things like heat, cold, electrical shock, noise, and lack of sleep (e.g.university exams, public appearance, graduation paper defence etc.).The amygdala (AG) is primarily affected by physical stress, while the hippocampus (HC) and perifrontal cortex are affected by psychological stress (PFC).(34Pruessner et al. found that the subjects' HC activation was decreased during psychological stress and came to the conclusion that there was an inverse relationship between HC activation and the cortisol response to stress.On the other hand, different PFC components have a connection to cortisol secretion.Strongly stressed subjects showed increased ventro lateral cortical activity as well as decreased medial, orbitofrontal, and anterior cingulate activity [14,15 & 16].Salivary cortisol has the significant benefit that samples can be taken in both the participant's natural environment and in specific conditions outside of the laboratory.Additionally, because the process of collecting saliva is noninvasive, individuals don't experience any added stress[17,18].Salivary cortisol is a novel technique in the research of acute stress indicators due to its simplicity of collection and potential for wide application.

Figure 1 :
Figure 1: Percentage distribution of the level of stress among substance abuse patients in both the experimental and control groups.