Comparing the effectiveness of acceptance and commitment therapy and mindfulness-based cognitive therapy on substance- induced visual cues and pain perception in heroin users

Introduction and Objective: Substance use disorders, particularly heroin dependence, are frequently associated with heightened cue reactivity and altered pain perception, underscoring the need for evidence-based psychological interventions targeting these mechanisms. The present study aimed to compare the effectiveness of Acceptance and Commitment Therapy (ACT) and Mindfulness-Based Cognitive Therapy (MBCT) on drug cue–induced visual stimuli and pain perception among heroin users residing in the Karamat Rehabilitation Camp of Mobarakeh County during the 2023–2024 period.
Research Methodology: This study employed a quasi-experimental design with a mixed (between–within) repeated-measures approach, including pretest, posttest, and follow-up assessments. The statistical population consisted of approximately 400 heroin users undergoing a six-month residential treatment program. A total of 90 participants were selected through purposive sampling and randomly assigned to three groups (n = 30 per group): ACT, MBCT, and a control group. Inclusion criteria were an age range of 30–50 years, literacy sufficient for questionnaire completion, heroin use, the presence of physical pain, and commitment to a six-month residential stay. Exclusion criteria included concurrent use of multiple psychoactive substances, medication use during the study period, age below 30 or above 50 years, nonadherence to treatment protocols, participation in other psychotherapeutic interventions, and absence from more than two sessions. Data were collected using the McGill Pain Questionnaire (MPQ; 1977) and the Drug Cue–Induced Visual Stimuli Questionnaire (Ekhtiari, 2006). Statistical analyses were conducted using repeated-measures analysis of variance (ANOVA) with a mixed-design approach in SPSS version 24.
Findings: The results indicated that Acceptance and Commitment Therapy was significantly effective in reducing drug cue–induced visual stimuli, whereas Mindfulness-Based Cognitive Therapy significantly improved pain perception.
Conclusion: These findings suggest that MBCT is a more effective intervention for managing pain perception, while ACT is more effective in reducing drug cue reactivity among heroin users.