Mindfulness Intervention Shown to Lower Opioid Misuse

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SALT LAKE CITY – Active-duty servicemembers with chronic pain will be among the next groups tested with a new mindfulness-focused treatment to lower opioid misuse.

The new intervention, called Mindfulness-Oriented Recovery Enhancement (MORE) is designed to train patients to respond differently to pain, stress and opioid-related cues.

A study published online recently in the Journal of Consulting and Clinical Psychology indicated that MORE led to a 63% reduction in opioid misuse, compared with a 32% reduction among participants of a conventional support group.1

At the same time, participants in the new treatment group experienced a 22% reduction in pain-related impairment, which lasted for three months after the end of treatment.

MORE targets the underlying processes involved in chronic pain and opioid misuse by combining three therapeutic components: mindfulness training, reappraisal and savoring.

“Mental interventions can address physical problems, like pain, on both psychological and biological levels because the mind and body are interconnected,” said lead researcher Eric Garland, PhD, associate professor of social work at the University of Utah and research fellow of the National Center for Veterans Studies. “Anything that happens in the brain happens in the body — so by changing brain functioning, you alter the functioning of the body.”

For the National Institute on Drug Abuse-funded study, 115 chronic pain patients were randomly assigned to eight weeks of either MORE or conventional support group therapy. Before starting the program, nearly three-quarters of the group misused opioid painkillers by taking higher doses than prescribed, using opioids to alleviate stress and anxiety or another method of unauthorized self-medication.

Participants in the MORE group had daily 15-minute mindfulness practice sessions guided by a CD and three minutes of mindful breathing prior to taking opioid medication. The practice was intended to increase awareness of opioid craving and to help patients understand whether opioid use was driven by urges versus a legitimate need for pain relief, according to the study.

Outcomes were measured through questionnaires at pre- and post-treatment and again at a three-month follow-up.

“People who are in chronic pain need relief, and opioids are medically appropriate for many individuals,” Garland said. “However, a new option is needed, because existing treatments may not adequately alleviate pain while avoiding the problems that stem from chronic opioid use.”

MORE is being tested in a pilot brain-imaging trial as a smoking cessation treatment and is planned for testing in mental health patients with alcohol addiction. Further testing on active-duty soldiers with chronic pain and a larger trial among civilians also is in the works.

1Garland EL, Manusov EG, Froeliger B, Kelly A, Williams JM, Howard MO. Mindfulness-Oriented Recovery Enhancement for Chronic Pain and Prescription Opioid Misuse: Results From an Early-Stage Randomized Controlled Trial. J Consult Clin Psychol. 2014 Feb 3. [Epub ahead of print] PubMed PMID: 24491075.

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