Mindfulness‐Oriented Recovery Enhancement: Implementing an evidence‐based intervention for chronic pain, opioid use, and opioid addiction in clinical settings
British Journal of Clinical Pharmacology July 24, 2024 Eric L. Garland
The opioid crisis partly stems from overprescribing opioid analgesics for chronic pain, though not all patients can taper off opioids. Mindfulness-Oriented Recovery Enhancement (MORE) integrates mindfulness training, cognitive behavioral therapy, and positive psychology to target reward and stress systems underlying addiction, emotion dysregulation, and chronic pain. Across 13 completed randomized clinical trials involving over 1300 patients, MORE demonstrated efficacy against active control conditions for reducing opioid dosing, opioid misuse, illicit drug use, depression, post-traumatic stress symptoms, and chronic pain. Implementation opportunities include facilitating opioid tapering in primary care and specialty pain clinics and enhancing medication-assisted treatment for opioid use disorder.