People with chronic pain who misuse opioids report lower awareness of internal bodily signals compared to those who take opioids as prescribed. In a study of 372 adults on long-term opioid therapy, lower scores on attention regulation and trusting one's body were linked to higher opioid misuse, even after accounting for pain severity. Among 250 participants at elevated risk, an 8-week mindfulness-based program (MORE) produced greater increases in interoceptive awareness than supportive group therapy, and these increases explained reductions in opioid misuse over nine months. The findings suggest that boosting interoceptive awareness may help reduce opioid misuse.
Mindfulness-Oriented Recovery Enhancement (MORE) reduces acute opioid craving, pain, and negative affect more than supportive group psychotherapy for chronic pain patients on long-term opioid therapy. In a trial with 50 participants receiving MORE and 45 receiving supportive group therapy, medium-to-large effects favored MORE for session-level improvements in craving, pain, and negative affect. Higher curiosity predicted craving reductions; greater decentering and daily mindfulness practice predicted reduced negative affect. Momentary measures showed significant group-by-time interactions for craving and pain. The findings suggest MORE provides immediate symptom relief on therapeutic targets in daily life.