Psychological Medicine
April 1, 2023
Eric L Garland, Spencer T Fix, Justin Hudak et al.
51 citations
Long-term opioid therapy for chronic pain can lead to anhedonia, or reduced ability to experience pleasure from natural rewards. A behavioral intervention called Mindfulness-Oriented Recovery Enhancement (MORE) was tested in 63 veterans on long-term opioid therapy for chronic pain, who were randomly assigned to eight weeks of MORE or a supportive group therapy. MORE increased brain and physiological responses to natural reward cues and reduced subjective anhedonia more than the control. The reduction in anhedonia was linked to increased brain activity during savoring of rewards. MORE may be an effective treatment for anhedonia in chronic opioid users and those at risk for opioid use disorder.
Science Advances
October 14, 2022
Eric L Garland, Adam W. Hanley, Justin Hudak et al.
39 citations
Theta oscillations (4 to 8 Hz) in frontal midline brain regions, which support self-regulation, are inversely linked to default mode network activity involved in self-referential processing. Addiction involves impaired self-regulation and default mode network dysfunction. In a mechanistic study of 165 long-term opioid users, Mindfulness-Oriented Recovery Enhancement increased frontal midline theta during meditation compared to supportive psychotherapy. Theta during meditation was associated with self-transcendent experiences such as ego dissolution and bliss. Increased theta mediated the treatment's effect on reducing opioid misuse, suggesting mindfulness-induced theta stimulation may reset default mode network dysfunction to inhibit addictive behavior.
Neuroscience and Neuroeconomics
July 1, 2016
Eric L Garland, Matthew O. Howard, Sarah E. Priddy et al.
12 citations
Addiction arises from an imbalance between bottom-up reward-learning processes and top-down executive control in the brain, with drug use weakening prefrontal cognitive control networks and hijacking striatal circuits meant for natural rewards. Mindfulness-based interventions (MBIs) can be seen as mental training that exercises and strengthens these brain networks. This review proposes that MBIs remediate addiction by regulating frontostriatal circuits, restoring balance between top-down and bottom-up processes. Evidence indicates MBIs improve cognitive control over drug-related automaticity, attentional bias, and cue reactivity, while increasing responsiveness to natural rewards. An integrative account of neural mechanisms is offered to inform addiction therapy.
JAMA Internal Medicine
February 28, 2022
E. Garland, Adam W. Hanley, Y. Nakamura et al.
A mindfulness-based program called Mindfulness-Oriented Recovery Enhancement (MORE) reduced opioid misuse and improved chronic pain more than supportive group psychotherapy in adults with both conditions. After 9 months, 45.0% of participants receiving MORE had stopped misusing opioids, compared with 24.4% receiving supportive therapy. MORE also led to significant improvements in chronic pain symptoms. The program appears to be an effective treatment for opioid misuse among people with chronic pain in primary care.
Annals of Behavioral Medicine
January 22, 2019
E. Garland, M. A. Bryan, Sarah E. Priddy et al.
A mindfulness-based intervention, Mindfulness-Oriented Recovery Enhancement (MORE), improved the ability to inhibit responses when exposed to pain-related emotional distractors in adults with chronic pain and long-term prescription opioid use. In a controlled trial, participants in MORE showed greater reductions in errors of commission on an Emotional Go/NoGo Task with pain-related stimuli compared with a support group. More mindfulness practice and increased nonreactivity predicted better emotional response inhibition. Improvements in emotional response inhibition were linked to later reductions in pain severity at 3-month follow-up. The results provide preliminary evidence that MORE enhances inhibitory control under negative emotional interference.
Evidence-based complementary and alternative medicine : eCAM
January 1, 2012
Brett Froeliger, Eric L Garland, F Joseph McClernon
Practicing hatha yoga—physical postures, breathing exercises, and meditation—may increase gray matter volume in brain regions involved in executive function, emotion, and memory. In a preliminary study, yoga meditation practitioners showed greater gray matter volume in frontal, limbic, temporal, occipital, and cerebellar areas compared to matched controls, who showed no such differences. The yoga group also reported fewer cognitive failures, and the size of this benefit correlated with gray matter volume in several brain regions. Longer yoga practice was associated with greater gray matter volume. These results suggest that hatha yoga may promote neuroplastic changes in executive brain systems, potentially offering therapeutic benefits that grow with continued practice.
Evidence-based complementary and alternative medicine : eCAM
January 1, 2012
Brett Froeliger, Eric L Garland, Rachel V Kozink et al.
Meditation practitioners show stronger functional connectivity within the Dorsal Attention Network during rest compared to non-meditators. While meditating, practitioners increase connectivity between the Dorsal Attention Network and networks involved in self-referential processing and emotion (default mode and salience networks), while decreasing connectivity between attention regions and prefrontal and insular areas. More years of meditation experience correlate with stronger connectivity between attention networks and subcortical and parietal regions, but weaker connectivity with lateral parietal and insular areas. These findings suggest meditation strengthens attention networks and their coupling with other brain networks.