Enhancing interoceptive awareness in chronic pain and opioid misuse via mindfulness-oriented recovery enhancement.
Anna Parisi, Lisa Taylor-Swanson, Jennifer L. Stewart, Sahib S. Khalsa, Eric L Garland
Drug and Alcohol Dependence June 2, 2025 DOI: 10.1016/j.drugalcdep.2025.112741 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 372 |
| Population | Adults with chronic pain on long-term opioid therapy |
| Intervention | Mindfulness-Oriented Recovery Enhancement (MORE) |
| Duration | 8-week intervention, 9-month follow-up |
| Topics | Meditation |
| Keywords | Interoception Interoceptive awareness Opioid misuse treatment Opioid addiction treatment Opioid dependence management Opioid misuse reduction Body awareness Internal sensation perception Visceral perception Mindfulness-based therapy Mindfulness intervention Meditation therapy Awareness training Mindfulness program Chronic pain management Pain relief Chronic pain treatment Pain therapy |
| Citations | 1 |
| Key findings | Lower interoceptive awareness was associated with higher opioid misuse at baseline, and a mindfulness-based intervention (MORE) increased interoceptive awareness, which mediated reductions in opioid misuse over nine months. |
Abstract
Individuals with substance use disorders often report altered interoceptive awareness of internal bodily signals. However, it is unclear whether these alterations also extend to patients with chronic pain who misuse opioids, and whether interventions that enhance interoceptive awareness, such as mindfulness-based therapies, may reduce opioid misuse in this population. At baseline, participants (N = 372) with chronic pain on long-term opioid therapy completed the Multidimensional Assessment of Interoceptive Awareness (MAIA), Current Opioid Misuse Measure (COMM), and the Brief Pain Inventory. A subset identified as having an elevated risk for opioid misuse (n = 250) were randomized to an 8 week Mindfulness-Oriented Recovery Enhancement (MORE) program or supportive group (SG) psychotherapy, and completed MAIA and COMM ratings through a 9-month follow-up period. At baseline, lower scores on the MAIA Attention Regulation and Trusting subscales were associated with higher levels of opioid misuse, even after accounting for pain severity and interference. MORE led to significantly greater increases in MAIA total and subscale scores (Attention Regulation, Trusting, and others) compared to SG, which mediated its effects on reducing opioid misuse over the 9-month follow-up period. Individuals with chronic pain who misuse opioids report lower interoceptive awareness than those using opioids as prescribed. By increasing interoceptive awareness, mindfulness-based interventions such as MORE may lessen the misuse of opioid analgesic medications. These findings suggest that interoceptive awareness is a promising intervention target for opioid misuse.
Comparable studies
Other randomized controlled trials on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Alterations in Brain and Immune Function Produced by Mindfulness Meditation Healthy employees in a work environment | 2003 | Randomized controlled trial | n = 41 |
| Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Recovered recurrently depressed patients | 2000 | Randomized controlled trial | n = 145 |
| Open hearts build lives: Positive emotions, induced through loving-kindness meditation, build consequential personal resources. Working adults | 2008 | Randomized controlled trial | n = 139 |
| Short-term meditation training improves attention and self-regulation Undergraduate Chinese students | 2007 | Randomized controlled trial | n = 40 |
| Mindfulness-Based Cognitive Therapy for Depression: Replication and Exploration of Differential Relapse Prevention Effects. Recovered recurrently depressed patients | 2004 | Randomized controlled trial | n = 73 |
Citations in the library
Cites 14
- How Does Mindfulness Meditation Work? Proposing Mechanisms of Action From a Conceptual and Neural Perspective Perspectives on Psychological Science October 14, 2011
- Interoception, contemplative practice, and health Frontiers in Psychology June 9, 2015
- Interoceptive awareness in experienced meditators Psychophysiology May 22, 2008
- Effects of Mindfulness-Based Cognitive Therapy on Body Awareness in Patients with Chronic Pain and Comorbid Depression Frontiers in Psychology June 30, 2016
- Immediate Effects of Mindful Awareness in Body-Oriented Therapy as an Adjunct to Medication for Opioid Use Disorder. Mindfulness November 1, 2024
and 9 more in the library