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 DOI: 10.1111/bcp.16147 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Review Randomized Peer reviewed |
|---|---|
| Topics | Addiction Meditation |
| Key findings | MORE reduced opioid dosing, opioid misuse, illicit drug use, depression, post-traumatic stress symptoms, and chronic pain across 13 randomized clinical trials. |
Abstract
The opioid crisis emerged in part due to the overprescribing of opioid analgesics for chronic pain. Although not the only source of the current epidemic of opioid use disorder (OUD), the prescription of opioids for chronic pain remains one vector for the development of opioid misuse and OUD. However, opioid tapering is not appropriate for all patients, and some patients may need to remain on opioid therapy for the long term. To reduce the risk of opioid‐related harm among people with chronic pain and to treat incipient or entrenched addictive behaviours, new interventions are needed. This review discusses the clinical outcomes, biobehavioural mechanisms and implementation considerations for a novel, evidence‐based intervention for chronic pain, opioid use and OUD called Mindfulness‐Oriented Recovery Enhancement (MORE). MORE unites complementary aspects of mindfulness training, cognitive behavioural therapy and principles from positive psychology to simultaneously address addictive behaviour, emotion dysregulation and chronic pain by targeting brain reward and stress systems. MORE has been tested in 13 completed randomized clinical trials, including over 1300 patients, and has demonstrated efficacy against a range of active control conditions for reducing opioid dosing, opioid misuse, illicit drug use, depression, post‐traumatic stress symptoms and chronic pain. Opportunities for implementing MORE include facilitating opioid tapering and promoting safe opioid use in primary care and specialty pain clinics, decreasing opioid misuse and enhancing medication‐assisted treatment for OUD. Given evidence of MORE's efficacy, it is now time to consider disseminating this evidence‐based treatment in the United States, the United Kingdom and worldwide.
Comparable studies
Other narrative reviews on addiction, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Classic psychedelics: An integrative review of epidemiology, therapeutics, mystical experience, and brain network function. General population | 2019 | Integrative review | |
| Mindfulness meditation–based pain relief: a mechanistic account | 2016 | Review | |
| Psychedelics as anti-inflammatory agents Animal models and cellular studies | 2018 | Review | |
| A narrative review of yoga and mindfulness as complementary therapies for addiction. | 2013 | Review | |
| The neuropsychopharmacology of cannabis: A review of human imaging studies | 2018 | Review |
Citations in the library
Cited by 2
Cites 23
- Restructuring reward processing with Mindfulness-Oriented Recovery Enhancement: novel therapeutic mechanisms to remediate hedonic dysregulation in addiction, stress, and pain. Annals of the New York Academy of Sciences April 1, 2016
- Restructuring Reward Mechanisms in Nicotine Addiction: A Pilot fMRI Study of Mindfulness‐Oriented Recovery Enhancement for Cigarette Smokers Evidence-based Complementary and Alternative Medicine 2017
- Pain, hedonic regulation, and opioid misuse: Modulation of momentary experience by Mindfulness-Oriented Recovery Enhancement in opioid-treated chronic pain patients Drug and Alcohol Dependence March 29, 2017
- Mindfulness-Oriented Recovery Enhancement remediates anhedonia in chronic opioid use by enhancing neurophysiological responses during savoring of natural rewards. Psychological Medicine April 1, 2023
- Endogenous theta stimulation during meditation predicts reduced opioid dosing following treatment with Mindfulness-Oriented Recovery Enhancement. Neuropsychopharmacology September 12, 2020
and 18 more in the library