Mindfulness-Oriented Recovery Enhancement reduces opioid craving, pain, and negative affect among chronic pain patients on long-term opioid therapy: An analysis of within- and between-person state effects.
Anna Parisi, Adam W. Hanley, E. Garland
Behaviour Research and Therapy February 28, 2022 DOI: 10.1016/j.brat.2022.104066 (opens in new tab) via Semantic Scholar
Summary
AI-generated from the abstractMindfulness-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.
Study at a glance
| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 95 |
| Population | Chronic pain patients on long-term opioid therapy |
| Interventions | Mindfulness-Oriented Recovery Enhancement supportive psychotherapy |
| Keywords | Medicine Psychology |
| Key finding | MORE produced medium-to-large effects on state measures of craving, pain, and negative affect compared to supportive psychotherapy. |
Abstract
Mindfulness-Oriented Recovery Enhancement (MORE) is an integrative treatment that simultaneously addresses chronic pain and opioid misuse. MORE has been found to produce sustained reductions in opioid craving, pain, and negative affect-key risk mechanisms precipitating opioid misuse for patients on long-term opioid therapy (LTOT). However, less is known about MORE's impact on state measures of acute symptoms. We examined the impact of MORE versus a supportive psychotherapy group (SG) among chronic pain patients on LTOT. Mixed models examined session and momentary effects of MORE (n = 50) versus SG (n = 45) on state measures of craving, pain, and negative affect. Decentering, curiosity, and time spent engaging in daily mindfulness practice were examined as session effect predictors. For session effects, statistically significant medium-to-large effects of treatment group were observed in favor of MORE for craving, pain, and negative affect. Higher levels of curiosity predicted improvements in craving, whereas greater decentering and mindfulness practice were associated with improvements in negative affect. For momentary effects, a significant group by time interaction was observed for craving and pain. Findings suggest that MORE provides immediate symptom relief on therapeutic targets in daily life among chronic pain patients receiving LTOT.