Mindfulness-Oriented Recovery Enhancement for Addictive Behavior, Psychiatric Distress, and Chronic Pain: A Multilevel Meta-Analysis of Randomized Controlled Trials.
Anna Parisi, R Lynae Roberts, Adam W. Hanley, Eric L Garland
Mindfulness September 15, 2022 DOI: 10.1007/s12671-022-01964-x (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Meta-analysis Randomized Peer reviewed |
|---|---|
| Sample size | 816 |
| Population | Participants in eight randomized controlled trials of Mindfulness-Oriented Recovery Enhancement |
| Intervention | Mindfulness-Oriented Recovery Enhancement (MORE) |
| Topics | Addiction Meditation |
| Keywords | Chronic pain Opioids Mental health Substance use disorders |
| Key findings | Across eight randomized controlled trials (N=816), Mindfulness-Oriented Recovery Enhancement showed small to moderate benefits for addictive behaviors, craving, opioid dose, chronic pain, and psychiatric symptoms, with effects on psychiatric symptoms and craving not moderated by race, gender, age, or income. The authors argue that MORE is efficacious across diverse individuals and should be disseminated broadly in healthcare. |
Abstract
Objectives: Mindfulness-Oriented Recovery Enhancement (MORE) is an integrative intervention designed to ameliorate addiction, chronic pain, and psychiatric symptoms. Although multiple randomized controlled trials (RCTs) have examined the clinical efficacy of MORE, no study has quantitatively synthesized this body of research. Thus, we conducted a meta-analysis of RCTs examining the effects of MORE on addictive behaviors, craving, opioid dose, pain, and psychiatric symptoms.
Methods: Relevant manuscripts were identified through comprehensive searches of four bibliographic databases. Two- and three-level random-effects models were used to generate synthesized effect size estimates, and meta-regressions were performed to examine whether study and sample characteristics influenced the magnitude of aggregate effect sizes.
Results: Our search identified 16 manuscripts reporting data from eight RCTs (N = 816). Moderate to small effects in favor of MORE were observed for addictive behaviors (SMC = - .54, p = .007), craving (SMC = - .42, p = .010), opioid dose (MC = - 17.95, p < .001), chronic pain (SMC = - .60, p < .001), and psychiatric symptoms (SMC = - .34, p < .001). MORE's effects on psychiatric symptoms and craving were not moderated by participant race, gender, age, or income.
Conclusions: Study findings provide empirical evidence of MORE's efficacy for a wide diversity of individuals, and as such, MORE should now be disseminated broadly throughout the healthcare system. Meta-analysis pre-registration prospero #crd42022319006: Supplementary information: The online version contains supplementary material available at 10.1007/s12671-022-01964-x.
Comparable studies
Other systematic reviews and meta-analyses on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Meditation Programs for Psychological Stress and Well-being Diverse adult clinical populations | 2014 | Meta-analysis | n = 3,515 |
| Mindfulness-Based Stress Reduction for Stress Management in Healthy People: A Review and Meta-Analysis Healthy subjects | 2009 | Systematic review and meta-analysis | |
| The psychological effects of meditation: A meta-analysis. Nonclinical groups of adult meditators | 2012 | Meta-analysis | n = 163 |
| Efficacy of Mindfulness-Based Cognitive Therapy in Prevention of Depressive Relapse Adults with recurrent depression in full or partial remission | 2016 | Meta-analysis of individual patient data from randomized controlled trials | n = 1,258 |
| Mindfulness‐Based Stress Reduction and Mindfulness‐Based Cognitive Therapy – a systematic review of randomized controlled trials | 2011 | Systematic review |
Citations in the library
Cited by 28
- Effects of Savoring Meditation on Positive Emotions and Pain-Related Brain Function: A Mechanistic Randomized Controlled Trial in People With Rheumatoid Arthritis. Journal of Pain July 1, 2024
- Which type and dosage of mindfulness-based interventions are most effective for chronic pain? A systematic review and network meta-analysis. Journal of Psychosomatic Research April 1, 2025
- Be more mindful: Targeting addictive responses by integrating mindfulness with cognitive bias modification or cue exposure interventions Neuroscience & Biobehavioral Reviews September 25, 2023
- Immediate Effects of Mindful Awareness in Body-Oriented Therapy as an Adjunct to Medication for Opioid Use Disorder. Mindfulness November 1, 2024
- A Single-Session, 2-Hour Version of Mindfulness-Oriented Recovery Enhancement (One MORE) Improves Chronic Pain Patients' Pain-Related Outcomes Through 3-Month Follow-Up in a Randomized Controlled Trial. Journal of Integrative and Complementary Medicine September 1, 2024
and 23 more in the library
Cites 19
- 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
- Positive Psychological States in the Arc from Mindfulness to Self-Transcendence: Extensions of the Mindfulness-to-Meaning Theory and Applications to Addiction and Chronic Pain Treatment Current Opinion in Psychology January 14, 2019
- The Nondual Awareness Dimensional Assessment (NADA): New tools to assess nondual traits and states of consciousness occurring within and beyond the context of meditation. Psychological Assessment December 1, 2018
- 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
and 14 more in the library