Mindfulness-Meditation-Based Pain Relief Is Not Mediated by Endogenous Opioids.
Fadel Zeidan, Adrienne L Adler-Neal, Rebecca E Wells, Emily Stagnaro, Lisa M May, James C Eisenach, John G. Mchaffie, Robert C. Coghill
Journal of Neuroscience March 16, 2016 DOI: 10.1523/jneurosci.4328-15.2016 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Double-blind randomized study Peer reviewed |
|---|---|
| Population | Healthy human volunteers |
| Interventions | Mindfulness meditation Naloxone Saline placebo |
| Dose | naloxone 0.15 mg/kg bolus + 0.1 mg/kg/h infusion |
| Topics | Meditation |
| Keywords | Cognitive Mindfulness meditation Naloxone Opioid Pain |
| Key points | Mindfulness meditation during saline infusion significantly reduced pain intensity and unpleasantness ratings versus a control plus saline group, but naloxone infusion failed to reverse meditation-induced analgesia. Reductions in pain intensity and unpleasantness did not differ significantly between meditation plus naloxone and meditation plus saline, and meditation during naloxone produced significantly greater reductions than the control groups. The authors conclude that mindfulness-meditation-based analgesia does not rely on endogenous opioidergic mechanisms. |
Abstract
Mindfulness meditation, a cognitive practice premised on sustaining nonjudgmental awareness of arising sensory events, reliably attenuates pain. Mindfulness meditation activates multiple brain regions that contain a high expression of opioid receptors. However, it is unknown whether mindfulness-meditation-based analgesia is mediated by endogenous opioids. The present double-blind, randomized study examined behavioral pain responses in healthy human volunteers during mindfulness meditation and a nonmanipulation control condition in response to noxious heat and intravenous administration of the opioid antagonist naloxone (0.15 mg/kg bolus + 0.1 mg/kg/h infusion) or saline placebo. Meditation during saline infusion significantly reduced pain intensity and unpleasantness ratings when compared to the control + saline group. However, naloxone infusion failed to reverse meditation-induced analgesia. There were no significant differences in pain intensity or pain unpleasantness reductions between the meditation + naloxone and the meditation + saline groups. Furthermore, mindfulness meditation during naloxone produced significantly greater reductions in pain intensity and unpleasantness than the control groups. These findings demonstrate that mindfulness meditation does not rely on endogenous opioidergic mechanisms to reduce pain. Endogenous opioids have been repeatedly shown to be involved in the cognitive inhibition of pain. Mindfulness meditation, a practice premised on directing nonjudgmental attention to arising sensory events, reduces pain by engaging mechanisms supporting the cognitive control of pain. However, it remains unknown if mindfulness-meditation-based analgesia is mediated by opioids, an important consideration for using meditation to treat chronic pain. To address this question, the present study examined pain reports during meditation in response to noxious heat and administration of the opioid antagonist naloxone and placebo saline. The results demonstrate that meditation-based pain relief does not require endogenous opioids. Therefore, the treatment of chronic pain may be more effective with meditation due to a lack of cross-tolerance with opiate-based medications.
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
Cited by 53
- Mindfulness Meditation and Psychopathology Annual Review of Clinical Psychology December 11, 2018
- Mindfulness meditation–based pain relief: a mechanistic account Annals of the New York Academy of Sciences June 1, 2016
- Mindfulness in migraine: A narrative review Expert Review of Neurotherapeutics January 14, 2020
- Brief mindfulness training enhances cognitive control in socioemotional contexts: Behavioral and neural evidence PLoS One July 19, 2019
- Mindfulness meditation is related to sensory‐affective uncoupling of pain in trained novice and expert practitioners European Journal of Pain April 20, 2020
and 48 more in the library
Cites 9
- Effects of Brief and Sham Mindfulness Meditation on Mood and Cardiovascular Variables The Journal of Alternative and Complementary Medicine July 28, 2010
- Neural correlates of mindfulness meditation-related anxiety relief Social Cognitive and Affective Neuroscience April 24, 2013
- Mindfulness Meditation-Based Pain Relief Employs Different Neural Mechanisms Than Placebo and Sham Mindfulness Meditation-Induced Analgesia. Journal of Neuroscience November 18, 2015
- Meditative analgesia: the current state of the field. Annals of the New York Academy of Sciences 2014
- Mindfulness meditation-related pain relief: evidence for unique brain mechanisms in the regulation of pain. Neuroscience Letters April 6, 2012
and 4 more in the library