Mindfulness-oriented recovery enhancement for chronic pain and prescription opioid misuse: results from an early-stage randomized controlled trial.
Eric L Garland, Eron G Manusov, Brett Froeliger, Amber Kelly, Jaclyn M Williams, Matthew O Howard
Journal of Consulting and Clinical Psychology February 3, 2014 DOI: 10.1037/a0035798 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 115 |
| Population | Chronic pain patients (mean age 48 ± 14 years; 68% female) |
| Interventions | Mindfulness-Oriented Recovery Enhancement (MORE) support group |
| Duration | 8 weeks of intervention; outcomes at pre- and posttreatment and 3-month follow-up |
| Measures | Brief Pain Inventory, Current Opioid Misuse Measure |
| Topics | Meditation |
| Keywords | Humans Opioid-related disorders Analgesics, opioid Treatment outcome Combined modality therapy Feasibility studies Arousal Adult Middle aged Veterans United states Female Chronic pain |
| Key findings | MORE produced greater reductions in pain severity and interference than a support group, maintained at 3-month follow-up and mediated by increased nonreactivity and reinterpretation of pain sensations. MORE also reduced stress arousal and opioid desire and increased the likelihood of no longer meeting opioid use disorder criteria immediately posttreatment, though these effects were not sustained at follow-up. |
Abstract
Objective: Opioid pharmacotherapy is now the leading treatment for chronic pain, a problem that affects nearly one third of the U.S. population. Given the dramatic rise in prescription opioid misuse and opioid-related mortality, novel behavioral interventions are needed. The purpose of this study was to conduct an early-stage randomized controlled trial of Mindfulness-Oriented Recovery Enhancement (MORE), a multimodal intervention designed to simultaneously target mechanisms underpinning chronic pain and opioid misuse.
Method: Chronic pain patients (N = 115; mean age = 48 ± 14 years; 68% female) were randomized to 8 weeks of MORE or a support group (SG). Outcomes were measured at pre- and posttreatment, and at 3-month follow-up. The Brief Pain Inventory was used to assess changes in pain severity and interference. Changes in opioid use disorder status were measured by the Current Opioid Misuse Measure. Desire for opioids, stress, nonreactivity, reinterpretation of pain sensations, and reappraisal were also evaluated.
Results: MORE participants reported significantly greater reductions in pain severity (p = .038) and interference (p = .003) than SG participants, which were maintained by 3-month follow-up and mediated by increased nonreactivity and reinterpretation of pain sensations. Compared with SG participants, participants in MORE evidenced significantly less stress arousal (p = .034) and desire for opioids (p = .027), and were significantly more likely to no longer meet criteria for opioid use disorder immediately following treatment (p = .05); however, these effects were not sustained at follow-up.
Conclusions: Findings demonstrate preliminary feasibility and efficacy of MORE as a treatment for co-occurring prescription opioid misuse and chronic pain. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
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 104
- Mindfulness Interventions Annual Review of Psychology September 30, 2016
- A systematic review of the neurophysiology of mindfulness on EEG oscillations Neuroscience & Biobehavioral Reviews 2015
- Mindfulness meditation–based pain relief: a mechanistic account Annals of the New York Academy of Sciences June 1, 2016
- Prospects for a clinical science of mindfulness-based intervention. American Psychologist October 1, 2015
- Mindfulness-Based Interventions for the Treatment of Substance and Behavioral Addictions: A Systematic Review Frontiers in Psychiatry March 29, 2018
and 99 more in the library
Cites 11
- Using Self-Report Assessment Methods to Explore Facets of Mindfulness Assessment January 27, 2006
- Mindfulness-Oriented Recovery Enhancement Reduces Pain Attentional Bias in Chronic Pain Patients Psychotherapy and Psychosomatics 2013
- Mindfulness training reduces the severity of irritable bowel syndrome in women: results of a randomized controlled trial. The American journal of gastroenterology September 2011
- Brain mechanisms supporting the modulation of pain by mindfulness meditation. Journal of Neuroscience April 6, 2011
- Upward spirals of positive emotions counter downward spirals of negativity: insights from the broaden-and-build theory and affective neuroscience on the treatment of emotion dysfunctions and deficits in psychopathology. Clinical Psychology Review November 1, 2010
and 6 more in the library