Mindfulness-oriented recovery enhancement reduces opioid misuse risk via analgesic and positive psychological mechanisms: A randomized controlled trial.
Eric L Garland, Adam W. Hanley, Michael R. Riquino, Sarah E. Reese, Anne Baker, Karen Salas, Brooke P Yack, Carter E Bedford, Myranda A Bryan, Rachel M Atchley, Yoshio Nakamura, Brett Froeliger, Matthew O Howard
Journal of Consulting and Clinical Psychology October 1, 2019 DOI: 10.1037/ccp0000390 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Stage 2 randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 95 |
| Population | Adults with chronic pain receiving long-term opioid analgesics (mean age 56.8 years; 66% female) |
| Interventions | Mindfulness-Oriented Recovery Enhancement (MORE) Support group |
| Duration | 8-week intervention; 3-month follow-up |
| Topics | Meditation |
| Keywords | Humans Opioid-related disorders Analgesics, opioid Treatment outcome Analgesia Affect Psychotherapeutic processes Adult Middle aged Self-help groups Female Chronic pain |
| Key findings | Participants in MORE reported greater reductions in pain severity by posttreatment and in opioid misuse risk by 3-month follow-up, and greater increases in positive psychological health, than support group participants. Increases in positive psychological health mediated the effect of MORE on pain severity, which in turn predicted decreases in opioid misuse risk by follow-up. The authors conclude that targeting positive psychological mechanisms may reduce opioid misuse risk in this population. |
Abstract
Objective: Despite the heightened urgency of the current prescription opioid crisis, few psychotherapies have been evaluated for chronic pain patients receiving long-term opioid analgesics. Current psychological pain treatments focus primarily on ameliorating negative affective processes, yet basic science suggests that risk for opioid misuse is linked with a dearth of positive affect. Interventions that modulate positive psychological processes may produce therapeutic benefits among patients with opioid-treated chronic pain. The aim of this study was to conduct a theory-driven mechanistic analysis of proximal outcome data from a Stage 2 randomized controlled trial of Mindfulness-Oriented Recovery Enhancement (MORE), an integrative intervention designed to promote positive psychological health.
Method: Patients with opioid-treated chronic pain (N = 95; age = 56.8 ± 11.7; 66% female) were randomized to 8 weeks of therapist-led MORE or support group (SG) interventions. A latent positive psychological health variable comprised of positive affect, meaning in life, and self-transcendence measures was examined as a mediator of the effect of MORE on changes in pain severity at posttreatment and opioid misuse risk by 3-month follow-up.
Results: Participants in MORE reported significantly greater reductions in pain severity by posttreatment (p = .03) and opioid misuse risk by 3-month follow-up (p = .03) and significantly greater increases in positive psychological health (p < .001) than SG participants. Increases in positive psychological health mediated the effect of MORE on pain severity by posttreatment (p = .048), which in turn predicted decreases in opioid misuse risk by follow-up (p = .02).
Conclusions: Targeting positive psychological mechanisms via MORE and other psychological interventions may reduce opioid misuse risk among chronic pain patients receiving long-term opioid therapy. (PsycINFO Database Record (c) 2019 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 56
- Mindfulness-based programs for substance use disorders: a systematic review of manualized treatments Substance Abuse Treatment, Prevention, and Policy July 29, 2020
- 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
- A low dose of lysergic acid diethylamide decreases pain perception in healthy volunteers Journal of Psychopharmacology August 25, 2020
- From Self-Esteem to Selflessness: An Evidence (Gap) Map of Self-Related Processes as Mechanisms of Mindfulness-Based Interventions Frontiers in Psychology November 22, 2021
- 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 51 more in the library
Cites 19
- Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Journal of Consulting and Clinical Psychology 2000
- Self-awareness, self-regulation, and self-transcendence (S-ART): a framework for understanding the neurobiological mechanisms of mindfulness Frontiers in Human Neuroscience 2012
- Response of cluster headache to psilocybin and LSD Neurology June 26, 2006
- Neural correlates of nondual awareness in meditation. Annals of the New York Academy of Sciences 2014
- Influence of meditation on anti-correlated networks in the brain. Frontiers in Human Neuroscience 2011
and 14 more in the library