In a new study from the University of Utah, researchers found that an eight-week mindfulness therapy—Mindfulness-Oriented Recovery Enhancement (MORE)—decreased opioid use and misuse while reducing chronic pain symptoms.
The effects last as long as nine months.
This is the first large-scale clinical trial to demonstrate that psychological intervention can simultaneously reduce opioid misuse and chronic pain among people who were prescribed opioid pain relievers.
In the current study, the team followed 250 adults with chronic pain on long-term opioid therapy who met the criteria of misusing opioids.
Most participants took oxycodone or hydrocodone, reported two or more painful conditions, and met the clinical criteria for major depression.
More than half of the participants also had a diagnosable opioid use disorder.
All participants were randomly assigned to either a standard supportive psychotherapy group or a MORE group, both engaging in eight weekly two-hour group sessions, as well as 15 minutes of daily homework.
They found that nine months after the treatment period ended, 45% of participants in the MORE group were no longer misusing opioids, and 36% had cut their opioid use in half or greater.
Patients in MORE had more than twice the odds of those in standard psychotherapy to stop misusing opioids by the end of the study.
Moreover, participants in the MORE group reported clinically significant improvements in chronic pain symptoms, decreased opioid craving, and reduced symptoms of depression to levels below the threshold for major depressive disorder.
MORE combines meditation, cognitive-behavioral therapy, and principles from positive psychology into sequenced training in mindfulness, savoring, and reappraisal skills.
As Eric Garland, the lead author of the study, says, MORE demonstrated one of the most powerful treatment effects.
There’s nothing else out there that works this well in alleviating pain and curbing opioid misuse.
Remarkably, the effects of MORE seem to get stronger over time.
It is possible that the sustained benefits were linked to MORE’s ability to restructure the way the brain processes rewards, helping the participants’ brains shift from valuing drug-related rewards to valuing natural, healthy rewards like a beautiful sunset, the bloom of springtime flowers, or the smile on the face of a loved one.
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The study was conducted by Eric L. Garland et al., and published in JAMA Internal Medicine.
