Odds are good you know someone whose misuse of opioids started with seeking relief from a back injury or other chronic pain. If you’re not aware of friends or family members who traveled that sad path, you’ve likely heard of celebrities or politicians with opioid abuse problems. According to the CDC, death rates from opioid use increased more than five times in the 20-year period from 1999 to 2019. When patients with chronic pain self-medicate with opioids, the problem only gets worse because opioid use increases sensitivity to pain. In order to help significant numbers of people with opioid use disorder, the solution needs to address patient pain as well as the drug use.
Researchers at the University of Utah Center on Mindfulness and Integrative Health Intervention Development (C-MIIND) recently published the report of a clinical trial of the effect of mindfulness therapy on opioid use and chronic pain in JAMA Internal Medicine. In the study, 250 adults on long-term opioid therapy for chronic pain were randomly assigned to a standard psychotherapy support group or a Mindfulness-Oriented Recovery Enhancement (MORE) group. The intervention program took place from January 2016 though January 2020. Eric Garland, the C-MIIND director, developed the MORE program. MORE integrates mindfulness training, cognitive-behavioral therapy, and positive psychological principles. Garland developed MORE as an intervention and mental training program.
In the study, participants in the MORE group and the standard support group both attended weekly two-hour group sessions and had 15 minutes of daily homework. Research team members measured all study participants for opioid misuse, symptoms of pain, depression, anxiety, and stress, and their opioid dose throughout the study and in a nine-month follow-up. Nine months after the treatment, participants in the MORE group showed significantly better progress than the control group. In the MORE group, 45% no longer misused opioids and 36% cut their opioid use in half or more. These results are better than twice those of the standard psychotherapy, according to the report.
The primary findings of the C-MIIND support using the MORE intervention to reduce opioid misuse are impressive. Participants were assigned randomly to the intervention or psychotherapy support group and the interviewers were group-blind, meaning they didn’t know if they were interviewing someone from the test group or the control group. Further tests with larger populations in various parts of the U.S. and with other forms and combination of mindfulness, cognitive behavior therapy, and positivity are in order to learn more about these other-than-standard interventions and to validate the current findings. Results are results, though, and we’re happy to see that the MORE program helped people in pain who were misusing opioids. We hope that this approach can bring relief to more patients.
