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Mindfulness therapy reduces opioid misuse in chronic pain patients

“Mindfulness is a mental training approach. It’s a practice of focusing attention in the present moment, to become aware of thoughts, emotions, body sensations, perceptions, without holding on to experience, but just watching it."

That’s professor Eric Garland, the director of the Center on Mindfulness and Integrative Health Intervention Development at the University of Utah. The center seeks to transform healthcare through mindfulness-based therapies.

In February 2022, Garland and his colleagues published the results of a large randomized clinical trial in JAMA Internal Medicine. The study investigated the efficacy of mindfulness therapy in individuals struggling with chronic pain and opioid misuse.

“Mindfulness Oriented Recovery Enhancement (M.O.R.E) is an eight-week therapy. We delivered it as a group therapy. Each session begins with a formal mindful breathing practice. And then we taught patients how to apply mindfulness to cope with pain,” said Garland.

Garland said that addiction to drugs, like opioids, alters the brain’s wiring in ways that reduce the pleasure of everyday experiences. Experiences like sunsets, birds chirping, the warmth of a loved one’s hand, become less pleasurable. Simultaneously, the brain becomes hypersensitive to drug-related cues such as the presence of an opioid pill bottle. To combat this imbalance Garland says patients were taught what’s called ‘savoring.’

“We bring in a bouquet of roses, and the patients pull out a rose, and we asked them to focus mindful attention on the rose and to appreciate the pleasant colors, and textures, and scent of the flower, as well as the touch of the petals against their skin,” Garland said.

The results showed that mindfulness therapy is more effective than traditional group psychotherapy in reducing opioid misuse in chronic pain sufferers. Patients in the mindfulness treatment group reduced their opioid misuse by 45%, and 36% in this group were able to cut their opioid dose by at least half.

“This study is really important because this is the largest clinical trial, to my knowledge, of any psychological intervention for people with chronic pain who misuse opioids. And this is the first large scale clinical trial to show that a psychological intervention can reduce opioid misuse in people with chronic pain,” Garland said.

Garland adds that 70% of patients at the beginning of the study met the criteria for major depressive disorder. But that mindfulness-based therapy reduced depression symptom levels below the cutoff for major depression.

Max is a neuroscientist and science reporter. His research revolves around an underexplored protein receptor, called GPR171, and its possible use as a pharmacological target for pain. He reports on opioids, outer space and Great Salt Lake. He loves Utah and its many stories.