In the largest trial of its kind to date, researchers found mindfulness training reduced pain, opioid dosing, and depression for chronic pain patients.
By Kaitlin Sullivan – March 7, 2022
Another massive study has shown the power mindfulness-based therapy can have on the brain.
A randomized clinical trial by Utah researchers compared the efficacy of mindfulness-based therapy with cognitive behavioral therapy (CBT) in reducing both opioid use and pain in chronic pain patients.
The trial, published in JAMA Internal Medicine in February 2022, was the latest in a series of studies that use mindfulness-based techniques to reduce pain and opioid use in people with chronic pain. The lead study author, Eric Garland, PhD, a licensed clinical social worker, distinguished professor, and the director of the Center on Mindfulness and Integrative Health Intervention Development at the University of Utah in Salt Lake City, designed the Mindfulness-Oriented Recovery Enhancement (MORE) approach. It combines mindfulness training, changes to the course of negative thoughts, relearning how to appreciate positive experiences, and positive psychology, which encourages people to focus on their strengths rather than weaknesses.
The randomized clinical trial included 250 adults with chronic pain who were misusing the opioids they were prescribed to treat their pain. Half met criteria for opioid use disorder (OUD) at the time they were enrolled in the trial. Roughly half the patients underwent group mindfulness training for eight weeks using MORE. The control group received standard CBT in a group setting.
The researchers encouraged the patients to do what was right for them and did not force anyone to wean themselves off medication. For patients who wanted or needed to remain on opioids, MORE helped them reduce their risk of misuse and relieved pain.
Opioid misuse decreased by an average of 45 percent in the MORE group, double that of the CBT group. More than 35 percent of people in the MORE group cut their opioid use by at least half. The people in the MORE group also reported less pain, opioid cravings, and emotional distress, even though they were taking fewer pain pills. The effects lasted at least until the researchers’ nine-month follow-up period. And although the effects appeared to plateau between six and nine months for the MORE group, the effects of CBT actually waned in the control group.
“It’s difficult to make blanket statements about chronic pain since it’s so different in everyone, but there seems to be a way of modulating how one’s relationship with pain modulates the amount of craving they have for a drug,” says Fadel Zeidan, PhD, an associate professor of anesthesiology at the University of California in San Diego and the director of the Pain, Health, and Mindfulness Lab, who was not involved in the new research.
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