Mindfulness-Oriented Recovery Enhancement for Chronic Pain and Prescription Opioid Misuse: Preliminary Results From a Randomized Controlled Trial
Methods: We are conducting a NIH-funded, randomized controlled trial comparing the efficacy of MORE to a conventional support group (SG) for persons with chronic pain who have been prescribed opioid analgesic therapy for >3 months. Thus far, 33 individuals have been randomly assigned to participate in either 8 weekly, two-hour sessions of MORE (n = 15) or the SG (n =18). Pre- and post-treatment, participants complete a battery of validated questionnaires, cognitive tasks, and psychophysiological measures.
Results: Thus far, we have identified significant effects of MORE on relief from pain, pain attentional bias, and desire for opioid medication. We identified a significant Group X Time interaction on relief from pain treatments, F(1,27) = 8.16, p = .01, ηρ2 = .23, such that participation in MORE was associated with significantly greater increases in relief from pain treatments than the SG. We identified a significant Group X Time interaction on attentional bias toward pain-related cues, F(1,14) = 4.86, p = .04, ηρ2 = .26, such that participation in MORE was associated with significantly greater reductions in the pain attentional bias than the SG. We identified a significant Group X Time interaction on desire for opioid medication, F(1,27) = 4.19, p < .05, ηρ2 = .12, such that participation in MORE was associated with significantly greater reductions in desire for opioid medication than the SG. Although there was no significant Group X Time interaction on changes in well-being, there was a significant main effect of time F(1,28) = 5.67, p = .02, ηρ2 = .17, such that participants in both groups reported significant increases in well-being over the course of the interventions.
Discussion: Preliminary results suggest that MORE is a promising therapeutic approach for chronic pain patients treated with prescription opioid analgesics. Importantly, participation in MORE seems to ameliorate pain, decrease hypervigilance to pain-related cues, and reduce desire for opioid medication. In the future, we will continue to refine, optimize, and test MORE, as well as to elucidate the cognitive, affective, and neurobiological mechanisms underlying its therapeutic effects.