A Qualitative Exploration of the Impact of Mindfulness Oriented Recovery Enhancement for Those with Chronic Pain and a History of Opioid Misuse and Dependency

Background and purpose: While opioid pharmacotherapy is currently a leading medical treatment for chronic pain, a problem experienced by almost a third of the US population, this medical approach has led to rising levels of addiction, dependence, and misuse. Recent studies have shown that a novel behavioral treatment, Mindfulness-Oriented Recovery Enhancement (MORE), can ameliorate pain symptoms and opioid misuse among chronic pain patients (Garland, et al., 2014). Yet, more research is needed to understand the phenomenological experiences of participants in the intervention, and how they make meaning of the intervention in their lives. An in-depth understanding of the lived experiences of chronic pain and opioid misuse will help to further refine the treatment optimization process, leading to improved clinical outcomes for this public health problem of great significance.

Methods: Participants in the intervention group for a larger randomized control trial were recruited for follow-up phenomenological qualitative interviews. Participants in the larger study were recruited via fliers and other postings in the community, and were screened for opioid misuse prior to the beginning of the study. Each interview was an open ended exploration of participants’ experience of the intervention and effects and lasted one hour in length. Interviews were transcribed verbatim and coded thematically using Atlas.ti software. Thematic analysis distilled the essence of the lived experiences of the intervention group participants as they moved through the intervention based on their retrospective reflection.

Results: Qualitative interviews revealed shared experiences of change in participants' relationships to chronic pain-related symptomology and coping, views of self, and relationships with prescription medication. Participants shared rich and meaningful insights into their experiences of both the intervention and their pain, medication use, and quality of life. Several participants found that MORE provided their first opportunity to gain a personal sense of control over their experience of pain.

Conclusion & Implications: Findings demonstrate that participants in this mindfulness-oriented intervention show a narrative transformation in their experiences of their bodies, pain, medication use, and relationships. Study findings provide a wealth of information or researchers and practitioners of this evidence-based intervention for opioid misuse and chronic pain. Given the growing problem of prescription opioid misuse and addiction in the U.S., this qualitative exploration provides further evidence of the benefit and further potential of this unique intervention.

References:

Garland, E. L., Manusov, E. G., Froeliger, B., Kelly, A., Williams, J. M., & Howard, M. O. (2014). Mindfulness-oriented recovvery enhancement for chronic pain and prescription opioid misuse: Results from an eraly-state randomized controlled trial. Journal of Consulting and Clinical Psychology, 82, 448-459.