Session: Getting More out of Mindfulness-Oriented Recovery Enhancement: Increasing Access to an Evidence-Based Intervention to Address the Opioid Crisis (Society for Social Work and Research 27th Annual Conference - Social Work Science and Complex Problems: Battling Inequities + Building Solutions)

The science of social work has much to contribute to battling the opioid epidemic, a serious threat to public health that is now being addressed with extreme urgency by policymakers and practitioners. More than two decades ago, the medical community began to more liberally prescribe opioids to treat chronic pain, ultimately leading to the present crisis of opioid overdoses and addiction in the U.S. In 2020, 2.7 million Americans had an opioid use disorder (OUD) and 9.3 million misused prescription opioids. Among the millions of Americans who misused opioids in 2020, 43% of those individuals obtained opioids from a healthcare provider. As such, chronic pain continues to fuel the development of opioid misuse and OUD. Moreover, individuals with opioid misuse and OUD are often highly vulnerable and tend to suffer from high levels of trauma, stemming in part from structural inequalities, and thus are in need of social work services.

To meet this need, Mindfulness-Oriented Recovery Enhancement (MORE) is an evidence-based social work intervention that was generated through a decade-long NIH-funded treatment development process. MORE unites complementary aspects of mindfulness training, third-wave cognitive-behavioral therapy, and principles from positive psychology into an integrative intervention designed to simultaneously target addictive behavior, stress, and chronic pain. To date, MORE has been studied in 12 randomized controlled trials (RCTs). In the largest trial of MORE to date (N=250) published recently in JAMA Internal Medicine, MORE was found to reduce opioid misuse by 45%, more than doubling the effect of standard supportive therapy, while simultaneously reducing chronic pain symptoms and emotional distress. Yet, in spite of MORE's clear efficacy as a treatment for opioid misuse and its comorbidities, access to this evidence-based intervention is limited by a lack of trained providers and the COVID-19 pandemic. Now, social work scientists are studying ways of increasing access to MORE as a means of prevention and intervention for the opioid crisis.

This symposium presents results from studies examining accessible forms of MORE in various service delivery contexts. This presentation brings senior experts and promising junior scholars in the field who will present data from RCTs examining MORE along the spectrum from prevention to intervention. Hanley will present results from a RCT (N=127) of a nurse-led, ultra-brief, preoperative MORE intervention for patients undergoing knee replacement surgery. Garland will present late-breaking outcomes of a newly completed, NIH-funded RCT (N=154) of telehealth MORE for people with OUD and chronic pain receiving methadone treatment in a community-based addiction treatment setting. Finally, Parisi will present a NIH-funded RCT (N=250) where MORE was delivered in a primary care clinic setting to treat post-traumatic stress symptoms among people with chronic pain and opioid misuse. Lastly, Cooperman will serve as discussant by contextualizing the study findings with regard to treatment access barriers and facilitators for people with chronic pain, opioid misuse, and OUD. The symposium organizer will elicit interactive discussion between the presenters and audience on the potential role social work can play in increasing access to MORE to help halt the opioid crisis.