With nearly one-third of Americans suffering from chronic
pain, prescription opioid
painkillers have become the leading form of treatment for this debilitating
painkillers not as addictive as feared
Unfortunately, misuse of prescription opioids can lead to
serious side effects including death by overdose. A new treatment developed by University
of Utah researcher Eric Garland has shown to not only lower pain but also
decrease prescription opioid misuse among chronic pain patients.
Results of a study by Garland published online in the
Journal of Consulting and Clinical Psychology, showed that the new treatment
led to a 63% reduction in opioid misuse, compared to a 32% reduction among
participants of a conventional support group. Additionally, participants in the
new treatment group experienced a 22% reduction in pain-related impairment,
which lasted for three months after the end of treatment.
The MORE intervention
The new intervention, called Mindfulness-Oriented Recovery
Enhancement, or MORE, is designed to train people to respond differently to
pain, stress and opioid-related cues.
MORE targets the underlying processes involved in chronic
pain and opioid misuse by combining three therapeutic components:
mindfulness training, reappraisal and savouring.
in 8 teens misuses painkillers
training the mind to increase awareness, gain control over one’s attention and
regulate automatic habits.
Reappraisal is the
process of reframing the meaning of a stressful or adverse event in such a way
as to see it as purposeful or growth promoting.
Savouring is the
process of learning to focus attention on positive events to increase one’s
sensitivity to naturally rewarding experiences, such as enjoying a beautiful
nature scene or experiencing a sense of connection with a loved one.
“Mental interventions can address physical problems, like
pain, on both psychological and biological levels because the mind and body are
interconnected,” Garland said. “Anything that happens in the brain happens in
the body – so by changing brain functioning, you alter the functioning of the
To test the treatment, 115 chronic pain patients were
randomly assigned to eight weeks of either MORE or conventional support group
therapy, and outcomes were measured through questionnaires at pre- and
post-treatment, and again at a three-month follow-up. Nearly three-quarters of
the group misused opioid painkillers before starting the programme by taking
higher doses than prescribed, using opioids to alleviate stress and anxiety or
another method of unauthorized self-medication with opioids.
Among the skills taught by MORE were a daily 15-minute
mindfulness practice session guided by a CD and three minutes of mindful
breathing prior to taking opioid medication. This practice was intended to
increase awareness of opioid craving – helping participants clarify whether
opioid use was driven by urges versus a legitimate need for pain relief.
“People who are in chronic pain need relief, and opioids are
medically appropriate for many individuals,” Garland said. “However, a new
option is needed because existing treatments may not adequately alleviate pain
while avoiding the problems that stem from chronic opioid use.”
Pilot brain imaging
MORE is currently being tested in a pilot brain imaging
trial as a smoking cessation treatment, and there are plans to test the
intervention with people suffering from mental health problems who also have
alcohol addiction. Further testing on active-duty soldiers with chronic pain
and a larger trial among civilians is planned. If studies continue to
demonstrate positive outcomes, MORE could be prescribed by doctors as an adjunct
to traditional pain management services.Read more:
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