Open AccessMindfulness-oriented recovery enhancement reduces opioid dose in primary care by strengthening autonomic regulation during meditation.
Author(s) -
Eric L. Garland,
Justin Hudak,
Adam W. Hanley,
Yoshio Nakamura
Publication year - 2020
Publication title -
american psychologist/the american psychologist
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.124
H-Index - 230
eISSN - 1935-990X
pISSN - 0003-066X
DOI - 10.1037/amp0000638
Subject(s) - opioid , mindfulness , chronic pain , medicine , randomized controlled trial , meditation , anesthesia , opioid use disorder , physical therapy , clinical psychology , philosophy , receptor , theology
The current opioid crisis was fueled by escalation of opioid dosing among patients with chronic pain. Yet, there are few evidence-based psychological interventions for opioid dose reduction among chronic pain patients treated with long-term opioid analgesics. Mindfulness-Oriented Recovery Enhancement (MORE), which was designed to target mechanisms underpinning chronic pain and opioid misuse, has shown promising results in 2 randomized clinical trials (RCTs) and could facilitate opioid sparing and tapering by bolstering self-regulation. Here we tested this hypothesis with secondary analyses of data from a Stage 2 RCT. Chronic pain patients (N = 95) on long-term opioid therapy were randomized to 8 weeks of MORE or a support group (SG) control delivered in primary care. Opioid dose was assessed with the Timeline Followback through 3-month follow-up. Heart rate variability (HRV) during mindfulness meditation was quantified as an indicator of self-regulatory capacity. Participants in MORE evidenced a greater decrease in opioid dosing (a 32% decrease) by follow-up than did the SG, F(2, 129.77) = 5.35, p = .006, d = 1.07. MORE was associated with a significantly greater increase in HRV during meditation than was the SG. Meditation-induced change in HRV partially mediated the effect of MORE on opioid dose reduction (p = .034). MORE may boost self-regulatory strength via mindfulness and thereby facilitate self-control over opioid use, leading to opioid dose reduction in people with chronic pain. (PsycInfo Database Record (c) 2020 APA, all rights reserved).