Mindfulness is highly effective in treating opioid abuse in people with chronic pain, clinical studies show. In the largest study of its kind to date, researchers found that mindfulness training reduced pain, opioid dosage, and depression in patients with chronic pain.
A randomized clinical trial conducted by Utah researchers compared the effectiveness of mindfulness-based therapy to that of cognitive behavioral therapy (CBT) in reducing both opioid use and pain in patients with chronic pain. This study, published in the journal JAMA Internal Medicine in 2022, is the latest in a series of studies using mindfulness-based techniques to reduce pain and opioid use in people with chronic pain. The study’s lead author, Eric Garland, PhD, designed the Mindfulness-Oriented Recovery Enhancement (MORE) approach. It combines mindfulness training, changing the course of negative thoughts, relearning to value positive experiences, and positive psychology that encourages people to focus on their strengths rather than their weaknesses.
The randomized clinical trial enrolled 250 adults with chronic pain who had abused opioids prescribed to treat their pain. Half of them met criteria for opioid use disorder (OUD) when they were recruited into the study. About half of the patients completed an eight-week group mindfulness training with MORE. The control group received standard CBT in a group setting. Researchers encouraged patients to do what was good for them and did not force anyone to wean off their medication. For patients who wanted or needed to continue taking opioids, MORE helped reduce the risk of abuse and reduce pain.
Less medication, less pain
Opioid abuse decreased by an average of 45% in the MORE group, twice as much as in the CBT group. Over 35% of people in the MORE group reduced their opioid use by at least half. People in the MORE group also reported less pain, opioid cravings, and emotional distress, even though they used fewer painkillers. The effect lasted at least until the researchers’ nine-month follow-up period. And although the effects seemed to stabilize between six and nine months in the MORE group, the effects of CBT actually decreased in the control group.
The authors state, “It’s difficult to make generalizations about chronic pain because it varies so much from person to person, but there seems to be a way to modulate how a person’s relationship to pain affects cravings.” drug modulated. This data shows that the more people practice, the more benefits they receive.” This new study is the longest and most advanced of the studies testing the mindfulness intervention designed specifically for patients with chronic pain who abuse opioids . The goal in these patients is twofold: reduction of opioid dependence and continued pain management.
What makes the MORE approach unique is that it aims to help people who have used opioids long-term to relearn how to enjoy pleasure. For the researchers: “Due to the opioids, their reward system went completely out of control. Physiology was altered so that craving for the drug took over the reward pathways.
Opioids only temporarily relieve pain
Despite relatively high doses of opioids, study participants still suffered from significant chronic pain. This is explained by the fact that “opioids are not effective against chronic pain. Instead, opiates such as morphine can relieve acute pain that is temporary, such as B. postoperative pain. Chronic pain, on the other hand, is often lifelong. This makes mindfulness a particularly effective way to help people manage chronic pain.
According to research, the most immediate effect mindfulness can have is on pain. It’s one of the few techniques that can relieve pain instantly, and we’re just beginning to understand it. Research to date has shown that mindfulness’s effect on pain perception is not just a placebo effect, and unlike other pain relief modalities, it appears to work outside of the body’s internal opioid system. Medications like prescription opioids and even over-the-counter pain relievers like ibuprofen work in the body’s opioid system to prevent signals from reaching the brain, where they are processed and perceived as pain. Mindfulness engages neural and physiological processes that are quite unique. The theory is that we cannot use any other method to relieve pain outside of the opioid system.
Chronic pain is not “in your head”
In recent years, the question of whether chronic pain has psychological causes has been discussed. There are certainly psychological factors that affect people’s pain, but people also suffer from very painful conditions. Even if the pain comes from a purely physiological source, such as Whether it’s a herniated disc or an arthritic knee, mindfulness can still be a great way to reduce pain.
The most recent MORE study showed that mindfulness can also reduce the emotional side effects of chronic pain. At baseline, nearly 70% of patients met criteria for major depressive disorder (MDD). At the end of the study, people treated with MORE had fewer symptoms of depression that were no longer considered major depressive disorder. This effect is just as important as reducing pain and reducing opioid addiction.
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