PMID- 31404850
OWN - NLM
STAT- MEDLINE
DCOM- 20200501
LR  - 20201001
IS  - 1879-0046 (Electronic)
IS  - 0376-8716 (Print)
IS  - 0376-8716 (Linking)
VI  - 203
DP  - 2019 Oct 1
TI  - Mindfulness-Oriented Recovery Enhancement reduces opioid craving among 
      individuals with opioid use disorder and chronic pain in medication assisted 
      treatment: Ecological momentary assessments from a stage 1 randomized controlled 
      trial.
PG  - 61-65
LID - S0376-8716(19)30305-9 [pii]
LID - 10.1016/j.drugalcdep.2019.07.007 [doi]
AB  - BACKGROUND: Methadone maintenance therapy (MMT) is an efficacious form of 
      medication assisted treatment for opioid use disorder (OUD), yet many individuals 
      on MMT relapse. Chronic pain and deficits in positive affective response to 
      natural rewards may result in dysphoria that fuels opioid craving and promotes 
      relapse. As such, behavioral therapies that ameliorate chronic pain and enhance 
      positive affect may serve as useful adjuncts to MMT. This analysis of ecological 
      momentary assessment (EMA) data from a Stage 1 randomized clinical trial examined 
      effects of Mindfulness-Oriented Recovery Enhancement (MORE) on opioid craving, 
      pain, and positive affective state. METHODS: Participants with OUD and chronic 
      pain (N = 30) were randomized to 8 weeks of MORE or treatment as usual (TAU). 
      Across 8 weeks of treatment, participants completed up to 112 random EMA measures 
      of craving, pain, and affect, as well as event-contingent craving ratings. 
      Multilevel models examined the effects of MORE on craving, pain, and affect, as 
      well as the association between positive affect and craving. RESULTS: EMA showed 
      significantly greater improvements in craving, pain unpleasantness, stress, and 
      positive affect for participants in MORE than for participants in TAU. 
      Participants in MORE reported having nearly 1.3 times greater self-control over 
      craving than those in TAU. Further, positive affect was associated with reduced 
      craving, an association that was significantly stronger among participants in 
      MORE than TAU. CONCLUSION: MORE may be a useful non-pharmacological adjunct among 
      individuals with OUD and chronic pain in MMT.
CI  - Copyright (c) 2019 Elsevier B.V. All rights reserved.
FAU - Garland, Eric L
AU  - Garland EL
AD  - College of Social Work and Center on Mindfulness and Integrative Health 
      Intervention Development, University of Utah, 395 South, 1500 East, Salt Lake 
      City, UT 84112 USA. Electronic address: eric.garland@socwk.utah.edu.
FAU - Hanley, Adam W
AU  - Hanley AW
AD  - College of Social Work and Center on Mindfulness and Integrative Health 
      Intervention Development, University of Utah, 395 South, 1500 East, Salt Lake 
      City, UT 84112 USA.
FAU - Kline, Anna
AU  - Kline A
AD  - Rutgers Robert Wood Johnson Medical School, 675 Hoes Ln W, Piscataway, NJ 08854 
      USA.
FAU - Cooperman, Nina A
AU  - Cooperman NA
AD  - Rutgers Robert Wood Johnson Medical School, 675 Hoes Ln W, Piscataway, NJ 08854 
      USA.
LA  - eng
GR  - R01 DA042033/DA/NIDA NIH HHS/United States
GR  - R21 AT010109/AT/NCCIH NIH HHS/United States
GR  - R33 AT010109/AT/NCCIH NIH HHS/United States
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20190805
PL  - Ireland
TA  - Drug Alcohol Depend
JT  - Drug and alcohol dependence
JID - 7513587
RN  - 0 (Analgesics, Opioid)
RN  - UC6VBE7V1Z (Methadone)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Affect/drug effects
MH  - Analgesics, Opioid/therapeutic use
MH  - Chronic Pain/complications/drug therapy/*therapy
MH  - Combined Modality Therapy/methods
MH  - Craving/*drug effects
MH  - Ecological Momentary Assessment
MH  - Female
MH  - Humans
MH  - Male
MH  - Methadone/therapeutic use
MH  - Middle Aged
MH  - *Mindfulness
MH  - Opiate Substitution Treatment
MH  - Opioid-Related Disorders/complications/drug therapy/*therapy
MH  - Young Adult
PMC - PMC6939880
MID - NIHMS1537717
OTO - NOTNLM
OT  - Chronic pain
OT  - Ecological momentary assessment
OT  - MORE
OT  - Medication assisted treatment
OT  - Savoring
COIS- Disclosure of Potential Conflicts of Interest Eric Garland, PhD, LCSW is the 
      Director of the Center on Mindfulness and Integrative Health Intervention 
      Development. The Center provides Mindfulness-Oriented Recovery Enhancement 
      (MORE), mindfulness-based therapy, and cognitive behavioral therapy in the 
      context of research trials for no cost to research participants; however, Dr. 
      Garland has received honoraria and payment for delivering seminars, lectures, and 
      teaching engagements (related to training clinicians in MORE and mindfulness) 
      sponsored by institutions of higher education, government agencies, academic 
      teaching hospitals, and medical centers. Dr. Garland also receives royalties from 
      the sale of books related to MORE.
EDAT- 2019/08/14 06:00
MHDA- 2020/05/02 06:00
PMCR- 2020/10/01
CRDT- 2019/08/13 06:00
PHST- 2019/05/16 00:00 [received]
PHST- 2019/07/07 00:00 [revised]
PHST- 2019/07/08 00:00 [accepted]
PHST- 2019/08/14 06:00 [pubmed]
PHST- 2020/05/02 06:00 [medline]
PHST- 2019/08/13 06:00 [entrez]
PHST- 2020/10/01 00:00 [pmc-release]
AID - S0376-8716(19)30305-9 [pii]
AID - 10.1016/j.drugalcdep.2019.07.007 [doi]
PST - ppublish
SO  - Drug Alcohol Depend. 2019 Oct 1;203:61-65. doi: 10.1016/j.drugalcdep.2019.07.007. 
      Epub 2019 Aug 5.