PMID- 31556669
OWN - NLM
STAT- MEDLINE
DCOM- 20191224
LR  - 20201001
IS  - 1939-2117 (Electronic)
IS  - 0022-006X (Print)
IS  - 0022-006X (Linking)
VI  - 87
IP  - 10
DP  - 2019 Oct
TI  - Mindfulness-oriented recovery enhancement reduces opioid misuse risk via 
      analgesic and positive psychological mechanisms: A randomized controlled trial.
PG  - 927-940
LID - 10.1037/ccp0000390 [doi]
AB  - OBJECTIVE: Despite the heightened urgency of the current prescription opioid 
      crisis, few psychotherapies have been evaluated for chronic pain patients 
      receiving long-term opioid analgesics. Current psychological pain treatments 
      focus primarily on ameliorating negative affective processes, yet basic science 
      suggests that risk for opioid misuse is linked with a dearth of positive affect. 
      Interventions that modulate positive psychological processes may produce 
      therapeutic benefits among patients with opioid-treated chronic pain. The aim of 
      this study was to conduct a theory-driven mechanistic analysis of proximal 
      outcome data from a Stage 2 randomized controlled trial of Mindfulness-Oriented 
      Recovery Enhancement (MORE), an integrative intervention designed to promote 
      positive psychological health. METHOD: Patients with opioid-treated chronic pain 
      (N = 95; age = 56.8 +/- 11.7; 66% female) were randomized to 8 weeks of 
      therapist-led MORE or support group (SG) interventions. A latent positive 
      psychological health variable comprised of positive affect, meaning in life, and 
      self-transcendence measures was examined as a mediator of the effect of MORE on 
      changes in pain severity at posttreatment and opioid misuse risk by 3-month 
      follow-up. RESULTS: Participants in MORE reported significantly greater 
      reductions in pain severity by posttreatment (p = .03) and opioid misuse risk by 
      3-month follow-up (p = .03) and significantly greater increases in positive 
      psychological health (p < .001) than SG participants. Increases in positive 
      psychological health mediated the effect of MORE on pain severity by 
      posttreatment (p = .048), which in turn predicted decreases in opioid misuse risk 
      by follow-up (p = .02). CONCLUSIONS: Targeting positive psychological mechanisms 
      via MORE and other psychological interventions may reduce opioid misuse risk 
      among chronic pain patients receiving long-term opioid therapy. (PsycINFO 
      Database Record (c) 2019 APA, all rights reserved).
FAU - Garland, Eric L
AU  - Garland EL
AD  - Center on Mindfulness and Integrative Health Intervention Development and College 
      of Social Work, University of Utah.
FAU - Hanley, Adam W
AU  - Hanley AW
AD  - Center on Mindfulness and Integrative Health Intervention Development and College 
      of Social Work, University of Utah.
FAU - Riquino, Michael R
AU  - Riquino MR
AD  - Center on Mindfulness and Integrative Health Intervention Development and College 
      of Social Work, University of Utah.
FAU - Reese, Sarah E
AU  - Reese SE
AD  - Center on Mindfulness and Integrative Health Intervention Development and College 
      of Social Work, University of Utah.
FAU - Baker, Anne K
AU  - Baker AK
AD  - Center on Mindfulness and Integrative Health Intervention Development and College 
      of Social Work, University of Utah.
FAU - Salas, Karen
AU  - Salas K
AD  - Center on Mindfulness and Integrative Health Intervention Development and College 
      of Social Work, University of Utah.
FAU - Yack, Brooke P
AU  - Yack BP
AD  - Center on Mindfulness and Integrative Health Intervention Development and College 
      of Social Work, University of Utah.
FAU - Bedford, Carter E
AU  - Bedford CE
AD  - Center on Mindfulness and Integrative Health Intervention Development and College 
      of Social Work, University of Utah.
FAU - Bryan, Myranda A
AU  - Bryan MA
AD  - Center on Mindfulness and Integrative Health Intervention Development and College 
      of Social Work, University of Utah.
FAU - Atchley, Rachel
AU  - Atchley R
AD  - Center on Mindfulness and Integrative Health Intervention Development and College 
      of Social Work, University of Utah.
FAU - Nakamura, Yoshio
AU  - Nakamura Y
AD  - Center on Mindfulness and Integrative Health Intervention Development and 
      Department of Anesthesiology, University of Utah.
FAU - Froeliger, Brett
AU  - Froeliger B
AD  - Department of Neuroscience, Medical University of South Carolina.
FAU - Howard, Matthew O
AU  - Howard MO
AD  - School of Social Work, University of North Carolina at Chapel Hill.
LA  - eng
SI  - ClinicalTrials.gov/NCT03298269
GR  - R61 AT009296/AT/NCCIH NIH HHS/United States
GR  - National Center for Complementary and Alternative Medicine/
GR  - R01 DA042033/DA/NIDA NIH HHS/United States
GR  - Stephanie Loker Hurst/
GR  - Fahs Beck Fund for Research and Experimentation/
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - United States
TA  - J Consult Clin Psychol
JT  - Journal of consulting and clinical psychology
JID - 0136553
RN  - 0 (Analgesics, Opioid)
SB  - IM
MH  - Adult
MH  - Affect
MH  - Aged
MH  - Analgesia/psychology
MH  - Analgesics, Opioid/therapeutic use
MH  - Chronic Pain/drug therapy/psychology/*therapy
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - *Mindfulness
MH  - Opioid-Related Disorders/psychology/therapy
MH  - Psychotherapeutic Processes
MH  - *Self-Help Groups
MH  - Treatment Outcome
PMC - PMC6764586
MID - NIHMS1017629
EDAT- 2019/09/27 06:00
MHDA- 2019/12/25 06:00
PMCR- 2020/10/01
CRDT- 2019/09/27 06:00
PHST- 2019/09/27 06:00 [entrez]
PHST- 2019/09/27 06:00 [pubmed]
PHST- 2019/12/25 06:00 [medline]
PHST- 2020/10/01 00:00 [pmc-release]
AID - 2019-57426-009 [pii]
AID - 10.1037/ccp0000390 [doi]
PST - ppublish
SO  - J Consult Clin Psychol. 2019 Oct;87(10):927-940. doi: 10.1037/ccp0000390.