PMID- 32915027
OWN - NLM
STAT- MEDLINE
DCOM- 20210805
LR  - 20240329
IS  - 1935-990X (Electronic)
IS  - 0003-066X (Print)
IS  - 0003-066X (Linking)
VI  - 75
IP  - 6
DP  - 2020 Sep
TI  - Mindfulness-oriented recovery enhancement reduces opioid dose in primary care by 
      strengthening autonomic regulation during meditation.
PG  - 840-852
LID - 10.1037/amp0000638 [doi]
AB  - 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).
FAU - Garland, Eric L
AU  - Garland EL
AD  - Center on Mindfulness and Integrative Health Intervention Development, University 
      of Utah.
FAU - Hudak, Justin
AU  - Hudak J
AD  - Center on Mindfulness and Integrative Health Intervention Development, University 
      of Utah.
FAU - Hanley, Adam W
AU  - Hanley AW
AD  - Center on Mindfulness and Integrative Health Intervention Development, University 
      of Utah.
FAU - Nakamura, Yoshio
AU  - Nakamura Y
AD  - Center on Mindfulness and Integrative Health Intervention Development, University 
      of Utah.
LA  - eng
SI  - ClinicalTrials.gov/NCT03298269
GR  - R01 DA042033/DA/NIDA NIH HHS/United States
GR  - R61 AT009296/AT/NCCIH NIH HHS/United States
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Am Psychol
JT  - The American psychologist
JID - 0370521
RN  - 0 (Analgesics, Opioid)
SB  - IM
MH  - Analgesics, Opioid/*administration & dosage
MH  - Autonomic Nervous System/physiology
MH  - Chronic Pain/*therapy
MH  - Female
MH  - Humans
MH  - Male
MH  - *Meditation
MH  - Middle Aged
MH  - Mindfulness/*methods
MH  - *Primary Health Care
PMC - PMC7490853
MID - NIHMS1618489
EDAT- 2020/09/12 06:00
MHDA- 2021/08/06 06:00
PMCR- 2021/09/01
CRDT- 2020/09/11 12:11
PHST- 2020/09/11 12:11 [entrez]
PHST- 2020/09/12 06:00 [pubmed]
PHST- 2021/08/06 06:00 [medline]
PHST- 2021/09/01 00:00 [pmc-release]
AID - 2020-65461-009 [pii]
AID - 10.1037/amp0000638 [doi]
PST - ppublish
SO  - Am Psychol. 2020 Sep;75(6):840-852. doi: 10.1037/amp0000638.