Schedule:
Thursday, January 17, 2013 | 1:30 PM
Location: Executive Center 4, Sheraton San Diego Hotel & Marina
Presenting Author: Eric L. Garland, PhD, LCSW
Assistant Professor, Florida State University, Tallahassee, FL
Co-Author: Matthew Owen Howard, PhD
School of Social Work, University of North Carolina at Chapel Hill
Background
Prescription opioid misuse among individuals with chronic pain has become a public health crisis of epidemic proportions. Over the past two decades, the misuse of opioid medications has tripled, signaling the urgent need for targeted interventions. While opioid therapy can be beneficial for chronic pain, long-term use may lead to heightened pain sensitivity (hyperalgesia) and an increased risk of addiction.
These challenges often emerge from a cycle of behavioral escalation in which pain and stress intensify hypervigilance, catastrophizing, and attentional bias toward pain and opioid cues—ultimately fueling dependency even as analgesic benefits diminish. Few therapeutic interventions specifically address this stage of escalation.
To meet this need, researchers are evaluating Mindfulness-Oriented Recovery Enhancement (MORE)—a novel, integrative intervention combining mindfulness training, cognitive restructuring, and positive emotion regulation. The goal of MORE is to disrupt the cycle of chronic pain and opioid misuse.
Methods
This ongoing NIH-funded randomized controlled trial compares the effectiveness of MORE with a conventional support group (SG) for individuals with chronic pain who have been prescribed opioid analgesics for more than three months.
Participants:
Total enrolled: 33 individuals
MORE group: 15 participants
Support Group (SG): 18 participants
Intervention:
Participants attend eight weekly sessions, each lasting two hours.
Assessments:
Before and after treatment, participants complete:
Validated psychological questionnaires
Cognitive tasks
Psychophysiological measurements
Results
Preliminary analyses reveal several significant benefits of the MORE intervention:
1. Relief From Pain
Significant Group × Time interaction: F(1,27) = 8.16, p = .01, ηρ² = .23
Participants in MORE experienced greater increases in pain relief than those in the SG.
2. Pain-Related Attentional Bias
Significant Group × Time interaction: F(1,14) = 4.86, p = .04, ηρ² = .26
MORE participants showed greater reductions in attentional bias toward pain cues.
3. Desire for Opioid Medication
Significant Group × Time interaction: F(1,27) = 4.19, p < .05, ηρ² = .12
MORE participants demonstrated significantly reduced desire for opioid medication compared to SG participants.
4. Well-Being
No significant Group × Time interaction
However, there was a main effect of time: F(1,28) = 5.67, p = .02, ηρ² = .17
Both groups reported increased well-being over the duration of the interventions.
Discussion
Early results indicate that Mindfulness-Oriented Recovery Enhancement (MORE) is a highly promising treatment for individuals coping with chronic pain and prescription opioid use. Participation in MORE appears to:
Reduce pain intensity
Diminish hypervigilance toward pain-related cues
Lower desire for opioid medication
These findings suggest that MORE may interrupt the cognitive and emotional processes that perpetuate opioid misuse.
Future research will focus on further refining Owen Howard FSU the MORE intervention, optimizing its clinical delivery, and identifying the cognitive, affective, and neurobiological mechanisms responsible for its therapeutic effects.