Mindfulness Training Reduces Opioid Cravings, Study Finds

Posted on June 9th, 2015

Mindfulness Training Reduces Opioid Cravings, Study FindsMindfulness training helped chronic pain patients considered at risk for opioid medication abuse experience greater levels of non-substance-related pleasure, researchers report.

Mindfulness is the collective term for a group of activities that can increase your awareness of the moment-to-moment changes in your mental and physical environment. Current evidence indicates that participation in mindfulness training has a range of positive effects, including stress relief and the alteration of ongoing, harmful patterns of behavior. In a study published in late 2014 in the Journal of Behavioral Medicine, researchers from three U.S. universities explored the potential of mindfulness training to support an alternative pathway to pleasure inside the brain that can reduce long-term opioid medication users’ odds of developing an opioid addiction.

Opioid Addiction

Opioid drugs and medications produce intensely pleasurable effects by accessing the brain’s built-in reward system, which normally provides incentive for participating in such life-sustaining activities as eating and having sex. However, as a rule, opioid substances initially trigger much higher levels of pleasure than sex, eating or other non-drug-related activities. This means that, in some people, a desire for the pleasure-producing aspects of opioid use may outweigh any legitimate medical considerations. In turn, use of an opioid substance for non-medical purposes sharply increases the odds that any given person will become physically dependent on that substance and subsequently develop the symptoms of uncontrolled opioid addiction. A similar process can lead to addiction in people who take too much of an opioid medication in a misguided effort to increase their level of pain relief.

Under modern terminology established by the American Psychiatric Association in 2013, opioid addiction is a single aspect of opioid use disorder, a diagnosable illness that also covers cases of non-addicted, damaging opioid abuse. Depending on the individual, opioid use disorder can center on isolated symptoms of opioid addiction, isolated symptoms of opioid abuse or intermingled symptoms of abuse and addiction.

Mindfulness

Mindfulness is a concept that dates back more than 2,500 years to the origins of Buddhist religion. However, the actual practice of mindfulness is a non-secular activity openly available to people of any faith. During training, an individual learns how to pay close attention to the ever-present mental and physical processes that typically get overlooked in daily life, including such things breathing, feeling changes in various aspects of normal body function, thinking about various subjects and having emotional responses to situations or events. Mindfulness techniques can be practiced in a range of settings, including at home, in the workplace, in workshops oriented toward specific mental or physical health concerns and on specialized retreats. Even relatively short-term involvement with these techniques can produce notable benefits.

Potential Impact on Opioid Addiction Risks

In the study published in the Journal of Behavioral Medicine, researchers from the University of Utah, the Medical University of South Carolina and the University of North Carolina at Chapel Hill used a small-scale project to help determine if involvement in a specific program—called Mindfulness-Oriented Recovery Enhancement or MORE—can reduce the risks for opioid addiction in people affected by chronic pain by reducing the risks for an abusive pattern of prescription opioid intake. In addition to mindfulness-based techniques, MORE includes techniques used in a form of change-oriented psychotherapy called cognitive behavioral therapy, as well as techniques used in positive reinforcement-based psychology. A person enrolled in a MORE program learns how to pay closer attention to his or her inner and outer environment, reassess his or her involvement in harmful behaviors and gather greater amounts of enjoyment from everyday activities.

All 29 of the study participants were people with chronic pain problems considered at risk for abusive involvement in prescription opioid consumption. Eleven of the participants received an eight-week course of instruction in Mindfulness-Oriented Recovery Enhancement; the remaining 18 participants received access to a more traditionally structured support group. Before and after receiving treatment, the members of both groups were tested for their ability to experience reward or pleasure after exposure to a range of non-substance-related activities or situations. The researchers concluded that, after eight weeks of treatment, the group that received MORE had a significantly higher ability to feel non-substance-related pleasure or reward than the group that took part in a conventional support program. In addition, they concluded that the MORE recipients had substantially lower levels of craving for opioid substances. This is critically important, since a craving for opioids can ultimately become a driving force behind the development of an opioid addiction.

Before anyone can truly judge the real-world usefulness of MORE for people at risk for the abusive intake of opioid medications, future researchers will need to recreate the results of the current study on a much larger scale.

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