Objectives: Mindfulness-Oriented Recovery Enhancement (MORE) is an integrative intervention designed to ameliorate addiction, chronic pain, and psychiatric symptoms. Although multiple randomized controlled trials (RCTs) have examined the clinical efficacy of MORE, no study has quantitatively synthesized this body of research. Thus, we conducted a meta-analysis of RCTs examining the effects of MORE on addictive behaviors, craving, opioid dose, pain, and psychiatric symptoms.
Methods: Relevant manuscripts were identified through comprehensive searches of four bibliographic databases. Two- and three-level random-effects models were used to generate synthesized effect size estimates, and meta-regressions were performed to examine whether study and sample characteristics influenced the magnitude of aggregate effect sizes.
Results: Our search identified 16 manuscripts reporting data from eight RCTs ( = 816). Moderate to small effects in favor of MORE were observed for addictive behaviors (SMC = - .54, = .007), craving (SMC = - .42, = .010), opioid dose (MC = - 17.95, < .001), chronic pain (SMC = - .60, < .001), and psychiatric symptoms (SMC = - .34, < .001). MORE's effects on psychiatric symptoms and craving were not moderated by participant race, gender, age, or income.
Conclusions: Study findings provide empirical evidence of MORE's efficacy for a wide diversity of individuals, and as such, MORE should now be disseminated broadly throughout the healthcare system.
Supplementary Information: The online version contains supplementary material available at 10.1007/s12671-022-01964-x.
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http://dx.doi.org/10.1007/s12671-022-01964-x | DOI Listing |
J Pain Palliat Care Pharmacother
September 2024
Mental Health & Behavioral Sciences Service, James A. Haley Veterans' Hospital & Clinics, Tampa, Florida, USA.
Chronic pain is often treated with opioids, placing patients at risk for misuse. An estimated 11.5% of these patients engage in opioid misuse behaviors such as self-medication.
View Article and Find Full Text PDFAnn Med
December 2024
BEHAVR, LLC, DBA RealizedCare, Elizabethtown, Kentucky, USA.
Introduction: Medications for opioid use disorder (MOUD) are the most effective interventions for this condition, yet many patients discontinue treatment. Though adjunct psychosocial treatments are recommended to increase retention and reduce relapse, the scarcity of trained providers hinders access to and utilization of evidence-based interventions. We conducted a Phase 1 study to assess the feasibility of a virtual reality-delivered Mindfulness-Oriented Recovery Enhancement (MORE-VR) intervention for patients receiving MOUD.
View Article and Find Full Text PDFBMJ Open
July 2024
School of Medicine, University of Utah Health, Salt Lake City, Utah, USA.
Introduction: Many individuals receiving outpatient physical therapy have musculoskeletal pain and up to one-third use prescription opioids. The impact of physical therapist-led mindfulness-based interventions integrated with evidence-based physical therapy (I-EPT) to manage patients with chronic musculoskeletal pain and long-term opioid treatment has not been elucidated. This project evaluates the feasibility of conducting a cluster randomised trial to test the effectiveness of I-EPT.
View Article and Find Full Text PDFBr J Clin Pharmacol
December 2024
Department of Psychiatry, University of California-San Diego, La Jolla, California, USA.
The opioid crisis emerged in part due to the overprescribing of opioid analgesics for chronic pain. Although not the only source of the current epidemic of opioid use disorder (OUD), the prescription of opioids for chronic pain remains one vector for the development of opioid misuse and OUD. However, opioid tapering is not appropriate for all patients, and some patients may need to remain on opioid therapy for the long term.
View Article and Find Full Text PDFSubst Use Addctn J
January 2025
College of Social Work, University of Utah, Salt Lake City, UT, USA.
Traditional methadone treatment (MT) for opioid use disorder (OUD) fails to systematically address the physical pain, emotion dysregulation, and reward processing deficits that co-occur with OUD, and novel interventions that address these issues are needed to improve MT outcomes. Mindfulness-Oriented Recovery Enhancement (MORE) remediates the hedonic dysregulation in brain reward systems that is associated with OUD. Our pilot and phase 2 randomized controlled trials of MORE were the first to demonstrate MORE's feasibility, acceptability, and efficacy as delivered in MT clinics; MORE significantly reduced drug use (eg, benzodiazepines, barbiturates, cocaine, marijuana, opioids, and other drugs), craving, depression, anxiety, and pain among people with OUD.
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