In a new study published in the top medical journal JAMA Psychiatry, my colleagues and I found that Mindfulness-Oriented Recovery Enhancement (MORE) can help rewire the brain’s response to natural healthy pleasure in individuals with opioid use disorder (OUD), leading to improved mood, greater attention to positive experiences, and reduced opioid cravings. The findings add to the body of evidence demonstrating that MORE is an effective tool to help people heal from addiction.
Opioid addiction decreases the brain’s ability to experience natural healthy pleasure, driving increased cravings for the drug. This new study shows that MORE helps restore this capacity, reducing cravings and preventing opioid misuse.
In the study, participants with OUD showed difficulty enhancing positive emotions, as seen in weakened brain responses when they tried to savor images representing naturally rewarding objects and experiences, such as smiling babies, puppies or a beautiful sunset. The responses were measured through electroencephalogram (EEG) scans. This positive emotional blunting or numbing was directly linked to higher opioid cravings. However, the MORE therapy helped to heal this inability to savor by increasing brain responses to positive stimuli, which correlated with lower cravings and improved emotional well-being. The findings suggest that MORE can play a vital role in helping people with OUD increase their well-being and regain control over their cravings, thereby reducing opioid misuse.
Opioid addiction can sometimes develop when individuals misuse opioids originally prescribed for chronic pain, a condition affecting 50 million Americans each year. As people become increasingly dependent on opioids, they begin to lose the ability to feel joy and pleasure in everyday life, driving them to seek higher doses to maintain a fleeting sense of well-being — a downward spiral that leads to opioid addiction.
MORE is an evidence-based therapy developed and tested over the past two decades that integrates mindfulness training, cognitive behavioral therapy, and principles from positive psychology into a treatment that can simultaneously address addiction, emotional distress and chronic pain. MORE teaches mindfulness skills to regulate craving, relieve pain, and recover the ability to savor natural healthy pleasure, joy and meaning in life.
To date, MORE has been tested in over 16 randomized clinical trials involving more than 2,000 people. In the largest clinical trial of MORE involving 250 patients — published in JAMA Internal Medicine in early 2022 — MORE decreased opioid misuse by 45% at a 9-month follow-up, nearly tripling the effect of standard group therapy. In addition, 50% of patients treated with MORE reported clinically significant decreases in chronic pain. In a 2024 study published in JAMA Psychiatry, my colleagues and I showed that adding MORE to standard addictions care resulted in 42% less relapse and 59% less dropout from treatment when compared to standard addictions care alone.
Multiple rigorous, well-controlled clinical trials have demonstrated the efficacy of the MORE therapy. I’m now seeking support from policymakers and healthcare organizations, and the national opioids settlement, to disseminate this evidence-based treatment widely throughout the United States to help alleviate the opioid crisis.
