Healing Pain and the Opioid Crisis with Mindfulness-Oriented Recovery Enhancement

On May 4, I had the honor of giving an invited lecture for the National Center for Complementary and Integrative Health (NCCIH) of the National Institutes of Health, entitled “Healing the Opioid Crisis with Mindfulness-Oriented Recovery Enhancement: Clinical Efficacy and Neurophysiological Mechanisms.” The full video of this lecture can be found here. In this lecture, I described my decade-long research program focused on developing and testing MORE as a treatment for chronic pain, opioid misuse, and addiction, and reported results from the largest clinical trial of MORE to date.

Dr. Garland presents his research on Mindfulness-Oriented Recovery Enhancement to NIH Leadership

I began the talk discussing the destructive processes that unwittingly propel a person suffering from prolonged pain down the path toward an eventual loss of control over opioid use. I have been studying these risk mechanisms undergirding opioid misuse and OUD in people with chronic pain for more than a decade, and the discoveries I have made, along with great science from the field, informed the development of MORE. Then I described the Mindfulness-to-Meaning Theory, a key theoretical framework underlying MORE, as well as MORE’s treatment components, including mindfulness meditation, reappraisal, and savoring. Finally, I detailed MORE’s clinical outcomes and mechanisms of action across four randomized controlled trials involving nearly 500 patients. MORE works by strengthening self-control, reducing the brain’s reactivity to drug cues, increasing the brain’s response to natural, healthy rewards, enhancing meaning in life, and eliciting experiences of self-transcendence.

Following the lecture, I had a fascinating dialogue with the Director of NCCIH, Dr. Helene Langevin, and the Deputy Director of NCCIH, Dr. David Shurtleff about the emergence of self-transcendence in biological systems and its impact on health, and the use of mindfulness as a prevention and treatment strategy. This dialogue then opened up into a fantastic question and answer period. After the talk, I had the honor of discussing my research with multiple program directors and branch chiefs at NIH. If you didn’t have a chance to listen in, you can still watch the videocast here!

Research on MORE and Mindfulness Covered in the News

Results from a new Stage 2 randomized controlled trial of Mindfulness-Oriented Recovery Enhancement (MORE), to be published later this summer in the Journal of Consulting and Clinical Psychology, have been covered in a news story that also details findings from a recently published study of the effects of mindfulness on deautomatization of habit behaviors. A second news story also did a really nice job describing results from this study.

Results from this study, conducted in 95 people with chronic pain who had been prescribed long-term opioid therapy, demonstrate that MORE significantly decreased chronic pain intensity and significantly decreased the risk of future opioid misuse. Further, MORE boosted a range of positive psychological functions, including positive emotions, savoring, meaning in life, and the sense of self-transcendence. Importantly, the MORE’s effects on reducing pain and opioid misuse were linked with these increases in positive psychological functioning, suggesting that teaching people to “savor the good” and increase the sense of joy, meaningfulness, and natural healthy pleasure in life may be an antidote to the current pain and opioid crises in America – modern epidemics that have been termed “diseases of despair.”

This is the second randomized controlled trial to demonstrate therapeutic effects of MORE on chronic pain symptoms and opioid misuse, providing compelling evidence of MORE’s efficacy as a means of alleviating the suffering caused by the opioid crisis.