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Trained minds can lower the need for opioids for pain

Harold Mandel's picture

There has been deepening concerns about abuse of prescription opioids for chronic pain. The treatment for serious chronic pain can become deadlier than the condition, when opioid drugs are abused. People are worried about this and are often searching for natural alternatives to treat chronic pain. New research shows that the mind can be trained to cope effectively with chronic pain.

At this time opioid pharmacotherapy is the leading treatment for chronic pain, reported the Journal of Consulting and Clinical Psychology on Feb 3, 2014. Chronic pain is a widespread problem that affects nearly one third of the U.S. population. In view of the dramatic rise in prescription opioid misuse and opioid-related mortality, novel behavioral interventions are vitally necessary.

Researchers studied an early-stage randomized controlled trial of Mindfulness-Oriented Recovery Enhancement (MORE), which is a multimodal intervention designed to simultaneously target mechanisms responsible for chronic pain abuse of opioids. The participants in MORE reported significantly greater reductions in pain severity. The participants in MORE also experienced significantly less stress arousal and desire for opioids. Furthermore, the MORE participants were significantly less likely to meet criteria for opioid use disorder immediately after treatment. These findings have indicated the feasibility and efficacy of MORE as a treatment for co-occurring prescription opioid misuse and chronic pain.

In a discussion of this research in a news release by the University of Utah it is highlighted that with about one-third of Americans suffering from chronic pain, prescription opioid painkillers have become the leading form of treatment for this serious condition. This is not a healthy situation due to the fact that abuse of prescription opioids can lead to serious side effects which include death by overdose.

Utah researcher Eric Garland has developed a new treatment which has been shown to lower pain and decrease prescription opioid abuse among chronic pain patients. This new treatment led to a 63 percent reduction in opioid misuse, in comparison to a 32 percent reduction among participants in a conventional support group. Furthermore, the participants in the new treatment group experienced a 22 percent reduction in pain associated impairment, which was seen to last for three months after the end of treatment.

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This new treatment is called Mindfulness-Oriented Recovery Enhancement, or MORE, and is designed to train people to respond differently to pain, stress and opioid associated cues. With MORE the underlying processes involved in chronic pain and opioid misuse are targeted by combining several therapeutic components, which include:

1: Mindfulness training

2: Reappraisal


With mindfulness you are trained to increase awareness, gain control over one’s attention and regulate automatic habits. With the process of reappraisal you reframe the meaning of a stressful or adverse event in such a manner as to see it as purposeful or growth promoting. With savoring there is the process of learning to focus attention on positive events in order to increase one’s sensitivity to naturally rewarding experiences. Naturally rewarding experiences could include such things as enjoying a beautiful nature scene or experiencing a sense of connection with someone you love.

Garland has said, “Mental interventions can address physical problems, like pain, on both psychological and biological levels because the mind and body are interconnected.” Garland has gone on to explain that when something happens in the brain, something also happens in the body. Therefore by changing the functioning of the brain, you change the functioning of the body.

Nearly three-quarters of the 115 chronic pain patients in the group studied abused opioid painkillers before starting the program by taking higher doses than prescribed, using opioids in order to alleviate stress and anxiety or another method of which has not been authorized for self-medication with opioids. MORE patients took part in a daily 15-minute mindfulness practice session which was guided by a CD and three minutes of mindful breathing before taking opioid medication. There were significant improvements in dealing with chronic pain with MORE.

I have observed a growing concern among people about the serious problem of deaths associated with abuse of prescribed opioid painkillers.. The search for natural interventions for pain has led to considerations of massage, hypnosis, acupressure, acupuncture, biofeedback, chiropractic, and hydrotherapy. MORE is now also worth considering to help with the treatment of chronic pain, naturally and safely.