Summary: Opioid addiction is not rare among patients treated with these drugs for chronic pain. Methadone, a kind of opioid, a painkiller, is used to help these patients overcome opioid addiction. However, any treatment is associated with significant dropout rates and relapses. A new study shows that mindfulness therapy, provided even remotely, can help enhance treatment success rates.
Telehealth Mindfulness Oriented Recovery Enhancement (MORE), when used along with traditional medical treatment, has better recovery rates in patients undergoing treatment for opioid addiction. However, the benefits of opioid addiction treatment with mindfulness are not just limited to lower dropout or relapse rates but are much broader.
Many patients living with chronic pain are treated with opioids. However, many of them become addicted to these drugs. They start seeking these drugs. Even after the discontinuation of therapy, they keep using illicit opioids. Many such patients are treated with methadone, a much safer opioid and a drug used for chronic pain. However, not all patients benefit from this drug therapy.
It is no secret that human factors matter in promoting recovery from chronic pain and managing opioid addiction. That is why there are massive differences between addiction recovery in patients treated in different clinics. Some specialists better realize the importance of psychotherapy or non-pharmacological means in helping their patients.
What is incredible is that therapies like greater focus on mindfulness can be implemented remotely. They could be a part of the clinic’s telehealth services. Implementing such therapies does not necessarily require visiting the clinic, as it could be a major hurdle in many instances. In fact, you can get opioid use disorder (OUD) treatment without leaving the privacy of your home.
Does mindfulness help people stay in opioid addiction treatment?
The study, published in JAMA Psychiatry, investigated the efficacy of methadone treatment (MT) combined with telehealth Mindfulness-Oriented Recovery Enhancement (MORE) versus MT alone in addressing opioid use disorder (OUD) and chronic pain. Conducted as a randomized clinical trial from August 2020 to June 2022 across five clinics in New Jersey, the study included 154 participants, with an average age of 48.5 years, predominantly female (57%).
Participants in the control group received standard MT, including medication and counseling. The intervention group received MT plus MORE, which involved eight weekly, two-hour telehealth sessions focusing on mindfulness, reappraisal, and savoring techniques. The study’s primary outcomes were the return to drug use and dropout rates from MT over 16 weeks. Secondary outcomes included the number of days of drug use, methadone adherence, pain, depression, and anxiety levels.
Results showed that participants in the MORE plus usual care group had a significantly lower rate of return to drug use (hazard ratio [HR], 0.58) and MT dropout (HR, 0.41) compared to those in the usual care group. Specifically, 50.6% of participants in the MORE group returned to drug use versus 57.1% in the usual care group. Dropout rates were also lower in the MORE group (13.0%) compared to the usual care group (22.1%).
Furthermore, participants in the MORE group experienced significantly fewer days of drug use and better methadone adherence, with 95.5% maintaining adherence compared to 83.6% in the usual care group. Pain and depression levels also decreased more significantly in the MORE group. Pain ratings in the MORE group decreased from a mean of 5.79 at baseline to 5.17 at 16 weeks, while the usual care group saw a reduction from 5.19 to 4.96. Depression scores dropped from 22.52 to 18.98 in the MORE group and from 22.65 to 20.03 in the usual care group.
Although anxiety scores showed a decrease in the MORE group and an increase in the usual care group, the difference was not statistically significant. The study found that the MORE intervention effectively reduced opioid use, improved methadone adherence, and alleviated pain and depression among participants, indicating that mindfulness-based approaches could enhance the outcomes of methadone treatment for OUD.
Is mindfulness worth adding to methadone treatment?
Using mindfulness along with drug therapy, that is, methadone, could be a safe way to enhance treatment effectiveness. It reduces treatment dropout rates and relapses and also results in lower anxiety and depression risks. In some instances, these differences might not be massive, but mindfulness is a safe therapy with many health benefits. Moreover, once the patient is used to practicing mindfulness, one may continue to experience its benefits lifelong.
Frequently asked questions
What is Mindfulness-Oriented Recovery Enhancement (MORE)?
MORE is a mindfulness therapy used alongside medical treatment for opioid addiction and chronic pain. It teaches three skills: mindfulness, reappraisal and savoring. In the study on this page, patients on methadone attended eight weekly, two-hour sessions by telehealth, on top of their usual medication and counseling.
Does mindfulness reduce relapse in opioid addiction?
Yes. In the randomized trial of 154 adults on methadone, 50.6% of the mindfulness group returned to drug use, compared with 57.1% of the usual-care group. Treatment dropout fell from 22.1% to 13.0%. The mindfulness group also had fewer days of drug use and better methadone adherence (95.5% vs. 83.6%).
Can mindfulness therapy for addiction be done online?
Yes. The mindfulness sessions in this study were delivered entirely by telehealth, and they still lowered relapse and dropout. That matters because traveling to a clinic is a major hurdle for many patients. Mindfulness can be part of a clinic’s telehealth services, and once a patient learns it, the practice can continue for life.
Does mindfulness help with pain and depression during methadone treatment?
In this trial, pain and depression both improved more in the mindfulness group. Pain ratings fell from 5.79 to 5.17, against 5.19 to 4.96 with usual care. Depression scores dropped from 22.52 to 18.98, against 22.65 to 20.03 with usual care. Mindfulness is a safe therapy with many health benefits.
Source:
Cooperman, N. A., Lu, S.-E., Hanley, A. W., Puvananayagam, T., Dooley-Budsock, P., Kline, A., & Garland, E. L. (2024).
Telehealth Mindfulness-Oriented Recovery Enhancement vs Usual Care in Individuals With Opioid Use Disorder and Pain:
A Randomized Clinical Trial. JAMA Psychiatry, 81(4), 338-346. https://doi.org/10.1001/jamapsychiatry.2023.5138