(PS6-D76) Mindfulness Based Relapse Prevention (MBRP) to Improve Medication Assisted Treatment (MAT) Adherence and Treatment Outcomes for Opioid Use Disorder (OUD): Preliminary Results from a Randomized Trial

Background: Between September 2020 and September 2021 more than 100,000 individuals died of drug overdoses in the US with ~70% of these deaths being due to an opioid overdose. An estimated 2.7 million Americans identified as having an opioid use disorder (OUD) diagnosis in 2020. This record-breaking increase in overdose deaths is attributable in part to the COVID-19 pandemic and the increase in use of synthetic opioids. Despite the availability of evidenced-based pharmacological (i.e., Medication Assisted Treatments; MAT) and behavioral treatments for OUD, adherence to MAT is poor and relapse rates and overdose deaths remain high. As the opioid epidemic persists, it is prudent to invest in therapeutic approaches that promote MAT adherence and long-term OUD recovery. Mindfulness-Based Relapse Prevention (MBRP) is an efficacious approach for SUD. However, minimal research has examined the utility of MBRP in promoting MAT adherence for OUD patients. In the present study, we test whether MBRP, relative to Treatment-As-Usual (TAU), increases MAT adherence and reduces drug-use. Results reflect preliminary analyses from a recently funded and ongoing randomized clinical trial examining the efficacy of MBRP for promoting MAT adherence among adults who are enrolled in a residential treatment program for OUD.

Methods: N=19 adults in a 45–90-day residential program for OUD were screened for study inclusion and randomized to MBRP (n = 11) or TAU (n = 8). MBRP was modified to be open-enrollment and include a MAT didactic in each session. Repeated measures assessments occur at residential admission (baseline), immediately prior to residential discharge (post-treatment), and for three months following discharge (follow-up). Primary treatment outcomes include post-treatment MAT adherence and drug-use (urine drug screen, Timeline Followback; Sobell, 1992) with secondary outcomes including self-reported drug-craving (Opioid Craving Scale, McHugh et al., 2021), mindfulness (Cognitive and Affective Mindfulness Scale, Feldman et al., 2007), and global mental health (Hays et al., 2009).

Results: Significant reductions on craving (p < .000) were observed from pre- (M: 17, SD: 6.46) to post-MBRP (M: 6.36; SD: 6.84) and pre- (M: 20.50, SD: 6.50) to post (M: 7.67, SD: 8.86) for the TAU (p < .05). Dispositional mindfulness increased from pre- to post-treatment for both MBRP and TAU, however changes did not reach statistical significance. Significant increases on mental health (p < .05) were observed from pre (M: 9.14, SD: 2.41) to post-MBRP (M: 12.00; SD: 2.82), but pre- to post-TAU changes in mental health did not reach statistical significance (p = .31). Post-treatment follow-up data indicates 100% MAT adherence and 0% relapse for MBRP where TAU follow-up data indicates 88% MAT adherence and two incidences of drug-use relapse.

Discussion: Preliminary examination of data collected thus far indicates modest superiority of MBRP across self-report measures and moderate benefit on MAT adherence and relapse prevention. As data collection is underway, continued recruitment and data collection will enable more robust statistical analyses to determine treatment effects of MBRP on MAT adherence and reduced drug-use.