Mindfulness-Oriented Recovery Enhancement: A New, Neuroscience-Based Treatment for Opioid Misuse, Opioid Use Disorder, and Chronic Pain

Opioid misuse among people with chronic pain helped to fuel the current opioid epidemic. However, to date, there are no evidence-based interventions that can simultaneously address chronic pain and opioid misuse. To meet this need, Mindfulness-Oriented Recovery Enhancement (MORE) was generated through a decade-long treatment development process funded by the National Institutes of Health. Rooted in affective neuroscience, MORE unites complementary aspects of mindfulness training, third-wave cognitive behavioral therapy, and principles from positive psychology into an integrative mind-body therapy designed to target addictive behavior, stress, and chronic pain.

This session will present evidence from four randomized controlled trials (RCT) demonstrating the efficacy and biobehavioral mechanisms of MORE for reducing opioid misuse and opioid use disorder (OUD) among people with chronic pain, including late-breaking outcomes from the largest clinical trial to date. Across these studies, MORE has been shown to decrease opioid misuse twice as effectively as standard psychological therapy, while simultaneously reducing chronic pain symptoms, opioid craving, emotional distress, and depression. These clinical outcomes last as long as nine months following the end of the MORE treatment. Findings from a series of complementary neuroscience experiments demonstrate that MORE reduces opioid misuse by decreasing neurophysiological reactivity to drug cues and increasing neurophysiological responses to natural rewards, healthy pleasure, and meaningful life experiences. Given this clear demonstration of MORE’s efficacy and mechanisms, MORE should now be disseminated by addiction treatment, behavioral health, and primary care providers throughout the country to help stem the tide of the opioid crisis.