How can people who are dependent on prescription opioids reduce their cravings? Learn to enjoy other aspects of their lives.

That’s the key finding in a new study published in the Journal of Behavioral Medicine by Eric L. Garland, associate professor at the University of Utah College of Social Work. Garland and colleagues studied how an intervention program for chronic pain patients called Mindfulness-Oriented Recovery Enhancement (MORE) decreased patients’ desire for prescription drugs.

The MORE intervention concentrates on helping people to recover a sense of meaning and fulfillment in everyday life, embracing its pleasures and pain without turning to substance use as a coping mechanism. It integrates the latest research on addiction, cognitive neuroscience, positive psychology and mindfulness.  Participants in Garland’s study received eight weeks of instruction in applying mindfulness-oriented techniques to alleviate pain and craving while strengthening positive emotions and the sense of reward and meaning in life.

For example, to enhance their sense of reward in life, participants in Garland’s study were taught a “mindful savoring practice,” in which they focused attention on pleasant experiences such as a beautiful nature scene, sunset or feeling of connection with a loved one. In a meditation session, participants were taught to focus their awareness on colors, textures and scents of a bouquet of fresh flowers and to appreciate joy arising from the experience. As part of their daily homework, they were then asked to practice the meditation technique as a way to enjoy other pleasant life experiences.

Results from Garland’s new research shows that after a sample of chronic pain patients misusing opioids went through MORE, they exhibited increased brain activation on an EEG to natural healthy pleasures. The more their brains became active in response to natural healthy pleasure, the less the patients craved opioids.

“These findings are scientifically important because one of the major theories about how and why addiction occurs asserts that over time drug abusers become dulled to the experience of joy in everyday life, and this pushes them to use higher and higher doses of drugs to feel happiness,” said Garland.

“This study suggests that this process can be reversed. We can teach people to use mindfulness to appreciate and enjoy life more, and by doing that, they may feel less of a need for addictive drugs. It’s a powerful finding.”

Garland’s latest study builds on earlier work published in February in The Journal of Consulting and Clinical Psychology, in which the MORE intervention was found to reduce opioid misuse among a sample of chronic pain patients compared to another sample of chronic pain patients participating in a conventional support group.

The results are of particular interest in Utah, which claims one of the highest prescription drug abuse rates in the U.S.  According to the most recent statistics available from the state Division of Substance Abuse and Mental Health, Utah ranks eighth in the U.S. for its number of deaths attributed to prescription drug overdose.

Garland, who developed MORE intervention, noted the method is also being tested on people who want to quit smoking or lose weight.

 

At a glance

What is Mindfulness-Oriented Recovery Enhancement (MORE)?
MORE is designed to train people to respond differently to pain, stress and drug-related triggers.

MORE targets the underlying processes involved in chronic pain and addiction by combining three therapeutic components: mindfulness training, reappraisal and savoring.

?         Mindfulness involves training the mind to increase awareness, gain control over one’s attention and regulate automatic habits.

?         Reappraisal is the process of reframing the meaning of a stressful or adverse event in such a way as to see it as purposeful or growth promoting.

?         Savoring is the process of learning to focus attention on positive events to increase one’s sensitivity to naturally rewarding experiences, such as enjoying a beautiful nature scene or experiencing a sense of connection with a loved one.