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Exercise That Reduces Opioid Analgesic Abuse and Chronic Pain – benefits last up to 9 Months

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People suffering from chronic pain and opioid addiction face unique challenges, as opioid use disorder has been proven to enhance sensitivity to pain, which promotes more opioid abuse.

According to new research published in the journal JAMA Internal Medicine, mindfulness, a mindfulness-based therapy that entails paying attention to the present moment acceptingly and nonjudgmentally, can reduce chronic pain and opioid substance misuse.

This technique has already demonstrated to help with stress, anxiety, and worry, as well as removing negative thoughts and enhancing sleep quality.

According to the findings of a new clinical trial, an eight-week mindfulness-based therapy (Mindfulness-Oriented Recovery Enhancement means MORE) reduces opioid use and misuse while also lowering chronic pain symptoms, with effects lasting up to nine months.

This is the first large-scale clinical experiment to show that a psychosocial intervention can reduce opioid abuse and chronic pain in persons who are administered opioid medicines at the same time.

The study monitored 250 patients with chronic pain who fit the criteria for opioid misuse and were on long-term opioid medication. The majority of the people in the study used oxycodone or hydrocodone, had two or more painful diseases, and met the clinical criteria for serious depression. More than half of the subjects had an opioid use disorder that could be diagnosed.

Participants were randomly assigned to either a regular supportive psychotherapy group or a MORE group, with both groups meeting eight times a week for two hours and doing 15 minutes of homework each day. The research treatment groups were administered in doctor’s offices, in the same clinical care setting where patients were receiving opioid pain relief.

During a nine-month follow-up, researchers assessed the participants’ opioid abuse behaviors, pain symptoms, depression, anxiety, and stress, and opioid dose. The participants’ opioid craving was tested three times a day, prompted by a text message delivered to their smartphones.

After nine months of treatment, 45 percent of MORE group participants were no longer misusing opioids, and 36 percent had cut their opioid usage in half or more. Patients in MORE had more than double the chance of quitting using opioids at the conclusion of the study than those in normal psychotherapy. Participants in the MORE group also reported clinically significant reductions in chronic pain symptoms, decreased opioid seeking, and depression symptoms that were below the major depressive disorder threshold.

“MORE demonstrated one of the most powerful treatment effects I’ve seen,” says Eric Garland, lead author of the study. “There’s nothing else out there that works this well in alleviating pain and curbing opioid misuse.”

Garland, based on previous research, also speculated that the long-term benefits could be linked to MORE’s ability to restructure the way the brain processes rewards, allowing participants’ brains to shift from valuing drug-related rewards to valuing natural, healthy rewards such as a beautiful sunset, the blooming of springtime flowers, or a loved one’s smile.

What is Mindfulness-Oriented Recovery Enhancement or MORE therapy?

MORE blends mindfulness, savoring, and reappraisal skills training with meditation, cognitive-behavioral therapy, and positive psychology principles.

Participants are trained to break down their pain or opioid desire experience into its sensory components, “zooming in” on what they are experiencing and breaking it down into different feelings such as heat, tightness, or tingling.

They are taught to observe how such experiences evolve over time and to develop an observer’s perspective. They are also taught to relish pleasurable, healthy, and life-affirming experiences, enhancing the sense of joy, satisfaction, and purpose that positive, ordinary events can provide.

Finally, participants are taught how to reinterpret stressful events in order to discover meaning in the midst of adversity, as well as how to realize what can be learnt from unpleasant experiences and how dealing with them may make a person stronger.

“”Rather than getting caught up in the pain or craving, we teach people how to step back and observe that experience from the perspective of an objective witness. When they can do that, people begin to recognize that who they truly are is bigger than any one thought or sensation. They are not defined by their experiences of pain or craving; their true nature is something more,” explains Garland.

People experiencing chronic pain and opioid misuse are People who have chronic pain as well as opioid use disorder pose a substantial treatment challenge because opioid use disorder has been proven to worsen pain sensitivity, which promotes additional opioid abuse. MORE may offer an effective, cost-effective, and life-saving solution to help halt the ongoing opioid crisis by lowering pain and opioid consumption at the same time.

Source: 10.1001/jamainternmed.2022.0033

Image Credit: Getty

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