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Cited by 190Opioid Use Disorder TreatmentPain Management and Opioid UseMusculoskeletal pain and rehabilitation

Mind-Body Therapies for Opioid-Treated Pain: A Systematic Review and Meta-analysis

Open access
Garland, Eric L., Brintz, Carrie E., Hanley, Adam W., Roseen, Eric J., Atchley, Rachel M., Gaylord, Susan A., Faurot, Keturah R., Yaffe, Joanne +2 more·2020·JAMA Internal Medicine
DOI 10.1001/jamainternmed.2019.4917PMC PMC6830441
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Abstract

Importance: Mind-body therapies (MBTs) are emerging as potential tools for addressing the opioid crisis. Knowing whether mind-body therapies may benefit patients treated with opioids for acute, procedural, and chronic pain conditions may be useful for prescribers, payers, policy makers, and patients. Objective: To evaluate the association of MBTs with pain and opioid dose reduction in a diverse adult population with clinical pain. Data Sources: For this systematic review and meta-analysis, the MEDLINE, Embase, Emcare, CINAHL, PsycINFO, and Cochrane Library databases were searched for English-language randomized clinical trials and systematic reviews from date of inception to March 2018. Search logic included (pain OR analgesia OR opioids) AND mind-body therapies. The gray literature, ClinicalTrials.gov, and relevant bibliographies were also searched. Study Selection: Randomized clinical trials that evaluated the use of MBTs for symptom management in adults also prescribed opioids for clinical pain. Data Extraction and Synthesis: Independent reviewers screened citations, extracted data, and assessed risk of bias. Meta-analyses were conducted using standardized mean differences in pain and opioid dose to obtain aggregate estimates of effect size with 95% CIs. Main Outcomes and Measures: The primary outcome was pain intensity. The secondary outcomes were opioid dose, opioid misuse, opioid craving, disability, or function. Results: Of 4212 citations reviewed, 60 reports with 6404 participants were included in the meta-analysis. Overall, MBTs were associated with pain reduction (Cohen d = -0.51; 95% CI, -0.76 to -0.26) and reduced opioid dose (Cohen d = -0.26; 95% CI, -0.44 to -0.08). Studies tested meditation (n = 5), hypnosis (n = 25), relaxation (n = 14), guided imagery (n = 7), therapeutic suggestion (n = 6), and cognitive behavioral therapy (n = 7) interventions. Moderate to large effect size improvements in pain outcomes were found for meditation (Cohen d = -0.70), hypnosis (Cohen d = -0.54), suggestion (Cohen d = -0.68), and cognitive behavioral therapy (Cohen d = -0.43) but not for other MBTs. Although most meditation (n = 4 [80%]), cognitive-behavioral therapy (n = 4 [57%]), and hypnosis (n = 12 [63%]) studies found improved opioid-related outcomes, fewer studies of suggestion, guided imagery, and relaxation reported such improvements. Most MBT studies used active or placebo controls and were judged to be at low risk of bias. Conclusions and Relevance: The findings suggest that MBTs are associated with moderate improvements in pain and small reductions in opioid dose and may be associated with therapeutic benefits for opioid-related problems, such as opioid craving and misuse. Future studies should carefully quantify opioid dosing variables to determine the association of mind-body therapies with opioid-related outcomes.

AI snapshot

Written from the paper’s full text.

TL;DR

This systematic review and meta-analysis found that mind-body therapies (MBTs) were associated with moderate reductions in pain and small reductions in opioid dose among adults prescribed opioids for clinical pain. Effects varied by MBT type, with meditation, hypnosis, therapeutic suggestion, and CBT showing significant pain associations, while evidence for opioid-related outcomes was limited by poor opioid dosing reporting.

Key findings

  • Across 29 studies (n = 2916; 1679 receiving MBT), MBTs were associated with moderate pain reduction: Cohen d = −0.51 (95% CI, −0.76 to −0.26; P < .001).
  • Across 8 studies (n = 435; 250 receiving MBT), MBTs were associated with small opioid dose reduction: Cohen d = −0.26 (95% CI, −0.44 to −0.08; P = .01).
  • Significant pain associations were found for meditation (d = −0.70), hypnosis (d = −0.54), therapeutic suggestion (d = −0.68), and CBT (d = −0.43), but not relaxation (d = −0.45; 95% CI, −1.13 to 0.22; P = .19); guided imagery had insufficient pain data for meta-analysis.
  • Opioid-related improvements were reported in 4 of 5 meditation studies (80%), 4 of 7 CBT studies (57%), and 12 hypnosis studies (63%), with fewer suggestion, guided imagery, and relaxation studies reporting such improvements; 2 relaxation studies reported significantly worsened opioid dosing outcomes.

Methods

  • Systematic review and meta-analysis following PRISMA; searched MEDLINE, Embase, Emcare, CINAHL, PsycINFO, and Cochrane Library from inception to March 2018, plus gray literature, ClinicalTrials.gov, and bibliographies.
  • Included randomized clinical trials of adults aged ≥18 years prescribed opioids for chronic, acute, procedural, or cancer pain, testing psychologically oriented MBTs (meditation, hypnosis, guided imagery, relaxation, therapeutic suggestion, CBT); excluded acupuncture, spinal manipulation, and yoga/Tai Chi without formal meditation, as well as studies without pain outcomes or with unspecified analgesics.
  • Independent screening, data extraction, and Cochrane risk-of-bias assessment; mixed-effects meta-analyses in R Metafor using standardized mean differences, with pain standardized to a 0–10 numeric rating scale and opioid dose converted to morphine equivalents; heterogeneity assessed with Q and I², publication bias with funnel plots and Egger test.

Limitations

  • The paper states that high study heterogeneity precluded quantitative conclusions about outcome modifiers such as dose or delivery format, or about durability of treatment effects; outcomes ranged from immediate postintervention to 3 months or longer.
  • Approximately one-third of studies had small samples and may have been underpowered; some trials had risk of bias from lack of blinding of participants, personnel, and/or outcome assessors, and lack of intention-to-treat analysis; nearly half were conducted before the revised CONSORT statement in 2001, and funnel plots/Egger statistic indicated some publication bias for meditation and suggestion studies.
  • Opioid dosing was insufficiently reported: less than one-fifth of reviewed trials yielded opioid dosing data sufficient for meta-analysis, and many studies were excluded because the analgesic type was unspecified or outcomes for opioid users were not analyzed separately; only 8 studies contributed to the opioid dose meta-analysis, and separate meta-analyses by MBT type for opioid dosing could not be conducted.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1001/jamainternmed.2019.4917

Cites

102 of 102 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

0 of 18 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    Therapeutic suggestion had a significant moderate association with pain reduction (Cohen d = -0.68; 95% CI, -1.18 to -0.18; P = .008).

    “Meta-analytic results indicated that suggestion had a significant moderate association with pain reduction (Cohen d = -0.68;95% CI, -1.18 to -0.18; P = .008)”
    Quote in the paperSubstantial claim
  • Findingown data

    Two guided imagery studies (29%) reported significant effects on opioid dose.

    “Two studies 41,80 (29%) reported statistically significant effects of guided imagery on opioid dose.”
    Quote in the paperNot a substantial claim
  • Findingown data

    Fifteen of 23 hypnosis studies (65%) reported statistically significant improvements in pain intensity, pain unpleasantness, and/or pain affect.

    “Fifteen of the 23 hypnosis studies 26,[29][30][31]33,34,47,[61][62][63][64][65][66][67]69 (65%) reported statistically significant improvements in pain intensity, pain unpleasantness, and/or pain affect.”
    Quote in the paperSubstantial claim
  • Findingown data

    One cognitive behavioral therapy study (14%) reported statistically significant improvements in postoperative mobility.

    “One study 86 (14%) reported statistically significantly improvements in postoperative mobil-ity.”
    Quote in the paperNot a substantial claim
  • Findingcitation

    Nearly half of the reviewed trials predated the 2001 revised CONSORT statement.

    “nearly approximately half of the trials reviewed were conducted before publication of the revised CONSORT statement in 2001”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [95] source

      Not checked in the free run.

  • May combine two claims. 18
  • Classified as probably not a substantial claim. 13

  • May combine two claims.

    Findingown data

    Most meditation-based intervention studies focused on chronic noncancer pain, while most hypnosis, relaxation, guided imagery, and suggestion studies focused on acute, procedural, or cancer-related pain.

    “Most of the meditation-based intervention studies focused on treating chronic noncancer pain (eg, low back pain).In contrast, most hypnosis, relaxation, imagery, and suggestion studies focused on treating acute, procedural, or cancer-related pain.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    The included studies tested meditation (n = 5), hypnosis (n = 25), relaxation (n = 14), guided imagery (n = 7), therapeutic suggestion (n = 6), and cognitive behavioral therapy (n = 7).

    “Studies tested meditation (n = 5), hypnosis (n = 25), relaxation (n = 14), guided imagery (n = 7), therapeutic suggestion (n = 6), and CBT (n = 7) interventions.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    A total of 4212 citations and 603 full-text articles were screened.

    “We screened 4212 citations and 603 full-text articles.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    The included studies focused on procedural pain (n = 39), burn pain (n = 7), cancer pain (n = 5), chronic pain (n = 8), or heterogeneous acute pain conditions (n = 1).

    “The 60 studies focused on various clinical pain targets: procedural pain (n = 39), burn pain (n = 7), cancer pain (n = 5), chronic pain (n = 8), or heterogeneous acute pain conditions (n = 1).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    Extant evidence from controlled trials suggests that mind-body therapies can improve clinical pain and opioid-related outcomes.

    “Extant evidence from controlled trials suggests that MBTs can improve clinical pain and opioid-related outcomes.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    Guidelines encourage practitioners to consider nonopioid pain management options, including mind-body therapies.

    “To help combat the opioid crisis, guidelines encourage practitioners to consider nonopioid pain management options, including mind-body therapies (MBTs).7”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [7] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Opioids are considered useful in managing a wide continuum of pain, including acute, procedural, and chronic pain.

    “Although opioids are considered to be useful in managing a wide continuum of pain, including acute, procedural, and chronic pain”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [6] source

      Not checked in the free run.

  • May combine two claims.

    Interpretationown data

    Separate meta-analyses by specific mind-body therapy type demonstrated significant associations of meditation, hypnosis, cognitive behavioral therapy, and suggestion with pain outcomes, with the largest effect sizes observed for meditation.

    “Separate meta-analyses by specific MBT type demonstrated significant associations of meditation, hypnosis, CBT, and suggestion with pain outcomes, with the largest effect sizes observed for meditation studies.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductown data

    Approximately one-third of the included studies had small samples and may have been underpowered.

    “Approximately one-third of studies had small samples and therefore may have been underpowered.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    Studies that reported P values but did not report numerical means and standard deviations for baseline or postintervention pain or opioid use could not be included in the meta-analysis.

    “Studies that reported P values but did not report numerical means and SDs for baseline or postintervention pain or opioid use could not be included in the meta-analysis.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    The methods and reporting of this systematic review and meta-analysis followed PRISMA guidelines.

    “The methods and reporting of this systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines (Figure 1).15”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [15] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    Although quantitative meta-analyses were performed on all studies with extractable data, the entire body of studies was systematically reviewed qualitatively.

    “Although we performed quantitative meta-analyses on all studies for which we could extract data, the entire body of studies was systematically reviewed in a qualitative manner”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    Most studies of meditation, hypnosis, and cognitive behavioral therapy reported significant therapeutic associations with opioid-related outcomes, whereas fewer studies of suggestion, guided imagery, and relaxation reported such associations.

    “Most studies of meditation, hypnosis, and CBT reported significant therapeutic associations with opioid-related outcomes, including opioid dosing, craving, and opioid misuse, whereas comparatively fewer studies of suggestion, imagery, and relaxation reported significant associations with opioidrelated outcomes.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationcitation

    Two studies reported significantly worsened opioid dosing outcomes after relaxation, suggesting the possibility of adverse effects.

    “Of note, 2 studies 37,74 reported significantly worsened opioid dosing outcomes after relaxation, suggesting the possibility of adverse effects.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductnone given

    Most mind-body therapy studies used active or placebo controls and were judged to be at low risk of bias.

    “Most MBT studies used active or placebo controls and were judged to be at low risk of bias.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    The strength of evidence for therapeutic effects of mind-body therapies on pain and opioid dose reduction was moderate, although it varied by specific mind-body therapy.

    “The strength of the evidence for the therapeutic effects of MBTs on pain and opioid dose reduction was moderate, although this evidence varied by specific MBT.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data

    Most studies used active or placebo controls and had low risk of bias, increasing confidence that the reported benefits are not solely the result of nonspecific therapeutic factors.

    “Most studies used active or placebo controls and had low risk of bias (Figure 3 and eFigures 9-14 in the Supplement), increasing confidence that the reported benefits are not solely the result of nonspecific therapeutic factors.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data

    Moderate to large effect size improvements in pain outcomes were found for meditation, hypnosis, suggestion, and cognitive behavioral therapy but not for other mind-body therapies.

    “Moderate to large effect size improvements in pain outcomes were found for meditation (Cohen d = -0.70),hypnosis (Cohen d = -0.54),suggestion (Cohen d = -0.68),and cognitive behavioral therapy (Cohen d = -0.43)but not for other MBTs.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing). May combine two claims.

    Interpretationreasoning

    The observed findings on procedural pain are especially notable; if mind-body therapies can reduce procedural pain, they may serve as an important form of primary prevention of long-term opioid use and opioid use disorder.

    “The observed findings on procedural pain are especially notable; if MBTs can reduce procedural pain, they may serve as an important form of primary prevention of long-term opioid use and OUD.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    Study heterogeneity was investigated using Baujat plots together with Q and I2 statistics.

    “Study heterogeneity was investigated using Baujat plots in conjunction with the Q and I 2 statistics.52,53”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [52] source

      Not checked in the free run.

    • cites [53] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Risk of bias was assessed using the Cochrane risk of bias tool by two independent reviewers.

    “Risk of bias was assessed in Covidence using the Cochrane risk of bias tool by 2 independent reviewers (E.L.G., C.E.B., A.W.H., E.J.R., R.M.A., S.A.G., K.R.F., J.Y., and/or M.F.).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    The findings suggest that mind-body therapies are associated with moderate improvements in pain and small reductions in opioid dose and may be associated with therapeutic benefits for opioid-related problems such as opioid craving and misuse.

    “The findings suggest that MBTs are associated with moderate improvements in pain and small reductions in opioid dose and may be associated with therapeutic benefits for opioid-related problems, such as opioid craving and misuse.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    Standard deviations of change scores were imputed using Cochrane best practices.

    “The SDs of the change scores were imputed via Cochrane best practices.51”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [51] source

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductown data

    Abstracts and full texts were screened and data were extracted independently by two reviewers.

    “Abstracts and full texts were screened and data extracted independently by 2 reviewers (E.L.G., C.E.B., A.W.H., E.J.R., R.M.A., S.A.G., K.R.F., J.Y., and/or M.F.) via Covidence”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Few of the studies in prior reviews measured opioid use, and those reviews included patients who were not prescribed opioids.

    “Few of the studies reviewed measured opioid use, and reviews included patients who were not prescribed opioids.”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [9] source

      Not checked in the free run.

    • cites [10] source

      Not checked in the free run.

    • cites [11] source

      Not checked in the free run.

25 of 25

  • The paper relies on this without support.

    Mind-body therapies may ameliorate pain and prevent downstream transitions from long-term opioid use to opioid use disorder.

    “Mind-body therapies might ameliorate pain and prevent downstream transitions from long-term opioid use to OUD.”

  • The paper relies on this without support.

    Participant self-report of opioid use is unreliable.

    “Because participant self-report is unreliable, if possible, data should be extracted from electronic health records and prescription drug monitoring programs.”

  • The paper relies on this without support.

    The National Institutes of Health HEAL initiative has called for studies of mind-body therapies as interventions for pain and opioid use disorder.

    “Thus, the National Institutes of Health initiative Helping to End Addiction in the Long Term (HEAL) has called for studies of MBTs as interventions for pain and OUD.”

  • The paper relies on this without support.

    Mind-body therapies that primarily use mental techniques may be more accessible to people whose mobility is compromised by pain or used for pain relief during inpatient procedures when patients are immobilized.

    “We elected to focus our review on MBTs that primarily use mental techniques because they may be more accessible to people whose mobility is compromised by pain or used for pain relief during inpatient procedures when patients are immobilized.”

  • The paper relies on this without support.

    Less pain and lower opioid use among patients on opioid therapy for various pain conditions will reduce the opioid crisis.

    “Insofar as MBTs are associated with pain relief and opioid use reduction among patients prescribed opioids for a range of pain conditions, MBTs may help alleviate the opioid crisis.”
5 of 5

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Adjunctive therapies such as acupuncture and mindfulness-based interventions have been minimally explored in otoplasty.

    “Adjunctive therapies such as acupuncture and mindfulness-based interventions, though supported in broader surgical contexts, have been minimally explored in otoplasty, despite evidence suggesting they may reduce perioperative pain and opioid reliance.10”

    From Perioperative Analgesia and Postoperative Nausea and Vomiting Management in Otoplasty: A Systematic Review (2026) · cites this paper as [10]

    The Mindfulness or Meditation Studies section reports associations with reduced pain and some opioid-related outcomes, supporting the sentence’s broader rationale for mindfulness-based interventions. The Inclusion and Exclusion Criteria explicitly exclude acupuncture, and the paper provides no evidence about how extensively either therapy has been explored in otoplasty. No page numbers are available in our copy. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

Statistics recomputed

Every reported test result, recomputed from its test statistic and degrees of freedom. A result shows as not adding up only once an independent check has confirmed it.

  • Consistentz = -0.65reported p = .52 · recomputed p = .516

    “(z = -0.65,p = .52”

  • Consistentz = -0.3reported p = .76 · recomputed p = .764

    “(z = -0.30,p = .76”

2 of 2

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Relaxation study count changes from 14 to 16

    Minor

    The abstract reports 14 relaxation studies, whereas the relaxation results use a total of 16.

  • Relaxation opioid-outcome percentage does not match 16 studies

    Minor

    Two of the 16 relaxation studies is 12.5%, which rounds to 13%, not 14%.

    Reported 14 · recomputed 12.5

  • A plotted pain estimate lies outside its confidence interval

    Minor

    The reported estimate of −0.11 is outside its stated 95% CI of −0.70 to −0.48; the interval's midpoint is −0.59.

    Reported -0.11 · recomputed -0.59

  • Study 40 is both classified as single-session and said not to report session information

    Minor

    The relaxation section lists study 40 among single-session interventions, then says that study 40 did not report that information.

  • Hypnosis study count changes from 25 to 23

    Minor

    The abstract says 25 studies tested hypnosis, but the hypnosis results describe a total of 23 hypnosis studies.

  • Guided imagery study count changes from 7 to 9

    Minor

    The abstract reports 7 guided imagery studies, whereas the guided imagery results use a total of 9.

6 of 6

Cites

Flagged first, then by citations

2 of the 104 references couldn’t be matched to a known paper.

Research works printed but not linked: 1

  1. 2017, National Academies of Sciences, Engineering, and Medicine. Pain Management and the Opioid Epidemic: Balancing Societal and Individual Benefits and Risks of Prescription Opioid Use

Cited by

Sorted by citations

Related

Authors
Garland, E. L., Brintz, C. E., Hanley, A. W., Roseen, E. J., Atchley, R. M., Gaylord, S. A., Faurot, K. R., Yaffe, J., Fiander, M., & Keefe, F. J.
Affiliations
  • University of Utah (US)
  • University of North Carolina at Chapel Hill (US)
  • Boston University (US)
  • Brigham and Women's Hospital (US)
  • Independent consultant, Halifax, Nova Scotia
  • Duke University (US)
Corresponding author
Garland, Eric L.
ORCID
Venue
JAMA Internal Medicine
Publisher
American Medical Association (AMA)
Published
2020-01-01
Volume
180
Issue
1
Pages
91
ISSN
2168-6106 (ISSN-L)
DOI
10.1001/jamainternmed.2019.4917
PMC
PMC6830441
OpenAlex
W2984126577
Semantic Scholar
3f78b224fbf5ff9229a56db2574492b80e347318
Cited by
190
References
104
Citations by year
2026: 18 · 2025: 40 · 2024: 30 · 2023: 28 · 2022: 23 · 2021: 31 · 2020: 19 · 2018: 1
FWCI
2.98
Type
journal article
Language
en
Open access
Locations
  • JAMA Internal Medicine (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (1f32at009272-01)
  • National Institute on Drug Abuse (R34DA040954, R01DA042033)
  • National Institute of Nursing Research (R01NR013910)
  • National Center for Complementary and Integrative Health (K23AT010487, R61AT009296, UG3AT009790, T32AT003378, U24AT009769)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
  • Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
Keywords
mind-body interventions, opioid use, pain management, opioid dose reduction, meditation, hypnosis, guided imagery, therapeutic suggestion, cognitive behavioral therapy, relaxation, opioid misuse, chronic pain, acute pain, procedural pain, opioid epidemic, opioid craving, opioid withdrawal symptoms
MeSH terms
Analgesics, Opioid, Humans, Cognitive Behavioral Therapy, Meditation, Chronic Pain, Pain Management

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-09.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-09.

Statistics and arithmetic are recomputed, not judged.

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