Pain, hedonic regulation, and opioid misuse: Modulation of momentary experience by Mindfulness-Oriented Recovery Enhancement in opioid-treated chronic pain patients
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BACKGROUND: Given the risk of opioid misuse among chronic pain patients being treated with long-term opioid pharmacotherapy, non-pharmacological treatments are needed. Further, in light of hedonic deficits in this population, therapies that enhance positive affect may be useful. The purpose of this study was to examine effects of a Mindfulness-Oriented Recovery Enhancement (MORE) intervention on ecological momentary assessments (EMA) of pain and positive affective experience, and to determine if changes in pain, affect, and their interaction were associated with opioid misuse at post-treatment. METHODS: This study examined unpublished EMA data from a subset of participants (N=55) in a previously published RCT (NCT01505101) of MORE versus a support group (SG) control. Across 8 weeks of treatment, patients completed up to 224 EMA measures of pain and affect. Multilevel models and generalized estimating equations examined effects of treatment on momentary pain and positive affect, and generalized linear models examined associations between pain and affect and changes in opioid misuse by post-treatment. RESULTS: Patients in MORE reported significantly greater improvements in momentary pain (p=0.01) and positive affect (p=0.004) than patients in the SG. Further, over the entire course of treatment, patients in MORE were significantly more likely to exhibit positive affect regulation (OR=2.75) than patients in the SG. Finally, improvements in positive affect (but not pain) over the course of intervention were associated with reduced risk of misusing opioids by post-treatment (p=0.02). CONCLUSION: MORE may be a useful non-pharmacological treatment for pain and hedonic deficits among chronic pain patients at risk for opioid misuse.
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MORE significantly increased the trajectory of positive affect from moment-to-moment which in turn predicted decreased opioid misuse following treatment.
“These psychophysiological findings converged with ecological momentary assessment data collected during this trial, which indicated that MORE significantly increased the trajectory of positive affect from moment-to-moment which in turn predicted decreased opioid misuse following treatment [33].”
From Mindfulness-based treatment of addiction: current state of the field and envisioning the next wave of research (2018) · cites this paper as [33]
In individual studies, MBIs produced significant increases in emotion regulation, substance-related self-efficacy, and positive emotions.
“In individual studies, MBIs produced a host of other significant salutary effects including increases in emotion regulation [41, 54], substance-related self-efficacy [65, 66], and positive emotions [33]”
From Mindfulness-based treatment of addiction: current state of the field and envisioning the next wave of research (2018) · cites this paper as [33]
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The Role of Affect in Psychosocial Treatments for Substance Use Disorders
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Self-citationThe Effects of Mindfulness-Based Intervention on Emotion-Related Impulsivity in Addictive Disorders
Parisi, A. B., Hudak, J., & Garland, E. L. (2023) · Current Addiction Reports · doi:10.1007/s40429-023-00501-7 · Cited by 10 · see citing works
Self-citationThe subjective experience of information communication technology use among child welfare workers
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Self-citationThe 2019 Addiction Health Services Research Conference: Insights, Review, and Abstracts
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Self-citationEcological Momentary Assessment in Mindfulness Research
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Ecological Momentary Assessment in Mindfulness Research
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- Authors
- Garland, E. L., Bryan, C. J., Finan, P. H., Thomas, E. A., Priddy, S. E., Riquino, M. R., & Howard, M. O.
- Affiliations
- University of Utah (US)
- Johns Hopkins University (US)
- University of North Carolina at Chapel Hill (US)
- Corresponding author
- Garland, Eric L.
- ORCID
- Venue
- Drug and Alcohol Dependence
- Publisher
- Elsevier BV
- Published
- 2017-04
- Volume
- 173
- Pages
- S65-S72
- ISSN
- 0376-8716 (ISSN-L)
- OpenAlex
- W2603368509
- Cited by
- 71
- References
- 63
- Citations by year
- 2026: 5 · 2025: 5 · 2024: 1 · 2023: 7 · 2022: 7 · 2021: 13 · 2020: 11 · 2019: 9 · 2018: 10 · 2017: 3
- FWCI
- 11.16
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Drug and Alcohol Dependence (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Keywords
- Mindfulness-Oriented Recovery Enhancement, chronic pain, opioid misuse, positive affect, emotion regulation, non-pharmacological pain management, ecological momentary assessment
- MeSH terms
- Adult, Affect, Combined Modality Therapy, Female, Humans, Male, Middle Aged, Opioid-Related Disorders, Narcotics, Pain Measurement, Philosophy, Self-Help Groups, Young Adult, Chronic Pain, Pain Management, Mindfulness
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