To be aware, or to accept, that is the question: Differential roles of awareness of automaticity and pain acceptance in opioid misuse
Open accessAbstract
Background: Individuals with chronic low back pain (CLBP) are commonly prescribed long-term opioid therapy (LTOT) for analgesia, placing this population at increased risk for opioid misuse and opioid use disorder. Acceptance of aversive experiences (e.g., chronic pain) and awareness of automatic thoughts and behaviors (i.e., automaticity) are two facets of dispositional mindfulness that may serve as protective mechanisms against opioid misuse risk. Therefore, the aim of the current study was to examine the differential contributions of these constructs to opioid misuse risk among adults with CLBP receiving LTOT. Methods: Data were obtained from a sample of 770 adults with opioid-treated CLBP. Bivariate correlations and hierarchical linear regression analyses were used to determine whether chronic pain acceptance and awareness of automatic thoughts and behaviors explained a statistically significant portion of variance in opioid misuse risk after accounting for the effects of other relevant confounders. Results: Hierarchical regression results revealed that chronic pain acceptance and awareness of automatic thoughts and behaviors contributed a significant portion in the variance of opioid misuse risk. Awareness of automatic thoughts and behaviors was negatively associated with opioid misuse risk, such that individuals with lower levels of awareness of automaticity were at higher risk of opioid misuse. By contrast, pain acceptance was not associated with opioid misuse. Conclusions: Findings suggest that awareness of automaticity may buffer against opioid misuse risk. Interventions designed to strengthen awareness of automaticity (e.g., mindfulness-based interventions) might be especially efficacious among this population. © 2023 Elsevier B.V.
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Claims the paper makes
6 of 19 cited sources checked · 0 supported · 0 flagged · accuracy not yet measured
- Premisecitation
Lower levels of pain acceptance have been linked to opioid-related problems and opioid misuse.
“lower levels of pain acceptance have been linked to opioid-related problems (Lin et al., 2015) and misuse (Witkiewitz & Vowles, 2018)”
Quote in the paperSubstantial claim1 of 2 sources checked- cites Lin et al., 2015 source
- cites Witkiewitz & Vowles, 2018 source
The citation to Witkiewitz and Vowles (2018) is attached to the link between lower pain acceptance and opioid misuse, not the preceding claim about opioid-related problems. The section “Chronic Pain as a ‘Third Variable’ in Opioid and Alcohol Co-Use” discusses misuse among people with chronic pain, but does not link misuse to pain acceptance. Searches for “pain acceptance” and acceptance-based treatment found no passage establishing that link; page numbers were unavailable. (LLM, conf=0.74)
Experimental — accuracy not yet measured
- Premisecitation
Nonmedical use of prescription opioids may be influenced by thoughts and behaviors that become automatized through repetition and encoded in memory schemas.
“nonmedical use of prescription opioids may also be influenced by thoughts and behaviors that become automatized through repetition and encoded in memory schemas (Everitt & Robbins, 2016; Tiffany, 1990)”
Quote in the paperSubstantial claim1 of 2 sources checked- cites Everitt & Robbins, 2016 source
The Instrumental Learning and Addiction section says that, after much repetition, stimulus–response habits can dominate and behavior can become autonomous and occur outside conscious awareness. This supports the proposed automatization of drug-related behavior, but the paper does not specifically establish this for nonmedical prescription-opioid use or describe thoughts and behaviors as encoded in memory schemas. (LLM, conf=0.87)
Experimental — accuracy not yet measured - cites Tiffany, 1990 source
- Premisecitation
A large-scale randomized controlled trial found that Mindfulness-Oriented Recovery Enhancement reduced the occurrence of opioid misuse by 45%, nearly tripling the effect of standard supportive therapy (OR = 2.94).
“a recently completed large-scale RCT demonstrating that MORE reduced occurrence of opioid misuse by 45%, nearly tripling the effect (OR = 2.94) of standard supportive therapy (Garland, Hanley, Nakamura, et al., 2022)”
Quote in the paperSubstantial claim1 of 1 sources checked- cites Garland, Hanley, Nakamura, et al., 2022 source
The Results > Outcomes section reports that MORE reduced opioid misuse compared with supportive psychotherapy in a trial of 250 adults. But 45.0% is the proportion of MORE participants who were no longer misusing opioids at nine months, not a 45% reduction in occurrence; the reported between-group odds ratio is 2.06, not 2.94. The indexed copy provides no page number for this passage. (LLM, conf=0.90)
Experimental — accuracy not yet measured
- Findingown data
Chronic pain acceptance was not associated with COMM-measured opioid misuse risk in the adjusted model (B = 0.002, SE = 0.02, p = .911).
“chronic pain acceptance did not show an association with this outcome (B = 0.002, SE = 0.02, p = .911)”
Quote in the paperSubstantial claim - Findingown data
Adding chronic pain acceptance and awareness of automaticity to the regression model produced a significant increase in explained variance in COMM opioid misuse risk of 4.4%.
“the addition of chronic pain acceptance and awareness of automaticity contributed a significant increase in the model R2 (4.4%)”
Quote in the paperSubstantial claim
- Findingown data
In the sensitivity analysis, chronic pain acceptance was not significantly associated with OCC-measured opioid misuse risk (B = .002, SE = .002, p = .413).
“the association between chronic pain acceptance and OCC opioid misuse risk was not significant (B = .002, SE = .002, p = .413)”
Quote in the paperSubstantial claim - Findingown data
In step 1 of the hierarchical regression, opioid dose, pain severity, pain interference, age, gender, household income, education, depression and anxiety predicted 29.0% of the variance in COMM scores.
“opioid dose, pain severity, pain interference, age, gender, household income, education level, depression, and anxiety scores were found to predict 29.0% of the variance in the COMM score”
Quote in the paperNot a substantial claim - Findingown data
The hierarchical regression model predicted 33.4% of the variance in opioid misuse.
“our hierarchical regression predicted 33.4% of the variance in opioid misuse”
Quote in the paperSubstantial claim - Findingown data
In the sensitivity analysis, awareness of automaticity significantly predicted opioid misuse risk measured by the OCC (B = −0.1, SE = 0.03, p < .001).
“while awareness of automaticity significantly predicted OCC opioid misuse risk (B = −0.1, SE = 0.03, p < .001)”
Quote in the paperNot a substantial claim - Findingown data
In the linear regression, depression, anxiety and male gender were significantly associated with opioid misuse risk.
“linear regression results revealed that depression, anxiety, and male gender were significantly associated with opioid misuse risk”
Quote in the paperNot a substantial claim - Findingown data
The two measures of opioid misuse risk, the COMM and the OCC, were positively correlated with each other (r = 0.44, p < .001).
“both measures of opioid misuse risk (i.e., the COMM and the OCC) were positively correlated with one another (r = 0.44, p < .001)”
Quote in the paperNot a substantial claim - Findingown data
In adults with opioid-treated chronic low back pain, awareness of automaticity was negatively associated with opioid misuse risk as measured by the COMM (B = −1.77, SE = 0.27, p < .001) after adjustment for covariates.
“Although awareness of automaticity was negatively associated with opioid misuse risk as measured by the COMM (B = −1.77, SE = 0.27, p < .001)”
Quote in the paperSubstantial claim - Findingown data
COMM-measured opioid misuse risk was positively correlated with depression (r = 0.44, p < .001).
“opioid misuse risk (COMM) was positively correlated with depression (r = 0.44, p < .001) and anxiety (r = 0.48, p < .001)”
Quote in the paperNot a substantial claim - Findingown data
COMM-measured opioid misuse risk was negatively correlated with awareness of automaticity (r = −0.46, p < .001).
“and negatively correlated with awareness of automaticity (r = −0.46, p < .001)”
Quote in the paperSubstantial claim - Findingown data
COMM-measured opioid misuse risk was positively correlated with anxiety (r = 0.48, p < .001).
“opioid misuse risk (COMM) was positively correlated with depression (r = 0.44, p < .001) and anxiety (r = 0.48, p < .001)”
Quote in the paperNot a substantial claim - Premisecitation
Awareness of automaticity has been found to predict lower risk of opioid misuse among patients with opioid-treated chronic low back pain.
“has been found to predict lesser risk of opioid misuse among patients with opioid-treated CLBP (Villarreal et al., 2020)”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Villarreal et al., 2020 source
- Interpretationown data
The present findings diverge from prior research that identifies chronic pain acceptance as a factor mitigating opioid misuse risk.
“Notably, our findings diverge from prior research, which highlights acceptance of chronic pain as a factor that can mitigate opioid misuse risk”
Quote in the paperSubstantial claim - Interpretationown data
Awareness of automaticity may protect against opioid misuse risk in adults with opioid-treated chronic low back pain.
“Findings suggest that awareness of automaticity may buffer against opioid misuse risk.”
- Also stated in: § Conclusions · hedged
“results from this cross-sectional survey analysis in a large sample of adults with opioid treated CLBP suggest that awareness of automaticity, but not pain acceptance, buffers risk of opioid misuse”
Quote in the paperSubstantial claim- Rests on an assumption: Before this study, no research had examined the independent explanatory power of pain acceptance and awareness of automaticity in predicting opioid misuse among adults with opioid-treated chronic low back pain.
- Also stated in: § Conclusions · hedged
- Interpretationcitation
The observed inverse association between awareness of automaticity and opioid misuse risk is consistent with the cognitive processing model of addiction.
“The inverse association between awareness of automaticity and opioid misuse risk observed in the present study is consistent with the cognitive processing model of addiction (Tiffany, 1990)”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Tiffany, 1990 source
- Classified as probably not a substantial claim. 12
- May combine two claims. 7
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationHigher levels of dispositional mindfulness are associated with beneficial outcomes, including reduced alcohol and drug use.
“Meta-analytic evidence has found that higher levels of dispositional mindfulness are associated with a range of beneficial outcomes, including increased psychological well-being (Carpenter et al., 2019; Keng et al., 2011), enhanced engagement in positive health behaviors (Sala et al., 2020), and reduced alcohol (Sala et al., 2020) and drug use (Karyadi et al., 2014).”
Quote in the paperNot a substantial claim1 of 2 sources checked- cites Karyadi et al., 2014 source
The Discussion reports a small negative association between trait mindfulness and substance use behaviors overall. However, the Results (section 3.5) find significant associations for alcohol and tobacco, but not marijuana; the Discussion also notes that other drugs were underrepresented. Karyadi et al. therefore do not establish the broad claim of reduced drug use attached to this citation. (LLM, conf=0.88)
Experimental — accuracy not yet measured - cites Sala et al., 2020 source
Classified as probably not a substantial claim.
PremisecitationDispositional mindfulness comprises two distinct dimensions: acceptance of aversive experiences and awareness of automatic thoughts and behaviors.
“factor analytic research from multiple instruments designed to assess dispositional mindfulness have identified acceptance of aversive experiences and awareness of automatic thoughts and behaviors as two distinct dimensions of this construct (Baer et al., 2006; Brown & Ryan, 2003)”
Quote in the paperSubstantial claim1 of 2 sources checked- cites Baer et al., 2006 source
The General Discussion (p. 16) identifies acting with awareness as a mindfulness facet, but treats acceptance as potentially reflected in two other facets: nonjudging and nonreactivity. It does not identify acceptance of aversive experiences as a single, distinct dimension; the factor analysis found five facets overall (Deriving Mindfulness Facets, p. 10). (LLM, conf=0.87)
Experimental — accuracy not yet measured - cites Brown & Ryan, 2003 source
Classified as probably not a substantial claim. May combine two claims.
Study design and conductcitationThe Current Opioid Misuse Measure is a reliable and valid survey for assessing aberrant opioid use behaviors among patients with opioid-treated chronic pain.
“Prescription opioid misuse risk was measured using the Current Opioid Misuse Measure (COMM), a reliable and valid survey commonly used to assess aberrant opioid use behaviors among patients with opioid-treated chronic pain (Butler et al., 2008)”
Quote in the paperSubstantial claim1 of 1 sources checked- cites Butler et al., 2008 source
The Discussion (page unavailable) identifies the COMM as a questionnaire for periodically documenting current behavior in patients who have taken opioids for an extended period. The paper validates the SOAPP-R, not the COMM; our copy does not establish that the COMM is reliable, valid, or commonly used. (LLM, conf=0.88)
Experimental — accuracy not yet measured
May combine two claims.
Findingown dataNeither COMM nor OCC opioid misuse risk scores were significantly correlated with chronic pain acceptance scores.
“neither COMM (r = −.05, p = .210) nor OCC scores (r = .04, p = .280) were found to be significantly correlated with chronic pain acceptance scores”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S2 (checkable).
Interpretationown dataInterventions that strengthen awareness of automaticity, such as mindfulness-based interventions, might be especially efficacious for reducing opioid misuse risk in this population.
“Interventions designed to strengthen awareness of automaticity (e.g., mindfulness-based interventions) might be especially efficacious among this population.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductcitationThe Brief Pain Inventory is a validated measure commonly used in chronic pain trials.
“Pain severity and interference were assessed using the Brief Pain Inventory, a validated measure commonly used in chronic pain trials (Cleeland, 1994)”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Cleeland, 1994
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductcitationThe Hospital Anxiety and Depression Scale is a 14-item questionnaire designed to assess anxiety and depression symptoms among individuals with medical illness.
“Depression and anxiety symptom severity were assessed using the Hospital Anxiety and Depression Scale (HADS, α = .88), a 14-item questionnaire designed to assess the anxiety and depression symptoms among individuals with medical illness (Bjelland et al., 2002)”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Bjelland et al., 2002 source
Classified as probably not a substantial claim. May combine two claims.
Study design and conductcitationThe Chronic Pain Acceptance Questionnaire is a valid and reliable 20-item measure of chronic pain acceptance.
“The Chronic Pain Acceptance Questionnaire (CPAQ) is a 20-item questionnaire that has been shown to be a valid and reliable measure of chronic pain acceptance”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Wicksell et al., 2009 source
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductcitationThe Timeline Followback method is a validated, structured approach for assessing daily substance use patterns with good test-retest reliability.
“Daily opioid dose over the past 14 days was assessed via the Timeline Followback method, a validated, structured approach for assessing daily substance use patterns that has demonstrated good test-retest reliability (Sobell & Sobell, 1992)”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Sobell & Sobell, 1992 source
Classified as probably not a substantial claim.
Study design and conductcitationThe Mindful Attention Awareness Scale is a validated measure of the propensity to attend to present-moment experiences in daily life.
“Awareness of automaticity was assessed with Mindful Attention Awareness Scale (MAAS), a validated measure of the propensity to attend to present-moment experiences in the context of daily life (Brown & Ryan, 2003)”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Brown & Ryan, 2003 source
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductnone givenThe study protocol was approved by the Institutional Review Boards of all involved sites and registered with ClinicalTrials.gov.
“The study protocol was approved by the Institutional Review Boards of all involved sites and registered with ClinicalTrials.gov.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductcitationThe Opioid Compliance Checklist exhibits adequate sensitivity and specificity, with an area under the ROC curve of .65 in an opioid-treated chronic pain sample.
“Prior research has found that the OCC exhibits adequate sensitivity and specificity as evidenced by an area under the receiving operating characteristics curve (AUC) value of .65 in an opioid-treated chronic pain sample (Jamison et al., 2014)”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Jamison et al., 2014 source
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationDispositional mindfulness can be increased through mindfulness-based interventions.
“research suggests that dispositional mindfulness can be increased through mindfulness-based interventions (MBIs; Quaglia et al., 2016)”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Quaglia et al., 2016 source
The paper relies on this without support.
Before this study, no research had examined the independent explanatory power of pain acceptance and awareness of automaticity in predicting opioid misuse among adults with opioid-treated chronic low back pain.
“to our knowledge no studies have examined the independent explanatory power of these unique facets in predicting opioid misuse among adults with opioid-treated CLBP”
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.
Maximum pain acceptance score is overstated
MinorA 20-item questionnaire with each item scored from 0 to 6 has a maximum total of 120, not 140.
Reported 140 · recomputed 120
“Items are rated on a seven-point scale (0 = Never, 6 = Always), yielding total score of up to 140 that was used in the present analysis (α = .86).”
Education appears in the reported first-step model but not its specified predictors
MinorThe analysis plan lists the predictors entered in step 1 without education, whereas the results say education level was included in that step.
“In the first step, MEDD (Box-Cox transformed to reduce skew), pain severity, pain interference, depression, anxiety, age, gender, and income were examined as predictors of COMM opioid misuse risk.”
“In step 1, opioid dose, pain severity, pain interference, age, gender, household income, education level, depression, and anxiety scores were found to predict 29.0% of the variance in the COMM score.”
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Self-citationGarland, E. L., Hanley, A. W., Hudak, J., Nakamura, Y., & Froeliger, B. (2022) · Science Advances · doi:10.1126/sciadv.abo4455 · Cited by 48 · see citing works
Self-citationGarland, E. L., Baker, A. K., & Howard, M. O. (2017) · Journal of the Society for Social Work and Research · doi:10.1086/694324 · Cited by 47 · see citing works
Self-citationValidation of a brief opioid compliance checklist for patients with chronic pain
Jamison, R. N., Martel, M. O., Edwards, R. R., Qian, J., Sheehan, K. A., & Ross, E. L. (2014) · The Journal of Pain · doi:10.1016/j.jpain.2014.07.007 · Cited by 37 · see citing works
Self-citationThomas, D., Frascella, J., Hall, T. K., Smith, W., Compton, W. M., Koroshetz, W. J., Briggs, J. P., Grady, P., Somerman, M. J., & Volkow, N. D. (2014) · Journal of Internal Medicine · doi:10.1111/joim.12345 · Cited by 26 · see citing works
Jamison, R. N., Martel, M. O., Huang, C.-C., Jurcik, D. C., & Edwards, R. R. (2015) · Journal of Pain · doi:10.1016/j.jpain.2015.12.004 · Cited by 23 · see citing works
Self-citationBaker, A. K., & Garland, E. L. (2019) · Experimental and Clinical Psychopharmacology · doi:10.1037/pha0000225 · Cited by 21 · see citing works
Pain acceptance and opiate use disorders in addiction treatment patients with comorbid pain
Lin, L. (., Bohnert, A. S. B., Price, A. M., Jannausch, M., Bonar, E. E., & Ilgen, M. A. (2015) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2015.10.017 · Cited by 20 · see citing works
The Phenomics and Genetics of Addictive and Affective Comorbidity in Opioid Use Disorder
Freda, P., Moore, J. H., & Kranzler, H. (2021) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2021.108602 · Cited by 20 · see citing works
Priddy, S. E., Hanley, A. W., Riquino, M. R., Platt, K. A., Baker, A. K., & Garland, E. L. (2018) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2018.03.040 · Cited by 19 · see citing works
Self-citationRogers, A. H., Garey, L., Bakhshaie, J., Viana, A. G., Ditre, J. W., & Zvolensky, M. J. (2020) · The Clinical Journal of Pain · doi:10.1097/ajp.0000000000000870 · Cited by 19 · see citing works
Zgierska, A. E., Burzinski, C. A., Garland, E. L., Lennon, R. P., Jamison, R., Nakamura, Y., Barrett, B., Sehgal, N., Mirgain, S. A., Singles, J. M., et al. (2021) · Contemporary Clinical Trials · doi:10.1016/j.cct.2021.106548 · Cited by 18 · see citing works
Self-citationEsteve, R., Marcos, E., Reyes-Pérez, Á., López-Martínez, A. E., & Ramírez-Maestre, C. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18063054 · Cited by 17 · see citing works
Smit, T., Mayorga, N. A., Rogers, A. H., Nizio, P., & Zvolensky, M. J. (2023) · Addictive Behaviors · doi:10.1016/j.addbeh.2022.107495 · Cited by 15 · see citing works
Villarreal, Y. R., Stotts, A. L., Paniagua, S. M., Rosen, K., Eckmann, M., Suchting, R., & Potter, J. S. (2020) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2020.08.011 · Cited by 7 · see citing works
Young, J. C., Funk, M. J., & Dasgupta, N. (2019) · Pain Medicine · doi:10.1093/pm/pnz155 · Cited by 6 · see citing works
Trait Mindfulness is Associated with Enhanced Autonomic Regulation of Opioid Cue Reactivity
Sanyer, M. M., Odette, M. M., & Garland, E. L. (2022) · Mindfulness · doi:10.1007/s12671-021-01825-z · Cited by 5 · see citing works
Self-citation
Flagged first, then by citations
6 of the 71 references couldn’t be matched to a known paper.
Research works printed but not linked: 2
- Fairbank, 2000, 25, 2940
- Segal, Z., Williams, J.M., 2002. Mindfulness-based Cognitive Therapy for Depression. The Guilford Press.
Cited by
Sorted by citations
Barrado‐Moreno, V., Esteve, R., McCracken, L. M., & Ramírez‐Maestre, C. (2025) · European Journal of Pain · doi:10.1002/ejp.70048 · Cited by 4 · see citing works
“For example, Parisi et al. (2023) showed that when considering both pain acceptance and present-moment awareness as predictors of opioid misuse, only the latter significantly predicted opioid misuse.”
Södermark, M. (2023) · Linköping University medical dissertations · doi:10.3384/9789180753692 · Cited by 1 · see citing works
Schwartz, C. E., Borowiec, K., Rapkin, B. D., Finkelstein, J. A., Sutherland, T., Caan, O. B., & Skolasky, R. L. (2025) · North American Spine Society Journal (NASSJ) · doi:10.1016/j.xnsj.2025.100605 · Cited by 1 · see citing works
“Cognitive factors associated with opioid misuse include individuals not accepting their chronic pain and unawareness of automatic thoughts and behaviors [ 30 ].”
Jamison, R. N. (2024) · Pain · doi:10.1097/j.pain.0000000000003163
Self-citation
- Authors
- Parisi, A., Zgierska, A. E., Burzinski, C. A., Lennon, R. P., Jamison, R. N., Nakamura, Y., Barrett, B., Edwards, R. R., & Garland, E. L.
- Affiliations
- University of Utah (US)
- Pennsylvania State University (US)
- University of Wisconsin–Madison (US)
- Brigham and Women's Hospital (US)
- Corresponding author
- Garland, Eric L.
- ORCID
- Venue
- Drug and Alcohol Dependence
- Publisher
- Elsevier BV
- Published
- 2023-06
- Volume
- 247
- Pages
- 109890
- ISSN
- 0376-8716 (ISSN-L)
- PMC
- PMC10714486
- OpenAlex
- W4366525583
- Cited by
- 4
- References
- 71
- Citations by year
- 2025: 2 · 2024: 1 · 2023: 1
- FWCI
- 1.02
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.elsevier.com/tdm/userlicense/1.0/ (tdm)
- www.elsevier.com/legal/tdmrep-license (tdm)
- www.elsevier.com/open-access/userlicense/1.0/ (am, 343 d)
- doi.org/10.15223/policy-017 (stm-asf)
- doi.org/10.15223/policy-037 (stm-asf)
- doi.org/10.15223/policy-012 (stm-asf)
- doi.org/10.15223/policy-029 (stm-asf)
- doi.org/10.15223/policy-004 (stm-asf)
- Locations
- Drug and Alcohol Dependence (acceptedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Patient-Centered Outcomes Research Institute (OPD-1601-33860)
- National Center for Complementary and Integrative Health (R01AT011772)
- National Institutes of Health (R01DA056537, R01DA057631)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Keywords
- opioid misuse, chronic low back pain, long-term opioid therapy, pain acceptance, trait mindfulness, opioid use disorder, mindfulness-based interventions, protective factors
- MeSH terms
- Adult, Affect, Analgesics, Opioid, Humans, Opioid-Related Disorders, Low Back Pain, Chronic Pain, Mindfulness
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 under definition version 3 (extract-v3) on 2026-09-28.
Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-09-28.
Cited sources are checked by gpt-6-sol.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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