Low dispositional mindfulness predicts self-medication of negative emotion with prescription opioids

“Dispositional mindfulness was assessed with the Mindful Attention Awareness Scale (MAAS; Brown & Ryan, 2003).”

“…studies, dispositional mindfulness (as measured by the MAAS) has been shown to be a correlated but independent construct from neuroticism, thought suppression, alexithymia, emotion dysregulation, and psychological symptoms, with correlations ranging from r = −0.24 to −0.54 (Baer et al., 2006).”

“Moreover, the behavioral routines that subserve drug administration can become automated and deployed habitually in much the same was as other complex behavioral repertoires can be activated without intention by conditioned contextual cues (Bargh & Chartrand, 1999).”

“64 C© 2014 American Society of Addiction Medicine addictive behavior may derive, in part, from the motivation to alleviate dysphoric affective states; this compulsive behavior may be driven by interconnections between the extended amygdala and striatum (Koob & LeMoal, 2001, 2008).”

“This dispositionality may be strengthened through participation in mindfulness-based interventions (Carmody & Baer, 2008), and studies (eg, Bowen et al., 2009; Witkiewitz et al., 2012) have demonstrated the effects of mindfulness training on facets of dispositional mindfulness among persons with…”

“As a naturally occurring trait, dispositional mindfulness is roughly normally distributed among adults without clinical levels of psychopathology (Walach et al., 2006).”

“64 C© 2014 American Society of Addiction Medicine addictive behavior may derive, in part, from the motivation to alleviate dysphoric affective states; this compulsive behavior may be driven by interconnections between the extended amygdala and striatum (Koob & LeMoal, 2001, 2008).”

“Single-item 0 to 10 pain ratings have been widely validated in the literature (eg, Jensen et al., 1999) and are commonly used in pain research because of their clinical relevance and minimal subject burden.”

“Several studies have demonstrated a correlation between prescription drug dependence with depression and anxiety symptoms (McCabe et al., 2005; Conway et al., 2006; Dowling et al., 2006; Huang et al., 2006), and early prevalence estimates indicated that 45% of individuals with prescription opioid use disorders met ful…”

“Several studies have demonstrated a correlation between prescription drug dependence with depression and anxiety symptoms (McCabe et al., 2005; Conway et al., 2006; Dowling et al., 2006; Huang et al., 2006), and early prevalence estimates indicated that 45% of individuals with prescription opioid use disorders met ful…”

“Furthermore, stress and negative affect strengthen habitual responding while impairing executive function (Dias-Ferreira et al., 2009).”

“This dispositionality may be strengthened through participation in mindfulness-based interventions (Carmody & Baer, 2008), and studies (eg, Bowen et al., 2009; Witkiewitz et al., 2012) have demonstrated the effects of mindfulness training on facets of dispositional mindfulness among persons with…”

“…(Lembke, 2012), numerous studies have supported the general proposition of the SMH that individuals use drugs to self-medicate negative affect by, showing that affective disorders predict later substance abuse and dependence (eg, Bolton et al., 2009; Leeies et al., 2010; Robinson et al., 2011).”

“Plausibly, increasing mindfulness may decrease opioid self-medication; in that regard, results from a recent randomized controlled trial indicate that a Mindfulness-Oriented Recovery Enhancement intervention can significantly reduce nonmedical use of prescription opioids (Garland et al., 2014b).”

“Studies suggest that high levels of dispositional mindfulness are associated with enhanced ability to effectively regulate negative affective states (Coffey & Hartman, 2008).”

“…effects of mindfulness training on facets of dispositional mindfulness among persons with substance use disorders (although a small number of investigations have found null effects of mindfulness-based interventions on dispositional mindfulness in addictive populations, eg, Garland et al., 2010).”

“Several studies have demonstrated a correlation between prescription drug dependence with depression and anxiety symptoms (McCabe et al., 2005; Conway et al., 2006; Dowling et al., 2006; Huang et al., 2006), and early prevalence estimates indicated that 45% of individuals with prescription opioid use disorders met ful…”

“Three dichotomous question items adapted from the National Epidemiologic Survey on Alcohol and Related Conditions (Grant & Kaplan, 2005) and validated in prior studies (Leeies et al., 2010; Robinson et al., 2011) tapped self-medication of negative affective states with opioids: “Did you ever use opioids not prescribed…”

“In the largest longitudinal study on this topic to date, analysis of data from more than 34,000 adult participants in Waves 1 and 2 of the National Epidemiologic Survey on Alcohol and Related Conditions revealed that baseline mood disorders and anxiety disorders significantly predicted the incidence of nonmedical opio…”

“The observed inverse relationship between dispositional mindfulness and opioid self-medication accords with prior research, demonstrating a link between mindfulness and addiction-related factors (Garland et al., 2013a, 2013b, 2013c).”

“…is associated with dysregulated function in neural structures involved in self-regulation of attention and emotion (eg, prefrontal cortex; for a review, see Garland et al., 2013a, 2013b, 2013c), brain areas that are known to be associated with dispositional mindfulness (eg, Modinos et al., 2010).”

“…et al., 2006; Huang et al., 2006), and early prevalence estimates indicated that 45% of individuals with prescription opioid use disorders met full Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), diagnostic criteria for depression or anxiety (Sullivan et al., 2005).”

“…samples, the MAAS exhibits adequate psychometric characteristics (Brown & Ryan, 2003), and in prior studies of substance users, the MAAS total score demonstrated good internal consistency (α = 0.91-0.93) and medium-to-large, statistically significant test-retest correlations (Black et al., 2012).”

“Three dichotomous question items adapted from the National Epidemiologic Survey on Alcohol and Related Conditions (Grant & Kaplan, 2005) and validated in prior studies (Leeies et al., 2010; Robinson et al., 2011) tapped self-medication of negative affective states with opioids: “Did you ever use opioids not prescribed…”

“…cost of nonmedical use of prescription opioids in the United States was $53.4 billion in 2006, with $42 billion attributable to lost productivity, $8.2 billion to criminal justice costs, $2.2 billion to substance abuse treatment, and $0.9 billion to medical complications (Hansen et al., 2011).”

“Complementing these findings, qualitative research indicates that self-medication of emotional pain is a leading reason for nonmedical use of and dependence on prescription opioids (Merlo et al., 2013).”

“…associated with emotion regulatory capacity (Baer et al., 2006), and among patients with chronic pain receiving long-term opioid pharmacotherapy, dispositional mindfulness was significantly correlated with reappraisal as a means of coping with stress and negative affect (Hanley & Garland, 2014).”

“…experience more severe substance craving (Garland & Roberts-Lewis, 2013; Garland et al., 2014a), consume larger quantities of substances (Garland et al., 2012a, 2012b), and exhibit greater attentional fixation on substance-related cues (ie, attentional bias, see Garland et al., 2012a,…”

“In contrast, individuals with a low degree of dispositional mindfulness experience more severe substance craving (Garland & Roberts-Lewis, 2013; Garland et al., 2014a), consume larger quantities of substances (Garland et al., 2012a, 2012b), and exhibit greater attentional fixation on…”

“Although this specificity hypothesis of the SMH has been challenged because of the lack of empirical support (Lembke, 2012), numerous studies have supported the general proposition of the SMH that individuals use drugs to self-medicate negative affect by, showing that affective disorders predict later substance abuse…”

“A more recent survey of more than 26,000 respondents indicated that approximately 80% of individuals engaging in nonmedical use of prescription opioids had a history of depression and anxiety (Green et al., 2011).”

“The selfmedication hypothesis (SMH) suggests that negative affective states and related psychiatric disorders can lead to the development of substance use disorders (Khantzian, 1985; Hall & Queener, 2007).”

“The observed inverse relationship between dispositional mindfulness and opioid self-medication accords with prior research, demonstrating a link between mindfulness and addiction-related factors (Garland et al., 2013a, 2013b, 2013c).”

“…experience more severe substance craving (Garland & Roberts-Lewis, 2013; Garland et al., 2014a), consume larger quantities of substances (Garland et al., 2012a, 2012b), and exhibit greater attentional fixation on substance-related cues (ie, attentional bias, see Garland et al., 2012a,…”

“…have demonstrated a correlation between prescription drug dependence with depression and anxiety symptoms (McCabe et al., 2005; Conway et al., 2006; Dowling et al., 2006; Huang et al., 2006), and early prevalence estimates indicated that 45% of individuals with prescription opioid use disorders…”

“Plausibly, increasing mindfulness may decrease opioid self-medication; in that regard, results from a recent randomized controlled trial indicate that a Mindfulness-Oriented Recovery Enhancement intervention can significantly reduce nonmedical use of prescription opioids (Garland et al., 2014b).”

“Moreover, it is estimated that well over a million Americans meet diagnostic criteria for current prescription opioid dependence (Manubay et al., 2011).”

“…N % male Mean Age Sample Type Alcoholism’s alcohol frequency Garland et al. 2012 Journal FFMQ total and 5 subscales Drinks per day 58 81 39.8 C Garland et al. 2015 Journal MAAS Opioid self-medication for anger Opioid self-medication for depression Opioid self-medication for anxiety Opioid…”

“With respect to the focus of this article, trait mindfulness is positively associated with psychological well-being [79] and negatively associated with self-medication of negative emotions with opioids among a sample of chronic pain patients [80].”

“Our finding regarding the mediating role of internalizing symptoms supports the self-medication hypothesis (Colder et al., 2013; Garland et al., 2015; Martins et al., 2012).”

“, 2006) and overall (Garland et al., 2015; Olsen et al., 2006) in the late 90s compare to those with other types of insurance.”

“23 Unfortunately, standard MBSR-based mindfulness training requires extensive time commitment and cost and is not available in most rural primary care settings.”

“Nevertheless, this finding is consistent with prior research indicating a link between deficits in regulating negative emotional states and nonmedical prescription opioid use (Boyd et al., 2014; Garland et al., 2015).”

“For example, Garland et al. (2015) found that approximately 95% of patients in treatment for prescription opioid dependence reported using opioids to regulate negative affective states, suggesting an unwillingness to experience negative affect.”

“Extant literature suggests having chronic pain and having low mindfulness are associated with continued substance use (Garland et al., 2015; Levin et al., 2014; Weiss et al., 2014).”

“…opioid mis-use and both pain tolerance and fearlessness about death (which have been suggested to be consequences of opioid misuse; see (Anestis et al. 2019; Dowell et al. 2022; Garland et al. 2015)) may be due to the complex relationship between opioid use and both fear/anxiety and pain.”

“Dispositional mindfulness was also found to be associated with less self-medication for mitigating negative affect [75].”

“found in their study, most of their cases in comparison to control abused opioid as a way to treat their negative emotions [56].”

“This theory is supported by the results of another study that found that self-medication of negative affective stateswas commonwithopiates.(21) According to the self-medication hypothesis, the underlying defects in positive coping skills and failure in emotion regulation give out to susceptibility to increase in negat…”

“Another study found, in a small sample 79 individuals seeking treatment for prescription opioid disorder, 95% reported misusing opioids to self-medicate negative affective states, such as anxiety, fear, depression, sadness, or anger (Garland et al., 2015).”