This wide applicability may be particularly appealing to patients with chronic pain, as pain conditions often correspond with depression, anxiety and the misuse of pain killers. Opioid misuse and addiction are major problems in the field of pain management today because 1) the drugs are so commonly prescribed, and 2) they are highly addictive. Licensed Clinical Social Worker Eric Garland designed a program called Mindfulness-Oriented Recovery Enhancement (M.O.R.E.) specifically designed to help patients combat both pain and medication misuse issues.
The M.O.R.E. program meshes aspects of mindfulness with cognitive behavioral therapy, a form of psychotherapy that trains patients to identify automatic thought patterns that are negative, inaccurate, counterproductive, etc., and to restructure thought patterns to be more positive, accurate, constructive, etc. The M.O.R.E. program is designed to train patients to:
1. Strengthen attentional control: This is done by noticing when attention is fixated on pain or addictive cues and learning mindfulness breathing, which refocuses attention and increases self-control by interrupting automatic behaviors.
2. Reappraisal of thoughts: Patients are trained to step back from negative assessments of stressful events and restructure them into positive ones.
3. Savoring: Along with abating negative thoughts and feelings, the program promotes the enhancement of positive ones by training patients to truly savor in the positive elements of one’s day and life. This may work on the level of neurocircuitry to reverse negative automatic responses associated with chronic pain and addiction.
Read more about the M.O.R.E. program at drericgarland.com.
Preliminary research into the effectiveness of the program is promising. One-hundred fifteen chronic pain patients who use opioids were divided into a support group and the M.O.R.E. program for eight weeks. Patients were measured both for pain outcomes and opioid misuse outcomes after the treatment period and at a three-month follow-up.
Patients in the M.O.R.E. group outperformed support group patients in the areas of pain severity, pain interference, stress arousal, desire for opioids and opioid misuse criteria after treatment. However, only pain-related outcomes remained significantly more improved at the three-month follow-up.
See more on his study at www.ncbi.nlm.nih.gov.
This research suggests that mindfulness combined with cognitive behavioral therapy could provide long-term gains in pain-related problems for chronic pain patients and short-term gains in opioid misuse issues. Treatment beyond eight weeks may be needed in order for gains to persist in opioid misuse issues, such as booster sessions or longer-term therapy.
Combating opioid misuse and chronic pain with one form of treatment would be ideal for many patients. Talk with your doctor about the potential benefits of psychotherapy and mindfulness for the management of both pain and medication use.