Mindfulness Therapy Shows Promise for Improving Opioid Addiction Recovery

As overdose deaths spiral, experts say failures of medication like methadone underscore need for better interventions.

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For opioid addicts seeking a path to recovery, the journey is often filled with hurdles that can derail progress—the lure of euphoric highs, unrelenting cravings, the agony of withdrawal.

But a new therapy is emerging that can help reinforce recovery by reframing the brain’s reward system.

A mindfulness-based program called MORE—mindfulness-oriented recovery enhancement—integrates mindfulness techniques with cognitive behavioral ‘savoring’ exercises. The combination helps patients refocus their neural reward pathways away from the short-term pleasure of drug use toward more natural rewards.

The Details

Mindfulness—the practice of purposeful, non-judgemental attention to the present moment—has evolved from a popular concept into a mainstream approach for coping with stress and sharpening focus.

A new study, published in the JAMA Psychiatry, examined 154 racially diverse opioid users struggling with chronic pain. The participants were receiving treatment for opioid addiction at five New Jersey clinics between August 2020 and June 2022.

The standard 16-week treatment regimen typically involves daily methadone and individual or group counseling. Methadone is a medication that reduces cravings and withdrawal symptoms while blocking the euphoric high of opioid use.

For this study, an additional eight weeks of MORE therapy were added to the treatment program. The program consisted of two-hour group therapy sessions plus weekly at-home assignments. It teaches three main skills: mindfulness to improve self-regulation of drug use and to reduce pain, reappraisal and savoring, and enjoying the moment.

Together, these skills aim to alleviate the physical, emotional, and neurological barriers to overcoming addiction.

The results of adding MORE were promising, the researchers noted. MORE significantly increased treatment retention rates and decreased the likelihood of relapse.

After 16 weeks, 83.6 percent of those receiving standard treatment alone continued taking methadone, while 95.5 percent of those who also received MORE adhered to their medication regimen. Additionally, the MORE participants experienced greater improvements in depression and pain compared to standard care alone.

The findings offer hope that techniques emphasizing cognitive control and positive psychology can provide the missing link that leads to lasting recovery for so many battling opioid addiction.

Methadone No Match for Worsening Opioid Crisis, Experts Warn

The U.S. currently faces an opioid overdose epidemic, according to the Department of Health and Human Services. While first prescribed to treat pain, prolonged opioid use often leads to dependence. Full-blown addiction occurs when that dependence interferes with daily life.

The number of overdose deaths involving opioids has risen dramatically in the U.S. over the past decade. Specifically, there were 21,089 fatal opioid overdoses in 2010. By 2017, that number had more than doubled to 47,600. The number of opioid overdose deaths then remained steady for a couple years through 2019. There were steep increases reported in 2020 (68,630 deaths) and again in 2021 (80,411 deaths).

Methadone has been the standard medication for supporting opioid addiction recovery since the 1970s. However, the research team argued that methadone fails to address the emotional dysregulation, chronic pain, and neural reward processing deficits that drive opioid use disorder. “New interventions are needed to address these factors,” they wrote in JAMA.

A University of Pennsylvania study found that hospital readmission rates for opioid use disorder patients have risen over 50 percent between 2016-2020. The researchers proposed untreated withdrawal symptoms as a factor in early exits from treatment.