Concurrent Session 5 – Mindfulness-Oriented Recovery Enhancement Targets Neurocognitive Mechanisms of Opioid Misuse and Chronic Pain

Prescription opioid misuse among persons with chronic pain is an emerging public health threat of epidemic proportions. We conducted a randomized controlled trial of Mindfulness-Oriented Recovery Enhancement, a multimodal intervention designed to simultaneously target mechanisms underpinning chronic pain and opioid misuse. In this study, a sample of 115 chronic pain patients who were taking long-term opioids were randomly assigned to eight weeks of Mindfulness-Oriented Recovery Enhancement or a support group. Relative to the support group, Mindfulness-Oriented Recovery Enhancement led to significantly greater reductions in pain severity, functional impairment, opioid craving, and opioid misuse. These clinical outcomes were mediated by effects of Mindfulness-Oriented Recovery Enhancement on a number of neurocognitive mechanisms, including decreased pain attentional bias, reduced opioid cue-reactivity, enhanced natural reward processing, and improved autonomic nervous system regulation during attention to emotional information. Study findings indicate this novel intervention is a promising treatment for co-occurring opioid misuse and chronic pain.