chronic pain, opiate misuse,


Introduction – Successful treatment of opioid misuse among people with chronic pain has proven elusive. Guidelines recommend nonopioid therapies, but the efficacy of mindfulness-based interventions for opioid misuse is uncertain.


This study posed the question – does a mindfulness-based intervention reduce comorbid chronic pain and opioid misuse in the primary care setting more than supportive psychotherapy?


Design, Setting, and Participants -This interviewer-blinded randomized clinical trial enrolled patients from primary care clinics in Utah between January 4, 2016, and January 16, 2020.

The study included 250 adults with chronic pain receiving long-term opioid therapy who were misusing opioid medications

The participants were allocated into

  1. Mindfulness Orientated Recovery Enhancement (MORE) program – involved training in mindfulness and reappraisal and reflection on positive experiences




  1. Supportive psychotherapy (the control group) – involved a two-hour session each week in a group setting.


Results – Participants in the Mindfulness Orientated Recovery Enhancement (MORE) program were no longer misusing opioids after 9 months of follow-up compared with participants receiving supportive group psychotherapy.

Participants receiving MORE also reported significant improvements in chronic pain symptoms compared with those receiving supportive psychotherapy.


Conclusions  – In this randomized clinical trial, among adult participants in a primary care setting, the MORE intervention led to sustained improvements in opioid misuse and chronic pain symptoms and reductions in opioid dosing, emotional distress, and opioid craving compared with supportive group psychotherapy.


Comment – We believe this study demonstrates the value of mindfulness in helping to manage the complex issues of chronic pain and opiate misuse.

ACTforPAIN is an online chronic pain self – management program supported by a team of pain specialists and psychologists which utilises mindfulness as a core component