Mindfulness-Oriented Recovery Enhancement Reduces Opioid Attentional Bias Among Prescription Opioid-Treated Chronic Pain Patients

Abstract

Objective: Opioid-misusing chronic pain patients who are treated with opioid analgesics selectively attend to opioid-related cues. This opioid attentional bias (AB) is a maladaptive cognitive process that can lead to automatic, habitual misuse of opioids. The aim of this secondary data analysis was to explore the effects of a novel social work intervention, Mindfulness-Oriented Recovery Enhancement (MORE), on posttreatment opioid AB among a subgroup of chronic pain patients who exhibit attentional reactivity to opioid cues prior to treatment. MORE is a group-therapy program that integrates training in mindfulness, reappraisal, and savoring techniques. Method: Data were obtained from a sample of chronic pain patients (N = 115) who participated in a randomized controlled trial and were randomized to an 8-week MORE intervention or an 8-week support group. A dot-probe task assessed opioid AB for opioid-related cues, and the Current Opioid Misuse Measure assessed changes in opioid-misusing behaviors from pretreatment to 3-month follow-up. Results: Pretreatment opioid AB moderated the effect of treatment on changes in opioid AB. Among participants with a positive 200 millisecond (ms) opioid AB at pretreatment (n = 71), MORE was associated with significantly greater reductions in 200 ms opioid AB than the support group from pretreatment to posttreatment, but no changes in 2,000 ms opioid AB were observed. Decreases in 200 ms opioid AB over the course of treatment predicted reduced opioid misuse by 3-month follow-up. Conclusions: This exploratory study provides preliminary evidence that a mindfulness-oriented intervention may significantly reduce opioid AB.