Persons suffering from chronic pain who are treated with long-term opioid therapy are at risk of misusing prescription opioids and developing opioid addiction. Moreover, long-term use of opioids may result in hyperalgesia, which exacerbates opioid craving and consumption. Mindfulness interventions have been shown reduce chronic pain symptoms, addictive processes, and substance use. The investigators hypothesize that relative to a support group control condition, participation in a novel mindfulness-oriented cognitive intervention, Mindfulness-Oriented Recovery Enhancement (MORE), will result in improved well-being and decreased pain, opioid craving, and opioid misuse behaviors among chronic pain patients receiving opioid therapy.
Few behavioral treatments target the cognitive-affective mediators of opioid misuse and addiction in chronic pain patients. As such, novel, multimodal interventions are needed to effectively target key mechanisms in the risk chain from chronic pain to opioid misuse and addiction. The secondary aim of this study is to explore possible cognitive, affective, and psychophysiological mediators of intervention effects on pain, opioid craving, opioid misuse behaviors, and well-being.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
115
MORE is a multimodal, dual-process group intervention involving mindfulness training, cognitive restructuring, and positive emotion induction. MORE consists of eight, weekly, two-hour group sessions led by a trained therapist.
The control arm will participate in a time-matched, conventional SG led by a Master's level therapist, discussing topics pertinent to chronic pain and opioid misuse. The SG format is adapted from the support group detailed in the evidence-based, Matrix Intensive Outpatient Treatment manual. The SG consists of eight, weekly, two-hour sessions.
FSU College of Social Work
Tallahassee, Florida, United States
Pain severity, pain functional interference
Change in pain severity, functional interference, and relief from pain treatments measured on the Brief Pain Inventory-Short Form.
Time frame: Baseline, immediately following treatment, and at 3 month follow-up
Opioid craving
Change in opioid craving as measured by the Obsessive-Compulsive Drug Use Scale and a single-item measure of instantaneous craving.
Time frame: Baseline, immediately following treatment, and at 3 month follow-up
Opioid misuse behaviors
Change in opioid misuse behaviors as measured by the Current Opioid Misuse Measure
Time frame: Baseline, immediately following treatment, and at 3 month follow-up
Well-being
Change in well-being as measured by the WHO-5
Time frame: Baseline, immediately following treatment, and at 3 month follow-up
Attentional bias
Change in attentional bias as measured by a dot probe task
Time frame: Baseline and immediately following treatment
Psychophysiological cue-reactivity
Change in psychophysiological cue-reactivity
Time frame: Baseline and immediately following treatment
Emotional response inhibition
Change in emotional response inhibition
Time frame: Baseline and immediately following treatment
Pain coping strategies
Change in reinterpretation of pain sensations, catastrophizing, and suppression.
Time frame: Baseline, intervention midpoint, and immediately following treatment
Anhedonia
Change in anhedonia
Time frame: Baseline and immediately following treatment
Fear of pain
Change in fear of pain
Time frame: Baseline and immediately following treatment
Mindfulness
Change in mindfulness measured by the Five-Facet Mindfulness Questionnaire and the Toronto Mindfulness Scale
Time frame: Baseline, intervention midpoint, and immediately following treatment
Positive reappraisal
Change in positive reappraisal
Time frame: Baseline and immediately following treatment
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