Peer Reviewed Medical
CDMRP Funds Research to Reduce Opioid Use in Veterans and Service Members with Chronic Pain
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Research Program: Peer Reviewed Medical Research Program
Award Information: FY15 Clinical Trial Award, W81XWH-16-1-0522
Award Outcome: Garland EL, Bryan CJ, Hanley AW, Parisi A, Froeliger B, Marchand WR, Donaldson, GW. Mindfulness-Oriented Recovery Enhancement for Veterans and Military Personnel on Long-Term Opioid Therapy for Chronic Pain: A Randomized Clinical Trial. American Journal of Psychiatry 181, no. 2, 2024.
What is this study? This is a clinical trial testing Mindfulness-Oriented Recovery Enhancement, MORE, in Veterans and active-duty military personnel living with chronic pain and receiving long-term opioid therapy.
Participants included in the study experienced diverse types of chronic pain, including back pain, osteoarthritis pain, cervical pain, neuropathic pain, fibromyalgia, migraine or tension headache and extremity pain.
![Clinical Trial Grouping Image Clinical Trial Grouping Image](/images/page_image/PRMRP Garland Graphic_26Aug24.jpg)
Clinical trial design of MORE versus standard of care supportive psychotherapy in past and present military personnel living with chronic pain and receiving long-term opioid therapy.
How is the study conducted? Participants randomized into two groups received the MORE program or the traditional standard of care of supportive psychotherapy, a type of therapy focused on providing emotional support, encouragement and validation when psychological challenges are present.
What are the results? Compared to supportive therapy, MORE proved to be a more successful intervention for participants with chronic pain. Participants demonstrated significant reductions in pain interference, severity of pain, aberrant drug use behavior and daily opioid use.
Over the course of the eight-month follow-up, both treatment groups showed decreased drug use, emotional distress and post-traumatic stress disorder. However, MORE participants showed better attitudes and an improved ability to experience joy.
MORE provided the largest opioid dose reductions among patients with lower back pain and arthritis.
Why is this research important? Researchers identified an association between long-term opioid use and dysregulation of the reward center in the brain, which may result in opioid misuse. Among Veterans prescribed long-term opioid therapies, 25% to 29% demonstrate abnormal drug use behaviors associated with drug misuse.
By focusing on the cycle of behavior escalation that can become dysregulated after long-term opioid use or stressful conditions, MORE improved chronic pain symptoms and sustained improved opioid misuse among past and present military personnel. This study suggests MORE for safe opioid tapering.
Who is the principal investigator leading this research?
![Eric Garland Image Eric Garland Image](/images/page_image/Garland_Headshot_10_UseThisOne.jpg)
Photo provided
Last updated Sunday, December 31, 1600