Posted 10.28.2020 | by AMRA
The over-prescription of opioids for chronic pain is a significant risk factor for drug abuse and addiction. About one-fifth of chronic pain patients double their opioid dosage over the course of two years, and so primary care psychological interventions are needed to reduce the risk of eventual misuse and dependence.
In a previous clinical trial, a mindfulness training program for opioid users reduced pain and opioid dosage in chronic pain patients. Garland et al. [American Psychologist] conducted a secondary analysis of that clinical trial, now examining whether physiological changes in heart rate variability (HRV) predict opioid dose reduction. HRV is the variation of time between each heartbeat and serves as a biomarker for increased autonomic nervous system self-regulation. Greater HRV is associated with relaxation and greater emotional and behavioral self-control.
The researchers randomly assigned 95 primary care patients who were prescribed opioids for the management of chronic musculoskeletal pain (66% female; 90% Caucasian; average age = 57 years) to Mindfulness-Oriented Recovery Enhancement (MORE) or a support group. Both MORE and support groups were delivered once weekly for 2 hours across 8 weeks.
MORE included didactics and practice in mindfulness, cognitive reappraisal, and savoring naturally occurring rewards that included 15 minutes a day of home practice in these skills. Emphasis was placed on making the skills relevant to substance abuse, pain, stress reduction and self-regulation. The support group included nondirective counseling, social support, home journaling, and discussions of chronic pain, stigma, and stress.
Daily opioid dosage before and after intervention was assessed using retrospective self-report and prescription data from the medical record. After intervention, HRV was measured via electrocardiogram during a 5-minute baseline recording and a […]