Mini Symposium: Mindfulness and Opioid Use Disorder: Primary Outcomes of Five RCTs with Effects on Substance Use, Craving, Pain, Mental Health, and Potential Mechanisms

Abstract

Mindfulness cultivates non-judgmental present moment awareness and is an integrative behavioral approach spreading rapidly within addiction treatment and recovery. Studies demonstrate reduced craving and protective effects during relapse prevention for substance use disorders. Digital mobile apps have mainstreamed brief meditation practices, expanding usage of mindfulness in addiction recovery communities. Until recently, no large clinical trials have investigated the effects of evidence-based mindfulness interventions during opioid use disorder (OUD) treatment. Medication-based treatments (e.g., methadone, buprenorphine, naltrexone) are an effective first-line treatment for people with OUD. In 2018, NIH HEAL launched the BRIM program (Behavioral Research to Improve Medication-Based Treatment) to support research assessing if behavioral interventions can improve medication-based treatment for OUD, by testing the effectiveness of combining medications with evidence-based behavioral interventions (e.g., mindfulness). This symposium will be the first presentation of the primary and secondary outcomes of three recent BRIM-funded RCTs focused on mindfulness and OUD. We will first review recent federally-funded RCTs on mindfulness for reducing opioid misuse during prescription opioid treatment for chronic pain, then we will present the main outcomes of three BRIM RCTs: 1) online group mindfulness during methadone maintenance; 2) individual mindful body awareness during buprenorphine treatment; and 3) national RCT among people prescribed buprenorphine for OUD comparing remotely delivered live-online groups (trauma-informed mindful recovery versus recovery support). The symposium will describe effects on opioid use, craving, common co-morbidities (anxiety, pain, substance use, trauma), and neurophysiological and psychological mechanisms. Study design limitations, methods for optimal trauma-informed delivery, and implications for MOUD will be described.

Learning Objectives

Summarize the evidence-base for mindfulness in treating opioid use disorder, while addressing craving and common OUD co-morbidities (including anxiety, pain, trauma, and substance use)
Recall the definition of mindfulness, the basic format of evidence-based, clinical mindfulness approaches, and key factors for integrating mindfulness into Medication for Opioid Use Disorder (MOUD) treatment.
Identify potential neurophysiologic and psychological mechanisms for mindfulness in OUD treatment and recovery.

Keywords / Topics

Medication for Opioid Use Disorder
Opioid Use Disorder
Pain Management
Group Therapy
Mindfulness
Behavioral Interventions
Buprenorphine
Methadone
Craving
Anxiety

Presenters

Zev Schuman-Olivier, MD, Chairperson

Zev Schuman-Olivier, MD is an Assistant Professor of Psychiatry at Harvard Medical School and a board-certified addiction psychiatrist. He is Director of Addiction Research and the Founding Center Director of the Center for Mindfulness and Compassion (CMC) at Cambridge Health Alliance (CHA). He is a faculty affiliate of the Center for Technology and Behavioral Health, a NIDA-funded center of excellence at Dartmouth. He previously served as Medical Director for Outpatient Addiction Services and as Director of Addiction Psychiatry Residency Education at CHA for 5 years. He has been involved in clinical care of patients with chronic pain, substance use and mental health disorders both in mental health, primary care, and addiction recovery settings, with a research focus on behavioral interventions like mindfulness and compassion-based interventions. He has received funding through more than ten federal research grants, including the following: NCCIH, NIDA, NIMH, NCI, CDC, as well as the NIH Science of Behavior Change Initiative, NIH Helping End Addiction Long-term [HEAL], and NIH Behavioral Research to Improve Medication-Based Treatment [BRIM] program. He is a co-investigator on a NIMH P50 center grant focused on equitable mental health delivery for racial, ethnic, and linguistic minority youth. He is the Director of the Clinical Core for the NCCIH P01 Program Project grant focused on integrating mindfulness and transcutaneous vagal nerve stimulation for chronic pain. He has been a member of the American Academy of Addiction Psychiatry (AAAP) for 14 years and received the AAAP Young Investigator Award in 2010.

Eric Garland, PhD, LCSW, Presenter

Dr. Eric Garland, PhD, LCSW is Distinguished Endowed Chair in Research, Distinguished Professor, and Associate Dean for Research in the University of Utah College of Social Work and Director of the Center on Mindfulness and Integrative Health Intervention Development (C-MIIND). Dr. Garland is the developer of an innovative mindfulness-based therapy founded on insights derived from affective neuroscience, called Mindfulness-Oriented Recovery Enhancement (MORE). He has published more than 220 scientific manuscripts and received more than $70 million in research grants to conduct clinical trials of mindfulness for addiction and chronic pain. In recognition of his expertise, Dr. Garland was appointed by NIH Director Dr. Francis Collins to the NIH HEAL Multi-Disciplinary Working Group to help guide the $1.1 billion HEAL initiative to use science to halt the opioid crisis. In a recent bibliometric analysis of mindfulness research published over the past 55 years, Dr. Garland was found to be the most prolific author of mindfulness research in the world.

Nina Cooperman, PsyD, Presenter

Dr. Cooperman is an Associate Professor in the Division of Addiction Psychiatry at the Rutgers Robert Wood Johnson Medical School, Chair of Treatment and Recovery at the Rutgers Addiction Research Center, and a clinical psychologist specializing in research on substance use disorders. She has been active in developing and evaluating novel behavioral interventions among individuals with substance use disorders for over 20 years. Currently, she is the Principal Investigator of 1) a NIDA R01 clinical trial to investigate Mindfulness Oriented Recovery Enhancement (MORE) for chronic pain and opioid use 2) an NIH HEAL R01 to examine MORE for opioid, tobacco, and other polysubstance use in methadone treatment, 3) a New Jersey Department of Mental Health and Addiction Services (NJ DMHAS) grant to provide naloxone to communities and to deliver naloxone administration trainings to prevent opioid overdose, and 4) a NJ Department of Labor (DOL) grant to evaluate the Pathways to Recovery Program, a program to link people in recovery for a opioid use disorder to employment. Previously, she was the Principal Investigator of a NCCIH/NIDA HEAL R21/R33 to evaluate MORE in methadone maintenance treatment, an Arnold Ventures grant to evaluate emergency department peer recovery support for opioid overdose survivors, and a NIDA Career Development Award (K23) study to develop and evaluate a novel smoking cessation intervention for opiate dependent smokers in methadone treatment.

Cynthia Price, PhD, MA, LMT, Presenter

Dr. Price is a Research Professor at the University of Washington School of Nursing. Her clinical and research expertise is in interoceptive awareness training in mental health and addiction recovery. She is committed to research in community treatment to improve access and dissemination of integrative health among underserved and marginalized populations.

Roger D. Weiss, MD, Presenter

Roger D. Weiss, M.D., is Professor of Psychiatry at Harvard Medical School and Chief of the Division of Alcohol, Drugs, and Addiction at McLean Hospital in Belmont, Massachusetts. He has been Principal Investigator on numerous NIDA or NIAAA grants, and has developed Integrated Group Therapy, an evidence-based treatment for patients with co-occurring bipolar disorder and substance use disorders. Dr. Weiss led a multi-site national study of the treatment of prescription opioid dependence, as part of the NIDA Clinical Trials Network, and is currently a Lead Investigator on the multi-site Retention, Duration, Discontinuation (RDD) study, examining optimal treatments for opioid use disorder.

Dr. Weiss has authored over 400 articles and book chapters as well as 4 books, is a member of numerous journal editorial boards, and has participated in prominent national committees, including serving as Vice Chair of the American Psychiatric Association Task Force on Practice Guidelines for Patients with Substance Use Disorders. He also has served as substance use consultant to the Boston Red Sox. He was named a Member of Honor by the Spanish Society for Dual Disorders in 2011, and has received numerous other awards, including the H. David Archibald Award for Outstanding Research and/or Practice in the Addictions from The Centre for Addiction and Mental Health in Toronto (2007), the Jack H. Mendelson Research Award from McLean Hospital (2012), the Dan Anderson Research Award from the Hazelden Foundation (2012), and the Anne M. Cataldo Excellence in Mentoring Award from McLean Hospital (2014).

Summary


Availability:	On-Demand


Cost:	FREE


Credit Offered:	No Credit Offered

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