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. 2022;13(10):2396-2412.
doi: 10.1007/s12671-022-01964-x. Epub 2022 Sep 15.

Mindfulness-Oriented Recovery Enhancement for Addictive Behavior, Psychiatric Distress, and Chronic Pain: A Multilevel Meta-Analysis of Randomized Controlled Trials

Anna Parisi  1 , R Lynae Roberts  1 , Adam W Hanley  1 , Eric L Garland  1   2
Affiliations

Mindfulness-Oriented Recovery Enhancement for Addictive Behavior, Psychiatric Distress, and Chronic Pain: A Multilevel Meta-Analysis of Randomized Controlled Trials

Anna Parisi et al. Mindfulness (N Y). 2022.

Abstract

Objectives: Mindfulness-Oriented Recovery Enhancement (MORE) is an integrative intervention designed to ameliorate addiction, chronic pain, and psychiatric symptoms. Although multiple randomized controlled trials (RCTs) have examined the clinical efficacy of MORE, no study has quantitatively synthesized this body of research. Thus, we conducted a meta-analysis of RCTs examining the effects of MORE on addictive behaviors, craving, opioid dose, pain, and psychiatric symptoms.

Methods: Relevant manuscripts were identified through comprehensive searches of four bibliographic databases. Two- and three-level random-effects models were used to generate synthesized effect size estimates, and meta-regressions were performed to examine whether study and sample characteristics influenced the magnitude of aggregate effect sizes.

Results: Our search identified 16 manuscripts reporting data from eight RCTs (N = 816). Moderate to small effects in favor of MORE were observed for addictive behaviors (SMC = - .54, p = .007), craving (SMC = - .42, p = .010), opioid dose (MC = - 17.95, p < .001), chronic pain (SMC = - .60, p < .001), and psychiatric symptoms (SMC = - .34, p < .001). MORE's effects on psychiatric symptoms and craving were not moderated by participant race, gender, age, or income.

Conclusions: Study findings provide empirical evidence of MORE's efficacy for a wide diversity of individuals, and as such, MORE should now be disseminated broadly throughout the healthcare system.

Supplementary information: The online version contains supplementary material available at 10.1007/s12671-022-01964-x.

Keywords: Addiction; Chronic pain; Mental health; Mindfulness; Opioids; Substance use disorders.

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Conflict of interest statement

Competing InterestsEric Garland, PhD, LCSW, is the Director of the Center on Mindfulness and Integrative Health Intervention Development. The Center provides Mindfulness-Oriented Recovery Enhancement (MORE), mindfulness-based therapy, and cognitive behavioral therapy in the context of research trials for no cost to research participants; however, Dr. Garland has received honoraria and payment for delivering seminars, lectures, and teaching engagements (related to training clinicians in MORE and mindfulness) sponsored by institutions of higher education, government agencies, academic teaching hospitals, and medical centers. Dr. Garland also receives royalties from the sale of books related to MORE. Dr. Garland is also a consultant and licensor to BehaVR, LLC.

Figures

Fig. 1
Fig. 1
Search and screening process
Fig. 2
Fig. 2
Present review authors’ judgements of the risk of bias items presented as percentages across all included randomized controlled trials
Fig. 3
Fig. 3
Summary of studies examining the effects of mindfulness-oriented recovery enhancement on addictive behaviors
Fig. 4
Fig. 4
Summary of studies examining the effects of mindfulness-oriented recovery enhancement on craving
Fig. 5
Fig. 5
Forest plot of studies examining the effects of Mindfulness-Oriented Recovery Enhancement on opioid dose. Squares indicate point estimates, with the size of the squares indicating weight. Horizontal lines indicate 95% CIs. The diamond indicates the pooled effect estimate
Fig. 6
Fig. 6
Summary of studies examining the effects of mindfulness-oriented recovery enhancement on chronic pain
Fig. 7
Fig. 7
Summary of studies examining the effects of mindfulness-oriented recovery enhancement on psychiatric symptoms
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