Tai Chi Easy for Opioid Use Disorder: Pilot Feasibility Outcomes and Lessons Learned

Abstract

Background: Opioid use disorder (OUD) remains a global crisis, with chronic pain (CP), anxiety, and opioid cravings contributing to treatment discontinuation and return to opioid use. Despite the effectiveness of medications for OUD (MOUD) such as buprenorphine and methadone, they are underutilized, with nearly 50% of individuals discontinuing prematurely or returning to opioid use. Mind-body therapies (e.g., mindfulness, acupuncture, Tai Chi) have shown promise in reducing stress, drug cravings, and pain while improving well-being. However, Tai Chi has not been systematically tested for individuals with OUD and co-occurring CP and anxiety. The authors aimed to evaluate the feasibility of a virtual Tai Chi Easy (vTCE) intervention as an adjunct therapy for adults with OUD and co-occurring CP, and/or anxiety. Methods: A theory-driven, pre-post, single-group quasi-experimental design was used to evaluate intervention feasibility benchmarks and conduct baseline comparisons between inpatient and outpatient participants. The 8-week vTCE intervention consisted of gentle movements, breathing exercises, self-massage, and mindfulness practices, integrating these components into a holistic mind-body approach. Results: Of 32 screened individuals, 19 enrolled and 15 participated. Recruitment goals were partially met after expanding to outpatient settings (65% of the target). Retention was low, with only 3 participants (15.8%) completing the final assessment. Presurvey completion was high (95%), but postsurvey completion was limited (15.7%). Adherence was low, with only 20% attending more than one session. Acceptability and appropriateness averaged 3.5/5, and feasibility reached 4/5. No injuries were reported, supporting intervention safety. Conclusion: The vTCE intervention was not feasible in the inpatient setting. Outpatient settings showed greater feasibility, with notable differences in baseline characteristics, including self-reported opioid cravings. Lessons learned from this pilot study highlight the need to tailor recruitment, retention, and intervention strategies for future research testing vTCE as an adjunct therapy for individuals with OUD and co-occurring symptoms receiving outpatient MOUD. Trial Registration: ClinicalTrials.gov (Identifier: NCT05850533). Registered: 04/25/2023.

Keywords: Tai Chi Easy; anxiety; chronic pain; opioid use disorder.