Substance use therapists across the United States will be interested to learn of recent research pointing to the usefulness of mindfulness training in reducing the deficits in natural reward processing that may arise for those with more chronic pain and drug addiction issues.
This should be reassuring news for those drug-dependent people who do not show as much behavioral and brain reactivity to natural rewards as non-drug users. This typically leads drug-dependent individuals to spend less time attending to natural rewards, and more time attempting to obtain the drug.
However, new research suggests that opioid-dependent users’ natural reward processing could be restored with the help of a cognitive-based intervention. The study involved the randomization of chronic pain patients at risk for opioid misuse to eight weeks of either a support group (control) or a Mindfulness-Oriented Recovery Enhancement (MORE) intervention.
The MORE intervention’s participants used mindfulness meditation to focus on all of a pleasant experience or object’s (such as a sunset or other beautiful natural scene) sensory features, while reflecting on any positive emotions that they experienced as a result of this event. Meanwhile, in the support group, topics and emotions related to chronic pain and opioid use/misuse were discussed.
These interventions were followed by images representing natural rewards (such as endearing animals, appealing foods and landscapes) and neutral images – like household items, furniture or neutral facial expressions – being shown to all of the participants. Late positive potential (LPP) brain activity was also measured by the researchers as the images were viewed, to indicate the attention paid by the participants to emotionally salient information.
When compared to the control group, those participating in the MORE intervention displayed greater LPP responses to the natural reward images than to the neutral images. Furthermore, participants reporting higher LPP responses tended to report decreased opioid cravings.
Such findings indicated that misusers of opioids could be assisted in the control of their cravings by being taught to mindfully attend to positive aspects of their life, given how this may heighten the perceived value of natural rewards. Such processes can be diminished in those with chronic pain or addiction issues, as is well-recognized by substance use therapists.
