Mind Over Matter: Beating Pain and Painkillers
February 05, 2014
With nearly one-third of Americans suffering from chronic pain, prescription opioid painkillers have become the leading form of treatment for this debilitating condition. Unfortunately, misuse of prescription opioids can lead to serious side effects-including death by overdose. A new treatment developed by University of Utah researcher Eric Garland has shown to not only lower pain but also decrease prescription opioid misuse among chronic pain patients.
Results of a study by Garland published online Feb. 3 in the Journal of Consulting and Clinical Psychology, showed that the new treatment led to a 63 percent reduction in opioid misuse, compared to a 32 percent reduction among participants of a conventional support group. Additionally, participants in the new treatment group experienced a 22 percent reduction in pain-related impairment, which lasted for three months after the end of treatment.
The new intervention, called Mindfulness-Oriented Recovery Enhancement, or MORE, is designed to train people to respond differently to pain, stress and opioid-related cues.
MORE targets the underlying processes involved in chronic pain and opioid misuse by combining three therapeutic components: mindfulness training, reappraisal and savoring.
Mindfulness involves training the mind to increase awareness, gain control over one's attention and regulate automatic habits.
Reappraisal is the process of reframing the meaning of a stressful or adverse event in such a way as to see it as purposeful or growth promoting.
Savoring is the process of learning to focus attention on positive events to increase one's sensitivity to naturally rewarding experiences, such as enjoying a beautiful nature scene or experiencing a sense of connection with a loved one.
"Mental interventions can address physical problems, like pain, on both psychological and biological levels because the mind and body are interconnected," Garland said. "Anything that happens in the brain happens in the body-so by changing brain functioning, you alter the functioning of the body."
To test the treatment, 115 chronic pain patients were randomly assigned to eight weeks of either MORE or conventional support group therapy, and outcomes were measured through questionnaires at pre- and post-treatment, and again at a three-month follow-up. Nearly three-quarters of the group misused opioid painkillers before starting the program by taking higher doses than prescribed, using opioids to alleviate stress and anxiety or another method of unauthorized self-medication with opioids.
Among the skills taught by MORE were a daily 15-minute mindfulness practice session guided by a CD and three minutes of mindful breathing prior to taking opioid medication. This practice was intended to increase awareness of opioid craving-helping participants clarify whether opioid use was driven by urges versus a legitimate need for pain relief.
"People who are in chronic pain need relief, and opioids are medically appropriate for many individuals," Garland said. "However, a new option is needed because existing treatments may not adequately alleviate pain while avoiding the problems that stem from chronic opioid use."
MORE is currently being tested in a pilot brain imaging trial as a smoking cessation treatment, and there are plans to test the intervention with people suffering from mental health problems who also have alcohol addiction. Further testing on active-duty soldiers with chronic pain and a larger trial among civilians is planned. If studies continue to demonstrate positive outcomes, MORE could be prescribed by doctors as an adjunct to traditional pain management services.
Garland is an associate professor of social work at the University of Utah, research fellow of the National Center for Veterans Studies and associate director of integrative medicine in the Supportive Oncology and Survivorship Program at the U's Huntsman Cancer Institute. He conducted this early-stage trial with Eron Manusov, physician at Duke Southern Regional Area Health Education Center; Brett Froeliger, assistant professor of neuroscience at the Medical University of South Carolina; Amber Kelly, social work doctoral candidate at Smith College; Jaclyn Williams, social work doctoral student at Florida State University; and Matthew Howard, Frank Daniels Distinguished Professor of Social Work at University of North Carolina at Chapel Hill.
The study was published by the American Psychological Association and was funded by the National Institute on Drug Abuse, grant R03DA032517.
University of Utah
Related Chronic Pain Current Events and Chronic Pain News ArticlesScientists discover and test new class of pain relievers
A research team at Duke University has discovered a potential new class of small-molecule drugs that simultaneously block two sought-after targets in the treatment of pain.Cutting-edge findings in cannabis research
New evidence for the clinical efficacy of cannabis therapy is presented in the latest issue of the Journal of Basic and Clinical Physiology and Pharmacology (JBCPP), a De Gruyter publication. The authors have studied cannabis therapy for many years at international research centers, examining its effects, potential applications, and risks. Study finds many patients abusing drugs and alcohol are self-medicating chronic pain
With opioid addiction and prescription drug abuse considered one of the biggest public health threats of our time in the U.S., many are asking why so many Americans are struggling with addiction to illegal drugs and prescription medications.Research findings reveal potential to reverse cancer-related nerve pain
A study providing new information about neuropathic pain afflicting some 90 percent of cancer patients who have had nerve damage caused by tumors, surgery, chemotherapy or radiation indicates gene therapy as a possible treatment.Minimally invasive treatment could freeze out phantom limb pain
A pioneering technique significantly reduces phantom limb pain--chronic pain emanating from the site of amputated limbs--according to findings presented at the Society of Interventional Radiology's 2016 Annual Scientific Meeting. Researcher finds potential new source for pain inhibition
A UT Dallas scientist has found a new neurological mechanism that appears to contribute to a reduction in pain. Nonsurgical fibroid treatment: Research shows improved sexual desire, function
Women who underwent a nonsurgical, image-guided treatment, uterine fibroid embolization (UFE), for the treatment of uterine fibroids experienced improved sexual function and a higher overall quality of life. Electrical stimulation of deep brain structures to ease chronic pain
Abuse of prescription opioid medicines used to treat chronic pain has reached epidemic proportions, so much that the White House has announced new efforts to combat addiction and prevent the thousands of overdose-related deaths reported in the U.S. each year.Food insecurity and hospital visits -- is there a link?
More than half of patients with high hospitalization rates (at least 3 inpatient visits in a 12-month period) used food pantries or other community food resources, and 40% were worried that they would run out of food, according to the results of a study published in Population Health Management, a peer-reviewed journal from Mary Ann Liebert, Inc., publishers.New international research reinforces the link between public policy and life expectancy
While average life expectancy has been rising steadily in most countries over the past century, new research led by the Centre for Addiction and Mental Health (CAMH) shows that life expectancy declined significantly and rapidly in three countries where policy changes increased access to prescription opioids, alcohol or illicit drugs.
More Chronic Pain Current Events and Chronic Pain News Articles
Living Better While Living With Pain: 21 Ways to Reduce the Stress of Chronic Pain and Create Greater Ease and Relief TODAY.|
by Sarah Anne Shockley (Author)
Living With Pain Without Becoming Its Captive
Living in pain can be one of the most challenging things you will ever have to endure in your life. Chronic pain is relentless, unforgiving, and exhausting and is mostly invisible to others.
Living Better While Living With Pain offers practical advice from someone who has learned to live with pain without becoming captive to it. Beginning with a discussion of the ways in which chronic pain is experienced differently from short-term pain, the book offers useful suggestions for approaches to pain management and pain relief appropriate for anyone experiencing pain from surgery, fibromyalgia, thoracic outlet syndrome, arthritis, cancer, back pain, or other chronically painful conditions. Succinct, clear, and easily accessible to readers in...
Best Practices in Chronic Pain Management-Multidimensional Assessment to Multimodal Treatment|
by Integritas Communications Group
This multimedia eBook examines neurobiologic processes that contribute to chronic pain. Expert faculty also address how new mechanistic insights should shape best practices in pain assessment and treatment. The goal is to help clinicians maximize analgesia, functioning, and patient safety.
Chronic Pain Syndromes: Current Concepts and Treatment Strategies|
by CME Resource/NetCE
Chronic pain imposes a distressing sensory and emotional experience on the patient and potentially leads to life-altering negative outcomes. The purpose of this course is to provide clinicians with the information necessary to identify and appropriately manage chronic pain syndromes in accordance with evidence-based guidelines. In addition, members of the public may use this course to enhance their personal knowledge of the subject matter presented.
Upon completion of this course, you should be able to:
1. Describe key points in the pathophysiology and treatment of endometriosis.
2. Evaluate options available for the management of pain associated with sickle cell disease.
3. Identify postherpetic neuralgia and available treatment modalities.
Pain Free: A Revolutionary Method for Stopping Chronic Pain|
by Pete Egoscue (Author), Roger Gittines (Author)
Starting today, you don't have to live in pain.
That is the revolutionary message of this breakthrough system for eliminating chronic pain without drugs, surgery, or expensive physical therapy. Developed by Pete Egoscue, a nationally renowned physiologist and sports injury consultant to some of today's top athletes, the Egoscue Method has an astounding 95 percent success rate. The key is a series of gentle exercises and carefully constructed stretches called E-cises. Inside you'll find detailed photographs and step-by-step instructions for dozens of e-cizes specifically designed to provide quick and lasting relief of:
Lower back pain, hip problems, sciatica, and bad knees Carpal tunnel syndrome and even some forms of arthritis Migraines and other headaches, stiff...
How to Live Well with Chronic Pain and Illness: A Mindful Guide|
by Toni Bernhard (Author)
Comfort, understanding, and advice for those who are suffering--and those who care for them.
Chronic illness creates many challenges, from career crises and relationship issues to struggles with self-blame, personal identity, and isolation. Beloved author Toni Bernhard addresses these challenges and many more, using practical examples to illustrate how mindfulness, equanimity, and compassion can help readers make peace with a life turned upside down.
In her characteristic conversational style, Bernhard shows how to cope and make the most of life despite the challenges of chronic illness. Benefit from:
• Mindfulness exercises to mitigate physical and emotional pain
• Concrete advice for negotiating the everyday hurdles of medical appointments, household...
Staying Sane with Chronic Pain|
Staying Sane with Chronic Pain is a self-help book for people who have chronic pain. It is written by someone who has chronic pain and who has to live with it.
The focus of the book is how to find a way of coming to terms with pain and live with it in such a way that your mental health and your peace of mind is of primary importance.
Themes such as acceptance, responsibility and thought management are explored in an empathic kind way which is sympathetic to the unique difficulties of the person suffering with chronic pain. In fact, the principal aim of the book is to enable the reader to convert suffering with pain to management of pain.
The book's tone is one of kindness and empathy as the author's perspective is one of somebody who has endured many years...
You Are Not Your Pain: Using Mindfulness to Relieve Pain, Reduce Stress, and Restore Well-Being---An Eight-Week Program|
by Vidyamala Burch (Author), Danny Penman (Author)
Developed by two authors, Vidyamala Burch and Danny Penman who themselves have struggled with severe pain after sustaining serious injuries, You Are Not Your Pain reveals a simple eight-week program of mindfulness-based practices that will melt away your suffering. Accompanied by a CD to guide you, the eight meditations in this book take just ten to twenty minutes per day and have been shown to be as effective as prescription painkillers to soothe some of the most common causes of pain. These mindfulness-based practices soothe the brain's pain networks, while also significantly reducing the anxiety, stress, exhaustion, irritability, and depression that often accompanies chronic pain and illness.
Whether you experience back pain, arthritis, or migraines, are suffering from...
Back in Control: A spine surgeon's roadmap out of chronic pain|
by David Hanscom MD (Author)
In Back in Control, Dr. Hanscom focuses on an aspect of chronic pain that the medical world has largely overlooked: you must calm your nervous system in order to get better. Beyond any other book about back pain, Back in Control reveals how to quiet a turbocharged central nervous system and make a full recovery. His life-changing system has helped hundreds of patients heal their pain. These patients’ stories, as well as his own, show that you can take charge of your care and set yourself on the road to a healthy, rich and full life.
Managing Chronic Pain: A Cognitive-Behavioral Therapy Approach Workbook (Treatments That Work)|
by John Otis (Author)
Chronic pain has a multitude of causes, many of which are not well understood or effectively treated by medical therapies. Individuals with chronic pain often report that pain interferes with their ability to engage in occupational, social, or recreational activities. Sufferers' inability to engage in these everyday activities may contribute to increased isolation, negative mood and physical deconditioning, which in turn can contribute to their experience of pain.
Cognitive-behavioral therapy (CBT) has been proven effective at managing various chronic pain conditions, including rheumatoid arthritis, osteoarthritis, chronic back pain, and tension/migraine headache. The CBT treatment engages patients in an active coping process aimed at changing maladaptive thoughts and behaviors...
The Tapping Solution for Pain Relief: A Step-by-Step Guide to Reducing and Eliminating Chronic Pain|
by Nick Ortner (Author)
Over 100 million Americans suffer from chronic pain. Lower back pain alone accounts for more than $50 billion of lost work time and worker’s compensation claims annually. And let’s consider the fact that there are 600,000 knee replacement surgeries performed each year in the United States, and sadly, 20 percent of those patients end up with chronic pain after surgery.
The normal “solutions” we’ve been taught involve seeking out more doctors, surgeries, injections, and medications, all of which have a place in healing. But when it comes to chronic pain, conventional medicine isn’t getting the job done. So what can we do?
In The Tapping Solution for Pain Relief, which builds on the information contained in the New York Times bestseller The...