A new study published Nov. 4, 2019, in the journal JAMA Internal Medicine details the first comprehensive look across the scientific literature at the role of mind-body therapies in addressing opioid-treated pain. The researchers found that certain mind-body therapies can reduce pain, as well as reduce opioid use, among patients treated with prescription opioids.
These findings are critical for medical and behavioral health professionals as they work with patients to determine the best and most effective treatments for pain."
Eric Garland, lead author on the study, associate dean for research at the University of Utah College of Social Work and the director of the University of Utah's Center on Mindfulness and Integrative Health Intervention Development
Garland explained that mind-body therapies focus on changing behavior and the function of the brain with the goal of improving quality of life and health. Mind-body therapies include clinical use of meditation/mindfulness, hypnosis, relaxation, guided imagery, therapeutic suggestion and cognitive-behavioral therapy.
The researchers examined over 4,200 articles to identify 60 previously published randomized controlled trials on psychologically oriented mind-body therapies for opioid-treated pain. The randomized controlled trials included in the study involved more than 6,400 study participants. The research team looked at the type of pain experienced by the study participants (such as short-term pain from a medical procedure or long-term chronic pain), the type of mind-body therapy used, its effect on the severity of pain and the use (or misuse) of opioids.
They found that meditation/mindfulness, hypnosis, therapeutic suggestion and cognitive-behavioral therapy all demonstrated significant improvements in pain severity. They also found that the majority of the meditation/mindfulness, therapeutic suggestion and cognitive-behavioral therapy studies showed improvements in opioid use or misuse. In contrast, two studies utilizing relaxation found significantly worsened results in opioid dosing.
Notably, mind-body therapies seem to be effective at reducing acute pain from medical procedures, as well as chronic pain. The researchers highlighted this as an important finding, as mind-body therapies could be easily integrated into standard medical practice and could potentially prevent chronic use of opioids and opioid use disorder.
Since mind-body therapies primarily use mental techniques and can continue to be utilized by patients after formal treatment, they may be more easily-accessible than other treatments. The researchers also concluded that two of the mind-body therapies examined, meditation/mindfulness and cognitive-behavioral therapy, might have the highest clinical impact, since they are so widely accessible and affordable.
"A study published earlier this year projected that by 2025, some 82,000 Americans will die each year from opioid overdose," said Garland. "Our research suggests that mind-body therapies might help alleviate this crisis by reducing the amount of opioids patients need to take to cope with pain. If all of us--doctors, nurses, social workers, policymakers, insurance companies and patients--use this evidence as we make decisions, we can help stem the tide of the opioid epidemic."
Garland, E.L., et al. (2019) Mind-Body Therapies for Opioid-Treated Pain. JAMA Internal Medicine. doi.org/10.1001/jamainternmed.2019.4917.