Mindfulness as medicine: A powerful tool for pain and addiction

Mindfulness training has made its way into school districts, self-help and health books, and workplaces. One day soon, it could also be widely offered as a "medicine" for some physical and mental health conditions.

A particular form of mindfulness emphasizing pleasure is proven to work as well as a starting dose of a narcotic for pain and better than a traditional psychotherapy treatment for substance abuse, according to Eric Garland, PhD, a professor in the College of Social Work at the University of Utah and director of the Center on Mindfulness and Integrative Health Intervention Development.

Mindfulness may be helpful for many conditions beyond chronic pain and addiction.

The techniques that we teach are also very likely effective treatments for depression, anxiety, post-traumatic stress disorder, and simply increasing resilience in people without any diagnosable mental health conditions."

Eric Garland, PhD, Professor, College of Social Work, University of Utah

What is mindfulness?

Mindfulness might seem like a way to relax. But as a form of therapy, mindfulness is a kind of mental training for cultivating awareness, Garland says. Mindfulness means focusing attention on your thoughts, emotions, and body sensations in the moment you're experiencing them. The goal isn't to try to push these away, or to make them stay, but "watching your experience as if you were a witness," he says. "It's a practice of wakefulness, of becoming awake to the way your mind works and becoming aware of how you're operating in life." 

Garland studies Mindfulness-Oriented Recovery Enhancement (MORE), a specific form of mindfulness therapy. MORE therapy sessions include an important additional component: teaching people how to mindfully savor pleasure, meaningful experiences, and joy. 

That might mean, for example, focusing as you hear or see something beautiful or taste something delicious. Then, when you notice those feelings, you turn your attention inward, Garland says, "to savor the positive inner feeling and to absorb it deeply inside yourself, like water seeping into the soil."

Mindfulness as medicine

In a scientific study Garland and his team conducted, they found 15 minutes of mindfulness meditation can reduce pain by about 30%. This is an equivalent amount of pain relief as that provided by five milligrams of oxycodone, a common starting dose for the medication.

Chronic physical pain often also hurts people emotionally. People feel hopeless and worry the pain will never end, preventing them from living their lives fully. Mindfulness helps people with chronic pain separate emotional and physical reactions and think about pain as physical sensations, Garland says. That decreases pain intensity by changing how the brain processes pain, he adds. 

It hasn't yet been proven in research, but savoring healthy pleasure could also decrease pain intensity by making the brain produce endorphins, which reduce pain, Garland says. Brain research has shown that savoring increases activity in the brain's rewards system, Garland adds, which is associated with decreased pain.

Mindfulness to treat addiction takes a similar approach-;with a slightly different focus. It tackles the compulsion of addiction by cultivating both self-awareness and self-control. People become aware of their automatic reactions and habits around using substances and then can better control their choices, Garland says.

Learning to savor positive experiences helps with both conditions, he adds. For those suffering from addiction, Garland has found that as the brain and body become more sensitive to healthy pleasures, craving is reduced. Among people treated with MORE, Garland has also found they're nearly twice as likely as those treated with supportive psychotherapy to have stopped misusing opioids nine months later.

Limitations to mindfulness treatments

Like a drug for pain, though, a "dose" of mindfulness doesn't last forever. Currently, science doesn't have a thorough explanation for why, though Garland thinks this is because the brain returns to its habitual patterns. However, with months or years of practice, the brain becomes set to a more mindful baseline. 

Mindfulness studies back this up, Garland says. His work has found that an eight-week mindfulness treatment reduces addictive behavior and pain, and these reductions last at least nine months later. 

Mindfulness clearly offers many benefits. But is there anyone who shouldn't use it, or for whom the practice might not be safe? Garland says that although mindfulness is safe and beneficial for many people, it's not yet known for whom mindfulness works for and for whom it doesn't. He does caution that all mindfulness training isn't equal, and the quality of the techniques taught depends on the skill of the teacher. 

He also cautions that people who have experienced trauma or post-traumatic stress disorder could experience flashbacks or intrusive memories during mindfulness meditation. These groups should be particularly careful to learn correct mindfulness techniques from a well-trained and licensed psychotherapist, he says.

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