Testing Mindfulness-Based Relapse Prevention with Medications for Opioid Use Disorder Among Adults in Outpatient Therapy: a Quasi-experimental Study

Abstract

Objectives This study aimed to explore the effectiveness of mindfulness-based relapse prevention (MBRP) with individuals receiving medication for opioid use disorder (MOUD) in a naturalistic, open-ended outpatient group treatment setting. Methods Eighty participants (mean age 36.3) who had at least 90 consecutive days substance free self-selected into treatment (MBRP, n = 35) or comparison groups (treatment as usual, TAU, n = 45). Outcomes tracked included treatment retention and relapse, and self-reported craving, anxiety, depression, and mindfulness at baseline, 12 weeks, 24 weeks, and 36 weeks post-recruitment. MBRP group participants attended biweekly 60-min sessions for 24 weeks. A linear mixed model analysis of variance determined the significance of the MBRP intervention on changes in craving, anxiety, depression, and mindfulness. Results No significant differences in sex, education level, insurance status, relationship status, or employment status were detected at baseline between groups. The 36-week retention (74%, MBRP/MOUD; 71%, TAU/MOUD) and relapse rates (43%, MBRP/MOUD; 47%, TAU/MOUD) were similar for the groups. There were only four relapses on opioids. Significant reductions ( p < .05) were observed in the MBRP/MOUD group for craving, anxiety, and depression in addition to significant increases in mindfulness compared to those in TAU/MOUD. Conclusions Although state and federal resources are available to expand MOUD, no standard of behavioral therapy has been established as most complimentary to MOUD. The current study results suggest MBRP can be implemented as an outpatient therapy for individuals in MOUD.

Assessing Loneliness among Adults Receiving Outpatient Treatment with Medication for Opioid Use Disorder (MOUD)

“…In addition, Creswell and colleagues reported that mindfulness based programs can help with loneliness and isolation in adults [ 45 ]. However, the current study may be the first to document that loneliness can be diminished in people with OUD with concurrent psychological problems where between 43% to 49% of the sample (depending on group) reported anxiety above the clinical threshold and between 38% to 65% of the sample reported depression above the clinical threshold [ 39 ].…”

“…Quantitatively, MBRP/MOUD participants experienced approximately 2.5 times more improvement in loneliness from baseline to 12 weeks than TAU/MOUD participants and consistently better loneliness levels throughout the intervention. Studies with larger samples may have different conclusions [ 39 ].…”

“…MBRP/MOUD group participants were assigned to attend bi-weekly 60-min group therapy sessions for 24 weeks. For a full description of the intervention, see Zullig et al [ 39 ]. The referent university’s Institutional Review Board approved this study.…”

“…The current study is a secondary analysis of data examining loneliness levels among adults receiving Medication for Opioid Use Disorder (MOUD) in outpatient therapy in a rural Appalachian state as part of an intervention testing the effectiveness of Mindfulness-Based Relapse Prevention (MBRP). Conducted over a period of 36 weeks, the intervention from which these data are derived demonstrated significantly reduced self-reported craving, anxiety, and depression as perceived mindfulness increased among MBRP/MOUD participants when compared to treatment as usual (TAU) cognitive behavioral therapy MOUD participants [ 39 ]. The intervention was not designed with the intent to address loneliness among participants, nor has there been any empirical investigation into an intervention’s potential impact on loneliness.…”

Wiidookaage’Win: A Community-Based Qualitative Approach to Developing a Facebook Group Intervention for Native Women to Support Recovery From Opioid Use

“…41 MBRP is a group-based treatment integrating mindful meditation with traditional cognitive behavioral return to use prevention skills, 40 is effective for a variety of substances, [42][43][44] and is a promising adjunct to MOUD. 45,46 Treatment components include increasing awareness of substance use triggers and cravings and learning new ways (e.g., mindfulness strategies and behavioral skills) to respond to elicited sensations. 40 The SMART program utilizes 4 concepts to decrease stress and enhance resilience: gratitude, mindful presence, kindness, and resilient mindset.…”