Mindfulness-based therapy reduces opioid cravings and improves emotional health

Mindfulness-based therapy reduces opioid cravings and improves emotional health

Researchers at the University of California San Diego have found that mindfulness-focused recovery (more) can help rewire the brain's response to natural healthy pleasure, leading to improved mood, increased attention to positive experiences, and reduced opioid cravings. The findings, published on April 30, 2025 in theJournal of the American Medical Association(JAMA) suggest that this evidence-based therapy may be a promising tool in the fight against opioid use disorder (OUD).

Opioid addiction can develop when individuals misuse opioids originally prescribed for chronic pain, a condition that affects 50 million Americans each year, according to the Proceedings of the National Academy of Sciences. As people become increasingly dependent on opioids, they lose the ability to feel joy and meaning in everyday life, driving them to seek higher doses to maintain a fleeting sense of well-being - a cycle that can lead to opioid addiction.

More, a program developed by Eric Garland, Ph.D., professor of psychiatry at UC San Diego School of Medicine and professor at the Sanford Institute for Empathy and Compassion, is an evidence-based therapy that integrates mindfulness training, cognitive behavioral therapy and positive psychology techniques to treat addiction, emotional depression and chronic Treat pain that has worsened pain. More teaches mindfulness skills to regulate desire, relieve pain, and restore the ability to enjoy natural healthy pleasure, joy, and meaning in life.

The study included 160 people with chronic pain – both with and without OUD – from primary care and pain clinics. Participants completed a positive emotion (ER) task and questionnaires. A subsample of participants exposed for opioid abuse was randomized to one-to-one, eight weeks more, or supportive group therapy and the ER task at posttreatment and questionnaires followed up through 3 months.

Participants with OUD demonstrated difficulty enhancing positive emotions, as seen in weakened brain responses when they tried to enjoy images that depict naturally rewarding objects and experiences, such as smiling babies, puppies, or a beautiful sunset. This interruption or numbing of positive emotions was directly linked to higher opioid cravings. However, the more therapy helped cure this inability by increasing brain responses to positive stimuli, which was associated with a 50% lower opioid craving than standard group therapy. The results show that more could play an important role in helping people with OUD regain control of their emotions and cravings and potentially reduce opioid abuse.

Opioid addiction reduces the brain's ability to experience natural healthy pleasure and promote drug cravings. Our research shows that more will help restore this capacity, reduce cravings and potentially prevent opioid abuse. “

Eric Garland, Ph.D., lead author of the study, professor of psychiatry at UC San Diego School of Medicine

To date, more has been tested in over 10 randomized clinical trials involving more than 1,000 people. In the largest clinical study with 250 patients - published inJAMA INTERNAL MEDICINEEarly 2022-more reduced opioid abuse by 45% at 9-month follow-up, nearly tripling the impact of standard group therapy. In addition, 50% of patients were treated with more clinically significant decreases in chronic pain. A 2023 study published inJama Psychiatryshowed that providing more standard addiction care resulted in 42% fewer relapses and 59% fewer dropouts from treatment compared to standard addiction care alone.

For the past 20 years, Garland's research and development of more therapy has been supported by grants from the National Institutes of Health (NIH). New research shows that for every $1 spent on more, there is an estimated cost savings of $798 in preventing fatal overdoses, reduced health care costs, reduced criminal justice involvement and increased work productivity. The lifetime economic impact of more is estimated at $320,216 per person treated with more - a huge return to society.

“This study is a critical step, but we need more large-scale, long-term research to fully understand how treatments like More can help heal the brain to improve recovery from opioid addiction,” Garland added. "Several rigorous, well-controlled clinical trials have demonstrated the effectiveness of more therapy. Today is the right moment to work with policymakers, health organizations and opioid justice administrators to expand this evidence-based treatment nationwide to alleviate the opioid crises."

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