450 Participants Needed

Mindfulness Therapy + Methadone for Opioid Use Disorder

(IMPOWR-MORE Trial)

Recruiting at 1 trial location
NC
EG
Overseen ByEric Garland, PhD
Age: 18+
Sex: Any
Trial Phase: Phase 3
Sponsor: Rutgers, The State University of New Jersey
Must be taking: Methadone
Stay on Your Current MedsYou can continue your current medications while participating
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Pivotal Trial (Near Approval)This treatment is in the last trial phase before FDA approval
Prior Safety DataThis treatment has passed at least one previous human trial

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores how mindfulness therapy, combined with methadone treatment, can assist individuals with opioid use disorder. It seeks to determine if adding mindfulness practices can reduce drug use, cravings, and symptoms such as depression and anxiety. Participants will receive either intensive mindfulness sessions (Mindfulness Oriented Recovery Enhancement, MORE), a simpler mindfulness approach (Scripted Mindfulness Practice, SMP), or just methadone treatment. This trial suits English-speaking individuals already on methadone who have experienced ongoing pain for at least three months. As a Phase 3 trial, it represents the final step before FDA approval, offering participants the opportunity to contribute to potentially groundbreaking treatment advancements.

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications, but it does require that you continue methadone treatment.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that Mindfulness-Oriented Recovery Enhancement (MORE) aids individuals with opioid misuse and chronic pain. Two studies found MORE to be both effective and safe, with no major side effects reported, indicating participants generally tolerate it well.

Scripted Mindfulness Practice (SMP) offers a simpler form of mindfulness training. Although specific safety data for SMP is limited, similar mindfulness practices typically pose minimal risks. Mindfulness exercises are generally safe for most people.

Treatments in a Phase 3 trial have already demonstrated sufficient safety for testing in larger groups. Therefore, MORE and SMP are expected to be well-tolerated by participants.12345

Why are researchers excited about this trial's treatments?

Researchers are excited about combining mindfulness therapy with methadone for opioid use disorder because it offers a holistic approach to treatment. Most treatments, like methadone, focus primarily on the physical aspects of addiction. However, Mindfulness-Oriented Recovery Enhancement (MORE) and Scripted Mindfulness Practice (SMP) aim to address the psychological and emotional components by teaching patients to manage cravings and stress through mindfulness. This dual approach has the potential to improve overall treatment outcomes by fostering mental resilience alongside traditional medication.

What evidence suggests that this trial's treatments could be effective for opioid use disorder?

Research shows that Mindfulness-Oriented Recovery Enhancement (MORE), which participants in this trial may receive, can help people with opioid use disorder. Studies have found that MORE reduces opioid cravings and helps manage long-term pain. It also improves mood and overall quality of life. Another treatment arm in this trial involves the scripted mindfulness practice (SMP), a simpler version that includes basic mindfulness exercises. Although less specific research exists on SMP alone, mindfulness practices in general have been shown to help control opioid use. Both approaches aim to assist people in methadone treatment with managing cravings and improving their well-being.23678

Who Is on the Research Team?

EG

Eric Garland, Ph

Principal Investigator

Rutgers Robert Wood Johnson Medical School

Are You a Good Fit for This Trial?

This trial is for English-speaking adults over 18 who are on methadone treatment and have been experiencing pain for at least three months. It's not suitable for those unable to attend sessions, with severe cognitive issues or psychosis, at risk of suicide, or with previous formal mindfulness training.

Inclusion Criteria

I am currently taking methadone.
I have had pain that has lasted for more than 3 months.
English-speaking

Exclusion Criteria

I have completed a formal mindfulness training program.
I can attend and fully participate in all sessions and assessments.
You have significant problems with memory or thinking, or you experience hallucinations or delusions.
See 1 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive either Mindfulness-Oriented Recovery Enhancement, Scripted Mindfulness Practice, or Treatment-as-Usual alongside methadone treatment

8 weeks
8 group sessions

Follow-up

Participants are monitored for safety and effectiveness after treatment, including drug use, craving, and chronic pain

52 weeks

What Are the Treatments Tested in This Trial?

Interventions

  • Mindfulness Oriented Recovery Enhancement (MORE)
  • Scripted Mindfulness Practice (SMP)
Trial Overview The study tests Mindfulness-Oriented Recovery Enhancement (MORE) as an add-on to standard methadone treatment for opioid use disorder. Participants will try either a high-intensity MORE strategy, a minimal intensity scripted practice (SMP), or continue regular treatment without additional interventions.
How Is the Trial Designed?
3Treatment groups
Experimental Treatment
Active Control
Group I: MOREExperimental Treatment1 Intervention
Group II: Scripted Mindfulness Practice (SMP)Active Control1 Intervention
Group III: Treatment-as-UsualActive Control1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

Rutgers, The State University of New Jersey

Lead Sponsor

Trials
471
Recruited
81,700+

National Institute on Drug Abuse (NIDA)

Collaborator

Trials
2,658
Recruited
3,409,000+

University of Utah

Collaborator

Trials
1,169
Recruited
1,623,000+

Published Research Related to This Trial

The 8-week Mindfulness-Oriented Recovery Enhancement (MORE) intervention significantly improved emotional regulation in women undergoing treatment for opioid use disorder, as evidenced by decreased difficulty in managing emotions after the program.
Functional MRI results showed increased connectivity in brain regions associated with affect regulation after the MORE intervention, suggesting that this mindfulness approach may enhance brain function related to emotional control.
Mindfulness-oriented recovery enhancement in opioid use disorder: Extended emotional regulation and neural effects and immediate effects of guided meditation in a pilot sample.Ray, S., Bhanji, J., Kennelly, N., et al.[2023]
The Mindfulness-Oriented Recovery Enhancement Fidelity Measure (MORE-FM) was developed and validated to assess therapist competence and adherence to the MORE treatment manual, showing high internal consistency and adequate reliability across 40 treatment sessions involving 295 participants.
Higher fidelity in delivering the MORE treatment was linked to significant reductions in opioid misuse, suggesting that the MORE-FM is an effective tool for ensuring treatment integrity and predicting positive clinical outcomes.
The Mindfulness-Oriented Recovery Enhancement Fidelity Measure (MORE-FM): Development and Validation of a New Tool to Assess Therapist Adherence and Competence.Hanley, AW., Garland, EL.[2022]
A pilot study involving 15 adults in a 6-week Mindfulness-Based Relapse Prevention (MBRP) course showed that this approach is feasible and acceptable for individuals undergoing Methadone Maintenance Therapy (MMT) for opiate addiction.
Participants experienced significant reductions in depression, craving, and trauma symptoms after the course, suggesting that MBRP may enhance the effectiveness of MMT in treating opiate addiction.
Mindfulness-Based Relapse Prevention for Methadone Maintenance: A Feasibility Trial.Bowen, S., Somohano, VC., Rutkie, RE., et al.[2017]

Citations

Mindfulness-Oriented Recovery Enhancement vs ...In this study, MORE appeared to be an efficacious treatment for opioid misuse among adults with chronic pain.
Protocol for mindfulness-oriented recovery enhancement ...The outcome measures evaluate self-reported pain, physical function, quality of life, depression symptoms, trait mindfulness, and reinterpretation of pain, with ...
Mindfulness-Oriented Recovery Enhancement (MORE) May ...Study results suggest mindfulness-oriented recovery enhancement (MORE) may be a useful nondrug complementary treatment for people with ...
Full article: Virtual reality-based Mindfulness-Oriented ...Mindfulness-Oriented Recovery Enhancement reduces opioid craving among individuals with opioid use disorder and chronic pain in medication ...
Mindfulness‐Oriented Recovery Enhancement: Implementing ...This review discusses the clinical outcomes, biobehavioural mechanisms and implementation considerations for a novel, evidence-based ...
Mindfulness-Oriented Recovery Enhancement vs ...In this study, MORE appeared to be an efficacious treatment for opioid misuse among adults with chronic pain.
Study Details | NCT02602535 | Mindfulness-Oriented ...The central aim of this study is to test the efficacy of Mindfulness-Oriented Recovery Enhancement (MORE), an intervention designed to disrupt the risk chain.
Mindfulness-Oriented Recovery Enhancement Reduces ...MORE may boost self-regulatory strength via mindfulness and thereby facilitate self-control over opioid use, leading to opioid dose reduction in people with ...
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