Dispositional mindfulness may help reduce the risk for opioid misuse in patients with chronic pain by attenuating opioid craving and directing attention to naturally rewarding stimuli, according to a cross-sectional study in Drug and Alcohol Dependence.

Dispositional mindfulness consists of bringing mindfulness of an individual’s thinking and emotional patterns into daily life. In this study, patients treated with opioids for chronic pain were enrolled (civilian Southwestern US patients, n=115 [sample 1]; civilian Intermountain West patients, n=141 [sample 2]; and military Intermountain West patients, n=44 [sample 3]).

Dispositional mindfulness was assessed with the 39-item Five Facet Mindfulness Questionnaire, which evaluates  observing, describing, acting with awareness, non-judging of inner experience, and non-reactivity to inner experience, and its impact on opioid misuse and opioid craving was assessed with the 17-item Current Opioid Misuse Measure and the 10-item Obsessive-Compulsive Drug Use Scale – Revised, respectively.

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An inverse association between dispositional mindfulness and opioid misuse was found across all 3 study samples (r = −0.36; P <.001). Overall, participants with enhanced attention to positive information indicated reduced opioid craving, and these 2 factors were found to mediate the association between dispositional mindfulness and opioid misuse.

Study limitations include participants from limited geographical regions and the inability to develop causal inferences between dispositional mindfulness and reduced opioid craving and misuse.

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“Given the enormity of the prescription opioid crisis and the resurgence of heroin addiction in the United States, the effort to identify cost-effective interventions that can boost malleable resilience mechanisms like dispositional mindfulness should be treated with heightened urgency by researchers, clinicians, and policymakers alike,” concluded the investigators.

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Priddy SE, Hanley AW, Riquino MR, et al. Dispositional mindfulness and prescription opioid misuse among chronic pain patients: Craving and attention to positive information as mediating mechanisms. Drug Alcohol Depend. 2018;188:86-93.