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This randomized clinical trial, described by the authors as the first fMRI randomized trial of Mindfulness-Oriented Recovery Enhancement (MORE) in opioid use disorder, enrolled 86 inpatients at a long-term residential treatment facility in New York City, all receiving methadone or buprenorphine. Participants were randomized to 8 weeks of MORE (mindfulness, cognitive reappraisal and savoring training) or an active psychoeducational supportive therapy control. fMRI before and after treatment assessed responses to drug-related images, natural reward images and drug-related movie scenes. Compared with the control, MORE reduced drug-biased activity in the lateral prefrontal cortex during regulation of responses to drug cues, and reduced synchronized medial prefrontal activity while viewing drug-related scenes. Within the MORE group, greater shifts in lateral and ventromedial prefrontal responses away from drug cues and toward natural rewards were associated with larger reductions in cue-induced craving. The authors concluded that MORE may support recovery in opioid use disorder by rebalancing prefrontal responses to drug and natural reward cues.
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This randomized clinical trial, described by the authors as the first fMRI randomized trial of Mindfulness-Oriented Recovery Enhancement (MORE) in opioid use disorder, enrolled 86 inpatients at a long-term residential treatment facility in New York City, all receiving methadone or buprenorphine. Participants were randomized to 8 weeks of MORE (mindfulness, cognitive reappraisal and savoring training) or an active psychoeducational supportive therapy control. fMRI before and after treatment assessed responses to drug-related images, natural reward images and drug-related movie scenes. Compared with the control, MORE reduced drug-biased activity in the lateral prefrontal cortex during regulation of responses to drug cues, and reduced synchronized medial prefrontal activity while viewing drug-related scenes. Within the MORE group, greater shifts in lateral and ventromedial prefrontal responses away from drug cues and toward natural rewards were associated with larger reductions in cue-induced craving. The authors concluded that MORE may support recovery in opioid use disorder by rebalancing prefrontal responses to drug and natural reward cues.
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