Objective:

To investigate the effects of mindfulness-based therapy on brain responses and opioid craving in individuals with opioid use disorder (OUD).

Approach:

• Study Design: The study involved 160 adults with chronic pain, 98 of whom met the criteria for OUD. Participants completed an emotion regulation task while undergoing EEG recording to measure brain responses.
• Markers Measured: The researchers measured late positive potential (LPP) and P300 signals to assess brain processing of emotional and rewarding stimuli.
• Intervention: A subsample of 62 participants at risk for opioid misuse was randomly assigned to either Mindfulness-Oriented Recovery Enhancement (MORE) or a supportive group therapy control for 8 weeks.

Key Findings:

• Participants with OUD showed reduced LPP and P300 signals compared to those without OUD when asked to upregulate their emotional responses to positive images.
• Weaker LPP responses were associated with greater opioid craving.
• The MORE group exhibited increased LPP signals, better mood, increased attention to positive information, and reduced anhedonia after 8 weeks.
• Craving scores decreased more significantly in the mindfulness group than in the control group.
• Stronger LPP responses at 3-month follow-up predicted lower craving scores, indicating a potential link between enhanced emotional regulation and reduced craving.

Interpretation:

The study suggests that training in mindfulness and savoring via MORE may enhance positive emotion regulation, which could be linked to reduced craving in individuals with OUD.

Limitations:

• Participants were predominantly female, White, and middle-aged, which may limit generalizability to other populations.
• The study focused on a specific population with chronic pain, which may not represent all individuals with OUD.

Conclusion:

EEG markers like LPP could help identify emotion regulation deficits in OUD.

Sources:

• JAMA Psychiatry