Price Cynthia J, Pike Kenneth C, Treadway Anna, Palmer Julia K, Merrill Joseph O
Department of Biobehavioral Nursing and Health Informatics, University of Washington, Box 357266, Seattle, WA 98195, USA.
Department of Family and Community Health Nursing, University of Washington, Box 357262, Seattle, WA 98195, USA.
Mindfulness (N Y). 2024 Nov;15(11):2794-2811. doi: 10.1007/s12671-024-02463-x. Epub 2024 Nov 19.
The need for improve medication for opioid use disorder (MOUD) treatment outcomes can be limited by co-occurring polysubstance use, mental health, and chronic pain conditions. Interoceptive training may facilitate well-being and support medication treatment for MOUD.
While effective, medication for opioid use disorder (MOUD) treatment outcomes can be limited by co-occurring polysubstance use, mental health, and chronic pain conditions. Interoceptive training may facilitate well-being and support medication treatment for MOUD. This study examined the pre-post effects of the mindfulness-based intervention Mindful Awareness in Body-oriented Therapy (MABT) as an adjunct to MOUD. MABT teaches interoceptive awareness skills to promote self-care and emotion regulation.
Participants stabilized on medication for opioid use disorder (OUD) ( = 303) from six community clinics in North-western United States were recruited and randomly assigned to MABT plus MOUD or MOUD only. In a mixed-methods study, we used an intent-to-treat approach (analyzing participants based on their assigned group, regardless of adherence) to examine the proportion of days abstinent from non-prescribed opioids, and other substance use (primary outcomes) at baseline and 3 months post-intervention. Secondary outcomes included symptoms of mental health distress, emotional regulation difficulties, pain and physical symptom indicators, interoceptive awareness, and mindfulness skills. Participant experience of MABT was collected through post-intervention surveys. Changes in outcomes were assessed using linear mixed models; content analysis was used to analyze the qualitative data.
Levels of overall substance use were low and did not differ between groups. Significant improvements in PTSD symptoms, interoceptive awareness, pain severity, pain activity interference, and physical symptom frequency were found for those who received MABT compared to MOUD only.
In this stable MOUD population, substance use outcomes were not improved; however, MABT demonstrated significant positive changes across multiple health outcomes critical for improving MOUD treatment.
ClinicalTrials.gov identifer: NCT04082637.
阿片类物质使用障碍（MOUD）治疗效果的改善需求可能会受到同时存在的多种物质使用、心理健康和慢性疼痛状况的限制。内感受性训练可能有助于提升幸福感并支持MOUD的药物治疗。
虽然阿片类物质使用障碍（MOUD）的药物治疗有效，但其治疗效果可能会受到同时存在的多种物质使用、心理健康和慢性疼痛状况的限制。内感受性训练可能有助于提升幸福感并支持MOUD的药物治疗。本研究考察了以正念为基础的干预措施——体感正念导向疗法（MABT）作为MOUD辅助治疗的前后效果。MABT教授内感受性觉察技能以促进自我护理和情绪调节。
从美国西北部六个社区诊所招募了303名稳定接受阿片类物质使用障碍（OUD）药物治疗的参与者，并将他们随机分为MABT加MOUD组或仅MOUD组。在一项混合方法研究中，我们采用意向性分析方法（根据参与者的分组进行分析，无论其依从性如何）来考察基线时以及干预后3个月未使用非处方阿片类药物及其他物质使用的天数比例（主要结局）。次要结局包括心理健康困扰症状、情绪调节困难、疼痛及身体症状指标、内感受性觉察和正念技能。通过干预后的调查收集参与者对MABT的体验。使用线性混合模型评估结局的变化；采用内容分析法分析定性数据。
总体物质使用水平较低，且两组之间无差异。与仅接受MOUD治疗的参与者相比，接受MABT治疗的参与者在创伤后应激障碍症状、内感受性觉察、疼痛严重程度、疼痛活动干扰和身体症状频率方面有显著改善。
在这个稳定的MOUD人群中，物质使用结局并未得到改善；然而，MABT在对改善MOUD治疗至关重要的多个健康结局方面显示出显著的积极变化。
ClinicalTrials.gov标识符：NCT04082637。
