Mind-body therapies alleviate pain in people prescribed opioids
November 5, 2019
Science Daily/University of Utah
A new study published Nov. 4, 2019, in the journal JAMA Internal Medicine details the first comprehensive look across the scientific literature at the role of mind-body therapies in addressing opioid-treated pain. The researchers found that certain mind-body therapies can reduce pain, as well as reduce opioid use, among patients treated with prescription opioids.
"These findings are critical for medical and behavioral health professionals as they work with patients to determine the best and most effective treatments for pain," said Eric Garland, lead author on the study, associate dean for research at the University of Utah College of Social Work and the director of the University of Utah's Center on Mindfulness and Integrative Health Intervention Development.
Garland explained that mind-body therapies focus on changing behavior and the function of the brain with the goal of improving quality of life and health. Mind-body therapies include clinical use of meditation/mindfulness, hypnosis, relaxation, guided imagery, therapeutic suggestion and cognitive-behavioral therapy.
The researchers examined over 4,200 articles to identify 60 previously published randomized controlled trials on psychologically oriented mind-body therapies for opioid-treated pain. The randomized controlled trials included in the study involved more than 6,400 study participants. The research team looked at the type of pain experienced by the study participants (such as short-term pain from a medical procedure or long-term chronic pain), the type of mind-body therapy used, its effect on the severity of pain and the use (or misuse) of opioids.
They found that meditation/mindfulness, hypnosis, therapeutic suggestion and cognitive-behavioral therapy all demonstrated significant improvements in pain severity. They also found that the majority of the meditation/mindfulness, therapeutic suggestion and cognitive-behavioral therapy studies showed improvements in opioid use or misuse. In contrast, two studies utilizing relaxation found significantly worsened results in opioid dosing.
Notably, mind-body therapies seem to be effective at reducing acute pain from medical procedures, as well as chronic pain. The researchers highlighted this as an important finding, as mind-body therapies could be easily integrated into standard medical practice and could potentially prevent chronic use of opioids and opioid use disorder.
Since mind-body therapies primarily use mental techniques and can continue to be utilized by patients after formal treatment, they may be more easily-accessible than other treatments. The researchers also concluded that two of the mind-body therapies examined, meditation/mindfulness and cognitive-behavioral therapy, might have the highest clinical impact, since they are so widely accessible and affordable.
"A study published earlier this year projected that by 2025, some 82,000 Americans will die each year from opioid overdose," said Garland. "Our research suggests that mind-body therapies might help alleviate this crisis by reducing the amount of opioids patients need to take to cope with pain. If all of us -- doctors, nurses, social workers, policymakers, insurance companies and patients -- use this evidence as we make decisions, we can help stem the tide of the opioid epidemic."
https://www.sciencedaily.com/releases/2019/11/191105140919.htm
Taking stock of research on sleepless soldiers
October 16, 2013
Science Daily/Springer
Various behavioral treatment options are helping to treat the sleeplessness experienced by American soldiers who have been deployed in recent military operations. A review of research has been done on deployment-related insomnia among military personnel and veterans, conducted since 2010.
Insomnia is reported by up to 54 percent of the two million men and women who have served in various American combat efforts since 11 September 2001, compared to up to 22 percent of civilian adults. Although it is possible that a person's insomnia may develop prior to joining the military, it can also occur during the service period, or post-deployment when the soldier returns to civilian life. Studies have found that deployment-related stressors like combat exposure, mild traumatic brain injury, irregular sleep/wake schedules and the adjustment of returning home, all contribute to sleeplessness.
Soldiers who suffer from insomnia while being deployed have a bigger chance of developing traumatic stress reactions such as depression and posttraumatic stress disorders, and even committing suicide. Also, it contributes to physical war-related injuries.
Behavioral interventions such as cognitive-behavioral therapy and imagery rehearsal therapy often yield positive results in trying to reduce the effects of insomnia and nightmares, respectively. These treatments can be delivered during in-person sessions with clinicians, brief follow up sessions via telephone, or online and mobile resources. Training was recently rolled out to prepare providers in the Veterans Health Administration to use cognitive behavioral treatment of insomnia.
The goal is to eventually educate 1,000 clinicians in an effort to bridge the gap between veterans who need treatment, and available providers. Training of clinicians in military settings and other non-VA clinics is equally important to meet the needs of our service members and veterans.
"Training providers to be knowledgeable about insomnia and behavioral treatment options is a vital component to the treatment of chronic insomnia and managing its impact on other disorders," say the authors, who believe more research is needed on methods to increase access to care.
"In addition to research and clinical efforts specifically for service members and veterans, research and clinical efforts directed at military family members are also important components in providing the care needed and promoting health and recovery among service members and their families."
http://www.sciencedaily.com/releases/2013/10/131016123732.htm