# Analgesic and Opioid Sparing Brain Mechanisms of Mindfulness-Oriented Recovery Enhancement for Chronic Low Back Pain

> **NIH NIH R01** · UNIVERSITY OF CALIFORNIA, SAN DIEGO · 2024 · $436,220

## Abstract

ABSTRACT
Chronic low back pain (cLBP) is the most common clinical pain condition worldwide, and the top
chronic non-cancer condition for which opioids are prescribed. The current opioid crisis in the
U.S. emerged in large part from overuse and misuse of opioids by patients with cLBP. Yet, there
are few evidence-based interventions to reduce opioid use and misuse among patients with
cLBP. Faced with a lack of effective treatment options, some cLBP patients become ensnared
in a downward spiral of opioid dose escalation. Mindfulness-based interventions reduce chronic
pain and opioid dosing. However, lack of mechanistic data has limited the deployment of these
cost-effective and non-pharmacological treatment approaches. Multiple clinical trials indicate
that Mindfulness-Oriented Recovery Enhancement (MORE), a novel mind-body therapy that
integrates mindfulness with other affect regulation techniques, alleviates chronic pain symptoms
as well as opioid use among people with cLBP. Yet, the active brain mechanisms of action
underlying MORE’s analgesic and opioid sparing effects remain unknown. Further, no known
placebo-controlled studies have disentangled the specific neural mechanisms of MORE or other
mindfulness-based interventions for cLBP from nonspecific therapeutic factors like beliefs,
expectancy, and social support. As such, the proposed study will employ one of the most
rigorous control conditions in the mindfulness literature to date—a validated sham-mindfulness
meditation technique combined with supportive psychotherapy (Sham-MORE). Integrating
functional neuroimaging and psychophysics (noxious heat and behavioral pain ratings), the
overarching aims of the proposed R01 study are to a) identify the neural mechanisms
supporting the immediate analgesic effects of MORE (versus Sham-MORE and treatment-as-
usual), and b) to determine if changes in default mode network functional connectivity predict
individual differences in cLBP relief and opioid dose reduction following treatment with MORE.
Ultimately, the proposed work will yield insight into the fundamental neuro-functional processes
mediating the therapeutic effects of mindfulness-based interventions for cLBP, thereby
facilitating the optimization of novel biobehavioral treatments for this highly prevalent and
disabling chronic pain condition that helped to fuel the ongoing opioid crisis.

## Key facts

- **NIH application ID:** 11201474
- **Project number:** 7R01AT011772-04
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN DIEGO
- **Principal Investigator:** Eric Lee Garland
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $436,220
- **Award type:** 7
- **Project period:** 2022-09-01 → 2027-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11201474

## Citation

> US National Institutes of Health, RePORTER application 11201474, Analgesic and Opioid Sparing Brain Mechanisms of Mindfulness-Oriented Recovery Enhancement for Chronic Low Back Pain (7R01AT011772-04). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/11201474. Licensed CC0.

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