# The role of endogenous opioids in mindfulness-based chronic pain relief

> **NIH NIH R21** · UNIVERSITY OF CALIFORNIA, SAN DIEGO · 2020 · $157,500

## Abstract

Project Summary/Abstract
The subjective experience of pain is constructed and modulated by a constellation of interactions between
sensory, cognitive and affective factors. These dimensions render the efficacious treatment of chronic pain to
be challenging and has led to the exponential growth in opioid misuse and the so-called “opioid epidemic”.
Chronic pain is pervasive and a major financial burden affecting over 100 million Americans and costs the
United States approximately $635 billion dollars a year. These staggering statistics highlight the importance of
developing, testing and validating fast-acting, non-pharmacological approaches to treat pain. Mindfulness
meditation is a technique that significantly reduces pain in experimental and clinical settings. However, lack of
mechanistic data and the assumption that extensive meditation training is required to experience analgesia has
limited the clinical deployment of this cost-effective and narcotic-free treatment. Recent findings from our
laboratory determined that mindfulness meditation, after only four, 20-minute training sessions, dramatically
reduces pain. Yet, mindfulness meditation likely engages a number of non-specific factors (conditioning;
demand characteristics) associated with placebo responses. To this extent, it is critical that we disentangle and
identify the specific pain-relieving mechanisms supporting mindfulness. We have developed and validated a
novel comparison condition characterized as sham-mindfulness meditation that operationally resembles
mindfulness meditation. Our prior work revealed that mindfulness meditation is more effective than and
engages distinct neural mechanisms from sham-mindfulness meditation to reduce pain. We also recently
discovered that mindfulness-based pain reductions were not mediated by the release of endogenous opioids.
These findings show that mindfulness meditation reduces pain through multiple, unique processes that are
independent from the analgesic mechanisms supporting placebo. However, said results cannot be explicitly
generalized to chronic pain patients because they were conducted in healthy, pain-free participants using
noxious heat to induce pain. This point is critical because chronic pain patients exhibit a significant deficiency
in endogenous opioidergic functioning, potentially reflecting the inability to regulate pain. Importantly, the role
of endogenous opioids in the modulation of chronic pain by mindfulness meditation remains unknown. The
central aim of the proposed double blind, crossover randomized study is to determine if mindfulness meditation
attenuates acutely evoked chronic low back pain, the most prevalent and financially burdensome pain
condition, through endogenous opioids. We will test study hypotheses by assessing pain ratings in response to
a chronic low back pain-evoking maneuver during mindfulness meditation and infusion of the opioid antagonist,
naloxone and saline. If mindfulness-based chronic pain relief is ...

## Key facts

- **NIH application ID:** 9993280
- **Project number:** 5R21AT010352-02
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN DIEGO
- **Principal Investigator:** Fadel Zeidan
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $157,500
- **Award type:** 5
- **Project period:** 2019-08-09 → 2022-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9993280

## Citation

> US National Institutes of Health, RePORTER application 9993280, The role of endogenous opioids in mindfulness-based chronic pain relief (5R21AT010352-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9993280. Licensed CC0.

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