Millions of Americans suffer from chronic pain, opioid misuse, and opioid use disorder. New intervention strategies that integrate mindfulness, physical therapy, and medications for opioid use disorder (MOUD) are needed to address the multiple health needs of these vulnerable patients. To accomplish this aim, the University of Utah proposes the Opioid and Pain Effectiveness research Network for Mindfulness and Integrative Health Intervention Development (OPEN-MIIND), a multidisciplinary research center dedicated to addressing the opioid crisis.
As proposed to the NIH/NIDA, OPEN-MIIND will serve as hub for effectiveness-implementation research on novel integrated interventions to target the downward spiral of behavioral escalation linking chronic pain (CP) to opioid misuse (OM) and opioid use disorder (OUD). To that end, we propose three effectiveness-implementation trials of integrated treatment programs combining Mindfulness-Oriented Recovery Enhancement (MORE) with gold-standard clinical interventions for CP+OM/OUD, namely medications for OUD (MOUD) and physical therapy (PT) for persons with CP and opioid misuse (OM). These trials strategically leverage MORE’s demonstrated efficacy for simultaneously reducing opioid use, pain, and psychiatric distress, representing a set of complementary studies along the cascade of care designed to evaluate how patients with CP+OUD/OM can benefit from multicomponent treatment programs implemented in different clinical settings ranging from addiction specialty care to prevention contexts. OPEN-MIIND brings together personnel and resources of four separate scientific centers: the Center on Mindfulness and Integrative Health Intervention Development (C-MIIND), the Program for Addiction Research, Clinical Care, Knowledge, and Advocacy (PARCKA), the Greater Intermountain Node (GIN) of the NIDA Clinical Trials Network, and the Clinical Outcomes Research Lab.
OPEN-MIIND’s central mission is to evaluate the effectiveness of integrating MORE with other evidence-based interventions to improve outcomes in patients with co-occurring CP and OUD or OM. Guided by our OPEN-MIIND Stakeholder and Patient Advisory Groups as well as coordination with the larger IMPOWR and NIH HEAL networks, OPEN-MIIND will pursue overarching aims of enhancing care for persons with CP+OM/OUD in real world clinical settings. OPEN-MIIND’s interdisciplinary research infrastructure, including a) Intervention, b) Economic, Data Science, and Data Management, and c) Qualitative, Implementation, and Dissemination Cores, will support a research cluster of effectiveness-implementation trials for treatment of both CP and OUD/OM conditions. OPEN-MIIND is grounded in the implementation science model of Reach, Effectiveness, Adoption, Implementation Model (RE-AIM). Together with a pilot study program designed to explore innovations in intervention delivery, OPEN-MIIND studies will consider the impact of stigma and disparities, perspectives of people with lived experience, as well as organizational, regulatory, economic, and payer influences on clinicians, patients, and healthcare systems. OPEN-MIIND is poised to advance treatment development to significantly impact the ongoing opioid crisis.
More details to come the summer and fall of 2021.