A new meta-analysis of dozens of studies finds evidence that mind-body therapies, like meditation, can reduce not only pain, but also opioid use.
“There have been other reviews of studies of mind body therapies for people experiencing various types of pain,” said Eric Garland, lead author of the study in the Journal of the American Medical Association and director of the Center on Mindfulness and Integrative Health Intervention Development at the University of Utah. “By and large, those reviews have showed that my body therapies are effective for reducing pain.”
But Garland and his colleagues were interested in another question, and that is whether mind-body therapies could not only reduce pain but also reduce opioid use and misuse.
“We did not know whether these therapies could help people who were also prescribed opioids,” Garland explained. “Given the opioid crisis in this country, that question seemed really important.”
A search of published research turned up more than 4,000 studies – a number large enough to surprise even the authors. Only sixty of those addressed both pain and opioid use in randomized controlled trials – experiments that compare a therapy against an appropriate control, considered the gold standard of biomedical testing. But those sixty studies involved more than 6,000 participants.
“I think that was one of one of the most appealing findings from the from this study was that there really have been a large body of patients who've been treated with mind body therapies to alleviate pain and opioid use,” Garland said. “The studies, by and large, were fairly well conducted, fairly rigorous.”
And what those studies strongly suggest is that mind-body therapies, particularly mindfulness meditation, can reduce both pain and opioid use.
“Mindfulness meditation, hypnosis and cognitive behavioral therapy seemed to be the most effective,” said Garland, “whereas therapies like relaxation and guided imagery were seem to be less effective.”
In a couple of studies, relaxation therapies were actually associated with increased opioid use. But Garland says the risks of mind-body therapies are very small.
“I think really the conclusion when you look at the literature as a whole is that mind body therapies appear to be, by and large, safe and effective means of reducing pain and opioid dosing,” Garland asserted.
Garland isn’t trying to eliminate opioids. To the contrary, he sees them as a critical tool for treating pain. However, he also sees an urgent need to reduce opioid doses and break the chain leading from prescription opioid use to opioid addiction.
That is where he sees a role for mind-body therapies, and he says these techniques are gaining traction among both patients and medical professionals. The biggest challenge he sees right now is providing access to these therapies.
“I think we need to really work on that as a society” he said. “If we can offer people medication to help them with pain, we ought to be able to help them with meditation to help them with pain, which is a lot safer.”
