Landmark Study on Mindfulness Treatment for Opioid Use Disorder Published in JAMA
Mindfulness-Based Therapy Reduces Opioid Craving by 67 Percent, Highlights National Trial
CAMBRIDGE, Mass. – The Center for Mindfulness and Compassion at Cambridge Health Alliance, a Harvard Medical School-affiliated community health system serving Cambridge, Somerville, and Boston’s metro-north communities, has published groundbreaking results from its MINDFUL-OBOT clinical trial in JAMA Network Open. This first-of-its-kind national study evaluated the effects of an online mindfulness-based group program for people with opioid use disorder (OUD) during buprenorphine treatment.
Nearly 100,000 overdose deaths occur annually in the U.S., making opioid use disorder one of the country’s most pressing public health crises. Medication for OUD, including buprenorphine, reduces illicit opioid use and overdose risk, yet many patients discontinue treatment within six months, often due to mental health symptoms, substance use, pain, or opioid craving. Group-based opioid treatment (GBOT) is an emerging model that improves retention, but to this point no clinical trials of mindfulness during GBOT had been conducted.
This trial highlights mindfulness as a promising tool for enhancing GBOT models and improving outcomes for individuals struggling with OUD. It enrolled 196 participants across 16 states who were prescribed buprenorphine, a first-line treatment for OUD. Findings revealed that while the mindfulness-based program showed similar levels of opioid use and anxiety reduction compared to standard best-practice groups, it significantly outperformed in reducing self-reported opioid craving (67 percent vs. 44 percent, P<0.001).
"These findings are compelling evidence that trauma-informed mindfulness groups can be offered as an option for people during medication treatment for opioid use disorder," said Dr. Zev Schuman-Olivier, MD, principal investigator of the study, founding director of the Center for Mindfulness and Compassion, director of addiction research at Cambridge Health Alliance, and assistant professor of psychiatry at Harvard Medical School. "Mindfulness should be strongly considered for patients experiencing residual cravings after starting buprenorphine."
As one participant reported, "This program helped me learn new techniques that I didn't even know existed before I began. I still meditate all the time and don't even need to have any sound on. I just lay down and push away all of my stress. It was well worth every minute I spent there.”
The study marks the first national examination of a group-based opioid treatment model using a mindfulness approach. Past research demonstrated that the trauma-informed Mindful Behavior Change program helped people catalyze health behavior change. This study shows that mindfulness and the best practices group both resulted in low levels of opioid use and reduced anxiety, but the mindfulness group program had larger reductions in opioid craving during opioid use disorder treatment than the best practices group.
"Mindfulness Training vs Recovery Support for Opioid Use, Craving, and Anxiety During Buprenorphine Treatment: A Randomized Clinical Trial," Zev Schuman-Olivier, MD, Hannah Goodman, BA, Joseph Rosansky, PhD, Alaine Kiera Fredericksen, MSW, LICSW, Javier Barria, MPH, Gareth Parry, PhD, Randi Sokol, MD, Paula Gardiner, MD, Benjamin Lê Cook, PhD, and Roger D. Weiss, MD. JAMA Network Open, January 21, 2025.
About the Study
MINDFUL-OBOT was a prospective, national, randomized, single-blind clinical trial (NCT04278586) funded by the NIH, NCCIH, and NINDS through the Helping End Addiction Long-Term (HEAL) Initiative and the Behavior Research to Improve Medication-Based Treatment (BRIM) program. The study compared 24 weeks of mindfulness-based therapy using the Mindful Behavior Change program to an evidence-based comparator group with four substance use disorder modules.
About Mindful Behavior Change
The Mindful Behavior Change program was developed by the Center for Mindfulness and Compassion to support individuals in managing health behavior changes through mindfulness practices. The program’s development was funded by the NIH Science of Behavior Change Initiative. A modified 24-week version of the program was used in the MINDFUL-OBOT trial.
About the Center for Mindfulness and Compassion
The Center for Mindfulness and Compassion at Cambridge Health Alliance is dedicated to integrating evidence-based mindfulness and compassion interventions into healthcare, education, and the community. To learn more, visit its website.