, Volume 231, Issue 16, pp 3229–3238 | Cite as

Effects of Mindfulness-Oriented Recovery Enhancement on reward responsiveness and opioid cue-reactivity

  • Eric L. GarlandEmail author
  • Brett Froeliger
  • Matthew O. Howard
Original Investigation



Dysregulated reward processing is a hallmark feature of drug addiction; however, scant research has evaluated restructuring reward processing in the context of addiction treatment.


We examined effects of Mindfulness-Oriented Recovery Enhancement (MORE) on reward responsiveness (RR) and opioid cue-reactivity in a sample of chronic pain patients with opioid use problems. We previously reported that MORE decreased pain, opioid misuse, and craving relative to a social support control group (SG). Here, we examined whether these outcomes were linked to changes in RR in a subset of participants.


Participants were chronic pain patients (71 % women, age 46.6 ± 13.9) who received MORE (n = 20) or SG (n = 29). RR was measured before and after 8 weeks of treatment via heart rate (HR) and heart rate variability (HRV) responses during a dot probe task that included opioid-related, pain-related, and natural reward stimuli, as well as craving ratings.


The MORE group, who reported decreased opioid misuse and opioid craving during treatment, evidenced less subjective opioid cue-reactivity, greater HR decelerations, and greater increases in HRV to all cues after treatment compared to the SG; HR and HRV effects were most pronounced for natural reward cues. Within the MORE group, HR deceleration to natural reward cues was correlated with increased subjective arousal to the cues, whereas HR deceleration to opioid cues was correlated with decreased subjective arousal. Effects of MORE on craving were mediated by enhanced RR.


Results suggest that during treatment with MORE, cardiac-autonomic responsiveness to non-drug reward increases, while reactivity to opioid reward decreases. Studies are needed to discern whether changes in RR were a result or a determinant of reductions in opioid misuse and craving. RR may play a role in addiction treatment.


Mindfulness Chronic pain Opioid misuse Addiction Reward Heart rate variability Attentional bias Positive affect Allostasis Cue-reactivity 



This work was supported by grant numbers DA032517 and DA037005 from the National Institutes of Health awarded to E.L.G. and a grant from the Fahs Beck Fund for Research and Experimentation, also awarded to E.L.G.

Conflict of interest


Supplementary material

213_2014_3504_MOESM1_ESM.doc (26 kb)
ESM 1 (DOC 26 kb)


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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Eric L. Garland
    • 1
    Email author
  • Brett Froeliger
    • 2
  • Matthew O. Howard
    • 3
  1. 1.College of Social Work and Huntsman Cancer InstituteUniversity of UtahSalt Lake CityUSA
  2. 2.Department of Neuroscience, Hollings Cancer CenterMedical University of South CarolinaCharlestonUSA
  3. 3.School of Social WorkUniversity of North Carolina at Chapel HillChapel HillUSA

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