Longitudinal effects of interoceptive awareness training as an adjunct to medication treatment for opioid use disorder: A randomized clinical trial of Mindful Awareness in Body-oriented Therapy.

Abstract

Background and objective: Medication for opioid use disorder (MOUD) treatment outcomes can be limited by co-occurring mental and physical conditions, and new adjunctive interventions are needed to improve treatment. Mindful Awareness in Body-oriented Therapy (MABT) teaches interoceptive awareness skills to promote well-being. This study evaluated the longitudinal effects of MABT as an adjunct to MOUD treatment.

Methods: Patients stable on MOUD recruited from six community clinics were randomly assigned to MABT+MOUD or MOUD. Five assessments delivered over one year (N = 303) examined abstinence from non-prescribed opioid and overall substance use (primary outcomes), and secondary outcomes of mental and physical health distress, interoceptive and mindfulness skills, and opioid craving. An intent-to-treat approach to examine change across time involved generalized estimating equations and linear mixed multilevel models.

Results: This sample demonstrated high percent days abstinence from non-prescribed opioids and other substances, resulting in no statistical between-group differences over time. Significant overall longitudinal effects for MABT+MOUD vs. MOUD were evident on secondary outcomes of physical symptom frequency, and interoceptive awareness. In addition, significant baseline to 12 month between-group improvements were evident on PTSD symptoms, emotion regulation difficulties, and mindfulness skills.

Conclusions: While stable on MOUD, this sample had high levels of chronic pain and mental health distress. The results highlight improved longitudinal health outcomes in response to MABT critical to support recovery on MOUD. The MABT completion rate and maintained use of MABT skills over 12 months demonstrates MABT implementation feasibility and positive intervention response as an adjunct to MOUD treatment. PREREGISTRATION CLINICALTRIALS.GOV: NCT04082637.