An Ultra-Brief Mindfulness-Based Intervention for Patients in Treatment for Opioid Addiction with Buprenorphine: A Primary Care Feasibility Pilot Study

Objectives: To demonstrate the feasibility and acceptability of a brief mindfulness-based intervention taught by physicians for patients with opioid addiction and to determine if the intervention reduces likelihood of relapse or treatment failure within 6 months. Design: A prospective, feasibility, single-group, cohort pilot study. Setting: A Family Medicine teaching clinic serving a mixed urban and rural population in Bangor, Maine. Subjects: Adult patients initiating outpatient treatment for opioid addiction with buprenorphine (N = 40). Interventions: Study physicians conducted a 10- to 12-min education session for all patients starting treatment during the enrollment period, including a 5-min mindfulness exercise. Enrolled subjects received an MP3 player loaded with six mindfulness audio exercises (5-19 min) and were instructed to practice at least 5 min daily and record their practice in a logbook. Outcome measures: Acceptability and subjective usefulness to recovery were evaluated at 2, 4, and 6 months of follow-up, with qualitative analysis of themes in recorded poststudy interviews. Logbook entries and tablet-based surveys provided data on home mindfulness practice, classified as "high" or "low." Relapse or treatment failure was documented. Results: Feasibility and acceptability were demonstrated with 82% enrollment and 100%, 97%, and 90% completion of follow-up visits at 2, 4, and 6 months, respectively, among those still in treatment. Sustained positive impressions of the intervention and exercises remained at 6 months. Relapse or treatment failure was reduced in the "high" practice uptake group compared with "low" practice uptake (11% vs. 42%, p = 0.033). Conclusions: In contrast to more intensive 8-week models of meditation training, this study demonstrates that even a brief single training session can induce sustained home meditation practice that subjectively helped patients in recovery for opioid addiction and was associated with lower risk of relapse. Brief mindfulness-based interventions may be useful to increase access to mindfulness training in this population.