Mindfulness-Based Therapy for Opioid Misuse Delivers $12 in Savings for Every $1 Spent, UC San Diego Analysis Finds
核心洞察
Mindfulness-Oriented Recovery Enhancement (搜索) (MORE) generates a 12-to-1 benefit-to-cost ratio, yielding lifetime savings of $324,489 per patient.
MORE reduced opioid misuse by 45% in the underlying randomized clinical trial of 250 adults with chronic pain (搜索) misusing prescribed opioids.
The cost-effectiveness of MORE is two to six times greater than residential or intensive outpatient addiction treatment approaches.
A new economic evaluation from the University of California San Diego School of Medicine has found that Mindfulness-Oriented Recovery Enhancement (搜索) (MORE)—a neuroscience-informed behavioral therapy for opioid misuse and chronic pain (搜索)—delivers $12 in economic benefit for every dollar invested, positioning it as one of the most cost-effective interventions studied for the opioid crisis. The findings, published online in the journal Value in Health, translate to lifetime cost savings of more than $324,000 per patient.
"Opioid misuse is a major driver of overdose deaths, hospitalizations, homelessness and economic loss, so substantially reducing opioid misuse could have huge positive consequences for society," said lead author Eric Garland, PhD, professor of psychiatry at UC San Diego School of Medicine and endowed professor at the Sanford Institute for Empathy and Compassion. "Our study suggests that MORE could be part of a scalable solution that improves outcomes for patients while also reducing burdens on the health care system and society at large."
A Neuroscience-Informed Approach to Addiction and Pain
MORE, developed by Garland, integrates a distinctive sequence of mind-body techniques targeting addiction, emotional distress, and chronic pain (搜索) simultaneously. The intervention teaches three core skill sets: mindfulness skills to regulate craving and pain, cognitive reappraisal skills to manage stress and negative emotions, and savoring techniques designed to help patients reconnect with naturally rewarding experiences.
"Opioid addiction decreases the brain's ability to experience natural healthy pleasure, driving increased cravings for the drug," Garland explained. "Our research shows that MORE helps restore this capacity in the brain, reducing cravings and preventing opioid misuse."
The economic analysis builds on clinical data from a randomized clinical trial of 250 adults with chronic pain (搜索) who were misusing prescribed opioids. That trial demonstrated that MORE reduced opioid misuse by 45%—tripling the effect of standard therapy—while also leading to improvements in pain symptoms and opioid dosing, and strengthening the brain's responses to positive experiences to reduce cravings.
Comparative Cost-Effectiveness
The benefit-to-cost ratio of 12-to-1 for MORE significantly exceeds prior estimates for several other addiction treatment approaches. Comprehensive case management has been estimated at 1.8-to-1, residential treatment between 2.0-to-1 and 4.8-to-1, and intensive outpatient treatment at 5.1-to-1. This places MORE at two to six times more cost-effective than these existing modalities.
"At a relatively low cost, MORE has strong potential to reduce opioid misuse and generate substantial economic benefits for patients, health systems and society," said Fernando Wilson, PhD, co-author on the study, professor of economics and population health sciences at the University of Utah, and director and endowed chair of the Matheson Center for Health Care Studies. "The cost of implementing MORE is small, and its potential payoff in averting misuse and risk of opioid use disorder (搜索) is very large."
The researchers attribute the economic benefits to reductions across several major categories of harm associated with opioid misuse, including healthcare utilization, criminal justice involvement, lost productivity, and overdose mortality. The opioid crisis currently costs the U.S. as much as $4 trillion per year in health care, criminal justice, and lost productivity costs.
A Growing Evidence Base and the Path to Wider Adoption
MORE has now been tested successfully in more than 16 randomized clinical trials involving over 2,500 participants and has been taught to more than 1,200 clinicians in the United States and internationally. Despite this evidence base, the researchers emphasize that broader implementation will require commitment from healthcare organizations, insurers, and policymakers.
"My hope is that MORE can become a central part of the standard of care," said Garland, "not only in addiction treatment settings, but also upstream in primary care, where we have a chance to intervene before opioid misuse progresses to more severe addiction."
The study was funded in part by grants from the National Institutes of Health (R01DA058621, R01DA056537, and R01DA057631). Dr. Garland is Founder of the MORE Science Institute; the authors declare no other competing interests.