A structured mindfulness-based therapy changed how participants responded to drug-related cues in a new opioid-use-disorder trial. The October 28 report in JAMA Psychiatry studied Mindfulness-Oriented Recovery Enhancement, or MORE, alongside existing medication treatment. Its most useful contribution is a closer look at how a behavioral treatment may work, rather than a claim that meditation replaces established care.
The findings connect a familiar treatment question with a measurable research task: can people learn to respond differently when something in the environment draws their attention toward drug use? That question matters because receiving treatment does not make every reminder, urge or difficult situation disappear.
What the researchers tested
Mount Sinai reports that 86 people at a long-term inpatient facility in New York were enrolled. All were receiving methadone or buprenorphine. Participants were assigned to MORE or a supportive comparison therapy matched for time and group format.
MORE combined mindfulness, reinterpretation of drug-related cues and attention to everyday positive experiences. The program was delivered through eight weekly two-hour group sessions. This was a defined, clinician-delivered intervention, not an experiment in downloading an ordinary relaxation app.
What the main brain analysis found
The published abstract reports 59 participants in the drug-cue imaging analysis, with smaller subsets in the movie task and follow-up. Compared with supportive therapy, MORE changed prefrontal responses during attempts to regulate reactions to drug-related images. Within the MORE group, shifts toward natural rewards were associated with reduced cue-induced craving.
Those findings are more specific than saying the therapy “rewired the brain.” The study measured activity during particular tasks, not every aspect of brain function or a permanent recovery state. The analysis also involved fewer people than the total enrolled.
Why ordinary positive experiences were included
The intervention did not focus only on resisting a drug cue. Mount Sinai describes savoring as paying attention to positive everyday experiences. The research therefore considered the balance between responses to drug cues and responses to other rewarding material.
That is a useful distinction for understanding the treatment’s purpose. It is not simply an instruction to ignore an urge. It combines several learned skills in a structured setting, where a therapist can explain and practice them with participants.
For someone reading about the study, a practical question is what a local service actually offers. A group labeled mindfulness may have a different curriculum, staffing, length or treatment setting. The name alone does not establish that it reproduces the program studied here.
How it fits with established care
CDC guidance identifies medications and combinations of medication with behavioral therapy as evidence-based approaches to opioid-use-disorder treatment. Medication can support recovery by reducing withdrawal and cravings and helping normalize brain chemistry. Ask who delivers the sessions, whether the program has a defined curriculum and how the team reviews progress alongside your existing care. A behavioral addition should be discussed as part of that care, not used as a reason to interrupt it.
NCCIH’s guidance likewise places psychological and physical approaches within comprehensive addiction treatment. It describes emerging evidence for mindfulness-based interventions while recognizing that findings depend on the specific approach and population. That context matters when a new brain-imaging result receives an enthusiastic headline.
Someone interested in this type of support can ask their treatment team whether a structured program is available, how it fits their current plan and what attendance involves. Those are service questions, not a request to manage addiction alone through willpower.
What still needs to be established
The trial also reported a follow-up difference in abstinence duration, but the follow-up analysis was small. Mount Sinai says larger, more diverse studies are needed, including more women and people in other treatment settings. A long-term inpatient program provides a different environment from outpatient care or an unsupported home setting.
Future work needs to establish who benefits most, whether the gains last and how services can deliver the program consistently. The imaging findings may help refine those questions. They do not currently provide a brain scan that tells an individual which therapy will work.
The constructive message is that behavioral support can be studied as a serious component of addiction care, with defined methods and measurable outcomes. This trial adds evidence about one possible mechanism. For patients and families, the next step remains a conversation with an established treatment team about appropriate support alongside effective medical care.