Scientists at the University of California San Diego have unveiled a groundbreaking therapy called Mindfulness-Oriented Recovery Enhancement (MORE). This approach has demonstrated its ability to rewire the brain's response to natural, healthy pleasure. Consequently, it enhances mood, increases attention to positive experiences, and diminishes opioid cravings. The findings were published in the Journal of the American Medical Association (JAMA) on April 30, 2025. These results suggest that MORE could be an effective tool for addressing opioid use disorder (OUD). Individuals with OUD often experience diminished capacity to feel joy and meaning in everyday life, which drives them to seek higher doses of opioids for fleeting well-being.

Participants with OUD showed difficulty enhancing positive emotions due to weakened brain responses when attempting to savor naturally rewarding objects and experiences. However, MORE significantly boosts these brain responses to positive stimuli, reducing opioid cravings by half compared to standard group therapy. Additionally, previous studies indicate that MORE decreases opioid misuse by 45% and reduces relapse rates by 42%. With every dollar spent on MORE, there are substantial economic benefits, including $798 in cost savings per person treated.

Redefining Brain Responses Through Mindfulness

MORE therapy is designed to restore the brain’s natural ability to experience pleasure and reduce dependency on opioids. By integrating mindfulness training, cognitive behavioral techniques, and positive psychology, this evidence-based treatment addresses addiction, emotional distress, and chronic pain simultaneously. Participants who underwent MORE exhibited stronger brain responses to positive stimuli, leading to reduced opioid cravings and enhanced emotional regulation.

The study involved 160 individuals suffering from chronic pain, some of whom also had OUD. During the trial, participants engaged in a positive emotion regulation task and completed questionnaires. A subset of individuals at risk for opioid misuse were randomly assigned either to MORE or supportive group therapy for eight weeks. Those in the MORE group experienced significant improvements in their ability to savor natural pleasures. This was evidenced by increased brain activity when exposed to images representing naturally rewarding objects and experiences. As a result, their opioid cravings decreased by 50% compared to those receiving standard group therapy. The therapy not only aids in restoring the brain's capacity for joy but also helps individuals regain control over their emotions and cravings, potentially reducing opioid misuse.

Economic and Social Impacts of MORE Therapy

Beyond its clinical effectiveness, MORE therapy delivers substantial economic and societal benefits. Over the past two decades, Eric Garland, Ph.D., and his team have received support from the National Institutes of Health (NIH) to develop and test MORE. Their research indicates that for every dollar invested in MORE, there is an estimated return of $798 in cost savings. These savings stem from preventing fatal overdoses, reducing healthcare costs, minimizing criminal justice involvement, and increasing labor productivity. The lifetime economic impact of MORE is approximately $320,216 per person treated, showcasing its immense value as a societal investment.

In addition to its economic advantages, MORE has been rigorously tested in over 10 randomized clinical trials involving more than 1,000 participants. Notably, a large-scale trial published in JAMA Internal Medicine in 2022 revealed that MORE decreased opioid misuse by 45% at a nine-month follow-up, nearly tripling the effect of standard group therapy. Furthermore, 50% of patients reported clinically significant reductions in chronic pain after undergoing MORE. Another study published in JAMA Psychiatry in 2023 found that incorporating MORE into standard addiction care resulted in 42% less relapse and 59% less dropout from treatment. Garland emphasizes the need for further large-scale and long-term research to fully understand the potential of treatments like MORE. Collaborations with policymakers and healthcare organizations are essential to disseminate this evidence-based treatment nationwide and alleviate the opioid crisis effectively.