Stanford Pain Relief Innovations Lab Guest Speaker Series: Mindfulness-Oriented Recovery Enhancement (RECORDING)

Wednesday, July 19, 2023, 12:00 AM - Saturday, July 18, 2026, 11:59 PM, On Demand

The Stanford Pain Relief Innovations lab, hosted by Dr. Beth Darnall, PhD, presents a virtual guest speaker series, inviting visiting professors in Pain Medicine, Pain Management and Pain Science. This topic is Mindfulness-Oriented Recovery Enhancement: Clinical Outcomes and Biobehavioral Mechanisms of an Integrative Treatment for Chronic Pain, Opioid Misuse, and OUD, presented by Eric Garland, PhD, LCSW. Dr. Garland is the developer of an innovative mindfulness-based therapy founded on insights derived from cognitive neuroscience, called Mindfulness-Oriented Recovery Enhancement (MORE).

  Release Date: July 19, 2023
  Expiration Date: July 18, 2026
  Estimated Time to Complete: 1.0 hour
  Registration Fee: FREE
 *Originally recorded 06/02/2022

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AMA PRA Category 1 Credits™ (1.00 hours), AAPA Category 1 CME credits (1.00 hours), ACPE Contact Hours (1.00 hours), ANCC Contact Hours (1.00 hours), APA Continuing Education credits (1.00 hours), ASWB Continuing Education (ACE) credits (1.00 hours), Non-Physician Participation Credit (1.00 hours)

1. Discuss the conceptual framework underlying Mindfulness-Oriented Recovery Enhancement.
2. Evaluate the efficacy of Mindfulness-Oriented Recovery Enhancement.
3. Describe the mechanisms of Mindfulness-Oriented Recovery Enhancement.

In support of improving patient care, Stanford Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. 

Credit Designation 
American Medical Association (AMA) 
Stanford Medicine designates this Enduring Material for a maximum of 1.00 AMA PRA Category 1 Credits^TM.  Physicians should claim only the credit commensurate with the extent of their participation in the activity. 

Accreditation Council of Pharmacy Education (ACPE) 
Stanford Medicine designates this knowledge-based activity for a maximum of 1.0 hours. Credit will be provided to NABP CPE Monitor within 60 days after the activity completion. 

UAN#: JA0000751-0000-23-012-H08-P

American Nurses Credentialing Center (ANCC) 
Stanford Medicine designates this Enduring Material for a maximum of 1.0 ANCC contact hours.  

ASWB Approved Continuing Education Credit (ACE) – Social Work Credit 
As a Jointly Accredited Organization, Stanford Medicine is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Organizations, not individual courses, are approved under this program. Regulatory boards are the final authority on courses accepted for continuing education credit. Social workers completing this activity receive 1.0 continuing education credits. 

American Academy of Physician Assistants (AAPA) - Enduring Material
Stanford Medicine has been authorized by the American Academy of PAs (AAPA) to award AAPA Category 1 CME credit for activities planned in accordance with AAPA CME Criteria. This Enduring Material is designated for 1.0 AAPA Category 1 CME credits. Approval is valid until July 18, 2026. PAs should only claim credit commensurate with the extent of their participation.  

American Psychological Association (APA) 
Continuing Education (CE) credits for psychologists are provided through the co-sponsorship of the American Psychological Association (APA) Office of Continuing Education in Psychology (CEP). The APA CEP Office maintains responsibly for the content of the programs.

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Cultural and Linguistic Competency
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References

Baminiwatta, A., & Solangaarachchi, I. (2021). Trends and Developments in Mindfulness Research over 55 Years: A Bibliometric Analysis of Publications Indexed in Web of Science. Mindfulness, 12(9), 2099–2116. https://doi.org/10.1007/s12671-021-01681-x

Case, A., & Deaton, A. (2015). Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century. Proceedings of the National Academy of Sciences of the United States of America, 112(49), 15078–15083. https://doi.org/10.1073/pnas.1518393112

Case, A., Deaton, A., & Stone, A. A. (2020). Decoding the mystery of American pain reveals a warning for the future. Proceedings of the National Academy of Sciences of the United States of America, 117(40), 24785–24789. https://doi.org/10.1073/pnas.2012350117

Cooperman, N. A., Hanley, A. W., Kline, A., & Garland, E. L. (2021). A pilot randomized clinical trial of mindfulness-oriented recovery enhancement as an adjunct to methadone treatment for people with opioid use disorder and chronic pain: Impact on illicit drug use, health, and well-being. Journal of substance abuse treatment, 127, 108468. https://doi.org/10.1016/j.jsat.2021.108468

Froeliger, B., Mathew, A. R., McConnell, P. A., Eichberg, C., Saladin, M. E., Carpenter, M. J., & Garland, E. L. (2017). Restructuring Reward Mechanisms in Nicotine Addiction: A Pilot fMRI Study of Mindfulness-Oriented Recovery Enhancement for Cigarette Smokers. Evidence-based complementary and alternative medicine : eCAM, 2017, 7018014. https://doi.org/10.1155/2017/7018014

Garland E. L. (2020). Psychosocial intervention and the reward system in pain and opioid misuse: new opportunities and directions. Pain, 161(12), 2659–2666. https://doi.org/10.1097/j.pain.0000000000001988

Garland E. L. (2016). Restructuring reward processing with Mindfulness-Oriented Recovery Enhancement: novel therapeutic mechanisms to remediate hedonic dysregulation in addiction, stress, and pain. Annals of the New York Academy of Sciences, 1373(1), 25–37. https://doi.org/10.1111/nyas.13034

Garland, E. L., Atchley, R. M., Hanley, A. W., Zubieta, J. K., & Froeliger, B. (2019). Mindfulness-Oriented Recovery Enhancement remediates hedonic dysregulation in opioid users: Neural and affective evidence of target engagement. Science advances, 5(10), eaax1569. https://doi.org/10.1126/sciadv.aax1569

Garland, E. L., Baker, A. K., & Howard, M. O. (2017). Mindfulness-Oriented Recovery Enhancement Reduces Opioid Attentional Bias Among Prescription Opioid-Treated Chronic Pain Patients. Journal of the Society for Social Work and Research, 8(4). https://doi.org/10.1086/694324 

Garland, E. L., Baker, A. K., Larsen, P., Riquino, M. R., Priddy, S. E., Thomas, E., Hanley, A. W., Galbraith, P., Wanner, N., & Nakamura, Y. (2017). Randomized Controlled Trial of Brief Mindfulness Training and Hypnotic Suggestion for Acute Pain Relief in the Hospital Setting. Journal of general internal medicine, 32(10), 1106–1113. https://doi.org/10.1007/s11606-017-4116-9

Garland, E. L., Bryan, C. J., Finan, P. H., Thomas, E. A., Priddy, S. E., Riquino, M. R., & Howard, M. O. (2017). Pain, hedonic regulation, and opioid misuse: Modulation of momentary experience by Mindfulness-Oriented Recovery Enhancement in opioid-treated chronic pain patients. Drug and alcohol dependence, 173 Suppl 1, S65–S72. https://doi.org/10.1016/j.drugalcdep.2016.07.033

Garland, E. L., Bryan, C. J., Nakamura, Y., Froeliger, B., & Howard, M. O. (2017). Deficits in autonomic indices of emotion regulation and reward processing associated with prescription opioid use and misuse. Psychopharmacology, 234(4), 621–629. https://doi.org/10.1007/s00213-016-4494-4

Garland, E. L., Farb, N. A., Goldin, P. R., & Fredrickson, B. L. (2015). The mindfulness-to-meaning theory: Extensions, applications, and challenges at the attention-appraisal-emotion interface. Psychological Inquiry, 26(4), 377-387. https://doi.org/10.1080/1047840X.2015.1092493

Garland, E. L., Fix, S. T., Hudak, J. P., Bernat, E. M., Nakamura, Y., Hanley, A. W., Donaldson, G. W., Marchand, W. R., & Froeliger, B. (2023). Mindfulness-Oriented Recovery Enhancement remediates anhedonia in chronic opioid use by enhancing neurophysiological responses during savoring of natural rewards. Psychological medicine, 53(5), 2085–2094. https://doi.org/10.1017/S0033291721003834

Garland, E. L., Fredrickson, B., Kring, A. M., Johnson, D. P., Meyer, P. S., & Penn, D. L. (2010). Upward spirals of positive emotions counter downward spirals of negativity: insights from the broaden-and-build theory and affective neuroscience on the treatment of emotion dysfunctions and deficits in psychopathology. Clinical psychology review, 30(7), 849–864. https://doi.org/10.1016/j.cpr.2010.03.002

Garland, E. L., Froeliger, B., & Howard, M. O. (2014). Effects of Mindfulness-Oriented Recovery Enhancement on reward responsiveness and opioid cue-reactivity. Psychopharmacology, 231(16), 3229–3238. https://doi.org/10.1007/s00213-014-3504-7

Garland, E. L., Froeliger, B., & Howard, M. O. (2014). Mindfulness training targets neurocognitive mechanisms of addiction at the attention-appraisal-emotion interface. Frontiers in psychiatry, 4, 173. https://doi.org/10.3389/fpsyt.2013.00173

Garland, E. L., Froeliger, B., & Howard, M. O. (2015). Neurophysiological evidence for remediation of reward processing deficits in chronic pain and opioid misuse following treatment with Mindfulness-Oriented Recovery Enhancement: exploratory ERP findings from a pilot RCT. Journal of behavioral medicine, 38(2), 327–336. https://doi.org/10.1007/s10865-014-9607-0

Garland, E. L., Froeliger, B. E., Passik, S. D., & Howard, M. O. (2013). Attentional bias for prescription opioid cues among opioid dependent chronic pain patients. Journal of behavioral medicine, 36(6), 611–620. https://doi.org/10.1007/s10865-012-9455-8

Garland, E. L., Froeliger, B., Zeidan, F., Partin, K., & Howard, M. O. (2013). The downward spiral of chronic pain, prescription opioid misuse, and addiction: cognitive, affective, and neuropsychopharmacologic pathways. Neuroscience and biobehavioral reviews, 37(10 Pt 2), 2597–2607. https://doi.org/10.1016/j.neubiorev.2013.08.006

Garland, E. L., Hanley, A. W., Kline, A., & Cooperman, N. A. (2019). Mindfulness-Oriented Recovery Enhancement reduces opioid craving among individuals with opioid use disorder and chronic pain in medication assisted treatment: Ecological momentary assessments from a stage 1 randomized controlled trial. Drug and alcohol dependence, 203, 61–65. https://doi.org/10.1016/j.drugalcdep.2019.07.007

Garland, E. L., Hanley, A. W., Nakamura, Y., Barrett, J. W., Baker, A. K., Reese, S. E., Riquino, M. R., Froeliger, B., & Donaldson, G. W. (2022). Mindfulness-Oriented Recovery Enhancement vs Supportive Group Therapy for Co-occurring Opioid Misuse and Chronic Pain in Primary Care: A Randomized Clinical Trial. JAMA internal medicine, 182(4), 407–417. https://doi.org/10.1001/jamainternmed.2022.0033

Garland, E. L., Hanley, A. W., Riquino, M. R., Reese, S. E., Baker, A. K., Salas, K., Yack, B. P., Bedford, C. E., Bryan, M. A., Atchley, R., Nakamura, Y., Froeliger, B., & Howard, M. O. (2019). Mindfulness-oriented recovery enhancement reduces opioid misuse risk via analgesic and positive psychological mechanisms: A randomized controlled trial. Journal of consulting and clinical psychology, 87(10), 927–940. https://doi.org/10.1037/ccp0000390

Garland, E. L., & Howard, M. O. (2013). Mindfulness-oriented recovery enhancement reduces pain attentional bias in chronic pain patients. Psychotherapy and psychosomatics, 82(5), 311–318. https://doi.org/10.1159/000348868

Garland, E. L., & Howard, M. O. (2014). Opioid attentional bias and cue-elicited craving predict future risk of prescription opioid misuse among chronic pain patients. Drug and alcohol dependence, 144, 283–287. https://doi.org/10.1016/j.drugalcdep.2014.09.014

Garland, E. L., Manusov, E. G., Froeliger, B., Kelly, A., Williams, J. M., & Howard, M. O. (2014). Mindfulness-oriented recovery enhancement for chronic pain and prescription opioid misuse: results from an early-stage randomized controlled trial. Journal of consulting and clinical psychology, 82(3), 448–459. https://doi.org/10.1037/a0035798

Garland, E. L., Roberts-Lewis, A., Tronnier, C. D., Graves, R., & Kelley, K. (2016). Mindfulness-Oriented Recovery Enhancement versus CBT for co-occurring substance dependence, traumatic stress, and psychiatric disorders: Proximal outcomes from a pragmatic randomized trial. Behaviour research and therapy, 77, 7–16. https://doi.org/10.1016/j.brat.2015.11.012

Hanley, A. W., Gililland, J., Erickson, J., Pelt, C., Peters, C., Rojas, J., & Garland, E. L. (2021). Brief preoperative mind-body therapies for total joint arthroplasty patients: a randomized controlled trial. Pain, 162(6), 1749–1757. https://doi.org/10.1097/j.pain.0000000000002195

Hanley, A. W., Gililland, J., & Garland, E. L. (2021). To be mindful of the breath or pain: Comparing two brief preoperative mindfulness techniques for total joint arthroplasty patients. Journal of consulting and clinical psychology, 89(7), 590–600. https://doi.org/10.1037/ccp0000657

Hanley, A. W., Nakamura, Y., & Garland, E. L. (2018). The Nondual Awareness Dimensional Assessment (NADA): New tools to assess nondual traits and states of consciousness occurring within and beyond the context of meditation. Psychological assessment, 30(12), 1625–1639. https://doi.org/10.1037/pas0000615

Hudak, J., Bernat, E. M., Fix, S. T., Prince, K. C., Froeliger, B., & Garland, E. L. (2022). Neurophysiological Deficits During Reappraisal of Negative Emotional Stimuli in Opioid Misuse. Biological psychiatry, 91(12), 1070–1078. https://doi.org/10.1016/j.biopsych.2022.01.019

Hudak, J., Hanley, A. W., Marchand, W. R., Nakamura, Y., Yabko, B., & Garland, E. L. (2021). Endogenous theta stimulation during meditation predicts reduced opioid dosing following treatment with Mindfulness-Oriented Recovery Enhancement. Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology, 46(4), 836–843. https://doi.org/10.1038/s41386-020-00831-4

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