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Analgesic and Opioid Sparing Brain Mechanisms of Mindfulness-Oriented Recovery Enhancement for Chronic Low Back Pain

Award Number: R01AT011772
ORGANIZATION: CENTER FOR DRUG EVALUATION AND RESEARCH, NIH
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 09/01/2022
PERIOD OF PERFORMANCE END DATE: 05/31/2027

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Analgesic and Opioid Sparing Brain Mechanisms of Mindfulness-Oriented Recovery Enhancement for Chronic Low Back Pain - ABSTRACT Chronic low back pain (cLBP) is the most common clinical pain condition worldwide, and the top chronic non-cancer condition for which opioids are prescribed. The current opioid crisis in the U.S. emerged in large part from overuse and misuse of opioids by patients with cLBP. Yet, there are few evidence-based interventions to reduce opioid use and misuse among patients with cLBP. Faced with a lack of effective treatment options, some cLBP patients become ensnared in a downward spiral of opioid dose escalation. Mindfulness-based interventions reduce chronic pain and opioid dosing. However, lack of mechanistic data has limited the deployment of these cost-effective and non-pharmacological treatment approaches. Multiple clinical trials indicate that Mindfulness-Oriented Recovery Enhancement (MORE), a novel mind-body therapy that integrates mindfulness with other affect regulation techniques, alleviates chronic pain symptoms as well as opioid use among people with cLBP. Yet, the active brain mechanisms of action underlying MORE’s analgesic and opioid sparing effects remain unknown. Further, no known placebo-controlled studies have disentangled the specific neural mechanisms of MORE or other mindfulness-based interventions for cLBP from nonspecific therapeutic factors like beliefs, expectancy, and social support. As such, the proposed study will employ one of the most rigorous control conditions in the mindfulness literature to date—a validated sham-mindfulness meditation technique combined with supportive psychotherapy (Sham-MORE). Integrating functional neuroimaging and psychophysics (noxious heat and behavioral pain ratings), the overarching aims of the proposed R01 study are to a) identify the neural mechanisms supporting the immediate analgesic effects of MORE (versus Sham-MORE and treatment-as- usual), and b) to determine if changes in default mode network functional connectivity predict individual differences in cLBP relief and opioid dose reduction following treatment with MORE. Ultimately, the proposed work will yield insight into the fundamental neuro-functional processes mediating the therapeutic effects of mindfulness-based interventions for cLBP, thereby facilitating the optimization of novel biobehavioral treatments for this highly prevalent and disabling chronic pain condition that helped to fuel the ongoing opioid crisis.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = $602,775 )
2025	2025	UNIVERSITY OF CALIFORNIA, SAN DIEGO	9500 GILMAN DR	LA JOLLA	CA	92093	SAN DIEGO	USA	Research and Training in Complementary and Integrative Health	005	5	6/9/2025	NON-COMPETING CONTINUATION	$566,007
2025	2024	UNIVERSITY OF CALIFORNIA, SAN DIEGO	9500 GILMAN DR	LA JOLLA	CA	92093	SAN DIEGO	USA	Research and Training in Complementary and Integrative Health	004	4	4/3/2025	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$330,036
2025	2024	UNIVERSITY OF CALIFORNIA, SAN DIEGO	9500 GILMAN DR	LA JOLLA	CA	92093	SAN DIEGO	USA	Research and Training in Complementary and Integrative Health	001	4	12/24/2024	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$436,220
2025	2024	UNIVERSITY OF UTAH	201 PRESIDENTS CIR	SALT LAKE CITY	UT	84112	SALT LAKE	USA	Research and Training in Complementary and Integrative Health	003	3	4/3/2025	NON-COMPETING CONTINUATION	-$165,302
2025	2024	UNIVERSITY OF UTAH	201 PRESIDENTS CIR	SALT LAKE CITY	UT	84112	SALT LAKE	USA	Research and Training in Complementary and Integrative Health	000	3	12/24/2024	NON-COMPETING CONTINUATION	-$399,452
2025	2023	UNIVERSITY OF UTAH	201 PRESIDENTS CIR	SALT LAKE CITY	UT	84112	SALT LAKE	USA	Research and Training in Complementary and Integrative Health	002	2	4/3/2025	NON-COMPETING CONTINUATION	-$164,734
														Subtotal = $602,775

Issue Date FY: 2024 ( Subtotal = $564,754 )
2024	2024	UNIVERSITY OF UTAH	201 PRESIDENTS CIR	SALT LAKE CITY	UT	84112	SALT LAKE	USA	Research and Training in Complementary and Integrative Health	001	3	5/30/2024	NON-COMPETING CONTINUATION	$564,754
2024	2023	UNIVERSITY OF UTAH	201 PRESIDENTS CIR	SALT LAKE CITY	UT	84112	SALT LAKE	USA	Research and Training in Complementary and Integrative Health	000	2	12/28/2023	NON-COMPETING CONTINUATION	$0
														Subtotal = $564,754

Issue Date FY: 2023 ( Subtotal = $576,124 )
2023	2023	UNIVERSITY OF UTAH	201 PRESIDENTS CIR	SALT LAKE CITY	UT	84112	SALT LAKE	USA	Research and Training in Complementary and Integrative Health	000	2	5/19/2023	NON-COMPETING CONTINUATION	$576,124
														Subtotal = $576,124

Issue Date FY: 2022 ( Subtotal = $636,638 )
2022	2022	UNIVERSITY OF UTAH, THE	201 PRESIDENTS CIR	SALT LAKE CITY	UT	84112	SALT LAKE	USA	Research and Training in Complementary and Integrative Health	000	1	9/1/2022	NEW	$636,638
														Subtotal = $636,638

Grand Total All Awards = $2,380,291

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Analgesic and Opioid Sparing Brain Mechanisms of Mindfulness-Oriented Recovery Enhancement for Chronic Low Back Pain

Award Number: R01AT011772

ORGANIZATION: CENTER FOR DRUG EVALUATION AND RESEARCH, NIH

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 09/01/2022

PERIOD OF PERFORMANCE END DATE: 05/31/2027

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