Abstract
Although medication assisted therapy (MAT) for opioid use disorders (OUD) is safe and effective and is
currently considered the gold standard for treating OUD, adherence to MAT regimens remains a challenge.
Initial studies have demonstrated efficacy of mindfulness-based interventions as adjunctive treatment for
substance use disorders (SUD) while reducing substance use and cravings. Additionally, non-randomized pilot
studies suggest that mindfulness-based interventions may be effective in reducing symptoms of depression
and anxiety in individuals undergoing MAT for OUD.5 In addition, peer recovery support services delivered by
individuals in recovery from SUD have also been found to be effective in reducing relapse rates, increasing
treatment retention, and improving relationships with treatment providers and social supports.6 Nonetheless,
recent studies that have used a combination of therapy and MAT have yielded mixed results, thereby
necessitating further exploration.7-8 Several factors, including depression, anxiety, stress, and cravings affect
adherence to MAT and other SUD treatment regimens because they increase likelihood of relapse.9-12
Additionally, physiologic stress reactivity and drug cue reactivity, often measured by the hormone cortisol have
been shown to be predictors of relapse.
The goal of the present study is to determine the effectiveness of a mindfulness-based intervention that
also utilizes peer mentors in addition to professional substance abuse therapists (the Minds and Mentors
program [MiMP]) in improving adherence to MAT for OUD and reducing relapse rates in a sample of
individuals with OUD who are also on MAT versus a twelve-step facilitation (TSF) program. The MiMP is an
eight-week intervention that uses group therapy and meets once a week for about two hours. We hypothesize
that participants in MiMP will demonstrate better adherence, reduced relapse and cravings (primary outcomes
measures), reduced depression, anxiety, and stress, and improved social support (secondary outcomes
measures), and reduced cortisol levels and reactivity to drug cues (exploratory outcome measures). This study
will utilize an individually randomized group treatment design. Data collection will occur at baseline (T0), end of
treatment (T1), and at 3 (T2), 6 (T3), and 12 (T4) months follow-up.
The findings of the study have the potential to impact policy and practice changes related to treatment of
UUD and strategies to improve adherence to MAT. This intervention has the potential to ultimately decrease
morbidity and mortality in individuals with OUD by decreasing relapse and other comorbid psychosocial
outcomes such as depression, anxiety, and stress. Furthermore, this study may help in the identification of
individuals who are more reactive to stress, and who may need treatments that incorporate additional elements
focused on stress reduction.
