Dispositional mindfulness and prescription opioid misuse among chronic pain patients: Craving and attention to positive information as mediating mechanisms

Drug Alcohol Depend. 2018 Jul 1;188:86-93. doi: 10.1016/j.drugalcdep.2018.03.040. Epub 2018 May 3.


Objectives: Opioid-treated chronic pain patients may be at risk for prescription opioid misuse due to heightened opioid craving coupled with deficits in attention to naturally rewarding, positive stimuli. Conversely, dispositional mindfulness, which is associated with reduced craving and increased responsiveness to natural rewards, may serve as a protective factor and buffer opioid misuse risk. The current investigation aimed to examine the association between mindfulness and opioid misuse, and to test opioid craving and attention to positive information as mediators of this relationship.

Methods: This cross-sectional analysis examined data obtained from a sample of civilian opioid-treated chronic pain patients in the Southeastern U.S. (Sample 1: N = 115), as well as civilian (Sample 2: N = 141) and military samples in the Intermountain West (Sample 3: N = 44). Pearson correlations and path analyses were employed to test relations among participant self-reports on the Current Opioid Misuse Measure (COMM), the Five Facet Mindfulness Questionnaire (FFMQ), two measures of opioid craving, and the Attention to Positive and Negative Information Scale (APNIS).

Results: Across all three samples, dispositional mindfulness was significantly inversely associated with opioid misuse (N = 300, r = -0.36, p < .001). Reduced opioid craving and increased attention to positive information mediated the association between dispositional mindfulness and opioid misuse.

Discussion: Dispositional mindfulness may buffer opioid misuse risk by attenuating opioid craving and enhancing attention to naturally rewarding stimuli.

Keywords: Chronic pain; Mindfulness; Natural reward; Opioid craving; Opioid misuse.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Analgesics, Opioid / adverse effects
  • Analgesics, Opioid / therapeutic use*
  • Attention* / drug effects
  • Chronic Pain / drug therapy*
  • Chronic Pain / epidemiology
  • Chronic Pain / psychology
  • Craving* / drug effects
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Mindfulness* / trends
  • Opioid-Related Disorders / epidemiology
  • Opioid-Related Disorders / psychology
  • Opioid-Related Disorders / therapy*
  • Self Report
  • Southeastern United States / epidemiology
  • Substance-Related Disorders / epidemiology
  • Substance-Related Disorders / psychology
  • Substance-Related Disorders / therapy
  • Surveys and Questionnaires


  • Analgesics, Opioid