Opioid use disorder (OUD) and its effective treatment continue to be urgent topics in both medicine and public health. Recent research on mindfulness and opioid use disorder has generated discussion about whether mindfulness practices can offer meaningful benefits for those seeking recovery. This post unpacks a new large-scale clinical trial, explores what mindfulness can do, and what it can’t, based on the latest science.

Opioid use disorder has devastated families, communities and economies—not just in the United States, but worldwide. While medications like buprenorphine can help people reduce or stop opioid use, many still struggle with anxiety, drug cravings or dropping out of treatment. Mindfulness-based interventions are increasingly considered as an option for people with opioid use disorder, but how well do they really work compared to other forms of group support?

A recent clinical trial explored this question in detail. Researchers compared a mindfulness-based group programme to an active recovery support group in people receiving buprenorphine for opioid use disorder. Their findings give new insight into the role of mindfulness and how best to support those on the challenging road to recovery.

What is Mindfulness and Opioid Use Disorder?

Mindfulness means paying purposeful, non-judgmental attention to the present moment. It is often taught through meditation, breathing exercises, and techniques that help people notice thoughts, feelings and physical sensations. For opioid use disorder treatment, mindfulness is used to help patients observe cravings, emotions and stress with less reactivity, building skills to manage risk factors linked to relapse.

Scientists have wondered if teaching mindfulness in a supportive group setting could improve key outcomes in opioid use disorder, especially for people also prescribed medication like buprenorphine.

The Study at a Glance

Study Design

• Participants: 196 adults receiving buprenorphine for OUD, recruited from 16 US states (about 61% women; average age 41)
• Interventions:
  • Group mindfulness training (Mindful Recovery Opioid Use Disorder Care Continuum – M-ROCC)
  • Active recovery support group (using evidence-based approaches like cognitive behavioural therapy)
• Duration: 24 weeks, with weekly online group sessions
• Main Outcomes Tracked:
  • Illicit opioid use (biochemical and self-reported)
  • Anxiety
  • Opioid cravings
  • Other substance use (cocaine and benzodiazepines)

Mindfulness and Opioid Use Disorder Treatment Outcomes

Did Mindfulness Decrease Opioid Use?

Surprisingly, not very much. The rate of continued illicit opioid use was almost identical in both groups (13.4% in the mindfulness group vs 12.7% in the recovery support group), with no significant difference. Rates of cocaine and benzodiazepine use were also similar.

What About Anxiety?

Both groups experienced significant reductions in anxiety after 24 weeks, but there was no statistical difference between the mindfulness group and the active control group. This suggests that group-based support, whether it involves mindfulness or other therapeutic approaches, can be beneficial for anxiety in people receiving buprenorphine for opioid use disorder.

The Key Difference: Opioid Cravings

This is where mindfulness had an edge. Although mindfulness did not reduce opioid use more than the comparison group, participants in the mindfulness group reported a greater reduction in opioid craving. After six months:

• Mindfulness group experienced an average 67% reduction in craving
• Recovery support group saw a 44% reduction

This difference in craving was statistically significant and could matter for people who continue to experience strong cravings while on medication.

Why Does Mindfulness Help Reduce Craving?

Mindfulness appears to help people:

• Recognise and “surf” cravings (observe them without reacting impulsively)
• Regulate emotions rather than escape or suppress them
• Reduce attention-bias on drug-related cues
• Reconnect with values and long-term goals

Practising mindfulness has been shown in other studies to support self-regulation and change the way the brain processes both positive and negative experiences. Put simply, mindfulness may be most useful for helping people handle cravings, especially if cravings are a key part of ongoing risk after starting medical treatment.

The Importance of Group Support

It wasn’t only mindfulness that helped people in this study. Both group interventions had strong effects on reducing anxiety. Group-based care can:

• Offer positive social connections and accountability
• Teach new skills for coping with stress and emotion
• Strengthen a shared sense of recovery and hope

This matches findings from other research, showing group-based psychosocial programmes (especially when paired with medication like buprenorphine) help address the wider set of challenges that come with opioid use disorder.

What Are the Limits of Mindfulness for OUD?

While mindfulness in a group setting can help lessen cravings, this study shows it is not more effective than other active support interventions at reducing actual opioid use or anxiety. The content, structure and delivery of support programmes likely play a big role alongside any specific method.

Another important point is engagement. Just under 60% of participants completed the study, highlighting the challenge of keeping people involved across several months—even with online formats and flexibility.

What Do These Findings Mean for Opioid Use Disorder Care?

• Mindfulness training may be especially valuable for those struggling with strong residual cravings after starting buprenorphine. If this describes someone’s experience, mindfulness techniques and group work might add helpful skills for staying on track.
• Group support works. Both mindfulness and other evidence-based group support led to lower anxiety and helped people feel less alone as they worked through recovery.
• No “one-size-fits-all” approach. People with opioid use disorder benefit from a variety of strategies. Some may respond best to mindfulness, while others prefer different group or individual tasks.

Source: Jama Network