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

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.