In This Story
Our bodies send us signals throughout the day to prompt us into action. Our stomachs growl to indicate we’re hungry, so we eat. We shiver, so we put on a sweater. And when we feel pain, we may take medications to alleviate it. This is called interoceptive awareness. Our interoceptive awareness, the ability to recognize and interpret our body’s signals, is imperative to addressing our bodies’ needs and maintaining our health.
However, individuals who experience chronic pain can experience altered awareness of these body signals, which may impact their risk of misusing prescription pain management medications.
In a study conducted by addictive behavior researcher Anna Parisi, it was found that Mindfulness-Oriented Recovery Enhancement (MORE) helped participants increase their interoceptive awareness and, in doing so, reduce opioid misuse. Further, researchers found that chronic pain patients who reported lower trust in their body’s signals, greater difficulty regulating their attention to bodily sensations, and heightened worry about their pain were at higher risk for prescription opioid misuse.
“Individuals with chronic pain receiving long-term opioid therapy who reported lower interoceptive awareness were at higher risk of opioid misuse. Those who received MORE demonstrated significant improvements in their overall levels of self-reported interoceptive awareness, which in turn predicted long-term reductions in their opioid misuse risk,” said Parisi, an assistant professor of social work at George Mason University.
Participants in the MORE intervention received training in practices like mindful breathing and body scan exercises designed to strengthen interoceptive awareness and improve self-regulation of prescription opioid use. They also learned coping strategies to more effectively manage negative emotions, as well as how to intentionally focus on positive experiences to improve mood. The program consisted of weekly group therapy sessions facilitated by licensed clinical social workers. Participants were also asked to practice skills at home each day guided by an audio recording and to engage in mindful breathing before using their prescribed opioids.
MORE was originally created by University of California San Diego Professor of Psychiatry Eric Garland. Parisi’s study of the program is the first to examine how interoceptive awareness impacts the risk of prescription opioid misuse among individuals with chronic pain.
“These findings improve our understanding of how interoceptive awareness contributes to the risk of opioid misuse among individuals with opioid-treated chronic pain. Findings can also inform the development of more effective treatment strategies for this population,” Parisi said.
Enhancing interoceptive awareness in chronic pain and opioid misuse via mindfulness-oriented recovery enhancement was published in June 2025 in Drug and Alcohol Dependence. Co-authors include Lisa Taylor-Swanson from the University of Utah College of Nursing; Jennifer L. Stewart from the University of Tulsa Oxley College of Health and Natural Sciences; Sahib S. Khalsa from the University of California at Los Angeles Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine; and Eric L. Garland from the University of California San Diego Department of Psychiatry.
About the author
Parisi is an assistant professor in the Department of Social Work at the College of Public Health. Her research is focused on understanding the mechanisms that contribute to the development, maintenance, and recurrence of addictive behaviors, as well as the intersection between substance use and mental health disorders. She is also interested in evaluating different treatment approaches, like mindfulness, that can be used to address these mechanisms.
Thumbnail photo by Towfiqu Barbhuiya via Unsplash.