title: Mindfulness-Meditation-Based Pain Relief Is Not Mediated by Endogenous Opioids.
abstract: Mindfulness meditation, a cognitive practice premised on sustaining nonjudgmental awareness of arising sensory events, reliably attenuates pain. Mindfulness meditation activates multiple brain regions that contain a high expression of opioid receptors. However, it is unknown whether mindfulness-meditation-based analgesia is mediated by endogenous opioids. The present double-blind, randomized study examined behavioral pain responses in healthy human volunteers during mindfulness meditation and a nonmanipulation control condition in response to noxious heat and intravenous administration of the opioid antagonist naloxone (0.15 mg/kg bolus + 0.1 mg/kg/h infusion) or saline placebo. Meditation during saline infusion significantly reduced pain intensity and unpleasantness ratings when compared to the control + saline group. However, naloxone infusion failed to reverse meditation-induced analgesia. There were no significant differences in pain intensity or pain unpleasantness reductions between the meditation + naloxone and the meditation + saline groups. Furthermore, mindfulness meditation during naloxone produced significantly greater reductions in pain intensity and unpleasantness than the control groups. These findings demonstrate that mindfulness meditation does not rely on endogenous opioidergic mechanisms to reduce pain.
  
  
  CONCLUSIONS
  Endogenous opioids have been repeatedly shown to be involved in the cognitive inhibition of pain. Mindfulness meditation, a practice premised on directing nonjudgmental attention to arising sensory events, reduces pain by engaging mechanisms supporting the cognitive control of pain. However, it remains unknown if mindfulness-meditation-based analgesia is mediated by opioids, an important consideration for using meditation to treat chronic pain. To address this question, the present study examined pain reports during meditation in response to noxious heat and administration of the opioid antagonist naloxone and placebo saline. The results demonstrate that meditation-based pain relief does not require endogenous opioids. Therefore, the treatment of chronic pain may be more effective with meditation due to a lack of cross-tolerance with opiate-based medications.
authors.affiliation: Department of Neurobiology and Anatomy, fzeidan@wakehealth.edu.
authors.forename: Fadel
authors.initials: F
authors.lastname: Zeidan
authors.affiliation: Department of Neurobiology and Anatomy.
authors.forename: Adrienne L
authors.initials: AL
authors.lastname: Adler-Neal
authors.affiliation: Department of Neurology, and.
authors.forename: Rebecca E
authors.initials: RE
authors.lastname: Wells
authors.affiliation: Department of Psychology, Wake Forest University, Winston-Salem, North Carolina 27109.
authors.forename: Emily
authors.initials: E
authors.lastname: Stagnaro
authors.affiliation: Department of Biology, University of Oregon, Eugene, Oregon 97403, and.
authors.forename: Lisa M
authors.identifier: http://orcid.org/0000-0003-4299-4587
authors.initials: LM
authors.lastname: May
authors.affiliation: Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina 27157.
authors.forename: James C
authors.identifier: http://orcid.org/0000-0002-9841-0176
authors.initials: JC
authors.lastname: Eisenach
authors.affiliation: Department of Neurobiology and Anatomy.
authors.forename: John G
authors.initials: JG
authors.lastname: McHaffie
authors.affiliation: Department of Anesthesiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229.
authors.forename: Robert C
authors.initials: RC
authors.lastname: Coghill
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000378:metabolism*; D000704:Analysis of Variance; D004311:Double-Blind Method; D005260:Female; D064368:Healthy Volunteers; D006358:Hot Temperature / Q000009:adverse effects; D006801:Humans; D008297:Male; D019122:Meditation / Q000523:psychology; D009270:Naloxone / Q000633:toxicity; D009292:Narcotic Antagonists / Q000633:toxicity; D010146:Pain / Q000139:chemically induced / Q000378:metabolism* / Q000534:rehabilitation*; D010147:Pain Measurement; D011601:Psychophysics; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D009292:Narcotic Antagonists; D009270:Naloxone
keywords: cognitive; mindfulness meditation; naloxone; opioid; pain