Mindfulness therapy reduces opioid misuse and chronic pain in primary care, according to new research — ScienceDaily


Outcomes from a brand new scientific trial reveal that an eight-week mindfulness-based remedy — Mindfulness-Oriented Restoration Enhancement (MORE) — decreased opioid use and misuse whereas decreasing power ache signs, with results lasting so long as 9 months. That is the primary large-scale scientific trial to reveal {that a} psychological intervention can concurrently cut back opioid misuse and power ache amongst individuals who have been prescribed opioid ache relievers.

The examine, revealed within the peer-reviewed journal JAMA Inner Medication, adopted 250 adults with power ache on long-term opioid remedy who met the factors of misusing opioids. Most members took oxycodone or hydrocodone, reported two or extra painful situations and met the scientific standards for main melancholy. Greater than half of members additionally had a diagnosable opioid use dysfunction.

Research members have been randomly assigned to both a normal supportive psychotherapy group, or a MORE group, each participating in eight weekly two-hour group periods, in addition to quarter-hour of every day homework. The examine therapy teams have been delivered in physician’s places of work, in the identical scientific care setting the place sufferers obtained their opioid ache administration. Researchers measured the members’ opioid misuse behaviors; signs of ache; melancholy, nervousness and stress; and opioid dose by a nine-month follow-up. Opioid craving was measured at three random instances a day, prompted by a textual content message despatched to the members’ smartphones.

9 months after the therapy interval ended, 45% of members within the MORE group have been not misusing opioids, and 36% had minimize their opioid use in half or larger. Sufferers in MORE had greater than twice the chances of these in commonplace psychotherapy to cease misusing opioids by the tip of the examine. Moreover, members within the MORE group reported clinically important enhancements in power ache signs, decreased opioid craving and lowered signs of melancholy to ranges beneath the brink for main depressive dysfunction.

“MORE demonstrated some of the highly effective therapy results I’ve seen,” mentioned Eric Garland, lead creator of the examine, director of the Middle on Mindfulness and Integrative Well being Intervention Growth on the College of Utah and probably the most prolific creator of mindfulness analysis on this planet. “There’s nothing else on the market that works this properly in assuaging ache and curbing opioid misuse.”

“Remarkably, the consequences of MORE appear to get stronger over time,” mentioned Garland, who developed MORE and has been learning it for over a decade. “One potential rationalization is that these people are integrating the talents they’ve realized by MORE into their on a regular basis lives.” Garland additionally hypothesized that, primarily based on earlier analysis, the sustained advantages is perhaps associated to MORE’s potential to restructure the best way the mind processes rewards, serving to the members’ brains shift from valuing drug-related rewards to valuing pure, wholesome rewards like a ravishing sundown, the bloom of springtime flowers or the smile on the face of a liked one.

MORE combines meditation, cognitive-behavioral remedy and rules from constructive psychology into sequenced coaching in mindfulness, savoring and reappraisal expertise.

Individuals are taught to interrupt down the expertise of ache or opioid craving into their sensory parts, “zooming in” on what they’re feeling and breaking it down into totally different sensations like warmth, tightness or tingling. They’re educated to note how these experiences change over time, and to undertake the attitude of an observer. They’re additionally taught to savor nice, healthful and life-affirming experiences, amplifying the sense of pleasure, reward and that means that may come from constructive, on a regular basis occasions. Lastly, members are taught to reframe aggravating occasions to discover a sense of that means within the face of adversity, to acknowledge what might be realized from tough occasions and the way coping with these experiences may make an individual stronger.

Garland defined, “Slightly than getting caught up within the ache or craving, we train folks learn how to step again and observe that have from the attitude of an goal witness. Once they can try this, folks start to acknowledge that who they really are is greater than anyone thought or sensation. They aren’t outlined by their experiences of ache or craving; their true nature is one thing extra.”

Individuals experiencing each power ache and opioid misuse current a major therapy problem, since opioid use dysfunction has been proven to extend ache sensitivity, which in flip promotes additional opioid misuse. By concurrently decreasing ache and opioid use, MORE could provide an efficient, economical and lifesaving intervention to assist halt the continued opioid disaster.

Story Supply:

Supplies offered by College of Utah. Unique written by Jennifer Nozawa. Be aware: Content material could also be edited for fashion and size.

Texas 2022 Primary Election Key Results: Live : NPR


Voting concludes Tuesday night time within the Texas main elections.

The contests are each the primary races of the 2022 midterms, and in addition the primary elections carried out since Republican state lawmakers enacted new voting restrictions.

There are notable primaries for governor and legal professional basic, and in key congressional districts. (Listed here are extra particulars on 4 prime contests.) Discover these outcomes beneath, and head to the Texas secretary of state’s web site for all state outcomes.

Polls shut in Texas at 7 p.m. native time (8 p.m. ET for the overwhelming majority of the state).

4 races to watch in the Texas primary : NPR


Texas Gov. Greg Abbott faces major challengers from the fitting in his reelection bid. A major win would probably arrange a high-profile match-up towards Democrat Beto O’Rourke.

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Texas Gov. Greg Abbott faces major challengers from the fitting in his reelection bid. A major win would probably arrange a high-profile match-up towards Democrat Beto O’Rourke.

Brandon Bell/Getty Pictures

The 2022 midterm elections kick off in earnest Tuesday as voting concludes in Texas for the state’s major. (Polls shut at 7 p.m. native time. Observe key outcomes right here.)

High GOP statewide leaders face reelection challenges from fellow Republicans, whereas congressional and state legislative candidates navigate redrawn political maps.

Texas, which gained two congressional districts in redistricting, will likely be a focus for the 2 main events as they jockey for management of the U.S. Home. Democrats goal to protect their slim majority in what’s anticipated to be a troublesome cycle for them.

Whereas many Texas suburbs trended extra Democratic within the 2020 and 2018 elections, former President Donald Trump made important positive aspects in 2020 amongst voters on the closely Latino southern border, a historically vital location for Democrats.

The Lone Star State’s elections system can be not with out competition. The Division of Justice is suing the state over its redistricting plan, and the first is the primary election since GOP state lawmakers enacted new voting restrictions. 1000’s of voters have run into points navigating new necessities, reminiscent of with mail-in ballots.

Listed below are 4 Texas races to look at as outcomes are available in:

1. twenty eighth Congressional District

The marquee match-up is on the Democratic facet, the place progressive immigration legal professional Jessica Cisneros is difficult longtime Democratic Rep. Henry Cuellar, as he concurrently offers with an FBI probe.

Cuellar — who’s represented the district, which spans from the south ends of San Antonio via Laredo, for 9 phrases — narrowly beat Cisneros in 2020.

Cisneros, who’s 28, helps progressive concepts like Medicare for all, the Inexperienced New Deal and free public faculty, whereas Cuellar is among the most conservative Home Democrats, taking right-leaning stances on abortion rights and immigration points.

Endorsements from progressive leaders are pouring in for Cisneros, together with from Sens. Bernie Sanders and Elizabeth Warren and Rep. Alexandria Ocasio-Cortez.

It is a rematch in South Texas: Democratic Rep. Henry Cuellar faces a major problem from progressive candidate Jessica Cisneros. Two years in the past, Cuellar narrowly defeated Cisneros to carry on to his seat.

Kevin Dietsch/Getty Pictures; Brandon Bell/Getty Pictures


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Kevin Dietsch/Getty Pictures; Brandon Bell/Getty Pictures


It is a rematch in South Texas: Democratic Rep. Henry Cuellar faces a major problem from progressive candidate Jessica Cisneros. Two years in the past, Cuellar narrowly defeated Cisneros to carry on to his seat.

Kevin Dietsch/Getty Pictures; Brandon Bell/Getty Pictures

January FBI raids of Cuellar’s dwelling and workplace have altered the race.

Cuellar co-chairs the Home Azerbaijan Caucus, and information shops like ABC and CBS Information report that the raids are a part of a federal investigation into the nation and U.S. businessmen who’ve ties to it. NPR has not confirmed that reporting. Cuellar says there’s been no wrongdoing on his half.

Cuellar, 66, has acquired an endorsement from Home Majority Chief Steny Hoyer, D-Md. Nonetheless, regardless of supporting him in 2020, Home Speaker Nancy Pelosi, D-Calif., has but to make a public endorsement.

Although Cisneros has given Cuellar a run for his cash earlier than, the general ideological lean of the twenty eighth district stays unsure. If Cisneros had been to defeat Cuellar within the major, she’d be operating on a considerably extra progressive platform than he has prior to now, which may push away extra average Democratic voters.

No matter who wins the first, Republicans undoubtedly have their eye on the district. Cook dinner Political Report at present labels the twenty eighth as simply leaning Democratic.

2. fifteenth Congressional District

The fifteenth, which spans east of San Antonio via McAllen, is each an open and aggressive district.

Following the state’s newest spherical of redistricting, the district now skews barely extra Republican than earlier than, prompting present Democratic Rep. Vicente Gonzalez to run for the close by thirty fourth district as an alternative, a safely blue seat.

Monica De La Cruz has the backing of a variety of Republicans in her bid to win the fifteenth district.

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Eric Homosexual/AP


Monica De La Cruz has the backing of a variety of Republicans in her bid to win the fifteenth district.

Eric Homosexual/AP

From Trump to Home Minority Chief Kevin McCarthy, Republicans throughout the nation are backing Monica De La Cruz’s candidacy to take the fifteenth district.

De La Cruz, an insurance coverage agent who misplaced to Gonzalez in 2020 by lower than 3 proportion factors, has obtained the largest fundraising haul, and is seen because the front-runner within the race — however a crowded discipline of lesser-known Republican candidates.

Regardless of her nationwide assist, De La Cruz’s candidacy has met controversy. Her estranged husband is accusing her of displaying “merciless and aggressive conduct” towards his daughter — an allegation De La Cruz denies. As a part of their ongoing authorized battle, De La Cruz can’t return to the house she shared along with her husband till April.

On the Democratic facet, each progressive and average candidates have thrown their hat within the ring, although nobody rivals De La Cruz in fundraising or title recognition. Gonzalez has endorsed Military veteran Ruben Ramirez to fill the seat.

3. Governor’s race

Republican Gov. Gregg Abbott is searching for a 3rd time period, however first should get previous major challengers who’re attacking him from the fitting. Polls have Abbott, who has been endorsed by Trump, in robust place, and he is sitting on a considerable battle chest of round $65 million.

Beto O’Rourke is the front-runner to win the Democratic nomination for the governor’s race.

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Brandon Bell/Getty Pictures

Abbott might have the cash for what might be a high-profile basic election match-up towards former presidential candidate and Rep. Beto O’Rourke, who stands because the clear front-runner on the Democratic facet.

Although Abbott leads towards O’Rourke in current polling of the crimson state — and although Texas hasn’t elected a Democratic governor in 32 years — O’Rourke has defied expectations earlier than. He got here near ousting Sen. Ted Cruz in his 2018 bid for U.S. Senate. Nonetheless, that was a very stable 12 months for Democrats once they ran because the opposition to Trump.

4. Legal professional basic’s race

Embattled Republican incumbent Ken Paxton faces major challenges from Rep. Louie Gohmert, former state Supreme Courtroom Justice Eva Guzman and Land Commissioner George P. Bush, the son of Jeb Bush and nephew of George W. Bush.

Although the two-term legal professional basic is polling greater than his rivals, he is nonetheless in jeopardy of triggering a runoff election. A current UT/Texas Tribune survey had him at 47%, with Bush in second at 21% — which might put Paxton below the 50% threshold wanted to keep away from a Could runoff.

Trump has endorsed Paxton, who helps the previous president’s false claims that the 2020 election was fraudulent and filed a authorized problem towards election leads to a number of states. He additionally appeared on the pro-Trump rally that preceded the assault on the U.S. Capitol on Jan. 6, 2021. Gohmert — who entered the race after Trump had endorsed Paxton — can be a giant ally of the previous president.

Embattled Republican Legal professional Common Ken Paxton faces three major challengers for his reelection bid.

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Tony Gutierrez/AP

Authorized controversies involving Paxton have surfaced all through his tenure as legal professional basic, however at present, he is dealing with an FBI investigation over claims of bribery and abuse of workplace by the use of a number of whistleblowers. He is additionally accused of violating Texas’ open information legislation for refusing to show over associated planning communication from the times main as much as the rebel on the U.S. Capitol.

On the Democratic major facet, former ACLU lawyer Rochelle Garza leads in current polling. Trailing Garza is Joe Jaworski, a lawyer and former mayor of Galveston. Decrease in the identical ballot is civil rights legal professional Lee Merritt, who gained nationwide consideration representing a number of households of Black males who had been shot and killed by police, together with George Floyd.



Texas primary voting complicated by new election laws : NPR


Future Laurence receives a name on the Harris County Election Workplace in downtown Houston. In January alone, Washington and the 14 different staff within the name heart obtained 8,000 calls from folks asking for assist navigating the voting course of.

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Scott Dalton for NPR


Future Laurence receives a name on the Harris County Election Workplace in downtown Houston. In January alone, Washington and the 14 different staff within the name heart obtained 8,000 calls from folks asking for assist navigating the voting course of.

Scott Dalton for NPR

Inside a name heart in a downtown Houston constructing, a group of election staff sits throughout from one another in rows of sparsely adorned gray cubicles. It is one week earlier than the primary statewide election since Texas enacted sweeping modifications to its voting legal guidelines, and issues are hectic.

“The telephone is ringing again to again to again just about with involved voters eager to know the place their ballots are and what is the standing on their purposes,” mentioned Angela Washington, a name heart clerk.

In January alone, Washington and the 14 different staff within the name heart obtained 8,000 calls from individuals who wished assist navigating the voting course of.

Name heart clerk Angela Washington says involved voters have been calling nearly always, checking on their purposes.

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Scott Dalton for NPR


Name heart clerk Angela Washington says involved voters have been calling nearly always, checking on their purposes.

Scott Dalton for NPR

1000’s of rejected mail-in ballots previous to the March 1 major left some voters not sure how and whether or not they’ll be capable to take part, together with many individuals with disabilities and senior residents, who’re amongst these eligible to vote by mail.

In Harris County, dwelling to Houston and the state’s most populous county, 40% of mail-in poll purposes have been flagged for rejection.

Supporters of the state’s new voting regulation say it’s supposed to revive voter confidence in elections. However some elections officers say it’s simply inflicting widespread confusion.

“It breaks my coronary heart to see that they have been rejected for varied causes,” Washington mentioned. “At that time, it is a matter of looking for them a location the place they’ll go [vote] in individual.”

ID guidelines are an enormous supply of confusion

The regulation now requires voters who qualify for mail-in voting to offer both their driver’s license quantity or a partial Social Safety quantity. That quantity should match what’s on file of their voter registration file. So if a voter registered many years in the past with their Social Safety quantity however utilized this yr utilizing their driver’s license as an alternative, they’d be rejected.

Washington mentioned she may perceive why some callers are annoyed, even offended.

“I simply hear, I consolation them as a lot as I can and a few of them simply must know that anyone cares on the opposite finish,” she mentioned.

Nayda Arnold, who additionally works on the name heart, mentioned it may be upsetting when she’s confronted with an emotional voter.

Nayda Arnold, the deputy director of voter companies, says she spends lots of time on the telephone to ensure every voter feels comfy.

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Scott Dalton for NPR


Nayda Arnold, the deputy director of voter companies, says she spends lots of time on the telephone to ensure every voter feels comfy.

Scott Dalton for NPR

“However more often than not I’ve discovered that once they’re upset, it is as a result of they do not perceive,” she mentioned, including meaning staying on the telephone so long as it takes to make each caller really feel comfy.

The rollout of the regulation, which took impact in December, is burdening native election staff who’re already stretched skinny.

“Daily, they’re on a telephone name the place they break down crying. We’ve folks stop nearly each week,” mentioned Isabel Longoria, the elections administrator in Harris County. She has been vocal concerning the challenges that this regulation – often called Senate Invoice 1 – has brought about.

“The hours are an excessive amount of, the stress is an excessive amount of, the being questioned by the general public is an excessive amount of, the sensation like we’re shouting right into a void the place nobody is listening is an excessive amount of,” she mentioned.

Harris County Elections Administrator Isabel Longoria says the rollout of the brand new Texas voting regulation is severely burdening the already stretched native election staff.

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Scott Dalton for NPR


Harris County Elections Administrator Isabel Longoria says the rollout of the brand new Texas voting regulation is severely burdening the already stretched native election staff.

Scott Dalton for NPR

Republicans argue that voting restrictions like these included in Senate Invoice 1 make it simpler to vote and more durable to cheat, regardless of no widespread proof of voter fraud.

Texas Secretary of State John Scott’s workplace didn’t reply to an NPR request for remark. However final month, he pushed again in opposition to criticism that the mail-in voting course of was complicated for voters.

“It is the primary time for this workplace to manage an software to poll by mail the way in which it’s occurring, so I believe there’s a bit little bit of a studying curve that is happening,” he instructed Spectrum Information.

However Longoria says that is callous.

“Your core rights on this nation ought to by no means be another person’s studying curve,” she mentioned.

Some Texans see intentional hurdles to vote

The regulation’s modifications usually are not restricted to identification necessities. It additionally features a slew of different restrictions, together with banning drive-through voting and 24-hour voting websites, issues that Harris County carried out in 2020 to assist folks vote extra simply and safely in the course of the pandemic.

“It is like, we lastly make some progress, after which we now have the rug pulled out from beneath us,” mentioned Lydia Nunez Landry, who lives in a suburb of Houston. “It simply sort of looks like they wish to discourage us from voting.”

Nunez Landry has a progressive and presently untreatable type of muscular dystrophy. Due to the dangers of the coronavirus, she shouldn’t be leaving her dwelling a lot. However as a result of confusion surrounding mail-in voting, she feels she has to vote in individual to make sure that her vote is counted.

“I am simply too afraid to threat it,” Nunez Landry mentioned.

She additionally worries concerning the expanded rights of partisan ballot watchers underneath the brand new regulation, which permits them “free motion” in most areas of polling locations.

“That actually bothers me, having folks scrutinize or surveil me,” she mentioned. “I do not assume it needs to be the case for disabled folks to be handled that method, or any marginalized group.”

Carlos Vanegas pushes a cart with mail-in ballots that shall be despatched to voters on the Harris County Elections Workplace in Houston.

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Scott Dalton for NPR


Carlos Vanegas pushes a cart with mail-in ballots that shall be despatched to voters on the Harris County Elections Workplace in Houston.

Scott Dalton for NPR

Different provisions of the regulation straight concentrate on voters with disabilities, and advocates say these have created lots of confusion, notably round what sort of help an individual with disabilities could entry when voting.

“We’re right here in the midst of an election cycle, the place folks with disabilities and older adults are scared to vote in individual, as a result of we simply do not know what meaning for us,” mentioned Gabe Cazares, the director of the Houston Mayor’s Workplace for Folks with Disabilities.

Cazares mentioned the regulation opens up the door for attendants who help voters to face prison penalties, however that there is no readability on what constitutes a violation.

That is led to some private care attendants worrying about “being criminally answerable for offering help that they ordinarily present to folks with disabilities,” he mentioned.

Cazares additionally worries that folks with disabilities that aren’t seen could face new challenges whereas voting.

“It’s extremely simple to qualify a incapacity if you’re somebody who seems like me. You may look into my eyes and see that I’m a blind individual,” he mentioned. “However there are of us with disabilities the place these usually are not apparent. And we aren’t within the enterprise of policing incapacity.”

Texas is one in every of 18 states that handed extra restrictive voting legal guidelines after the 2020 presidential election. James Slattery, a senior employees legal professional for the Texas Civil Rights venture, mentioned the rollout of the regulation right here may present a preview of what is to return throughout the nation.

“Texas shouldn’t be the one state that handed a voter suppression invoice like this,” Slattery mentioned. It’s merely the primary to have a major underneath its new regulation, and there is no purpose to assume it is going to go any higher in any of the opposite states the place they did one thing related.”

‘I do not get to fail at this’

In Fort Bend County, 73-year-old Lydia Ozuna painstakingly paperwork every step in her voting course of, within the hopes of training others.

However this yr, even she bought tripped up when she stuffed out an software to vote by mail. Ozuna unintentionally used an outdated software type, one which didn’t have the newly-required fields for together with a driver’s license quantity or partial social safety quantity.

Ozuna came upon instantly as a result of she filed her software in individual. Had she mailed it in, she mentioned, she would not have identified till somebody from her native elections workplace reached her by telephone or mail to inform her that she’d made a mistake.

Employees reply questions within the name heart on the Harris County Elections Workplace in Houston. In Harris County, 40% of mail-in poll purposes have been flagged for rejection.

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Scott Dalton for NPR


Employees reply questions within the name heart on the Harris County Elections Workplace in Houston. In Harris County, 40% of mail-in poll purposes have been flagged for rejection.

Scott Dalton for NPR

Ozuna, who leads an anti-gerrymandering group, grew up watching her father pay ballot taxes in order that he may vote.

“Our state has a historical past of violating the civil rights of its residents. I lived it as a child,” she mentioned.

Ozuna mentioned she sees shades of that historical past right this moment.

“I believe the purpose is to only have the few individuals who have the know-how be those to vote, and everybody else keep dwelling,” she mentioned. “And that is a grim prospect.”

Again on the Harris County elections workplace, Isabel Longoria says that prospect is why she and her group hold working by means of burnout, and even their very own frustrations with how the rollout has gone.

“If I’ve everybody stop tomorrow in elections, democracy shouldn’t be occurring. I do not get to fail at this job, and I believe that is what everybody on my group understands, who does nonetheless discover one other day to work,” she mentioned.