A new evaluation from the University of California San Diego School of Medicine changes that for one approach, reporting that Mindfulness-Oriented Recovery Enhancement returns $12 in economic benefit for every $1 spent on treating opioid misuse and chronic pain.
The findings were published in the journal Value in Health by Fernando Wilson of the University of Utah and Eric Garland of UC San Diego.
What the Economic Analysis Found
The benefit-to-cost ratio of 12-to-1 outpaced published estimates for several established treatment options. Comprehensive case management came in at 1.8-to-1. Residential treatment ranged between 2.0-to-1 and 4.8-to-1. Intensive outpatient treatment reached 5.1-to-1.
Across a patient’s lifetime, the researchers calculated savings of $324,489 per person. They attribute those savings to reductions in healthcare use, criminal justice involvement, lost productivity and overdose mortality.
For context, the authors note that the opioid crisis costs the United States as much as $4 trillion annually across healthcare, criminal justice and lost productivity.
How the Therapy Works
MORE, developed by Garland, sequences three sets of mind-body techniques. Patients learn mindfulness skills to regulate craving and pain, cognitive reappraisal skills to manage stress and difficult emotions, and savoring techniques that help them reconnect with ordinary rewarding experiences.
Garland describes the underlying mechanism in terms of blunted reward response. Opioid addiction reduces the brain’s capacity to experience natural pleasure, which drives cravings for the drug. His research indicates the therapy helps restore that capacity.
The economic modeling draws on a randomized clinical trial of 250 adults with chronic pain who were misusing prescribed opioids. That trial found the therapy reduced opioid misuse by 45%, roughly triple the effect of standard therapy, alongside improvements in pain symptoms and opioid dosing.
Why Cost Ratios Matter for Treatment Access
Cost-effectiveness data shapes what insurers pay for and what rehab centers can afford to staff. When an approach produces strong returns at low delivery cost, health systems have a clearer case for building it into standard care rather than offering it as an add-on.
That distinction matters for people evaluating treatment options, because coverage decisions determine which therapies actually appear on the menu at a given facility.
The therapy has now been tested in more than 16 randomized clinical trials involving over 2,500 participants, and more than 1,200 clinicians in the United States and internationally have been trained to deliver it. The researchers argue wider adoption will require investment from healthcare organizations, insurers and policymakers.
Garland told UC San Diego he hopes the approach becomes central to standard care, including in primary care settings where clinicians could intervene before opioid misuse progresses to more severe addiction.
What This Means for Treatment Seekers
If you are researching addiction treatment for opioid misuse alongside chronic pain, it is reasonable to ask prospective programs whether they offer mindfulness-based interventions and which clinicians are trained in them. Availability remains uneven, and a therapy backed by this volume of trial evidence is worth asking about by name.
Cost-effectiveness research also gives people a concrete argument to raise with insurers when a specific therapy is denied or excluded from a plan’s covered services.
Finding the Right Rehab
When comparing rehab centers, ask which evidence-based therapies each program actually delivers, who is credentialed to provide them, and how those services are billed.
Verify insurance coverage for rehab before admission rather than after, and confirm whether co-occurring chronic pain is treated alongside substance use or referred out.
Rehab.com’s directory lets you compare verified treatment centers by location, level of care, accepted insurance and specialty programs. Call
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