Everyone knows that stubbing your toe
hurts. What makes it stop hurting is the body’s main pain-blocking process – the natural production of opioids.
Cognitive-based approaches found to reduce pain, such as hypnosis,
acupuncture, distraction and even the placebo response, have been shown to work
through this system. But does meditation also use opioids to reduce pain?
In a study published in the current issue of the Journal
of Neuroscience, a team led by Fadel Zeidan, Ph.D., assistant professor of
neurobiology and anatomy at Wake Forest Baptist Medical Center, reports that
mindfulness meditation does not employ the endogenous opioid system to reduce
“Our finding was surprising and could be important for
the millions of chronic pain sufferers who are seeking a fast-acting,
non-opiate-based therapy to alleviate their pain,” Zeidan said.
The Institute of Medicine estimates that approximately 100
million Americans suffer from chronic pain at a cost of more than $600 billion
annually for treatment. And due to the increase in the number of people
addicted to opiate drugs, from prescription medications to heroin, the Centers
for Disease Control has labeled the problem an epidemic.
To determine if meditation uses the body’s opioids to
reduce pain, the Wake Forest Baptist researchers injected study participants
with either a drug called naloxone, which blocks the pain-reducing effects of
opioids, or a saline placebo.
In this randomized, double-blinded study, 78 healthy,
pain-free volunteers were divided into four groups for the four-day (20 minutes
per day) trial. The groups consisted of: meditation plus naloxone;
non-meditation control plus naloxone; meditation plus saline placebo; or non-meditation
control plus saline placebo.
Pain was induced by using a
thermal probe to heat a small area of the participants’ skin to 49 degrees
Centigrade (120.2 degrees Fahrenheit), a level of heat most people find very painful. Study
participants rated their pain using a sliding scale.
Zeidan found that the participants’ pain ratings were
reduced by 24 percent from the baseline measurement in the meditation group
that received the naloxone. This is important because it showed that even when
the body’s opioid receptors were chemically blocked, meditation still was able
to significantly reduce pain by using a different pathway, he said. Pain ratings
also were reduced by 21 percent in the meditation group that received the placebo-saline
comparison, the non-meditation control groups reported increases in pain
regardless of whether they got the naloxone or placebo-saline injection.
“Our team has demonstrated across four separate studies
that meditation, after a short training period, can reduce experimentally
induced pain,” Zeidan said. “And now this study shows that meditation doesn’t
work through the body’s opioid system.
“This study adds to the growing body of evidence that
something unique is happening with how meditation reduces pain. These findings
are especially significant to those who have built up a tolerance to
opiate-based drugs and are looking for a non-addictive way to reduce their
The next step for Zeidan’s team is to determine if and
how mindfulness meditation can affect a spectrum of chronic pain conditions.
“At the very least, we believe that meditation could be
used in conjunction with other traditional drug therapies to enhance pain
relief without it producing the addictive side effects and other consequences
that may arise from opiate drugs,” he said.
The study was supported by the National Center for
Complementary and Integrative Health K99-AT008238, the Mind and Life Institute
and the Wake Forest Translational Science Institute.
Co-authors of the study are: A.L. Adler-Neal, M.P.H.,
R.E. Wells, M.D., J.C. Eisenach, M.D., and J.G. McHaffie, Ph.D., of Wake Forest
Baptist; E. Stagnaro, B.S., of Wake Forest University; L.M. May, B.S., of the
University of Oregon; and R.C. Coghill, Ph.D., of Cincinnati Children’s
Hospital Medical Center.