Details for Health Professionals

Background: Psychological comorbidities are disproportionately common in people with chronic pain with rates as high as 60%, comparing to only 10-15% in age matched controls. Having a mental health disorder is associated with an increased risk of being prescribed an opioid, being maintained on long-term opioid therapy (LTOT), and being on higher dose opioids. Furthermore, those with mental health disorders who are prescribed opioids have a higher risk of developing a substance use disorder and of overdosing. Taken together, these data suggest that chronic pain sufferers with comorbid mental health disorders on opioid therapy are a critical population to target for interventions to reduce population-level harms from opioids. A substantial body of evidence suggests meditation as a promising intervention to address the needs of this vulnerable population. In terms of efficacy, a recent systematic review demonstrated moderate effects for meditation and pain (ES: 0.33), as well as common comorbidities such as depression (ES: 0.30) and anxiety (ES: 0.38). Sahaj Samadhi is a meditation practice whose processes lead to stress reduction and deep relaxation. Two existing RCTs comparing this kind of meditation to a Health Education Program in adults >55 years of age, showed clinically significant reductions (48%) in depressive symptoms.

Objectives: We aim to assess the role of Sahaj Samadhi Meditation (SSM) compared to an active control, Health Enhancement Program (HEP) in a 12-week RCT in patients with depression in chronic pain which will assess the effects of these interventions on depression and a number of relevant health-related outcomes. We also aim to evaluate the implementation of the SSM intervention at the study site to facilitate interpretation of the RCT outcomes and inform future program implementation.

Study Plan: All study procedures, including recruitment, assessments, and study interventions (both SSM and HEP), will take place at RMG. Both interventions will be taught over 4 consecutive days in similar sized groups (10-15 participants) followed by weekly reinforcement sessions for 11 weeks. We hope to recruit a sample size of 160 participants: 80 per intervention, 6 cohorts each, with paired cohorts starting one month apart from one another. The overall duration of the study is anticipated to span approximately 8-9 months once the first cohort begins around the end of October.

What we need from you: Apart from coordinating logistics, we need help from clinicians and staff to introduce RMG patients to the study and connect them with study personnel to be recruited. We are not expecting you to actively recruit patients – brochures, posters, and scripts will be provided when we obtain approval from the ethics board to begin the study.

Right now: For the time-being, please refer to the attached document which includes the basic eligibility criteria for participating in the study. If you could begin compiling a list of current patients that potentially meet the criteria, that would help expedite the initial recruitment process once we have approval.