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Mindfulness-Oriented Recovery Enhancement (MORE) remediates the hedonic dysregulation in brain reward systems that is associated with OUD. Our pilot and phase 2 randomized controlled trials of MORE were the first to demonstrate MORE\u2019s feasibility, acceptability, and efficacy as delivered in MT clinics; MORE significantly reduced drug use (eg, benzodiazepines, barbiturates, cocaine, marijuana, opioids, and other drugs), craving, depression, anxiety, and pain among people with OUD. However, uptake of novel, efficacious interventions like MORE may be slow in MT because time and resources are often limited. Therefore, to best address potential implementation issues and to optimize future MORE implementation and dissemination, in this study, we will utilize a Type 2, Hybrid Implementation-Effectiveness study design. We will not only evaluate MORE\u2019s effectiveness but also assess barriers and facilitators to integrating MORE into MT. MT clinicians will receive training in (1) a higher intensity MORE implementation strategy consisting of training in the full MORE treatment manual or (2) a minimal intensity implementation strategy consisting of a simple, scripted mindfulness practice (SMP) extracted from the MORE treatment manual with minimal training. We aim to: (1) using a Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework, examine barriers and facilitators to implementation of MORE and SMP in MT, and evaluate strategies for optimizing training, fidelity, and engagement, (2) optimize existing MORE and SMP training and implementation toolkits, including adaptable resources that can accelerate the translation of evidence into practice, and (3) compared to usual MT, evaluate the relative effectiveness of MORE plus MT or SMP plus MT (N\u2009=\u2009450).<\/jats:p>","DOI":"10.1177\/29767342241261890","type":"journal-article","created":{"date-parts":[[2024,6,22]],"date-time":"2024-06-22T07:50:42Z","timestamp":1719042642000},"page":"160-165","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Commentary With Study Protocol: Implementation and Effectiveness of Mindfulness-Oriented Recovery Enhancement (MORE) as an Adjunct to Methadone Treatment for Opioid Use Disorder (IMPOWR-MORE)"],"prefix":"10.1177","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2086-6042","authenticated-orcid":false,"given":"Nina A.","family":"Cooperman","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jincheng","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2453-8871","authenticated-orcid":false,"given":"Adam J.","family":"Gordon","sequence":"additional","affiliation":[{"name":"Program for Addiction Research, Clinical Care, Knowledge and Advocacy (PARCKA), Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA"},{"name":"Informatics, Decision-Enhancement, and Analytic Sciences (IDEAS) Center, VA Salt Lake City Health Care System, Salt Lake City, UT, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric L.","family":"Garland","sequence":"additional","affiliation":[{"name":"College of Social Work, University of Utah, Salt Lake City, UT, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2024,6,22]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1402780"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1080\/00952990802342899"},{"key":"e_1_3_2_4_2","first-page":"9","article-title":"A prospective study to investigate predictors of relapse among patients with opioid use disorder treated with methadone","volume":"10","author":"Naji L","year":"2016","unstructured":"Naji L, Dennis BB, Bawor M, et al. 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