UAMS researchers test app designed to prevent opioid use relapse
University of Arkansas for Medical Sciences researchers have developed an award-winning smartphone app designed to decrease opioid cravings and optimize medication-assisted treatment for people with opioid use disorder.
Supported by a $2.8 million grant from the National Institute on Drug Abuse, the research team is testing the effectiveness of OptiMAT (Optimizing Medication Assisted Treatment) among individuals receiving medication-assisted treatment for opioid use disorder at the UAMS Center for Addiction Services and Treatment. Researchers are piloting the program before launching a clinical trial this year.
Self-monitoring of daily opioid use is one of the app’s features. Once a day, the app asks users to report factors like their current craving level, mood, severity of withdrawal symptoms and if they’ve lapsed in misuse. The app provides personalized feedback such as congratulations for maintaining sobriety or encouragement to seek help in the event of a relapse.
Analyzing this data can help people understand how their behaviors influence their opioid misuse, said Andy James, an associate professor in UAMS’ Department of Psychiatry and a neuroimaging scientist in the UAMS Helen L. Porter and James T. Dyke Brain Imaging Research Center.
Cravings can have a contextual component so during intake, pilot program participants are asked about places where they are likely to relapse or have high cravings, like a nightclub or bar, James said. The location’s GPS coordinates are then programmed into the app so participants will receive a text-based intervention when they are near that place.
Ronald Thompson and Mary Bollinger, assistant professors in the UAMS Psychiatry Department, developed the app with James who said they were all studying addiction from different angles when they came together to work on the app. Thompson is a behavioral psychologist, Bollinger is a demographer who works with GPS data and James is a neuroscientist who studies how addiction and recovery changes the brain.
“That’s what I love about this project is all three of us, we have our own unique component that comes together to create an app that we think can provide that just-in-time immediate intervention when a person needs it the most,” James said.
The two main brain networks that experience changes during addiction and recovery are the reward and attentional control systems, he said. For people with substance use disorder, the drug being abused takes on a higher reward value and it pulls their attention.
Those systems return to normal over time during the recovery process and James’ research is focused on discovering which system changes first. To collect data, participants will lie in an MRI and James will study blood flow as they complete different attention-based and reward-based tasks using money or drug cues, he said.
During the grant’s five-year lifespan, the goal is to recruit 240 participants receiving medication-assisted treatment for opioid use disorder, James said. Some individuals will use the app while others will not. Researchers will then follow the participants over time to see if those who used the app see a reduction in opioid misuse compared to those without the app.
Researchers hope to start the clinical trial in February, and if it’s successful, roll out the app to the public in a few years, James said.
Approximately 75% of all drug overdose deaths in the United States in 2020 involved an opioid, according to the U.S. Centers for Disease Control and Prevention. Arkansas reported 546 overdose deaths in 2020, the most recent data readily available from the CDC.
A prototype of OptiMAT earned an honorable mention and a $5,000 cash prize at the National Institute on Drug Abuse’s (NIDA) Product Prototypes to Combat Drug Craving Challenge in 2022. Submissions featured a variety of products designed to reduce drug cravings and prevent drug misuse.
Officials awarded $50,000 to first place, $35,000 to second and three honorable mention entries each received $5,000.
NIDA’s director requested the Office of Translational Initiatives and Program Innovations create and run the new challenge centered on drug cravings, which can increase the likelihood that someone in recovery will return to drug use, said Sara Lioi, NIDA Challenge Lead.
Individuals may experience cravings differently and those cravings can persist long after someone has stopped substance use, Lioi said.
“There is no one size fits all treatment for drug craving, so it’s important to address drug cravings on an individual basis,” she said. “This is why we were looking for multifaceted product prototypes that could be tailored to the individual in our challenge.”
Sana Health Inc. created the winning submission — a wearable mask device that uses light and sound to help individuals reach a state of relaxation. The device has been shown to reduce symptoms of anxiety and sleep dysfunctions, and more recently has shown promise as a drug craving management tool, Lioi said.
The development of apps and devices to treat substance use disorder is a relatively new area of research, but there have been promising results and new apps are being developed all the time, she said.
“There are social connectivity apps that help substance use disorder patients in recovery find peer support, there are apps to help health care workers find an open bed in a treatment facility for a patient who needs it, and there are apps like the one the Arkansas researchers developed where a patient can track their cravings and mood and get updates on their progress during recovery to attain their personal goals,” Lioi said.
NIDA doesn’t plan to host this same challenge in 2023, but Lioi said anyone with an idea for a product for the prevention, diagnosis and or treatment of substance use disorders can contact her office, which has organized different competitions over the years and will continue to do so.
“Even if we do not release this particular challenge competition again, NIDA is committed to understanding and ameliorating the impacts of substance use on individuals and will work to continuously improve individual and public health,” Lioi said. “The long-term goal for this particular challenge would be to assist the creators of these product prototypes in any way we can to further test and commercialize the products so that they are widely available.”
The UAMS researchers have reached out to Sana Health and the second place winners who created an automated nicotine reduction device. The three research groups submitted a proposal and will discuss their prototypes during the College on Problems and Drug Dependence’s annual meeting this summer, James said.