Lebanon,
New Hampshire
03766
Purpose:
The majority of opioid users meet criteria for anxiety and depressive disorders, but most
substance use disorder treatment programs do not offer treatment for co-occurring mental
health problems. Anxiety and depression may also be directly linked to opioid use itself.
Although treatments have been developed for anxiety and depressive symptoms for opioid users
within face-to-face settings, few treatment facilities offer these in-person interventions
due to their high cost and time burden. Given the deficits in research on treatments for
anxiety and depression among those with opioid use disorder, the current research will
examine the efficacy of a digital intervention designed to treat anxiety and depressive
symptoms by augmenting the state of the science medication-based opioid use disorder
treatment. Over the course of the proposed study, the research team will design and test the
feasibility and acceptability of a standalone mobile intervention designed to treat persons
receiving medication treatment for opioid use disorder. Participants receiving medication
treatment for opioid use disorder will be randomized to receive a digital intervention to
treat anxiety and depression or care as usual for a total of four weeks. The overarching goal
of the proposed work is to test the feasibility and acceptability of the proposed mobile
intervention. The Investigators will also explore the preliminary efficacy by examining
reductions in anxiety and depressive symptoms and opioid cravings and use. This work could
lead to a low-cost scalable solution to augment gold-standard treatment as usual in opioid
use disorder by decreasing levels of comorbidity of anxiety and depressive disorders, thereby
ultimately improving the outcomes of opioid use disorder itself.
Study summary:
The study team will recruit a population of 60 adults who are receiving medication treatment
for OUD from an online study based on Google Adwords, Reddit, and Facebook advertisements as
online recruitment has been shown to be a viable and cost-effective recruitment method for
opioid users. The total sample size may be expanded if recruitment costs are lower than
expected.
Participants will complete self-report assessments on their anxiety symptoms, depressive
symptoms, opioid cravings, and opioid use behaviors. Participants will be randomized to a
smartphone-based digital intervention or waitlist control condition. The digital intervention
will be designed to treat participants' anxiety and depressive symptoms, and participants
will be asked to use the intervention four times per week for four weeks (16 digital
sessions).The smartphone intervention will also collect passive sensing data continuously
during the 4 week period. Participants will complete post measures and one-month follow-up
measures on anxiety symptoms, depressive symptoms, opioid cravings, and opioid use behaviors.
The urine drug screen will be mailed to participants. Participants will also be asked to
complete five urine tests to detect substance use (amphetamines, barbiturates,
benzodiazepines, cocaine, ecstasy, marijuana, methamphetamine, opioids, oxycodone, and pcp)
across the study (1 at pre-digital intervention, 1 during the digital intervention, 1
post-digital intervention, 1 between post and follow-up of the digital intervention, and 1 at
the 1-month follow-up of the digital intervention). Participants will be instructed when to
complete each urine test and will be asked to take a photo of the back the label of each test
showing the results to the experimenters and to text these photos to a Google Voice Number
maintained by the experimenters.
Thus, this proposal seeks to address a crucial deficit in the availability of treatments for
anxiety and depressive disorders among persons with OUD to ultimately augment treatment for
OUD.
Criteria:
Inclusion Criteria:
- Adults (age 18 or older)
- fluent in English
- able to provide informed consent
- meet current criteria for OUD (as defined by a Rapid Opioid Dependence Screen)
- are receiving methadone, buprenorphine, and/or naltrexone for OUD
- meet current criteria for an anxiety and/or depressive disorder (based on the Patient
Health Questionnaire and the Generalized Anxiety Disorder Questionnaire).
Exclusion Criteria:
- active suicidality
- psychosis
- bipolar disorder