KALAMAZOO, Mich.—Research on the horizon at Western Michigan University could lead to life-saving results for people struggling with opioid addiction. Addiction recovery technology company DynamiCare Health, in collaboration with WMU, has been awarded a $222,383 grant from the National Institutes of Health's Helping to End Addiction Long-term, or NIH HEAL, Initiative.
Dr. Anthony DeFulio, associate professor of psychology, will lead the research, which involves testing the feasibility of a smartphone application to reduce relapse in patients who have overdosed and enroll them in medication-assisted treatment.
"It's clear that a multi-pronged scientific approach is needed to reduce the risks of opioids, accelerate development of effective non-opioid therapies for pain and provide more flexible and effective options for treating addiction to opioids," says Dr. Francis S. Collins, NIH director, who launched the initiative in early 2018.
The Research
DeFulio
The project focuses on contingency management—a behavioral intervention that employs incentives to motivate healthy behavior. The incentive in this study is money
"The classic treatment interventions work better when you use more powerful incentives, because drugs are powerful incentives on their own," says DeFulio. "So, you have to compete with alternative reinforcers to get people to make different decisions."
DeFulio collaborated with DynamiCare, which is based in Boston, to develop an app that works in tandem with salivary toxicology tests. It ensures participants are actually taking the test with video selfies and also employs GPS tracking technology in smartphones to ensure that they are going to counseling appointments and receiving the treatment they need to stay healthy.
DeFulio will work with Dr. Philip Pazderka, director of the Emergency Medicine Residency Program at the WMU Homer Stryker M.D. School of Medicine, to collaborate with local hospitals and offer patients who have recently overdosed a chance to immediately enroll in treatment and participate in the study. The group will also enlist the peer recovery team at Kalamazoo Community Mental Health and Substance Abuse Services.
“WMU is committed to bringing the expertise of our faculty to address the challenges of opioid abuse treatment and prevention, and our partnerships with companies and community groups result in far more than additive advances in our research,” says Dr. Terri Goss Kinzy, vice president for research and innovation at WMU. “The National Institutes of Health funding is essential to developing new approaches."
About 20 participants are expected to participate in the two-month study. As participants successfully engage and adhere to treatment over the course of a month, they will receive money on a smart debit card. Restrictions will be placed on where the card can be used to ensure that purchases are consistent with the goals of the treatment.
DynamiCare has received recognition for its technology platform, but this is the first time the company's system—or contingency management itself—will be used in emergency departments to engage patients upon reversal from acute opioid overdose.
"Dr. DeFulio is conducting a seminal demonstration of the potentially life-saving use of motivational incentives, based on operant conditioning and behavioral economics," says Dr. David R. Gastfriend, co-founder and chief medical officer of DynamiCare.
"WMU is situated in a region of the U.S. that is being devastated by this epidemic," he adds, "and its ability to collaborate with medical and emergency facilities and personnel makes it optimally suited to this groundbreaking research."
NIH HEAL Initiative
The National Institutes of Health launched the Helping to End Addiction Long-term Initiative, or HEAL Initiative, in April 2018 to improve prevention and treatment strategies for opioid misuse and addiction and enhance pain management.
WMU's award is one of 375 grant awards across 41 states made by the NIH in fiscal year 2019 to apply scientific solutions to reverse the national opioid crisis.
"This unprecedented investment in the NIH HEAL Initiative demonstrates the commitment to reversing this devastating crisis," says Collins.
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