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A solid evidence base suggests patients who participate in formal substance use treatment experience high relapse rates upon discharge due to repeated exposure to environmentally-triggered stimuli. Exposure to such triggers leads to heightened autonomic arousal, craving, and ultimately substance use. Traditionally, cue paradigm research programs in addiction science have sought to understand how drug cues/triggers affect brain and behavior (i.e., relapse), typically via craving mechanism. Our research examines the flip side of this traditional line of inquiry by seeking to understand the impact of recovery cues on reorganizing the addicted brain towards health and recovery. A personalized mobile intervention that deploys individually-tailored strategies to resist the stimuli could reduce the probability of drug use and reduce the likelihood of relapse during this high-risk institution-to-community transitioning process. Recovery Engaged Mind-health (REMind-h) is one such new technological innovation that helps individuals in recovery regulate in-vivo craving response to drug cues by activating a personalized recovery-cue intervention on their mobile phone when their neurophysiological reactivity threshold is detected by a connected wearable sensor. The research aim was to conduct a feasibility study for the REMind-h prototype by examining the effect of personalized recovery cues on reducing drug cue exposure reactivity, as measured by Heart Rate Variability (HRV) change, in a sample of young adults in substance use recovery.
METHODS
Participants were recruited through the campus wellness office. A total of 8 young adults in substance use recovery participated in the study and completed two individual interviews. The first interview asked open-ended questions about their drug cue triggers and requested that they come to the second interview with a compilation of their recovery-specific images, music, sounds, inspirational quotes, associated with their commitment to recovery. In the second interview, we measured HRV at baseline, just after exposure to their drug-related stimuli (pictures of their specific drug-related cues), and immediately after exposure to their individualized music/imagery recovery cues.
RESULTS
Participants’ personalized recovery interventions included inspirational quotes, images/photos of special hobbies, images of their own artwork, pictures of meaningful relationships, important places, songs/music that was healing or otherwise held significant meaning to participants. Results showed that a person’s recovery intervention was associated with a more relaxed physiological state immediately after drug cue exposure (HRV rMSSD drug cue Mean = 53.55 vs HRV rMSSD recovery cue Mean = 71.90; P<= .05).
CONCLUSIONS and IMPLICATIONS
Our newly designed Recovery Engaged Mind-health (REMind-h) prototype is the first-of-its-kind mobile device support system for patients in substance use recovery. REMind-h is significantly different than what is currently available in that it delivers an individually tailored recovery cue intervention to improve behavioral health decision-making. REMind-h is designed to activate when it registers a patient-specific neurophysiological reaction threshold, and then displays the personalized intervention on the patient’s mobile phone. Our science team is currently working with scientists in bioengineering to invent the hardware device (wearable sensor technology) that can be used to monitor HRV and other physiological stress metrics, which will connect to the REMind-h phone application.