App could help identify risk of relapsing from opioid addiction treatment

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Researchers at NYU Langone Health want to see whether a computer betting game could predict the risk that a person recovering from opioid addiction will relapse.

The game, which researchers now are developing as an app, tests a patient’s willingness to take risks, producing mathematical scores called betas that economists use to measure consumer willingness to try new products.

The researchers then employed a statistical test to determine whether changes in risk-taking tracked with opioid reuse and found that people who placed higher-risk bets had higher beta scores.

When combined with other test scores that quiz a patient about recent drug use or desire to use drugs, as many as 85 percent of patients who showed sharp increases in their total beta scores were likely to relapse during the next week.
Those whose beta scores did not show a spike were much less likely to use during treatment, which generally includes a combination of therapy and drugs to wean patients off their addiction.

Findings in the Journal of the American Medical Association Psychiatry that were published on line recently could lead to the design of clinical tools for tracking and reducing the number of patients relapsing and using opiates during treatment.

More than 2 million Americans are believed to have a form of opioid use disorder, and a majority of patients relapse during treatment, with more than half doing so within a year of having therapy.

“Our study shows that computer-based diagnostic tests may offer a useful new option,” says Paul Glimcher, the senior investigator and a neuroeconomist. “Ideally, clinicians would have several tools for real-time monitoring of how well patients are doing to get off opioids, which includes betting games.”

Researchers recruited 70 men and women undergoing therapy at NYCHealth+Hospital/Bellevue. Each played the game regularly for seven months when they came in for clinic visits. Their results were compared with those of 50 other Bellevue patients who played the game weekly and were never addicted to opioids. Risk scores were plotted on a graph to track patients’ willingness to take known or unknown risk.

“Patients generally demonstrate a pattern of ups and downs during treatment, with low beta scores when they feel able to resist the urge to reuse, but the scores then rise quickly right before patients reuse, when they start feeling lucky and are willing to place higher-risk bets,” Glimcher explains.

Now, the goal is to use the smartphone app that Glimcher created to provide daily monitoring of patients. Results could be sent to a patient’s medical team, mental health support group, family and friends, to alert them when a patient is vulnerable and at risk to reuse.

The complete study is available here.

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