Text Messaging Tool Aids in Curbing Opioid Abuse

senior author, Avik Som, MD/PhD, student at Washington University

Avik Som, PhD

A new automated text messaging system, EpxSubstanceUse, created by researchers at Washington University School of Medicine and Epharmix, may aid as an additional tool in curbing opioid abuse and reduce the likelihood of relapse while decreasing treatment costs.

Patients being treated for opioid addiction can utilize the service by responding to automated text messages and phone calls that inquire about patients’ status or if they’re struggling with possible relapse, which the app then relays responses to a doctor.

The new form of support also has an emergency panic button that users can activate for immediate help. Once the button is activated, health care workers phone patients and provide counseling, scheduling for in-person appointments or other resources.

By checking in through text, doctors will be able to evaluate patients’ general status and determine if more attention is necessary. Those that reported struggling, receive automated follow-up questions that classify the risk of relapse as high, moderate or low, while health care workers are alerted immediately to intervene.

“A plethora of programs exist that address opioid addiction recovery, but the challenge will be how efficiently existing programs can be scaled to meet the needs of an ever-growing population of people struggling with substance use disorder,” researchers noted.

According to the Centers for Disease Control and Prevention, nearly 100 people die each day due to opioid overdoses.

“There is an urgent need to address the opioid crisis in powerful new ways” senior author, Avik Som, PhD, MD student, Washington University, chief medical officer, Epharmix, said in a statement. “With the opioid epidemic, time is of the essence because of how quickly it’s grown and the lives that are lost.”

The mobile technology is designed to supplement cognitive behavioral therapy, support services and other treatments aimed at combating the addiction and is not meant to replace programs or face-to-face interactions.

Researchers conducted a study on 21 patients who began using the service in late 2016 as part of treatment at Preferred Family Healthcare, a St. Louis community-based organization offering treatment for substance abuse.

Data collected through text correspondence found that at time of enrollment, 9 patients (42%) reported substance abuse use in the previous 3 days, and 9 patients (41%) reported no use, while the remaining did not respond.

After the 3 months, half of the 21 patients reported no substance abuse, while the number of patients using dropped to 2 (10%). Nine patients admitted to using again within the first 3 days of the study.

While the positive trend cannot solely be attributed to the app, results are encouraging.

Patients and caregivers reported that the ease and familiarity of the text message system was preferred, and since texting has become an integral part of society, it’s a convenient, immediate and nonjudgmental way to communicate to health care providers.

The patients included in the study were on Medicaid and individually accrued more than $20,000 in medical costs related to substance abuse and other health issues. Per-patient costs for caregiver services specific to addiction-related care, calculated by researchers, would drop 19% from $926 annually to $753.

According to researchers, reduced costs were attributed to the texting service, which allows for more efficient patient follow-up and better patient treatment targeting.

While 21 patients were enrolled in the initial study, about 100 are expected to participate by early 2019. Patients remain in the program for anywhere from a few months to years, depending on the length of recovery.

Further studies are needed for researchers to examine the strategy in a larger patient group and to gauge the potential savings in Medicaid funding and related costs.

Findings of the small study, “Messaging System Helps Caregivers Keep Tabs on Growing Number of Patients with Substance Use Disorder” are published in NEJM Catalyst.