Addiction treatment providers scrambled at the start of the coronavirus pandemic to find ways to keep people engaged after closing their physical doors.
For the most part, that meant telehealth or audio or video calls. But with fatal overdoses on the rise in Maryland and nationally, leaders of the Center for Addiction Medicine at the University of Maryland Medical Center Midtown Campus have turned to an additional measure that is becoming a silver lining in their efforts.
This is a mobile app that they started testing about a year ago specifically for people with opioid use disorder.
Called reSET-O, it is intended for people being treated for opioid use. Another called reSET is for people being treated for alcohol and other substance use. These were the first prescription apps approved by the US Food and Drug Administration for substance use disorders, in 2018 and 2017, respectively.
There are now several other FDA-approved behavioral health mobile apps that help get insurance coverage after they are proven to work. There are possibly thousands of other apps that the FDA says don’t need approval because they don’t treat a condition but are still aimed at helping people with their mental health. This includes some meditation apps, for example.
ReSET provides cognitive behavioral therapy, a method to help people deal with problems by changing the way they think and act, and is offered in addition to counseling and medication.
A year into the effort, and on the heels of the state’s record 2,500 opioid overdose deaths in 2020, clinic leaders say the results so far are promising. Midtown center director Marian Currens said 67 of her 130 patients had downloaded the app and half had completed the 12-week program. Sixteen prescriptions renewed.
“It is my goal to ensure that no patient is left untreated, even if they cannot come into our practice,” she said. “It’s not for all patients, but digital technology is the way of the future and we need to make it more accessible.”
The app uses modules that users can tap on at any time to develop their adaptive skills and stay engaged. The modules focus on things like improving sleep, finances and relationships, or managing anxiety. The app also asks users about their substance use, cravings and triggers and relays the information to therapists. It provides small gift cards once users complete certain modules.
The app was developed by Boston-based Pear Therapeutics and initially gained FDA approval through a process called de novo premarket review, which provides a pathway for new devices with low to moderate risk. , after a 12-week trial showed an increase in abstinence.
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Keisha Manns, a 47-year-old Baltimore woman, started using the app last June to help her avoid prescription opioids she said she started abusing during cancer treatment and around the when she lost her son.
She said she developed anger issues and, like many people desperate to pay for opioids, she ended up incarcerated. But when she was released, she sought out a treatment program and the center in Midtown offered her the app along with other treatments.
She said the advice was helpful, but insists the app made the difference.
“It gives you other routes to get off and other ways to stay clean,” she said. “Once I’ve finished the modules, I do a few again. They talk about everything you could think of, all the real world stuff, like what to do when you see an old friend on the way to a job interview so you don’t end up in a house and using again.
Some of the non-drug use modules are the most helpful, she said, such as those focused on anger management, coping and even journaling.
Manns plans to renew her prescription for as long as she can. In June, she plans to become a certified medical assistant and hopes to eventually provide end-of-life care for the elderly.
“I really want to get the word out to people about this app,” she said. “I want to put it on T-shirts and coffee mugs.”