An Effective and Safe Novel Treatment of Opioid Use Disorder: Unilateral Transcranial Photobiomodulation
Background: The opioid epidemic is a global tragedy even with current treatments, and a novel, safe, and effective treatment would be welcomed. We report here our findings from our second randomized controlled trial to evaluate unilateral transcranial photobiomodulation as a treatment for opioid use...
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| Format: | Article |
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Frontiers Media S.A.
2021-08-01
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| Series: | Frontiers in Psychiatry |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpsyt.2021.713686/full |
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| author | Fredric Schiffer Fredric Schiffer Fredric Schiffer Alaptagin Khan Alaptagin Khan Elizabeth Bolger Edward Flynn William P. Seltzer Martin H. Teicher Martin H. Teicher |
| author_facet | Fredric Schiffer Fredric Schiffer Fredric Schiffer Alaptagin Khan Alaptagin Khan Elizabeth Bolger Edward Flynn William P. Seltzer Martin H. Teicher Martin H. Teicher |
| author_sort | Fredric Schiffer |
| collection | DOAJ |
| description | Background: The opioid epidemic is a global tragedy even with current treatments, and a novel, safe, and effective treatment would be welcomed. We report here our findings from our second randomized controlled trial to evaluate unilateral transcranial photobiomodulation as a treatment for opioid use disorder.Methods: We enrolled 39 participants with active opioid cravings at 2 sites, 19 received the active treatment which consisted of a 4-min twice weekly (every 3 or 4 days) application of a light-emitting diode at 810 nm with an irradiance of 250 mW/cm2 and a fluence of 60 J/cm2 to the forehead over either the left or right dorsolateral prefrontal cortex with a fluence to the brain of 2.1 J/cm2. Twenty participants received a sham treatment with the same device with foil over the bulb. The side of the treatment was based on Dual-Brain Psychology, which posits that one hemisphere is more affected by past maltreatments and is more prone to anxiety and drug cravings that the other hemisphere. We treated the hemisphere with the more positive hemispheric emotional valence (HEV) by 2 tests for HEV.Results: Our primary outcome was changes in pre-treatment opioid craving scale (OCS) minus baseline, and we found using a mixed model that the active group had a highly significant treatment * time benefit over the sham group, p < 0.0001, effect size at the last follow-up of 1.5. The active treatment benefited those not on buprenorphine as well as those not on it. The TimeLine Follow Back measure of opioid use was significantly better in the actively treated group, p = 0.0001, with an effect size of 0.45. We observed no adverse effects.Conclusion: Active unilateral transcranial photobiomodulation to the brain hemisphere with the better HEV was better than sham in the reduction of opioid cravings and opioid use to a very significant degree in a RCT of 39 participants at 2 independent sites. In the active group those on buprenorphine and those not on it both had improvements in cravings over the study. No adverse responses were reported in either group. ClinicalTrials.gov Identifier: NCT04340622. |
| first_indexed | 2024-12-21T20:00:38Z |
| format | Article |
| id | doaj.art-c118cf288edf4242a406660d0571fd0a |
| institution | Directory Open Access Journal |
| issn | 1664-0640 |
| language | English |
| last_indexed | 2024-12-21T20:00:38Z |
| publishDate | 2021-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Psychiatry |
| spelling | doaj.art-c118cf288edf4242a406660d0571fd0a2022-12-21T18:51:59ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402021-08-011210.3389/fpsyt.2021.713686713686An Effective and Safe Novel Treatment of Opioid Use Disorder: Unilateral Transcranial PhotobiomodulationFredric Schiffer0Fredric Schiffer1Fredric Schiffer2Alaptagin Khan3Alaptagin Khan4Elizabeth Bolger5Edward Flynn6William P. Seltzer7Martin H. Teicher8Martin H. Teicher9MindLight, LLC, Newton Highlands, MA, United StatesDevelopmental Biopsychiatry Research Program, McLean Hospital, Belmont, MA, United StatesDepartment of Psychiatry, Harvard Medical School, Boston, MA, United StatesDevelopmental Biopsychiatry Research Program, McLean Hospital, Belmont, MA, United StatesDepartment of Psychiatry, Harvard Medical School, Boston, MA, United StatesDevelopmental Biopsychiatry Research Program, McLean Hospital, Belmont, MA, United StatesMindLight, LLC, Newton Highlands, MA, United StatesMindLight, LLC, Newton Highlands, MA, United StatesDevelopmental Biopsychiatry Research Program, McLean Hospital, Belmont, MA, United StatesDepartment of Psychiatry, Harvard Medical School, Boston, MA, United StatesBackground: The opioid epidemic is a global tragedy even with current treatments, and a novel, safe, and effective treatment would be welcomed. We report here our findings from our second randomized controlled trial to evaluate unilateral transcranial photobiomodulation as a treatment for opioid use disorder.Methods: We enrolled 39 participants with active opioid cravings at 2 sites, 19 received the active treatment which consisted of a 4-min twice weekly (every 3 or 4 days) application of a light-emitting diode at 810 nm with an irradiance of 250 mW/cm2 and a fluence of 60 J/cm2 to the forehead over either the left or right dorsolateral prefrontal cortex with a fluence to the brain of 2.1 J/cm2. Twenty participants received a sham treatment with the same device with foil over the bulb. The side of the treatment was based on Dual-Brain Psychology, which posits that one hemisphere is more affected by past maltreatments and is more prone to anxiety and drug cravings that the other hemisphere. We treated the hemisphere with the more positive hemispheric emotional valence (HEV) by 2 tests for HEV.Results: Our primary outcome was changes in pre-treatment opioid craving scale (OCS) minus baseline, and we found using a mixed model that the active group had a highly significant treatment * time benefit over the sham group, p < 0.0001, effect size at the last follow-up of 1.5. The active treatment benefited those not on buprenorphine as well as those not on it. The TimeLine Follow Back measure of opioid use was significantly better in the actively treated group, p = 0.0001, with an effect size of 0.45. We observed no adverse effects.Conclusion: Active unilateral transcranial photobiomodulation to the brain hemisphere with the better HEV was better than sham in the reduction of opioid cravings and opioid use to a very significant degree in a RCT of 39 participants at 2 independent sites. In the active group those on buprenorphine and those not on it both had improvements in cravings over the study. No adverse responses were reported in either group. ClinicalTrials.gov Identifier: NCT04340622.https://www.frontiersin.org/articles/10.3389/fpsyt.2021.713686/fullopioid use disorderopioid cravingsopioid usehemispheric lateralityphotobiomodulation |
| spellingShingle | Fredric Schiffer Fredric Schiffer Fredric Schiffer Alaptagin Khan Alaptagin Khan Elizabeth Bolger Edward Flynn William P. Seltzer Martin H. Teicher Martin H. Teicher An Effective and Safe Novel Treatment of Opioid Use Disorder: Unilateral Transcranial Photobiomodulation Frontiers in Psychiatry opioid use disorder opioid cravings opioid use hemispheric laterality photobiomodulation |
| title | An Effective and Safe Novel Treatment of Opioid Use Disorder: Unilateral Transcranial Photobiomodulation |
| title_full | An Effective and Safe Novel Treatment of Opioid Use Disorder: Unilateral Transcranial Photobiomodulation |
| title_fullStr | An Effective and Safe Novel Treatment of Opioid Use Disorder: Unilateral Transcranial Photobiomodulation |
| title_full_unstemmed | An Effective and Safe Novel Treatment of Opioid Use Disorder: Unilateral Transcranial Photobiomodulation |
| title_short | An Effective and Safe Novel Treatment of Opioid Use Disorder: Unilateral Transcranial Photobiomodulation |
| title_sort | effective and safe novel treatment of opioid use disorder unilateral transcranial photobiomodulation |
| topic | opioid use disorder opioid cravings opioid use hemispheric laterality photobiomodulation |
| url | https://www.frontiersin.org/articles/10.3389/fpsyt.2021.713686/full |
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