A Text Messaging Program to Help Prevent Early Opioid Relapse

The vast majority of those with opioid dependence do not receive treatment. This may be due to the limited availability of existing treatment programs and to a range of societal and individual-level barriers, including the stigma associated with identifying oneself as a substance user and difficulty attending a treatment program on a regular basis. Technology-based interventions have potential to help address these barriers and to expand access to evidence-based psychosocial treatment. Automated, computer-based interventions have found high user acceptance and utilization and shown promise in treating substance use disorders. The current study will evaluate a text-message-based psychosocial program called PIER1 (Preventing and Interrupting Early Relapse 1) when delivered to treatment-seeking opioid-dependent emergency department (ED) patients. PIER1 is an interactive program based on the Relapse Prevention Model. It is also informed by cognitive behavioral therapy and motivational interviewing.

Inclusion criteria

• Age 18 - 60 years
• Seeking treatment for substance abuse (chief complaint of "detox")
• English speaking
• Opioid dependence (nursing history of opioid use + RODS score>3)
• Ownership of a mobile phone with text messaging
• Medically and psychologically stable (as determined by the clinician or investigator)

Exclusion criteria

• No mobile phone ownership or mobile phone without text messaging capabilities
• Incarcerated/in police custody
• Being treated for a self-inflicted injury or suicidal ideation (as determined by the clinician)
• Medical condition affecting cognition (as determined by the clinician or investigator's discretion)
• Unable to read, speak, or comprehend English (at the clinician or investigator's discretion)
• Patients who are under the influence of illicit drugs or alcohol (at the clinician or investigator's discretion)