Symposia
Addictive Behaviors
Kirsten Langdon, Ph.D. (she/her/hers)
Warren Alpert medical School of Brown University
Providence, Rhode Island
ENhancing Distress Tolerance to Uplift Motivation in REcovery (iENDURE) is a two-part program designed to enhance motivation and improve tolerance of distress to promote buprenorphine uptake and recovery from Opioid Use Disorder. iENDURE focuses on enhancing motivational processes in combination with teaching strategies for tolerating distress through a single, brief, web-based session followed by eight weeks of personalized text messages.
Daily messages serve to remind participants of salient motivational factors for recovery as well as provide suggestions for distress tolerance coping skills that were tailored to mood state and level of urges/cravings. A Pilot Randomized Clinical Trial comparing the efficacy of iENDURE to a control condition (e.g., treatment-as-usual) is currently being conducted. While data collection is ongoing, the present investigation sought to examine initial feasibility and acceptability of iENDURE by evaluating engagement among participants assigned to the intervention arm.
Participants included 48 patients (53% Male; Mage = 47.2; 66% White, 86% Non-Hispanic), actively engaged in buprenorphine care, through an outpatient addiction treatment setting. The mean daily response rate to text messages was 66%. The average rating on the System Usability Scale at the end of the 8-week program was 70%, suggesting that the intervention was relatively easy to use. At the end of the intervention, there was an observed increase in motivation for recovery (Mbaseline = 8.6; M8-Week = 9.8), confidence in the ability to maintain abstinence (Mbaseline = 9; M8-Week = 9.3), and recovery capital (Mbaseline = 47.9; M8-Week = 51.8). Mean level of opioid craving decreased from baseline to the 8-week follow-up (Mbaseline = 2; M8-Week = 1.3).
Mean level of negative affect also decreased from baseline to the 8-week follow-up (Mbaseline = 21.8; M8-Week = 18.4). Our preliminary data suggests that when combined with buprenorphine medication, adjunctive motivational enhancement and distress tolerance skills training, delivered via a digital health platform, may hold promise for promoting recovery processes among individuals engaging in outpatient treatment for Opioid Use Disorder. Future work will compare the effectiveness of iENDURE to treatment-as-usual.