Empower Opioid Misuse & Chronic Pain (RAP_EOM)

University of California San Francisco (UCSF)

Status: Completed

Conditions: Chronic Pain; Opioid Use

Treatments: Device: Empower Neuromodulation System Transcutaneous Electrical Nerve Stimulation

Study type: Interventional

Funder types: Other

Identifiers

NCT04184362

19-27491

Details and patient eligibility

About

This study evaluates the effects of peripheral nerve stimulation on opioid craving and use and pain in participants with chronic non-cancer pain (NCP) and opioid misuse. Participants will be randomized to receive the active or sham control treatment for the duration of the study.

Full description

This pilot study aims to examine the feasibility, acceptability, and preliminarily examine efficacy of peripheral nerve stimulation with the Empower Neuromodulation System on reducing opioid craving and use and decreasing pain. Opioid prescribing for chronic pain has increased dramatically over the past several decades, with devastating public health consequences, including high rates of opioid misuse and overdose deaths. Safe nonpharmacological treatments are urgently needed. In this randomized, controlled study, thirty Veterans with chronic non-cancer pain (NCP) and opioid misuse will be recruited and randomly assigned (1:1) to either the Active or Control treatment. On Days 1-7, participants will undergo baseline monitoring, and on Days 8-21, participants will undergo daily nerve stimulation treatment. Pain scores, craving, and opioid use will be measured daily Days 0-21. Our goal is to provide an intervention that, alone or in conjunction with current treatments, reduces craving and reduces reliance on opioids in high-risk chronic pain patients.

Enrollment: 10 patients

Sex: All

Ages: 18 to 75 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• VA-eligible Veterans
• Ages 18-75
• Currently prescribed and taking chronic opioids (≥90 days dispensed in past 12 months) for non-malignant, non-palliative pain
• Current (past 12 months) opioid misuse, defined as opioid use not as prescribed. Participants with COMM ≥ 9, SOAPP-R ≥ 18, and/or medical and pharmacy records reflective of opioid misuse in the past 12 months.

Exclusion criteria

• Injury or damage to the ulnar nerve, and/or neuropathy in the upper extremities
• Pregnant or planning to become pregnant
• Currently implanted with an electrical and/or neurostimulator device, including cardiac pacemaker or defibrillator, vagal neuro-stimulator, deep brain stimulator, spinal stimulator, sacral stimulator, bone growth stimulator, or cochlear implant
• Use of an investigational drug/device therapy within the past 4 weeks
• Current medical or psychiatric instability as determined by the participant's primary care provider and/or study PI
• Severe opioid use disorder (OUD) requiring medication-assisted therapy (buprenorphine, methadone, or naltrexone IM) for OUD
• Injury or nerve damage at the arm or palm that prevents safe use of Empower device at either site
• Unable to provide informed written consent
• Prone to epilepsy or seizures

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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10 participants in 2 patient groups

Experimental group tested at the active treatment site

Experimental group

Description:

The theranova empower device will be tested at the active treatment site.

Treatment:

Device: Empower Neuromodulation System Transcutaneous Electrical Nerve Stimulation

Control sham group tested at the sham control treatment site

Sham Comparator group

Description:

The theranova empower device will be tested the sham control treatment site.

Treatment:

Device: Empower Neuromodulation System Transcutaneous Electrical Nerve Stimulation