The results of a new study carried out by researchers from Mass General Bringham in Massachusetts show that a wearable device can help manage stress, decrease cravings, and reduce the risk of relapse in real time for individuals diagnosed with substance use disorders (SUD). The study, published in the peer-reviewed journal JAMA Psychiatry, was a phase 2 clinical trial with 115 adult participants with severe SUD in their first year of recovery. 

Previous findings have already demonstrated that stress and low self-awareness of emotional states can often trigger cravings and relapse among individuals in their first year of abstinence.

Stress and craving are also linked to reduced heart rate variability (HRV), while controlled breathing exercises can help increase HRV, promoting better emotional regulation and cognitive control. Modern HRV biofeedback devices can detect decreases in HRV and provide visual or auditory prompts to guide users through these breathing adjustments. Moreover, previous research has shown that such biofeedback can help decrease anxiety and craving in individuals recovering from SUD.

As part of the study, half of the participants received a biofeedback smart patch device (the Lief HRVB Smart Patch), and the other half of the participants followed the recovery plan they had in place, such as recovery meetings, psychotherapy, or medication. Over eight weeks, study participants reported their mood, cravings, and any substance use twice a day with their smartphone.

“The latest HRV biofeedback devices can detect when people are stressed or experiencing cravings, and, using AI, prompt them to do a brief burst of biofeedback,” said David Eddie, Mass General Brigham psychologist at the Recovery Research Institute at Massachusetts General Hospital in a press release. “This allows people to get out in front of risk.”

The study participants were asked to do at least 10 minutes of scheduled practice a day and at least five minutes of prompted practice. According to the findings, participants who used the biofeedback device had less negative emotions, reported fewer cravings for alcohol or drugs and were 64% less likely to use substances on any given day. Taken together, this shows that the intervention interfered with the cycle of craving and substance use.

“The first year of recovery is immensely challenging,” added Eddie. “Our goal is to find tools that not only bridge people during that first year, but also help them manage their stress for the rest of their life.”