Transcranial Photobiomodulation Therapy as an Intervention for Opioid Cravings and Depression: A Pilot Cohort Study
Introduction: The opioid crisis, a declared national health emergency, has prompted the exploration of innovative treatments to address the pervasive issues of opioid cravings and associated depression.
Photobiomodulation as a promising new tool in the management of psychological disorders: A systematic review
Abstract: Photobiomodulation is a brain modulation technique that has become a promising treatment for multiple pathologies. This systematic review collects studies up to 2019 about the beneficial effects of photobiomodulation as a therapy for treating psychological disorders and a tool for modulating cognitive processes. This technique is mostly used for the treatment of depression and stress, as well as to study its effects on psychological variables in healthy subjects. Despite the lack of parameters used, photobiomodulation seems to achieve enough brain penetration to produce beneficial effects in healthy subjects and patients with multiple pathologies. The best parameters are the wavelengths of 810 nm for the treatment of depression and 1064 nm for cognitive enhancement, along with a scalp irradiance of 250 mW/cm2 and a scalp yield of 60 J/cm2. It weekly application on the bilateral prefrontal area and the default mode network seems to be ideal for the maintenance of the effects. Photobiomodulation could be used as an effective and safe therapy for the treatment of multiple psychological pathologies.
Unilateral transcranial photobiomodulation is a novel treatment of opioid cravings.
Opioid use disorders (OUDs) are an epidemic causing catastrophic consequences to individuals, families, and society despite treatments including psychotherapy, substitution therapy or receptor blockers, and psychoeducation. We have developed a novel treatment that combines unilateral transcranial photobiomodulation (t-PBM) to the hemisphere with a more positive valence by Dual Brain Psychology (DBP).
Frontiers in Psychiatry
A Novel Treatment of Opioid Cravings With an Effect Size of .73 for Unilateral Transcranial Photobiomodulation Over Sham
Abstract
Background: Opioid use disorders (OUDs) are an epidemic causing catastrophic consequences to individuals, families, and society despite treatments including psychotherapy, substitution therapy or receptor blockers, and psychoeducation. We have developed a novel treatment that combines unilateral transcranial photobiomodulation (t-PBM) to the hemisphere with a more positive valence by Dual Brain Psychology (DBP).
Methods: We used a randomized, double blind, placebo-controlled protocol in which 22 patients with significant opioid cravings and a history of recent or current OUD attended three 1-h weekly sessions. After baseline measures of opioid craving and other psychometrics, subjects received two unilateral t-PBM applications (810 nm CW LED, 250 mW/cm2, 60 J/cm2, 4 min) or a sham (foil-covered LED) at F3 or F4. Prior to any treatment we used two tests to determine which hemisphere was more associated with a negative outlook and cravings and treated that side before the more positive hemisphere. Primary outcome measure was an opioid craving scale (OCS). Secondary outcomes were weekly Hamilton Depression (HDRS) and Anxiety (HARS) Rating Scales prior to treatments and at follow-up.
Results: Immediately after treatment the OCS improved significantly for both the sham and active treatments, but one week later the active treatment showed a 51.0% (SD 33.7) decrease in OCS while a week after the sham treatments there was a decrease of only 15.8% (SD 35.0) (by Wilcoxon Sign Rank Test, p = 0.004) and by a mixed model it was p = 0.0071. The effect size for the differences between active and sham was 0.73. For the active treatment from before and after treatment the effect size was 1.51 and for the sham, 0.45. The HDRS improved from a baseline of 15.1 to 8.8 (SD 10.3) a week after the active treatment and to 13.3 (SD 12.9) after the sham (p = 0.0071). HARS improved from 14.7 to 8.0 (SD 13.2) after the active treatments and to 14.3 (SD 16.0) after the sham, p = 0.08. Active treatment of the positive hemisphere after the negative hemisphere significantly improved the OCS, but there was no significant difference after the sham treatment. One patient complained of 2 h of abdominal bloating and dropped out; no other adverse effects were observed.
Discussion: Unilateral t-PBM to the hemisphere with a more positive hemispheric emotional valence was an effective and safe treatment for opioid cravings as well as for depression and anxiety. Our results also lend support to the underlying premises of DBP.
Study on the efficacy and safety of near infra-red light in the treatment of opiate use disorders.
Investigators will test, for safety and efficacy, a novel treatment for opiate addiction that applies a 4-minute treatment of intense near infra-red light to stimulate a side of the brain that the investigators determine to be healthier, more mature, and less traumatized. Investigators will compare an active and a sham treatment given twice weekly for 4-weeks. Investigators hope this will lead to a significant weapon in the battle against the opioid epidemic as well as lead to psychological and physiological insights into possible relations among trauma, cerebral laterality, and addiction.
Mclean Hospital
Harvard Medical School
National Institute on Drug Abuse (NIDA)
Why Photobiomodulation Might be the Answer to the Opioid Crisis
PBM addresses three components that are typically present in Opioid Use Disorder including reduction of pain, regeneration and decreasing depression and anxiety, and can be used exclusively or as an adjunct to existing treatments.
Alliance for Science & Technology Research in America
Transcranial Photobiomodulation for the Treatment of Major Depressive Disorder.
The objective was to test the antidepressant effect of transcranial photobiomodulation (t-PBM) with near-infrared (NIR) light in subjects suffering from major depressive disorder (MDD). t-PBM with NIR light demonstrated antidepressant properties with a medium to large effect size in patients with MDD.
Photomedicine and Laser Surgery
Ending Opioids by Photobiomodulation
Photobiomodulation (PBM) Therapy previously known as Low-Level Laser Therapy (LLLT) is the application of monochromatic light which means light of one color, and if we have light at the right color (or to use the technical phrase the right wavelength) and if the light is of the right intensity, and if we aim it in the right place, for the right amount of time, then we can increase the speed of tissue repair, we can reduce inflammation and edema, and we can induce an analgesic effect. We believe that Photobiomodulation therapy can help reduce the prescribing of opioid medication for pain relief.
Congressional Briefing on Ending Opioid Use
Photobiomodulation: Taking the Next Step in Treating Opioid Use Disorder
At the Annual Scientific Conference, NAALT 2018, in Detroit Michigan outlined several important roles for clinicians in combating the opioid epidemic with a focus on using photobiomodulation to breach the gap between opioid use and opioid free pain management. During the 2018 NAALT conference a call for clinicians to train to prescribe and utilize photobiomodulation therapy that can be used in conjunction with behavior therapy to treat opioid use disorder.
North American Association for Laser Therapy (NAALT)