Oxygen therapy is the use of oxygen as a medical intervention for a variety of reasons in both chronic and acute patient care. According to a pair of trials headed by Washington State University researchers, hyperbaric oxygen therapy may help persons in treatment for opioid addiction reduce their methadone dose and better manage pain and withdrawal symptoms.
Oxygen is essential for metabolic activities in cells and, as a result, the function of tissues throughout the body. Only 21% of the oxygen in room air is dissolved in the atmosphere. Although this amount is plenty for healthy people, persons suffering from certain conditions may benefit from a larger oxygen fraction in the gas they breathe, which will enhance the oxygen content of their blood.
The research team recruited participants enrolled in a local opioid treatment program to test the effects of hyperbaric oxygen therapy, a treatment that involves breathing pure oxygen in a pressurized environment.
The first paper, published in the Journal of Addictions Nursing, describes a pilot study of 31 participants in which those who received hyperbaric oxygen therapy as part of a planned methadone taper were able to maintain a significantly larger dose reduction of 4.3 mg three months after the study, compared to 0.25 mg in those who did not receive the therapy. They also had half the withdrawal symptoms as control subjects after only one day of hyperbaric oxygen therapy.
“While methadone helps people with opioid addiction recover stable and resume their normal lives, it’s still an opioid that they’re taking every day. Our findings imply that hyperbaric oxygen therapy could be utilized as a non-pharmacological technique to assist people taper off methadone.
Professor Matthew Layton
“While methadone helps people with opioid addiction recover stable and resume their normal lives, it’s still an opioid that they’re taking every day,” said study co-author Matthew Layton, a professor at WSU’s Elson S. Floyd College of Medicine and a former opioid treatment program medical director. “For different reasons, almost half of persons in treatment desire to come off methadone, but many who have tried have failed and relapsed. Our findings imply that hyperbaric oxygen therapy could be utilized as a non-pharmacological technique to assist people taper off methadone.”
The second study, published in Pain Management Nursing, was a small randomized controlled trial with eight patients that focused on withdrawal symptom alleviation in greater detail. It was shown that individuals in the hyperbaric oxygen therapy treatment group reported less pain intensity and drug cravings than control participants who received an oxygen mixture similar to room air supplied at normal atmospheric pressure. Other outcomes, including as sleep quality and happiness, were also improved, according to the study.
“While for some, the challenge is getting off methadone, for others, staying in treatment early on can be difficult because finding the right dose to stabilize symptoms can be difficult,” said first author Marian Wilson, an associate professor in the WSU College of Nursing and an expert on pain management and opioid use disorder. “As a result, many patients have withdrawal symptoms during the transition period, which can be severe enough to cause them to relapse into illegal drug use or drop out of treatment.”
The researchers are exploring funding for a clinical trial to confirm their findings in a larger sample of people who would be followed for several years based on the findings from the two investigations. The two studies were inspired by earlier study by one of the WSU researchers, who discovered that hyperbaric oxygen therapy relieved pain and reduced physical indications of opiate withdrawal in mice.
“We were excited to see if it would work in individuals,” said study co-author and WSU College of Arts and Sciences professor Raymond Quock, who conducted the research. If their findings hold up in a larger clinical trial, hyperbaric oxygen therapy could become a non-pharmacological tool that providers can use to help people manage pain and potentially reduce their opioid use.
“Over 100,000 individuals perished last year as a result of the opioid epidemic in the COVID-19 pandemic,” Layton added. “This demonstrates that opioid addiction is still a major issue, and we need to find better ways to address it.”
In addition to Layton, Wilson, Quock, and others at WSU, Karen Stanek, the medical director of the Spokane Hyperbaric Center, and Alvina Jesse, a program manager at the Spokane Regional Health District, were collaborators on these studies.
