Prospective Study of Masimo NSS-2 BRIDGE; as a Non-Pharmacological Treatment for Acute Opioid Withdrawal Symptoms

Abstract

PurposeOpioids are commonly employed for treatment of acute and chronic pain. However, continued opioid use can lead to opioid use disorder. Opioid withdrawal symptoms can be severe, and avoidance of the discomfort is a key barrier to voluntary discontinuation. The NSS-2 BRIDGE™ (Masimo Corporation, Irvine, CA) is a percutaneous nerve field stimulator that can decrease symptoms of acute opiate withdrawal. The device fits behind the ear and stimulates branches of Cranial Nerves V, VII, IX, X, and periauricular occipital nerves, which synapse with nuclei involved in processing perception of pain and pleasure, as well as in addiction. The objective of this prospective study was to investigate the effects of NSS-2 BRIDGE™ on outpatients experiencing acute opioid withdrawal symptoms. We hypothesized that participants using the active NSS-2-BRIDGE™ device would have a reduction in Clinical Opioid Withdrawal Scale (COWS) scores compared to those using the sham device, when monitored at 30-minute intervals. MethodsAdult patients (≥18 years old) who voluntarily presented to the Zephyr outpatient clinic (Santa Anna, CA) were enrolled in the study and fitted with the NSS-2 BRIDGE™ device. Initial COWS scores were recorded at baseline and at 30 minutes intervals, up to 120 minutes. ResultsThe study included 16 participants, 8 subjects in each group. The mean COWS score of the active group decreased from 17.125 at baseline to 5.75 at 30 minutes, a mean decrease of 11.375 (P<0.001). The mean COWS score of the sham group decreased from 16.25 at baseline to 12.875 at 30 minutes, a mean decrease of 3.375 (P=0.186). ConclusionThe active device group showed a statistically and clinically significant mean drop in COWS score compared to the sham group. This study demonstrated that NSS-2 BRIDGE™ can assist in opioid withdrawal and may increase initial treatment retention.