The following is a summary of “Hyperbaric Oxygen Therapy for Pain, Opioid Withdrawal, and Related Symptoms: A Pilot Randomized Controlled Trial” published in the October 2022 issue of Pain Management by Wilson et al.
Opioid tapering or substance abuse treatment could be hampered by pain, drug cravings, and withdrawal symptoms. The purpose of this pilot study was to determine whether or not it would be possible to implement a protocol to test whether or not 2 days of hyperbaric oxygen therapy (HBOT) for adults prescribed daily methadone for opioid use disorder would alleviate withdrawal symptoms compared to a sham condition. About 8 people were randomly assigned to receive either 90 minutes of HBOT in a pressurized chamber with 100% oxygen at 2.0 atmospheres absolute (ATA) or a sham condition receiving 21% oxygen (equal to room air within the chamber) at a minimum pressure of ≤1.3 ATA.
Pre- and post-intervention effects on opioid withdrawal symptoms, drug cravings, pain severity, interference, sleep quality, and mood were measured, as well as patient retention in the study and satisfaction with therapy. Both medication adherence and retention in the study were quite successful. Except for clinically observable withdrawal symptoms, all metrics improved more for those receiving full-dose HBOT treatment than those receiving sham treatments. The greatest reductions in pain and drug-seeking were found in surveys.
These preliminary findings provide credence to the idea that hyperbaric oxygen therapy (HBOT) could be an effective adjuvant to methadone maintenance therapy for persons with opioid use disorder. In the complete treatment group, symptoms tended to improve from pre- to post-HBOT, while in the sham group, symptoms worsened. Improving therapeutic outcomes requires more investigation into nonpharmacologic strategies for managing the distressing feelings associated with pain and opioid use disorder.