# A Mobile Executive Functioning Intervention for Momentary Craving in Opioid Use Disorders

> **NIH NIH K23** · MCLEAN HOSPITAL · 2021 · $174,641

## Abstract

Project Summary/Abstract
Even when treated with methadone or buprenorphine maintenance, many people with opioid use disorder
(OUD) continue to experience craving. Among both users of heroin and users of prescription opioids, mounting
evidence shows that craving predicts return to use and undermines existing treatments for OUD, thus, the
development of new interventions to reduce craving is a priority for addressing the opioid crisis (NIH HEAL
Initiative Research Plan, 2019). Deficits in executive functioning, particularly working memory, are a central
mechanism that undermines the ability to inhibit craving. Laboratory studies in non-clinical samples show that
engaging in working memory tasks before or during a craving induction increases the ability to resist craving.
This suggests that people with OUD may benefit from engaging in working memory tasks at the specific
moment when craving occurs. Although previous research shows that working memory “training” does not
improve clinical outcomes in OUD, these studies have not delivered training at the moment that craving
actually occurs in daily life. Thus, engaging in working memory tasks at the moment that craving occurs could
presumably help individuals with OUD to manage this persistent symptom, but this has not been tested.
Further, studies using Ecological Momentary Assessment (EMA) methods show that people with OUD can
accurately track moment-to-moment fluctuations in craving in their daily lives, suggesting that it may be
feasible to deliver interventions for craving in the moment when craving is reported. This study will test the
efficacy of embedding a mobile cognitive intervention into an EMA design in people with OUD. Using the NIH
Stage Model of Intervention Development, Stage 1A of this project will optimize a working memory intervention
based on iterative feedback from a sample of people with OUD (n = 20), in preparation for a Stage 1B trial
using a randomized design. In this trial, participants with OUDs (n = 60) will complete a two-week EMA study in
which they complete smartphone-based assessments of craving five times daily. When craving is reported, a
mobile application containing the working memory intervention will activate. Half of the participants will
complete the intervention, while half will complete a control task. At the conclusion of the trial, participants will
be granted unrestricted access to the intervention during a feasibility phase. Outcomes include change in
momentary craving, change in working memory performance, and feasibility and acceptability, including use of
the intervention during follow-up. Substance use will also be assessed. This project supports the applicant’s
goal of leveraging cognitive mechanisms to conduct treatment development research for OUD. The applicant
will receive training in the etiology and treatment of OUD, craving, mobile intervention development and
human-centered design of interventions, and analysis of intensive longitudinal data. ...

## Key facts

- **NIH application ID:** 10204437
- **Project number:** 1K23DA051406-01A1
- **Recipient organization:** MCLEAN HOSPITAL
- **Principal Investigator:** Andrew D Peckham
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $174,641
- **Award type:** 1
- **Project period:** 2021-04-01 → 2026-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10204437

## Citation

> US National Institutes of Health, RePORTER application 10204437, A Mobile Executive Functioning Intervention for Momentary Craving in Opioid Use Disorders (1K23DA051406-01A1). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10204437. Licensed CC0.

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