1. Guided smartphone-based treatment for patients in opioid maintenance treatment in Iran -transdiagnostic treatment for substance use and common mental disorders

The lifetime prevalence of opioid use in Iran is the highest worldwide (12.9%) while approximately 50% of opioid-dependent users remain unreached. In high-income countries, digital interventions have been shown to be a cost-effective approach to treat common mental health problems. In low- and middle-income countries, digital interventions have been tested to a much lesser extent. Initial results suggest that cultural adaptation is associated with larger effect sizes. This study aims to examine the effectiveness of a culturally-adapted gender-sensitive integrated Community Reinforcement Approach- and CBT-based guided smartphone intervention (Promoting Recovery in Opioid Maintenance and Psychosocial Treatments; PROMPT).

The cultural adaptation process of existing modules has followed a conceptual framework that includes deep structure adaptation and formative cultural concepts of distress research with the Barts Explanatory Model Inventory. The final PROMPT will be compared with OMT as usual in a randomized controlled trial (RCT) within 400 opioid dependent patients at eight treatment centers.

The four key findings from deep structure adaptation process are that: a) addiction suits as a label for opioid abuse; b) explanatory models are explained multidimensional and mostly by external factors; c) idioms of distress include diagnostic criteria of OUD as well as negative consequences on the living environment; and d) the impact of opioid abuse on and the importance of the social environment as cause and resource that must be addressed in the development of PROMPT.

This study will provide substantial knowledge for designing culturally adapted and at the same time effective smartphone interventions for opioid use disorders in general.

ISGF has received funding from governmental or competitive research grants. No pharmaceutical grants were received in the development of this study. This work was supported by the Swiss National Science Foundation (Grant-No. 194093).