What Are You Craving? Using Wearables to Distinguish Food and Drug Cravings During Treatment with Extended-Release Buprenorphine

Craving, or the subjective, strong desire to use a substance, is a central factor in addiction, and part of the diagnostic criteria for substance use disorders (SUDs). Cravings can also occur for other triggers such as food, and cravings for food and drugs have been found to activate distinct neural pathways in the brain. Recently, physiologic signals from wearable devices have been applied to digitally detect cravings in patients with SUDs. But to date, no studies have explored digital detection of cravings by subtype. We collected continuous physiologic sensor data from N = 12 participants with opioid use disorder, treated with extended-release buprenorphine (BUP-XR). Data were analyzed to assess whether sensor signals carried differential information that could distinguish between food-, drug- and mixed-craving types. Accelerometer, heart rate and heart rate variability features significantly differed between drug, food and mixed trigger cravings. Cross validated models trained with these features distinguished each type of craving with area under ROC curve ranging from 75%-80%. These findings support the ability of wearable sensor-based digital biomarkers to distinguish craving subtypes in individuals with SUD.