Chronic pain and opioid use disorder are two of the most pressing and interconnected challenges in healthcare today. Roughly 20% of adults in the U.S. live with chronic pain, and more than 2 million individuals have opioid use disorder, a condition that continues to drive high rates of overdose and mortality. For patients receiving medication for opioid use disorder, chronic pain is even more prevalent, affecting 37-61% of patients. This confluence significantly increases risk for relapse, treatment dropout, and hospitalizations.

At Nimblemind, we’ve been working to address the intersection of chronic pain and opioid use disorder through wearable devices, multimodal data integration, and AI-driven predictions. Our research in collaboration with the APT Foundation explores how wearables can help predict chronic pain spikes, ultimately resulting in improved outcomes for both patients and providers.

The Challenge: Chronic Pain and Addiction Care

Traditional opioid treatment programs often do not assess or manage chronic pain in a systematic way. This gap means that pain spikes often go undetected until they lead to relapse, emergency visits, or costly inpatient stays. By continuously monitoring patients with wearable devices, we can track signals such as sleep quality, stress, physical activity, and heart rate variability. By combining these with electronic health records (EHRs) and patient-reported surveys, we can create a more complete picture of patient well-being.

What We Studied 

We conducted a proof-of-concept study with a select group of patients. Participants wore Fitbit Charge 5 devices, completed daily pain assessments, and provided survey data on stress, mood, and substance use. We trained machine learning models to predict pain spikes (defined as a pain level above each patient’s 70th percentile of pain) and found that:

• Machine learning models achieved >0.7 accuracy in predicting pain spikes several days in advance.

• Key predictors included sleep duration, daily step counts, and levels of light activity.

• Real-time monitoring could enable personalized interventions that reduce the risk of relapse and improve adherence to medication for opioid use disorder.

Case Study: APT Foundation

The APT Foundation, a Connecticut-based nonprofit, treats more than 8,000 patients annually, including over 5,500 receiving medication for opioid use disorder. We partnered with their team to apply our research in wearable data, surveys, and EHRs to clinical operations.

Here’s what we built together:

• Data integration: Combined Fitbit data, patient surveys, and anonymized EHR records.

• AI annotation: Generated risk scores for chronic pain spikes, dropout, and overdose, plus operational features like ICD-10/DRG codes.

• Predictive workflows: Clinicians could identify patients at high risk of relapse or pain spikes and reach out proactively.

The impact was evident:

• A projected 50-65% increase in billing revenue through more complete coding and proactive visits.

• Significant cost savings from preventing inpatient stays and reducing pain-related ER visits.

• Reduced clinician burden, with automated DRG coding cutting admin time from 10 minutes to ~2 minutes per code.

“By organizing and curating data from our EMR, patient surveys, and wearable devices, they are helping us identify patient interventions more effectively. This kind of AI-driven insight is the future of personalized, proactive care” 

Lynn M. Madden, PhD, CEO of APT Foundation

Building Smarter, More Integrated Care

This combined research and real-world deployment demonstrates the power of wearable data and AI in improving care for patients with chronic pain and opioid use disorder. Wearables alone can’t solve substance use issues or chronic pain , but when integrated with data that presents a more complete picture of patient well-being, they give providers a new set of tools. This allows clinicians to intervene earlier, personalize treatment, and reduce both clinical and financial strain. At Nimblemind, we believe that data-driven insights can help transform chronic pain and addiction care and we’re excited to keep building on this foundation. This blog post is just a highlight of our work. Reach out to learn more.