The Acute Stress Reaction Story

Daniel Powell [00:00:04]:
When treating addiction, almost always therapists come to the root cause as trauma. We've recently been exploring whether we can not only treat addiction, but actually prevent it. Could we treat someone before addiction begins? Why don’t you walk through how we’re looking at that?

Navid Khodaparast [00:00:24]:
Addiction is often rooted in trauma. That trauma could be physical—like a car accident leading to pain and an opioid prescription—or emotional and psychological, like witnessing a horrific event. Especially in military contexts, someone might see a colleague injured or killed, and that acute trauma can lead to anxiety, depression, and self-medication through alcohol or drugs. This falls under acute stress reaction (ASR) or acute stress disorder.

Navid Khodaparast [00:02:14]:
Not everyone develops ASR. Many manage stress through coping strategies. But for those repeatedly exposed—soldiers, first responders—it can cause lasting brain changes and lead to PTSD. Repetitive ASR is a key risk factor for developing PTSD.

Navid Khodaparast [00:03:20]:
There’s no true treatment for PTSD—just therapies and meds for symptoms. Cognitive behavioral therapy is helpful, and medications manage anxiety, but nothing treats the core PTSD.

Alejandro Covalin [00:03:45]:
That repetitive exposure creates strong memories—neural networks that reinforce the stress. These become hardwired and trigger PTSD. It’s a learning mechanism, unfortunately one tied to trauma.

Navid Khodaparast [00:04:32]:
These memories are powerful and tied to senses. Vision can trigger it, but the strongest trigger is actually smell. A single scent can transport someone to a traumatic event—even decades later. These stressful memories become deeply ingrained.

Daniel Powell [00:05:06]:
I believe that.

Navid Khodaparast [00:05:07]:
Yeah, even a smell like cookies can take you back. Sadly, trauma triggers are the most potent and hardest to erase.

Daniel Powell [00:05:41]:
So how are we addressing this?

Navid Khodaparast [00:05:43]:
Our work in opioid use disorder showed patients arriving at treatment in high anxiety states. We realized acute stress reaction plays a role, not just in addiction, but in emergency room visits—car crashes, heart attacks, even just receiving a difficult diagnosis like cancer. These moments elevate sympathetic nervous system activity.

Alejandro Covalin [00:06:22]:
Exactly. When someone hears bad news from a doctor, it can trigger acute stress. Our treatment increases parasympathetic tone to balance that. It’s all about restoring autonomic balance—sympathetic vs. parasympathetic.

Alejandro Covalin [00:07:14]:
By boosting parasympathetic activity, we shift the balance and reduce symptoms of stress and anxiety.

Navid Khodaparast [00:07:26]:
Initially, we thought about treating PTSD directly because our device had shown great improvement in PTSD symptoms in OUD patients. But we found the Department of Defense was funding more research into ASR—acute stress reaction—because preventing PTSD by treating ASR is more achievable.

Navid Khodaparast [00:08:36]:
So we pursued that. We received Department of Defense funding to study ASR and adapt our tech for both battlefield and civilian ER settings.

Alejandro Covalin [00:09:12]:
The military supports “dual-use” innovations—ones that benefit both soldiers and civilians. It’s part of their mission.

Daniel Powell [00:09:25]:
They require that you have a viable civilian application. So, our first trial began in a lab environment before expanding to real-world ER use. Let’s talk about how we simulate acute stress in a lab.

Navid Khodaparast [00:10:05]:
We’re working with Battelle in Ohio—a nonprofit with strong military ties. They’re conducting a controlled acute stress model using approved military protocols.

Navid Khodaparast [00:11:11]:
One example: the hand cold plunge. The participant holds their hand in ice water (4°C) for up to 90 seconds while doing difficult math. Start at 2043 and subtract by 17 out loud.

Daniel Powell [00:11:33]:
That already stresses me out. Doing math out loud under pressure?

Navid Khodaparast [00:11:40]:
If they get it wrong, they start over. It’s stressful. I tried it—barely lasted 30 seconds. It’s physically painful and mentally taxing.

Navid Khodaparast [00:12:15]:
While they’re under stress, we apply neurostimulation. We’re measuring whether we can reduce sympathetic tone and improve performance. Think of first responders and soldiers—they need to function at a high level while under stress.

Alejandro Covalin [00:12:51]:
Stress and arousal follow a U-shaped curve. Too little or too much both impair performance. You need just the right level of stress to perform at your peak.

Navid Khodaparast [00:13:22]:
Exactly—peak performance comes from that balance.

Daniel Powell [00:13:41]:
What about after trauma? Someone gets mugged or in a crash. Can we help post-event?

Navid Khodaparast [00:13:57]:
Yes. We envision using the device in emergency rooms for a few hours after trauma to bring patients out of that hyperaroused state.

Alejandro Covalin [00:14:11]:
That’s critical. Patients in ASR can’t communicate clearly, which delays triage. Calming them helps nurses gather the right info and deliver faster care.

Daniel Powell [00:14:32]:
We never said we were going to do anything easy. Congratulations to you and your team for being bold.

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