Treatment/Substance Use Disorders/HIV Risk Reduction

描述（由申请人提供）： 这个新的高级科学家奖将释放临床时间在VA，所以我可以继续我的研究与物质使用障碍的人的治疗结果的研究。我的研究生涯始于1970年，从那时起，我一直是P.I.。17项赠款和另外20项或更多的共同研究者。多年来，我的研究活动不断增加，以至于与维持我的VA工资所需的临床职责相冲突，尽管75%的时间用于NIH和VA研究。这个奖项将使我能够减少VA时间到5/8，并减少病人护理和随叫随到的责任到6小时/周。近期计划是继续项目，包括1）临床试验网络（CTN）的特拉华州山谷节点，我是P.I.。并负责4个方案：丁丙诺啡/纳洛酮为阿片类药物依赖患者的14-21岁，动机增强疗法，动机激励，并在治疗实践的变化，由于CTN的参与; 2）研究长期过程中的艾滋病毒危险行为的人和美沙酮治疗和美沙酮对免疫功能的影响; 3）对退出或暂停美沙酮治疗的患者以及“寻求安全”的VA研究，这是一种针对患有物质使用障碍和创伤后应激障碍的退伍军人的团体治疗; 4）在彼得堡学习，俄罗斯比较纳洛酮与或不与氟西汀用于预防复发和降低HIV风险以及HIV、B和C型肝炎之间的合并症，肺结核酒精和药物依赖。长期计划是：1）在2003年秋季提交CTN研究的竞争性更新; 2）在彼得堡实施长效与口服纳洛酮的研究; 3）帮助巴西彼得堡和波尔图阿莱格雷的研究人员建立艾滋病毒预防、治疗和研究中心;以及4）提交一项在乌克兰基辅开展的丁丙诺啡用于治疗艾滋病毒阳性和艾滋病毒阴性患者海洛因成瘾的试点研究。这项工作将在宾夕法尼亚大学/费城VAMC成瘾治疗研究中心，治疗研究所和宾夕法尼亚艾滋病研究中心完成，我从一开始就积极参与其中。

DESCRIPTION (provided by applicant): This new Senior Scientist Award will free-up clinical time at the VA so I can continue my research on treatment outcome studies of persons with substance use disorders. My research career began in 1970 and since that time I have been P.I. on 17 grants and co-investigator on another 20 or more. Over the years my research activities have grown such that they conflict with clinical responsibilities that are necessary to maintain my VA salary, even though 75% of that time is for NIH and VA research. This award will allow me to reduce VA time to 5/8ths and reduce patient care and on-call responsibilities to 6 hours/week. Immediate plans are to continue projects that include 1) the Delaware Valley Node of the Clinical Trials Network (CTN) on which I am P.I. and responsible for 4 protocols: buprenorphine/naloxone for opioid dependent patients aged 14-21, motivational enhancement therapy, motivational incentives, and changes in treatment practices as a result of CTN participation; 2) studies on the long term course of HIV risk behavior among persons in and out of methadone treatment and the effect of methadone on immune function; 3) VA studies of patients who dropped out or were suspended from methadone treatment and of "Seeking Safety", a group therapy for veterans with substance use disorders and PTSD; and 4) studies in St. Petersburg, Russia comparing naltrexone with or without fluoxetine for relapse prevention and HIV risk reduction and of comorbidities between HIV, hepatitis B and C, TB and alcohol and drug dependence. Long term plans are to 1) submit a competing renewal of CTN studies in the Fall of '03; 2) implement a study of depot vs oral naltrexone in St. Petersburg; 3) help investigators in St. Petersburg and Porto Alegre, Brazil develop Centers for HIV prevention, treatment and research; and 4) submit a pilot study of buprenorphine for heroin addiction treatment of HIV+ and HIV- patients in Kiev, Ukraine. This work will be done at the University of Pennsylvania/Philadelphia VAMC Addiction Treatment Research Center, the Treatment Research Institute, and the Penn Center for AIDS Research where I have been an active participant since their beginnings.