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腾出退伍军人管理局的临床时间，这样我就可以继续我对药物使用障碍患者治疗结果研究的研究。我的研究生涯始于1970年，从那时起，我已经获得了17项拨款，并参与了另外20项或更多的研究。多年来，我的研究活动越来越多，以至于与维持我退伍军人管理局工资所必需的临床责任相冲突，尽管其中75%的时间用于NIH和退伍军人管理局的研究。这项奖励将使我将退伍军人管理局的时间减少到五分之五，并将患者护理和随叫随到的责任减少到每周6小时。近期的计划包括：1)临床试验网络(CTN)的特拉华谷节点，我是CTN的私人助理，负责4个方案：为14-21岁的阿片依赖患者提供丁丙诺啡/纳洛酮，激励增强疗法，激励激励，以及参与CTN后治疗实践的改变；2)关于接受和不接受美沙酮治疗的人的艾滋病毒危险行为的长期过程以及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进行VA研究，以及对患有物质使用障碍和创伤后应激障碍的退伍军人进行的团体治疗“寻求安全”的研究；4)在俄罗斯圣彼得堡进行的研究，比较了纳曲酮加或不加氟西汀预防复发和降低艾滋病毒风险，以及艾滋病毒、乙型和丙型肝炎、结核病与酒精和药物依赖之间的共病。长期计划是1)在‘03秋季提交CTN研究的竞争性更新；2)在圣彼得堡实施仓库与口服纳曲酮的研究；3)帮助圣彼得堡和巴西阿雷格里港的研究人员建立艾滋病毒预防、治疗和研究中心；以及4)提交丁丙诺啡用于治疗乌克兰基辅HIV+和HIV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进行，我从一开始就一直活跃在那里。

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.