Predictors of Relapse to Prescription Opioid Abuse Among Pain Patients

疼痛患者处方阿片类药物滥用复发的预测因素

基本信息

批准号：
7467760
负责人：
Maria A Sullivan
金额：
$ 10.31万
依托单位：
NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC
依托单位国家：
美国
项目类别：
财政年份：
2005
资助国家：
美国
起止时间：
2005-09-25 至 2010-12-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7467760
关键词：
Accident and Emergency department Address Alcohol abuse Amphetamines Analgesics Behavior Behavioral Benzodiazepines Buprenorphine Cannabinoids Chronic Clinic Clinical Condition Daily Data Diagnosis Dose Drug abuse Drug usage Effectiveness Euphoria Future General Population Goals Health Hospitals Individual Inpatients Intervention Knowledge Laboratories Maintenance Measures Medical Methods Mitochondrial Carnitine Palmitoyltransferase Pathway Modeling Naloxone Non-Malignant Numbers Opioid Opioid Analgesics Oral Outcome Outpatients Output Oxycodone Pain Pain management Participant Patient-Controlled Analgesia Patients Pattern Performance Persons Pharmaceutical Preparations Phase Physiological Placebos Population Prevalence Primary Health Care Protocols documentation Rate Recording of previous events Relapse Relative (related person)Reporting Research Research Personnel Sampling Self Administration Self-Administered Source Substance abuse problem Surveys Syndrome Task Performances Testing Toxicology United States Upper arm Urine Visit Water Week base benzoylecgonine chronic pain clinically relevant design drug of abuse opioid abuse prescription document prescription procedure programs response

项目摘要

The goal of this proposal is to address the growing problem of prescription opioid abuse by examining the effects of oxycodone in a laboratory setting in the presence of clinical pain and following significant pain relief following maintenance on the buprenorphine/naloxone combination (Bup/NX). Participants diagnosed with moderate pain initially will be admitted to hospital and transitioned from their baseline prescription opioid to a standing daily dose of Bup/NX. During the Bup/NX maintenance periods, participants will have the opportunity to self-administer oxycodone and subjective responses to oxycodone as well as analgesic, physiological and performance effects will be measured. In the second phase of this study, the same patients who participated in the inpatient phase will be followed on an outpatient basis while maintained on Bup/NX. Primary outcome variables during the outpatient phase will include percentage of negative urine toxicology samples for opioids and number of weeks in treatment. A major goal of this proposal is to determine which variables collected in the laboratory most reliably predict subsequent relapse to opioid abuse. In addition, the utility of Bup/NX in treating patients diagnosed with both chronic pain and substance abuse will be assessed. Despite the significant increase in prescription opioid abuse over the past 5-10 years, very few studies have systematically examined the issues surrounding prescription opioid abuse in the population of individuals with chronic pain. To our knowledge, no studies to date have examined opioid self-administration in persons with pain who have a history of opioid abuse. Specifically, the current proposal aims to 1) characterize the behavioral effects of oxycodone in Bup/NX-maintained pain patients who are currently abusing their prescription opioids; and 2) examine the relationship between behavioral effects of oxycodone as measured in the laboratory setting, and subsequent relapse to opioid abuse. These studies will provide important information about prescription opioid abuse liability in pain patients and will yield a laboratory model for predicting likelihood to relapse to prescription opioid abuse. These questions are of immediate clinical relevance to the treatment of chronic pain with opioid therapy.