Treatment of Opioid Dependence and Chronic Pain

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DESCRIPTION (provided by applicant): Project Summary: This is a resubmission of an application reviewed initially in July 2006. This K23 Mentored Patient-Oriented Research Career Development Award will permit, Dr. Jennifer Potter, a clinical psychologist, to obtain advanced training in the treatment of chronic pain and opioid dependence in order to conduct treatment-related research on co-occurring chronic pain and opioid dependence. The specific aims of this career development plan are to: 1) obtain advanced training in chronic pain treatment and assessment; 2) develop a greater understanding of the design and statistical analysis of longitudinal studies and clinical trials; 3) acquire further knowledge of opioid dependence treatment; 4) explore integrated psychosocial treatment for co-occurring opioid dependence and chronic pain; and 5) obtain advanced training in responsible conduct of research including ethical issues related to chronic pain. Dr. Potter will be guided by her sponsor, Roger Weiss, M.D., and three co-sponsors, David Borsook, M.D., Robert Jamison, Ph.D., and Garrett Fitzmaurice, Sc.D. The primary objective of the proposed research is to develop an integrated psychosocial treatment for co-occurring opioid dependence and chronic pain based on formative research. Specific Aim 1 will test the hypothesis that individuals with co-occurring chronic pain and opioid dependence have specific physical, emotional, and situational antecedents for their substance misuse distinct from individuals without chronic pain. Specific Aim 2 will test the hypothesis that chronic pain-related factors predict illicit opioid use following treatment for opioid dependence. Specific Aim 3 is to develop and test the feasibility and acceptability of a cognitive-behavioral manualized treatment for co-occurring opioid dependence and chronic pain. To accomplish these aims, I propose a series of three studies sequenced to coincide with training activities. Specific Aims 1 and 2, addressed in the initial two studies, will inform Specific Aim 3 examined in the study. Findings from the first two studies will guide selection of evidence-based treatment strategies and development of original treatment strategies as necessary. PUBLIC HEALTH RELEVANCE: Existing literature suggests that co-occurring opioid dependence and chronic pain are common. Specific treatment needs of individuals with both conditions are not well characterized. This proposal examines treatment needs within this population and develops a psychosocial intervention to address them.