Treatment of Opioid Dependence and Chronic Pain

描述（由申请人提供）： 项目摘要：这是对 2006 年 7 月最初审查的申请的重新提交。这项 K23 指导的以患者为导向的研究职业发展奖将允许临床心理学家 Jennifer Potter 博士获得治疗慢性疼痛和阿片类药物依赖的高级培训，以便对同时发生的慢性疼痛和阿片类药物依赖进行与治疗相关的研究。该职业发展计划的具体目标是：1）获得慢性疼痛治疗和评估方面的高级培训； 2）对纵向研究和临床试验的设计和统计分析有更深入的了解； 3) 进一步了解阿片类药物依赖治疗的知识； 4) 探索同时发生的阿片类药物依赖和慢性疼痛的综合心理社会治疗； 5) 获得负责任的研究行为的高级培训，包括与慢性疼痛相关的伦理问题。 Potter 博士将由她的资助者 Roger Weiss（医学博士）和三位共同资助者 David Borsook（医学博士）、Robert Jamison（博士）和 Garrett Fitzmaurice（理学博士）指导。拟议研究的主要目标是基于形成性研究，针对同时发生的阿片类药物依赖和慢性疼痛开发一种综合心理社会治疗方法。具体目标 1 将检验以下假设：同时患有慢性疼痛和阿片类药物依赖的个体与没有慢性疼痛的个体不同，其物质滥用具有特定的身体、情感和情境因素。具体目标 2 将检验以下假设：慢性疼痛相关因素预测阿片类药物依赖治疗后非法使用阿片类药物。具体目标 3 是开发和测试针对同时发生的阿片类药物依赖和慢性疼痛的认知行为手动治疗的可行性和可接受性。为了实现这些目标，我提出了一系列三项研究，这些研究按顺序与培训活动相一致。前两项研究中提到的具体目标 1 和 2 将为研究中检查的具体目标 3 提供信息。前两项研究的结果将指导基于证据的治疗策略的选择以及必要时制定原始治疗策略。 公共卫生相关性：现有文献表明，阿片类药物依赖和慢性疼痛同时发生是很常见的。患有这两种疾病的个体的具体治疗需求尚不明确。该提案审查了该人群的治疗需求，并制定了心理社会干预措施来解决这些需求。

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.