Co-Morbid Opioid Addiction and Chronic Pain

共病阿片类药物成瘾和慢性疼痛

• 批准号: 8190160
• 负责人: AMY B WACHHOLTZ
• 金额: $ 13.61万
• 依托单位: UNIV OF MASSACHUSETTS MED SCH WORCESTER
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-08-15 至 2016-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8190160
• 关键词: Abstinence; Address; Affect; Agonist; Alcohol or Other Drugs use; Area; Behavior Therapy; Behavioral; Buprenorphine; Chronic; Clinical; Clinical Research; Comorbidity; Data; Development; Dimensions; Disease remission; Distress; Doctor of Philosophy; Drug Metabolic Detoxication; Emotional; Environment; Frequencies; Future; Goals; Grant; Health; Human; Individual; Informal Social Control; Intervention; Intervention Studies; Intervention Trial; Knowledge; Laboratories; Laboratory Study; Learning; Maintenance; Mentored Patient-Oriented Research Career Development Award; Mentors; Methadone; Modeling; Opiate Addiction; Opioid; Outcome; Pain; Pain Measurement; Pain Threshold; Pain management; Participant; Patients; Pharmacological Treatment; Pharmacotherapy; Physiological; Population; Protocols documentation; Psychological Impact; Psychologist; Reaction; Recording of previous events; Relapse; Relaxation; Reporting; Research; Research Personnel; Research Training; Role; Self Efficacy; Series; Staging; Techniques; Testing; Therapeutic; Time; Toxicology; Training; Treatment Factor; Treatment Protocols; Treatment outcome; Urine; Writing; addiction; base; career; chronic pain; clinical practice; craving; experience; improved; innovation; meetings; novel; pain behavior; planetary Atmosphere; prevent; primary outcome; programs; psychologic; psychosocial; response; secondary outcome; skills; social; success; therapy development; tool

DESCRIPTION (provided by applicant): Co-Morbid Opioid Addiction and Chronic Pain ABSTRACT The primary goal of this K23 - Mentored Patient-Oriented Research Career Development Award is to provide Dr. Amy Wachholtz, a clinical health psychologist, with the advanced research training, protected time for research, and mentored experiences necessary for her to become an independent researcher in developing and evaluating innovative treatments for opioid addiction and co-morbid pain that are integrative (pharmacotherapy and psychosocial treatment) and novel (CBT and Self-Regulation Techniques). The candidate proposes a program of research and training to meet this career goal including: 1) developing knowledge about the psychological and physiological interactions between opioid addiction and pain , 2) increasing her knowledge about psychological and pharmacological treatment approaches to addiction, 3) building skills in psycho-social treatment development, 4) enhancing her understanding of advanced statistical techniques, and 5) building expertise in grant writing and grant administration. Dr. Wachholtz will be guided by her primary mentor, Gerardo Gonzalez, MD, and two co-mentors, Douglas Ziedonis, MD, MPH, and Martin Cheatle, PhD. Dr. Wachholtz will conduct two distinct studies in the area of co-morbid pain and opioid addiction. The first study (Pain Reactivity Study) is a laboratory study of 120 participants; 90 with opioid addiction and chronic pain to identify the unique physiological, psychological, and behavioral responses to induced pain among those on methadone opioid maintenance treatment for opioid addiction (30 participants); on buprenorphine opioid maintenance treatment (30 participants), with an opioid addiction history but prolonged abstinence (6+ months) from opioids (30 participants), and 30 opioid naive participants. Based on findings from the first study, the second study (Intervention Study) will develop and pilot test 30 subjects in an integrated CBT + Self-Regulation psycho-social treatment for co-morbid opioid addiction and pain to decrease substance use, reduce pain, and decrease physiological reactivity to pain and distress. Results will inform a future R01 application to test an integrated treatment for co-morbid pain and opioid addiction. Successful completion of this K23 award will advance Dr. Wachholtz into a career as an independent researcher with the expertise to conduct clinical research trials to improve treatment for co-morbid opioid addiction and pain. PUBLIC HEALTH RELEVANCE: Opioid addiction and pain are common co-morbidities, and pain is strongly related to opioid addiction relapse, yet there is limited knowledge about the unique pain reactions among those with opioid addiction and few treatments. These studies will add to the current knowledge by 1) identifying unique bio-psycho-social responses to pain in those on opioid maintenance; and 2) using this information to develop a novel CBT+ self- regulation intervention to provide a much needed empirically validated treatment option for individuals with co- morbid opioid addiction and pain.

描述（由申请人提供）：这个K23指导患者导向研究职业发展奖的主要目标是为临床健康心理学家Amy Wachholtz博士提供先进的研究培训，保护研究时间。以及她成为一名独立研究人员开发和评估阿片类药物成瘾和共病疼痛的创新治疗方法所必需的指导经验，这些治疗方法是综合的（药物治疗和社会心理治疗）和新颖的（CBT和自我调节技术）。候选人提出了一个研究和培训计划，以实现这一职业目标，包括：1)了解阿片类药物成瘾与疼痛之间的心理和生理相互作用，2)增加她对成瘾的心理和药理治疗方法的了解，3)建立心理社会治疗发展的技能，4)增强她对先进统计技术的理解，5)建立资助写作和资助管理方面的专业知识。Wachholtz博士将由她的主要导师Gerardo Gonzalez（医学博士）和两位共同导师Douglas Ziedonis（医学博士、公共卫生硕士）和Martin Cheatle（博士）指导。Wachholtz博士将在共病疼痛和阿片类药物成瘾领域进行两项截然不同的研究。第一项研究（疼痛反应性研究）是一项有120名参与者的实验室研究；90名阿片类药物成瘾和慢性疼痛患者，以确定美沙酮阿片类药物维持治疗阿片类药物成瘾患者对诱发疼痛的独特生理、心理和行为反应（30名参与者）；阿片类药物丁丙诺啡维持治疗（30名参与者），有阿片类药物成瘾史但长期戒断（6个月以上）阿片类药物（30名参与者）和30名阿片类药物新手参与者。基于第一项研究的结果，第二项研究（干预研究）将开发和试点测试30名受试者，采用CBT +自我调节心理-社会综合治疗阿片类药物成瘾和疼痛，以减少药物使用，减轻疼痛，降低对疼痛和痛苦的生理反应。结果将告知未来的R01申请，以测试对合并症疼痛和阿片类药物成瘾的综合治疗。此次K23奖项的成功完成将推动Wachholtz博士成为一名独立研究人员，具有开展临床研究试验以改善阿片类药物成瘾和疼痛共病治疗的专业知识。