Buprenorphine and Substance Abuse Services for Prescription Opioid Dependence

丁丙诺啡和针对处方阿片类药物依赖的药物滥用服务

基本信息

项目摘要

ABSTRACT Prescription opioid dependence affects 1.9 million in the U.S, with a 400% increase in treatment admissions in recent years, and more than 15,500 fatal overdoses a year. Buprenorphine/naloxone (BUP/NX) is an effective treatment for prescription opioid dependence, with longer adherence to the medication leading to a lower risk of opioid relapse. Yet adherence can be low, and behavioral services remain a critical part of treatment. This study addresses gaps in knowledge about the behavioral services needed to optimize BUP/NX adherence and substance use (SU) outcomes in the treatment of prescription opioid dependence. We propose a randomized trial of two group-based models of care for BUP/NX patients in SU specialty treatment: Standard Medical Management (SMM) and Intensive Outpatient Treatment (IOT). There is little evidence on what level of behavioral services can support BUP/NX adherence and improve outcomes, particularly for complex patients with medical and psychiatric comorbidities who present to specialty treatment. The proposed study addresses these important issues, responding to PA-12-237, "Health Services and Economic Research on the Prevention and Treatment of Drug, Alcohol, and Tobacco Abuse (R01)." The setting is a large outpatient SU specialty treatment program, where these models of care have not been empirically tested with BUP/NX patients, and where a high prevalence of patients with co-occurring psychiatric and medical comorbidities are treated. SSM includes brief weekly group-based visits consistent with previously studied medical models, and is drawn from primary care BUP/NX research. IOT is a predominant model of care in specialty treatment, and incorporates psychosocial support, 12-step, educational and relapse-prevention based approaches. We will recruit 600 adult patients inducted onto BUP/NX, randomize them to either SMM or IOT, and conduct telephone follow-up interviews at 6 and 12 months. We will examine the impact of these treatment approaches on 90-day BUP/NX adherence, opioid abstinence and reductions in use, other SU, quality of life, and health care and societal costs. Further, we will examine whether the effect of IOT versus SMM on adherence and SU treatment outcomes is greater for those with medical or psychiatric comorbidities. Our innovative approach includes a focus on complex patients with psychiatric and medical comorbidities in specialty care, adapting a care model previously only tested in primary care, a 12-month follow-up, no research-forced medication taper, an examination of health care and societal costs, and a combination of patient self-report and electronic medical record data Through this approach, the proposed study will yield critically important findings on how best to treat complex prescription opioid dependent patients, a growing patient population, with an integrative behavioral services and medication treatment model in SU treatment.
摘要

项目成果

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CYNTHIA I CAMPBELL其他文献

CYNTHIA I CAMPBELL的其他文献

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{{ truncateString('CYNTHIA I CAMPBELL', 18)}}的其他基金

Role of Health Care in Addressing Unhealthy Alcohol Use and Disparities among Aging Women
医疗保健在解决老年妇女不健康饮酒和差异方面的作用
  • 批准号:
    10505016
  • 财政年份:
    2022
  • 资助金额:
    $ 54.39万
  • 项目类别:
Role of Health Care in Addressing Unhealthy Alcohol Use and Disparities among Aging Women
医疗保健在解决老年妇女不健康饮酒和差异方面的作用
  • 批准号:
    10705652
  • 财政年份:
    2022
  • 资助金额:
    $ 54.39万
  • 项目类别:
Buprenorphine and Substance Abuse Services for Prescription Opioid Dependence
丁丙诺啡和针对处方阿片类药物依赖的药物滥用服务
  • 批准号:
    8927597
  • 财政年份:
    2014
  • 资助金额:
    $ 54.39万
  • 项目类别:
Buprenorphine and Substance Abuse Services for Prescription Opioid Dependence
丁丙诺啡和针对处方阿片类药物依赖的药物滥用服务
  • 批准号:
    9114551
  • 财政年份:
    2014
  • 资助金额:
    $ 54.39万
  • 项目类别:
The Impact of Health Care Reform on Addiction and HIV Services
医疗保健改革对成瘾和艾滋病毒服务的影响
  • 批准号:
    8535420
  • 财政年份:
    2013
  • 资助金额:
    $ 54.39万
  • 项目类别:
The Impact of Health Care Reform on Addiction and HIV Services
医疗保健改革对成瘾和艾滋病毒服务的影响
  • 批准号:
    8823048
  • 财政年份:
    2013
  • 资助金额:
    $ 54.39万
  • 项目类别:
The Impact of Health Care Reform on Addiction and HIV Services
医疗保健改革对成瘾和艾滋病毒服务的影响
  • 批准号:
    8836997
  • 财政年份:
    2013
  • 资助金额:
    $ 54.39万
  • 项目类别:
High Deductible Health Plans: Substance Abuse Service Use and Cost Trajectories
高免赔额健康计划:药物滥用服务的使用和成本轨迹
  • 批准号:
    8023874
  • 财政年份:
    2011
  • 资助金额:
    $ 54.39万
  • 项目类别:
High Deductible Health Plans: Substance Abuse Service Use and Cost Trajectories
高免赔额健康计划:药物滥用服务的使用和成本轨迹
  • 批准号:
    8330816
  • 财政年份:
    2011
  • 资助金额:
    $ 54.39万
  • 项目类别:
Alcohol Trajectories and Service Use in Young Adults: Nine Years Post Treatment
年轻人的酒精轨迹和服务使用:治疗后九年
  • 批准号:
    7890142
  • 财政年份:
    2010
  • 资助金额:
    $ 54.39万
  • 项目类别:
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