Adapting the HOPE social media intervention to reduce prescription drug abuse

描述（由申请人提供）：本提案旨在确定应用在线同伴教育（HOPE）干预或同伴支持社交媒体社区模式的可行性、可接受性和初步有效性，以减少慢性阿片类药物非癌性疼痛患者的处方药滥用。近年来，滥用处方药已达到流行病的程度。用于治疗慢性疼痛患者的慢性阿片类药物治疗是所有处方药中最常被滥用的。慢性阿片类药物误用/滥用的并发症包括呼吸抑制、传染病传播、药物依赖/成瘾和致命的过量。具有以下危险因素的慢性非癌性疼痛患者发生并发症的风险最高：1)阿片类药物剂量高，2)阿片类药物同时使用镇静剂（多物质使用），以及3)异常的药物相关行为（如早期续药要求）。虽然需要低成本、新颖的干预措施来减少这些导致成瘾和过量的风险行为，但很少有研究关注这一领域。以社区为基础的方法，如同伴领导和同伴支持干预措施，在创造健康行为改变方面取得了成功，可用于减少阿片类药物滥用。然而，由于同伴支持小组经常需要亲自拜访，需要大量的时间和财力资源，这些小组的辍学率很高。

DESCRIPTION (provided by applicant): This proposal seeks to determine the feasibility, acceptability, and preliminary effectiveness of applying the Harnessing Online Peer Education (HOPE) intervention, or peer support social media community model, to reduce prescription drug abuse among chronic opioid non-cancer pain patients. Prescription drug abuse has reached epidemic proportions in recent years. Chronic opioid therapy, prescribed to treat patients experiencing chronic pain, is the most frequently abused of all prescription medications. Complications from chronic opioid misuse/abuse include respiratory suppression, infectious disease transmission, drug dependence/addiction, and fatal overdose. Chronic non-cancer pain patients with the following risk factors are at the highest risk for complications: 1) High dosage of opiods, 2) opioid use with concomitant use of sedatives (polysubstance use), and 3) aberrant medication-related behaviors (e.g. early refills requests). Although low cost, novel interventions are needed to reduce these risk behaviors before they lead to addiction and overdose, few studies have focused on this area. Community-based approaches, such as peer leader and peer support interventions, have been successful in creating health behavior change and could be applied to reduce opioid abuse. However, because peer support groups often require in-person visits and a great deal of time and financial resources, these groups have high drop-out rates. With the recent increase in social media/online communities, these technologies could be used as cost-effective platforms to deliver peer support interventions for opioid abuse and overdose. The HOPE intervention is an evidenced-based peer-led social media intervention provided over Facebook that has been successfully used to change health behaviors. However, no published research has studied whether the HOPE approach, or other social media-based peer social support interventions can be adapted to reduce prescription drug abuse, making this an important feasibility study. We propose the following specific aims to address this research: Specific Aim 1: Explore (qualitatively) how the HOPE social media-based intervention can be adapted for opioid abuse/overdose prevention among patients on chronic opioid therapy. Specific Aim 2: Assess the feasibility, acceptability, and preliminary effectiveness of applying th HOPE model to reduce opioid abuse/overdose risk among high-risk chronic non- cancer pain patients. Secondary aim: Explore the feasibility of using participants' publicly-viewable social media conversations to better understand prescription opioid abuse and to improve intervention implementation. The pilot data collected from this study will be used to develop an R01 proposal for a larger randomized trial designed to assess the effectiveness of using social media to scale peer-led prescription drug abuse interventions to reduce prescription opioid abuse and polysubstance use among chronic opioid users.