Mindful Body Awareness Training as an Adjunct to Medication Assisted Treatment for Opioid Use Disorder: An ancillary study

正念身体意识训练作为阿片类药物使用障碍药物辅助治疗的辅助手段：一项辅助研究

• 批准号: 9893166
• 负责人: JOSEPH O MERRILL
• 金额: $ 223.53万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-28 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9893166
• 关键词: Abstinence; Address; Adherence; Adopted; Adult; Affect; Affective; Alcohol or Other Drugs use; American; Ancillary Study; Anxiety; Awareness; Behavior Therapy; Behavioral; Behavioral Research; Benzodiazepines; Buprenorphine; Care given by nurses; Case Manager; Chronic stress; Clinical; Clinical Trials; Cocaine; Comorbidity; Complex; Data; Development; Distress; Dose; Effectiveness; Epidemic; Evidence based treatment; Functional disorder; Funding; Future; Goals; HIV; Health; Healthcare; Hepatitis C virus; Heroin; Interoception; Intervention; Maintenance; Massachusetts; Measures; Medicaid; Mental Depression; Mental Health; Methadone; Methamphetamine; Mind-Body Intervention; Modeling; Morbidity - disease rate; National Institute of Drug Abuse; Neurocognitive; Opioid; Outcome; Overdose; Pain; Parents; Patient-Focused Outcomes; Patients; Persons; Pharmaceutical Preparations; Pharmacologic Substance; Physicians; Policies; Price; Primary Health Care; Psyche structure; Randomized; Regulation; Relapse; Research; Research Design; Role; Rural; Sample Size; Self Care; Severities; Site; Stress; Substance Use Disorder; System; Testing; Training; Treatment outcome; United States; United States Substance Abuse and Mental Health Services Administration; Variant; Washington; Well in self; addiction; base; behavior change; buprenorphine treatment; chronic pain; cost; craving; depressive symptoms; design; effective intervention; emotion dysregulation; emotion regulation; evidence base; illicit opioid; improved; innovation; medication-assisted treatment; mindfulness; mortality; non-opioid analgesic; novel; opioid agonist therapy; opioid epidemic; opioid overdose; opioid use; opioid use disorder; physical conditioning; physical symptom; prescription opioid; programs; reduced substance use; relapse risk; response; rural area; rural setting; skills; social; success; therapy design; treatment as usual; treatment optimization; treatment program; urban setting

Abstract The national opioid epidemic requires development of real-world evidence based treatments for opioid use disorder, including adjuncts to Medication Assisted Treatment (MAT) with buprenorphine. Interventions are needed that address the complex needs of patients with opioid use disorder, which include substantial mental health co-morbidity and high rates of chronic pain related to the complex interaction of opioid prescribing for pain and opioid use disorder. This study takes advantage of recent federal and state opioid use disorder treatment initiatives as a platform for testing a promising mind-body intervention, Mindful Awareness in Body-oriented Therapy (MABT) as an adjunct to MAT in three clinical settings funded through the Washington Opioid State Targeted Response (STR) program. Each setting employs a variation of the nationally recognized Massachusetts Nurse Care Manager model. Using a randomized, repeated measures design, we will compare those who receive MABT+ MAT to MAT only. The overarching goal of this application is to test MABT to improve MAT outcomes among patients receiving buprenorphine to treat OUD. The primary aims for this R01 study extend the final outcome to 12 months, but are otherwise the same as the parent R33. The first aim is to evaluate the effectiveness of MABT + MAT compared to MAT only (treatment-as- usual) in reducing opioid use (primary hypothesis) and non-opioid substance use (secondary hypothesis) at 12 months. Aim 2 will examine the effectiveness of MABT + MAT to improve mental and physical health distress (i.e. symptoms of depression and anxiety; emotional well- being, and physical symptoms and pain severity/interference) compared to MAT only at 12 months. Aim 3 will examine the effectiveness of MABT + MAT compared to MAT only to positively affect substance use related outcomes such as craving and treatment retention at 12 months. An additional exploratory aim (Aim 4) will explore the effectiveness of an increased MABT dose for MABT non-responders. Results of this study will inform the evidence base for behavioral treatment adjuncts to MAT with buprenorphine and directly impact the future direction of opioid use disorder treatment in Washington State.

摘要