The Impact of Addressing Loneliness on Opioid Use

孤独是一种主观的情绪状态，其特征是感觉到社会孤立， 与死亡率增加、阿片类药物使用相关的应激源，并与复发的促发因素相关 阿片类药物使用障碍（OUD）患者。重要的是，有一些有效的干预措施可以 用于减少孤独感;然而，没有研究直接干预孤独感， 需要阐明孤独感影响阿片类药物使用的机制。 认知行为疗法（CBT-L）通过解决消极信念来干预孤独 这会使人长期感到孤独，增加消极情绪，降低参与社会活动的能力。为 一个人与OUD，这是至关重要的，因为解决负面影响，并有一种感觉，一个人有社会 支持和争取社会支持是恢复的关键方面。这项为期两年的研究使用了一本小说， 应用简短的，电话传递的，基于证据的干预，CBT-L，以减少孤独感， 改变不适应的思维行为，增加愉快的社交活动， 通过电话提供的4次会议提高解决问题的技能。参与者将在全国范围内招募 使用在线和印刷广告。具体目的是：（1）评估CBT-L的效果，相对 教育控制，孤独，负面影响，以及社会交往的质量和数量， 125人与OUD，（2）评估认知，情感和行为机制的影响， CBT-L对阿片类药物使用轨迹的影响。我们希望CBT-L能减少孤独感，负面影响， 和社会互动的数量，从而减少阿片类药物的使用。此R21应用程序是响应PAS-18- 625，NIDA赞助的社会心理压力对阿片类药物使用模式影响的机制研究。的 研究团队在开展研究方面具有丰富的经验，因此非常适合开展这项研究 并在阿片类药物使用障碍患者中开展临床工作，具有CBT用于各种药物的临床试验经验， 难以接触和治疗的个人，以及招募和留住往往对治疗有抵抗力的人的能力， 包括那些有物质使用障碍的人。本研究的结果将提供关键信息， 一项完全有效的疗效试验，并评估认知和情感机制之间的联系， 孤独和OUD。

Loneliness—a subjective emotional state characterized by the perception of social isolation—is a psychosocial stressor that is associated with increased mortality, opioid use, and is associated with precipitants of relapse among individuals with opioid use disorders (OUDs). Importantly, there are effective interventions that can be used to decrease loneliness; however, there are no studies that have directly intervened on loneness among individuals with OUDs, and the mechanisms by which loneliness impacts opioid use need to be elucidated. Cognitive-Behavioral Therapy for Loneliness (CBT-L) intervenes on loneliness by addressing negative beliefs that perpetuate loneliness, increase negative affect, and reduce one’s ability to engage in social activities. For an individual with an OUD, this is critical as addressing negative affect, and having a sense that one has social support and engages social support are key aspects of recovery. The proposed two-year study uses a novel application of a brief, phone-delivered, evidence-based intervention, CBT-L, to decrease loneliness by modifying maladaptive thinking behaviors, increasing engagement in enjoyable and social activities, and improving problem solving skills over just 4 session delivered by phone. Participants will be recruited nationally using online and print advertising. The specific aims are to: (1) assess the efficacy of CBT-L’s impact, relative to an education control, on loneliness, negative affect, and the quality and quantity of social interactions among 125 people with an OUD, and (2) assess the cognitive, affective, and behavioral mechanisms of the impact of CBT-L on opioid use trajectories. We expect that CBT-L will reduce loneliness, negative affect, and the quality and quantity of social interactions, thereby reducing opioid use. This R21 application is in response to PAS-18- 625, Mechanistic investigations of psychosocial stress effects on opioid use patterns sponsored by NIDA. The study team is ideally suited to conduct this research given their extensive experience in conducting research and doing clinical work in individuals with opioid use disorders, clinical trial experience with CBT for a variety of difficult-to-reach and treat individuals, and ability to recruit and retain often treatment-resistant people, including those with substance use disorders. Results from this study will provide critical information to conduct a fully-powered efficacy trial and assessment of cognitive and affective mechanisms of the link between loneliness and OUD.