The Impact of Addressing Loneliness on Opioid Use

孤独是一种以社会孤立感为特征的主观情绪状态，是一种心理社会现象。 与死亡率增加、阿片类药物使用以及复发诱发因素相关的压力源 患有阿片类药物使用障碍 (OUD) 的个体。重要的是，可以采取有效的干预措施 用于减少孤独感；然而，目前还没有研究直接干预人们的孤独感。 需要阐明患有 OUD 的个体，以及孤独影响阿片类药物使用的机制。 孤独认知行为疗法（CBT-L）通过解决消极信念来干预孤独感 使孤独长期存在，增加负面影响，并降低一个人参与社交活动的能力。对于 对于一个拥有 OUD 的个体来说，这对于解决负面影响以及感受到自己具有社交能力至关重要。 支持和参与社会支持是康复的关键方面。拟议的为期两年的研究使用了一种新颖的 应用简短的、电话提供的、基于证据的干预措施 CBT-L，通过以下方式减少孤独感： 改变适应不良的思维行为，增加对愉快和社交活动的参与，以及 通过 4 次电话会议提高解决问题的能力。参与者将在全国范围内招募 使用在线和印刷广告。具体目标是：(1) 评估 CBT-L 影响的有效性、相对 教育控制，包括孤独感、负面影响以及社会互动的质量和数量 125 名具有 OUD 的人，以及 (2) 评估其影响的认知、情感和行为机制 关于阿片类药物使用轨迹的 CBT-L。我们预计 CBT-L 将减少孤独感、负面影响和质量 和社交互动的数量，从而减少阿片类药物的使用。此 R21 应用程序是为了响应 PAS-18- 625，心理社会压力对阿片类药物使用模式影响的机制研究，由 NIDA 赞助。的 鉴于研究团队在开展研究方面拥有丰富的经验，他们非常适合开展这项研究 并在患有阿片类药物使用障碍的个体中进行临床工作，具有 CBT 的临床试验经验 难以接触和治疗的个人，以及招募和留住经常对治疗有抵抗力的人的能力， 包括那些患有药物滥用障碍的人。这项研究的结果将为进行 对认知和情感机制之间联系的全面功效试验和评估 孤独和沉香。

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.