The Impact of Addressing Loneliness on Opioid Use

孤独--一种以社会孤立为特征的主观情绪状态--是一种心理社会状态 与死亡率增加、阿片类药物使用和复发诱因相关的应激源 在有阿片类药物使用障碍(OID)的个人中。重要的是，有有效的干预措施可以 用来减少孤独感；然而，还没有研究直接干预 需要阐明ODS患者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)通过解决负面信念来干预孤独 这会延长孤独，增加负面情绪，并降低一个人参与社会活动的能力。为 作为一个拥有OUD的人，这对于解决负面影响和有一种社交意识是至关重要的 支持和利用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部小说 应用一种简短的、电话传递的循证干预方法，CBT-L，通过以下方式减少孤独感 纠正不适应的思维行为，增加对愉快和社交活动的参与度，以及 通过电话提供的短短4次会议，提高解决问题的能力。参与者将在全国范围内招募 使用在线和平面广告。具体目的是：(1)评估CBT-L的疗效，相对 关于孤独感、负性情感以及社会互动的质量和数量的教育控制 125人，和(2)评估认知、情感和行为机制的影响 CBT-L关于阿片类药物使用轨迹的研究。我们期望CBT-L能减少孤独感、负性情感和生活质量 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调查，由NIDA赞助。这个 鉴于研究团队在进行研究方面的丰富经验，他们非常适合进行这项研究 以及在阿片类药物使用障碍患者的临床工作中，CBT治疗各种疾病的临床试验经验 难以接触和治疗的个人，以及招募和留住往往具有治疗耐药性的人的能力， 包括那些有药物使用障碍的人。这项研究的结果将为进行 全能疗效试验与认知和情感机制评估之间的联系 寂寞和寂寞。

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.