The Role of Nondrug Reward in Recovery from Opioid Use Disorder: Intrapersonal and Socio-spatial Contexts in Daily Life

项目总结

PROJECT SUMMARY Anhedonia, or loss of pleasure from nondrug rewards, is clinically significant for up to half of patients with an opioid use disorder (OUD) and is a strong predictor of poor outcome. Anhedonia is complex, however, because patients who report anhedonia in clinical settings may also report frequent, enjoyable nondrug rewards in daily life. Nondrug reward in people with OUD may be driven by dynamic personal, social, and built- environmental (i.e. socio-spatial) factors. It is critical that researchers understand the role of each factor in anhedonia, in order to build effective nondrug-reward interventions. The proposed studies will examine nondrug-reward heterogeneity in real time and socio-spatial context among OUD outpatients in Franklin County, Ohio. This proposal addresses the NIDA research priority of identifying the environmental, behavioral, and social consequences of addiction and is well positioned to translate findings into actionable interventions for OUD—a primary goal of the applicant’s career. In Aim 1 we will gain insight into experiences of drug and nondrug reward through a cross-sectional survey (n=200), geotagging to identify local contexts of typical nondrug reward experiences, and exploratory open-ended questions. In Aim 2 we will examine day-to-day experiences of nondrug reward (14 days, 2 assessments per day; n=50 recruited from Study 1) in socio-spatial contexts via ecological momentary assessments (EMAs) and passively collected GPS location data. We will also test which aspects of nondrug reward predict OUD recovery outcomes. In Aim 3 we will characterize heterogeneity in experiences of reward and their socio-spatial contexts. To achieve these aims, the analytical approach will include regression (Aim 1), multilevel modeling integrating EMA and socio-spatial data (Aim 2), and multilevel latent class analysis (Aim 3). Findings will clarify heterogeneity and environmental contexts of nondrug reward experiences and inform development of nondrug reward interventions that are personally and contextually adapted to support individuals’ recovery from OUD. The applicant’s exceptional mentor team has expertise in intensive longitudinal methods and modeling heterogeneity (Stephanie Lanza), health geography and geospatial methods (Louisa Holmes), OUD treatment (David Epstein), and substance use and geospatial analysis in Ohio (Bridget Freisthler); this team will provide outstanding support as the applicant becomes an independent investigator. The mentorship team will support training in the following areas: the role of nondrug reward in addiction, socio-spatial determinants of health, methods for geospatial analysis and characterizing heterogeneity, partnering with addiction treatment centers to collect data from diverse populations, and the responsible conduct of research. The proposed work will position the applicant to generate new knowledge on the role of nondrug reward in OUD and to advance the science of OUD treatment throughout his career.