Adaption of the STAIR-NT Trauma Intervention for Polysubstance Populations

STAIR-NT 创伤干预对多物质人群的适应

• 批准号: 10590166
• 负责人: Amanda M Bunting
• 金额: $ 72.32万
• 依托单位: NEW YORK UNIVERSITY SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-30 至 2025-09-29
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10590166
• 关键词: Abstinence; Address; Affective; Caring; Cocaine; Communities; Drug user; Enrollment; Evidence based intervention; Evidence based treatment; Exclusion; Feedback; Future; Goals; Health; Incidence; Individual; Intervention; Mental disorders; Modeling; Multiple Trauma; Online Systems; Opioid; Outcome; Overdose; Participant; Patients; Pattern; Persons; Pharmaceutical Preparations; Population; Post-Traumatic Stress Disorders; Process; Protocols documentation; Public Health; Randomized; Randomized Controlled Trials; Recording of previous events; Regulation; Research; Risk; Schedule; Severities; Site; Stimulant; Substance Use Disorder; Symptoms; Therapeutic Intervention; Time; Trauma; Treatment Protocols; Treatment outcome; Work; acceptability and feasibility; base; comorbidity; effective therapy; evidence base; high risk; high risk population; illicit opioid; implementation outcomes; improved; individualized medicine; innovation; methadone treatment; multi-site trial; opioid overdose; opioid treatment program; opioid use; opioid use disorder; overdose risk; pediatric trauma; polysubstance use; programs; randomized trial; skills training; standard care; stimulant use; stress related disorder; substance use; symptomatology; treatment as usual; treatment program

PROJECT ABSTRACT The purpose of this timely and significant R34 proposal is to adapt an evidence-based posttraumatic stress disorder (PTSD) intervention for use among a polysubstance population receiving treatment for opioid use disorder in a methadone maintenance treatment (MMT) program. Polysubstance use of high-risk combinations, such as illicit opioids and stimulants, is a critical public health issue. Individuals who engage in these high-risk combinations are more likely to have histories of childhood trauma, multiple traumas, PTSD, and greater PTSD severity as compared to mono-substance using individuals. Trauma, co-morbid mental health disorders such as PTSD, and polysubstance use complicate treatment outcomes. This innovative pilot will use three aims to adapt an existing evidence-based PTSD intervention, Skills Training in Affective and Interpersonal Regulation with Narrative Therapy (STAIR-NT), via a massed treatment model (i.e., condensed treatment schedule) for patients in MMT who are engaged in illicit opioid-stimulant polysubstance use. The following aims are proposed: (1) to adapt the evidence-based intervention STAIR-NT for polysubstance use populations informed by the ADAPT-ITT framework, (2) to assess the feasibility and acceptability of the provisionally adapted STAIR-NT via an open pilot (n=10) to inform further adaptations, and (3) to conduct a small-scale randomized control pilot using the adapted intervention to examine implementation (i.e., feasibility and acceptability) and short-term polysubstance use and PTSD symptomology outcomes among MMT patients who are engaged in illicit opioid-stimulant polysubstance use. Completion of study aims will result in a fully adapted protocol for use in a multi-site randomized trial of the adapted STAIR-NT approach. The long-term goal of this research is to improve the health and treatment outcomes of populations who engage in high-risk polysubstance use through complementary layering of trauma-informed evidence-based interventions in opioid treatment programs.

项目摘要 这一及时而重要的R34提案的目的是调整一个以证据为基础的创伤后应激障碍 用于接受阿片类药物使用治疗的多物质人群的创伤后应激障碍（PTSD）干预 美沙酮维持治疗（MMT）计划中的疾病。多物质使用高风险组合， 例如非法类阿片和兴奋剂，是一个严重的公共卫生问题。从事这些高风险活动的人 组合更有可能有童年创伤，多重创伤，创伤后应激障碍和更严重的创伤后应激障碍的历史 与使用单一物质的个人相比的严重程度。创伤、共病心理健康障碍， 如创伤后应激障碍和多种药物的使用使治疗结果复杂化。这一创新试点将利用三个目标， 调整现有的基于证据的PTSD干预，情感和人际调节技能培训 叙事疗法（STAIR-NT），通过大规模治疗模型（即，浓缩治疗时间表） 参与非法阿片类兴奋剂多种物质使用的MMT患者。以下目标是 建议：（1）将基于证据的干预措施STAIR-NT用于知情的多种物质使用人群 （2）通过ADAPT-ITT框架，评估临时适应的可行性和可接受性 STAIR-NT通过开放试验（n=10），以告知进一步的调整，和（3）进行小规模的随机 控制飞行员使用适应的干预来检查实施（即，可行性和可接受性）， 短期使用多种药物和PTSD精神病学结果在MMT患者中， 非法使用阿片类兴奋剂多种物质。完成研究目标将产生完全适应的方案以供使用 在一项多中心随机试验中，采用了改良的STair-NT方法。这项研究的长期目标是 通过以下方式改善使用高风险多种物质人群的健康和治疗结果 阿片类药物治疗计划中创伤知情循证干预措施的补充分层。