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 此及时且重要的R34建议的目的是适应基于证据的创伤后压力 疾病（PTSD）干预措施，用于在接受阿片类药物治疗的多物质种群中使用 美沙酮维护治疗（MMT）计划中的疾病。高风险组合的多物质使用， 例如非法阿片类药物和兴奋剂，是一个关键的公共卫生问题。从事这些高风险的个人 组合更有可能具有儿童创伤的历史，多种创伤，PTSD和更大的PTSD 与使用个体的单一物质相比，严重程度。创伤，联合心理健康障碍此类 作为PTSD，Polysubstance使用的治疗结果复杂化。这个创新的飞行员将使用三个目标 适应现有的基于证据的PTSD干预措施，情感和人际关系的技能培训 通过大规模治疗模型（即凝结治疗时间表）进行叙事疗法（楼梯-NT） MMT的患者从事非法阿片类药物刺激性多刺的使用。以下目标是 提议：（1）调整基于证据的干预楼梯-NT用于多刺激的使用人群 通过Adapt-Itt框架，（2）评估临时改编的可行性和可接受性 通过开放飞行员（n = 10）楼梯-NT，以告知进一步的适应，（3）进行小规模的随机调整 使用改编干预措施的控制飞行员检查实施（即可行性和可接受性）和 参与的MMT患者中的短期多层固定使用和PTSD症状结局 非法阿片类药物刺激性多物质的使用。学习目标的完成将导致完全适应的协议供使用 在适应的楼梯-NT方法的多站点随机试验中。这项研究的长期目标是 通过 阿片类药物治疗计划中基于循证的循证干预措施的互补分层。