Effect of Mindfulness Training on Opioid Use and Anxiety During Primary Care Buprenorphine Treatment

正念训练对初级保健丁丙诺啡治疗期间阿片类药物使用和焦虑的影响

• 批准号: 10636734
• 负责人: Zev David Schuman Olivier
• 金额: $ 70万
• 依托单位: CAMBRIDGE HEALTH ALLIANCE
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-07-01 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10636734
• 关键词: Abstinence; Address; Advertising; Alcohols; Anxiety; Behavioral; Benzodiazepines; COVID-19 pandemic; Cannabis; Characteristics; Clinical Trials; Cocaine; Code; Continuity of Patient Care; Contracts; County; Dangerousness; Databases; Dose; Drops; Enrollment; Facebook; Generations; Geography; Health; Hearing; Illicit Drugs; Individual; Informal Social Control; Information Systems; Maintenance; Measurement; Measures; Mental Depression; Mindfulness Training; Motivation; Opioid; Outcome; Pain interference; Participant; Patient Outcomes Assessments; Patient Self-Report; Patients; Phase; Primary Health Care; Provider; Psychosocial Stress; Recovery; Recovery Support; Relapse; Rural; Rural Community; Sampling; Self Efficacy; Site; Stress; Suboxone; Support Groups; Telemedicine; Training; acceptability and feasibility; addiction; base; buprenorphine treatment; chronic pain; clinically relevant; cocaine use; comparative effectiveness trial; compare effectiveness; design; emotion dysregulation; emotional distress; evidence base; flexibility; illicit opioid; mindfulness; mindfulness intervention; opioid mortality; opioid use; opioid use disorder; outreach; overdose death; patient oriented; prevent; programs; recruit; social media; substance use; virtual

Opioid Use Disorder (OUD) is a national health crisis. Office-Based Opioid Treatment (OBOT) with buprenorphine/naloxone (B/N) prevents overdose deaths. Psychosocial stress and psychiatric problems (e.g., Anxiety) are major reasons for OBOT drop out and relapse. Many patients turn to benzodiazepines (BZD) to address anxiety and emotional distress with dangerous consequences. Nonpharmacologic approaches to anxiety, stress, and emotion dysregulation are needed during primary care OBOT, which is the primary access point for OUD treatment in most US counties. Mindfulness-Based Interventions (MBI) safely and reliably reduce the impact of stress, anxiety, depression, and chronic pain, which could increase OBOT retention, while reducing rates of relapse and overdose deaths. However, current 8-week standard MBIs do not appear to have strong, sustained impact on substance use outcomes, suggesting longer or enhanced MBIs are needed in the OUD treatment setting. This project originally proposed to adapt, refine, and compare the effectiveness of the 6-month live-online Mindful Recovery OUD Care Continuum (M-ROCC) versus a standard recovery group in primary care. M-ROCC is derived from the evidence-based, established Mindfulness Training for Primary Care (MTPC) program, which has been adapted for Opioid Use Disorder. M-ROCC includes a flexible, patient-centered, motivationally responsive design, including a Low Dose Mindfulness Entry Group, Mindfulness Maintenance Check-in Support Group, and an intensive Mindfulness Training for Primary Care (MTPC-OUD) Group. M-ROCC builds on the previously demonstrated ascending mindfulness practice dose ladder approach, which helps individuals with OUD nurture motivation and resolve ambivalence for mindfulness practice. MTPC has been shown to lower anxiety, stress, and depression, while increasing self-efficacy and capacity for behavioral change by engaging self-regulation mechanisms. During the R21 phase, we established the feasibility and acceptability of the M-ROCC program and prepared for the R33 phase by training providers and obtaining necessary approvals and site contracts. In the R33 phase, we planned to conduct a five-site RCT comparing M-ROCC versus Group-Based Opioid Treatment (GBOT). Due to the COVID-19 pandemic, we modified all aspects of the R33 phase to be conducted with a national sample in a remote, live-online, virtual format, comparing M-ROCC versus a standard online recovery group for 196 patients prescribed B/N for OUD, primarily evaluating its impact on opioid use and anxiety. We all evaluate effects on cocaine and BZD use, as well as aspects of self-regulation needed for sustained addiction recovery. Participants in the online clinical trial are recruited from multiple U.S. states through provider outreach and social media advertising.

阿片类药物使用障碍（OUD）是一个全国性的健康危机。基于办公室的阿片类药物治疗(OBOT

项目成果

Building a Group-Based Opioid Treatment (GBOT) blueprint: a qualitative study delineating GBOT implementation.

建立基于群体的阿片类药物治疗 (GBOT) 蓝图：一项描述 GBOT 实施的定性研究。

• DOI: 10.1186/s13722-019-0176-y
• 发表时间: 2019
• 期刊: Addiction science & clinical practice
• 影响因子: 3.7
• 作者: Sokol,Randi;Albanese,Mark;Chew,Aaronson;Early,Jessica;Grossman,Ellie;Roll,David;Sawin,Greg;Wu,DominicJ;Schuman-Olivier,Zev
• 通讯作者: Schuman-Olivier,Zev