HEAL Initiative: Integrative Management of chronic Pain and OUD for Whole Recovery (IMPOWR): Research Centers

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There is an urgent need to conduct high impact multidisciplinary research for patients with chronic pain (CP) and opioid use disorder (OUD)in the settings where they receive care and in collaboration with stakeholders and persons with lived experience (PWLE). We propose to create the Integrative Management of chronic Pain and OUD for Whole Recovery– Yale and Organizations United (IMPOWR- YOU). IMPOWR-YOU is a multidisciplinary center led by established investigators with expertise studying CP and opioid use disorder/misuse (OUD/misuse) and working in partnership with stakeholders and PWLE. We conduct research in general medical settings (primary care, hospital) and specialty (opioid treatment programs (OTPs)) with a focus on supporting the career development of early stage investigators and those from groups traditionally underrepresented in research (URG). IMPOWR-YOU is comprised of 5 cores (Operations, Stakeholder/PWLE, Career Development and Diversity, Pilot Projects, Data and Measurement), 2 research projects, and annual Pilot Projects. Our research, built on previous work of our investigators and stakeholders, addresses critical issues that face practitioners across the healthcare system. Proposed studies include: 1) In primary care, compare the effectiveness of a pharmacist led collaborative care approach for patients prescribed long-term opioids who have CP and OUD/misuse vs. the pharmacist program plus patient referral to a phone- delivered, cognitive behavior therapy (CBT)-based pain self-management program; 2) In an OTP to compare the effectiveness of a stepped care multimodal interdisciplinary CP management that includes CBT, exercise and stress management to treatment as usual in patients receiving methadone or buprenorphine; 3. In Year 1 conduct a pilot to modify an opioid stewardship program to address the needs of hospitalized patients with CP and OUD and evaluate its preliminary efficacy. All studies include outcomes related to pain, OUD, alcohol use, anxiety, depressive symptoms, sleep problems and some assess stress, stigma and recovery capital. Our Pilot Project Core will oversee the selection of pilots in Years 2-5 to support early stage investigators and collaborations with stakeholders/PWLE. IMPOWR-YOU is built on long-standing multidisciplinary research collaborations among diverse stakeholders, including PWLE, early stage investigators, URG, health systems, and organizations that produce guidelines for CP and OUD/misuse. IMPOWR-YOU has the ideal mixture of investigators, including leaders in primary care, addiction medicine/psychiatry, psychology specialty care, clinical trials, qualitative research and implementation science; established relationships with stakeholders and PWLE; a track record of innovation, leadership, collaboration, and outstanding productivity to create a leading Center that will contribute to addressing the unique needs of patients with CP and OUD/misuse.