Treatment of Opioid Dependence and Chronic Pain

描述（由申请人提供）：项目总结：这是对2006年7月首次审查的申请的重新提交。该K23指导患者导向研究职业发展奖将允许临床心理学家Jennifer Potter博士获得慢性疼痛和阿片类药物依赖治疗方面的高级培训，以便对共存的慢性疼痛和阿片类药物依赖进行治疗相关的研究。该职业发展计划的具体目标是：1)获得慢性疼痛治疗和评估方面的高级培训；2)加深对纵向研究和临床试验的设计和统计分析的理解；3)进一步了解阿片类药物依赖治疗；4)探索阿片类药物依赖和慢性疼痛的综合心理社会治疗；5)在负责任的研究行为方面接受高级培训，包括与慢性疼痛相关的伦理问题。波特博士将由她的赞助人Roger Weiss医学博士和三位共同赞助人David Borsook医学博士、Robert Jamison博士和Garrett Fitzmaurice科学博士指导。本研究的主要目的是在形成性研究的基础上，开发一种综合的阿片类药物依赖和慢性疼痛的社会心理治疗方法。特异性目标1将检验同时发生慢性疼痛和阿片类药物依赖的个体与没有慢性疼痛的个体不同，他们的物质滥用有特定的身体、情感和情境前因。特异性目标2将检验慢性疼痛相关因素预测阿片类药物依赖治疗后非法使用阿片类药物的假设。具体目标3是开发和测试一种认知-行为手动治疗阿片类药物依赖和慢性疼痛的可行性和可接受性。为了实现这些目标，我提出了一系列的三项研究，以配合培训活动。在最初的两项研究中解决的具体目标1和2将为研究中检查的具体目标3提供信息。前两项研究的结果将指导循证治疗策略的选择和必要时原始治疗策略的开发。

DESCRIPTION (provided by applicant): Project Summary: This is a resubmission of an application reviewed initially in July 2006. This K23 Mentored Patient-Oriented Research Career Development Award will permit, Dr. Jennifer Potter, a clinical psychologist, to obtain advanced training in the treatment of chronic pain and opioid dependence in order to conduct treatment-related research on co-occurring chronic pain and opioid dependence. The specific aims of this career development plan are to: 1) obtain advanced training in chronic pain treatment and assessment; 2) develop a greater understanding of the design and statistical analysis of longitudinal studies and clinical trials; 3) acquire further knowledge of opioid dependence treatment; 4) explore integrated psychosocial treatment for co-occurring opioid dependence and chronic pain; and 5) obtain advanced training in responsible conduct of research including ethical issues related to chronic pain. Dr. Potter will be guided by her sponsor, Roger Weiss, M.D., and three co-sponsors, David Borsook, M.D., Robert Jamison, Ph.D., and Garrett Fitzmaurice, Sc.D. The primary objective of the proposed research is to develop an integrated psychosocial treatment for co-occurring opioid dependence and chronic pain based on formative research. Specific Aim 1 will test the hypothesis that individuals with co-occurring chronic pain and opioid dependence have specific physical, emotional, and situational antecedents for their substance misuse distinct from individuals without chronic pain. Specific Aim 2 will test the hypothesis that chronic pain-related factors predict illicit opioid use following treatment for opioid dependence. Specific Aim 3 is to develop and test the feasibility and acceptability of a cognitive-behavioral manualized treatment for co-occurring opioid dependence and chronic pain. To accomplish these aims, I propose a series of three studies sequenced to coincide with training activities. Specific Aims 1 and 2, addressed in the initial two studies, will inform Specific Aim 3 examined in the study. Findings from the first two studies will guide selection of evidence-based treatment strategies and development of original treatment strategies as necessary. PUBLIC HEALTH RELEVANCE: Existing literature suggests that co-occurring opioid dependence and chronic pain are common. Specific treatment needs of individuals with both conditions are not well characterized. This proposal examines treatment needs within this population and develops a psychosocial intervention to address them.