Modeling Physiology and Behavior of Veterans to Avert Opioid Related Mortality Through Timely Intervention

项目总结/摘要 阿片类药物成瘾影响着世界各地所有种族、年龄、性别认同、教育和收入水平的人。 美国的近年来，这一流行病愈演愈烈，复发率接近91%。 （Kadam等人，2017年）和2020年的临时数据表明有史以来过量死亡人数最多 在一年内记录，超过88，000（疾病控制和预防中心，2020年）。此外，只有10-20%的 与毒瘾作斗争的人接受他们的OUD（物质滥用和心理健康服务）的照顾 行政管理，2020年）。越来越多的文献揭示了一个非常容易受到阿片类药物影响的人群 成瘾和过量：美国退伍军人。 退伍军人面临着独特的挑战，使他们更容易滥用阿片类药物， 疼痛的患病率和严重程度高于一般人群（Nahin，2017），压力和 在返回平民生活时经常导致PTSD的部署风险（Seal等人，2012年）。事实上，这一群体， 虽然不是铁板一块，但可能普遍抵制支持;一半的军事人员报告说，他们 认为寻求心理健康问题的帮助会损害他们的军事生涯。自杀率持续上升， 即使人口减少，退伍军人人口的增长速度也快于非退伍军人人口， 退伍军人的比例。2018年，美国近七分之一的自杀者是退伍军人（“2020年全国 《预防自杀年度报告》，2020年。心理健康问题对物质使用有影响 紊乱也是。在全国范围内，退伍军人的过量死亡率从2010年到2016年增加了65% （Lewei等人，2019年）。战时部署的压力源，返回后往往难以摆脱 对平民生活的影响，造成严重和往往是慢性疼痛的受伤发生率，以及军事 文化，加上与OUD相关的耻辱，使退伍军人的成瘾循环永久化。 为了解决这个问题，我们正在提出一个新的解决方案，解决心理健康的发展。 通过首创的远程监控和干预软件即服务产品，在全国范围内为退伍军人提供服务。 我们的系统建立在我们的技术堆栈和从OUD患者的临床研究中学习的基础上。 考虑到退伍军人群体中的物质使用往往先于一个有害的循环， 严重和持续性精神疾病（SPMI），有时甚至自杀，先进和实时远程 监测心理健康状况将是一项重要指标。该工具提供及时干预 这解决了OUD，并进一步避免了SPMI的进展以及自杀倾向。

Project Summary/Abstract Opioid addiction affects people of all races, ages, gender identities, education, and income levels across the United States. The epidemic has been intensifying in recent years, with relapse rates reaching close to 91% (Kadam et al., 2017) and provisional data from 2020 indicating the highest number of overdose deaths ever recorded in a year, over 88,000 (Centers for Disease Control and Prevention, 2020). Further, only 10-20% of people struggling with addiction receive care for their OUD (Substance Abuse and Mental Health Services Administration, 2020). An increasing body of literature exposes a population extremely vulnerable to opioid addiction and overdose: United States veterans. Veterans face unique challenges that predispose them to greater risk for misusing opioids such as higher prevalence of and more severe pain than the general population (Nahin, 2017), and the stresses and risks of deployment that often result in PTSD upon return to civilian life (Seal et al., 2012). Indeed, this group, though not monolithic, may be generally resistant to support; half of military personnel reported that they believe seeking help for mental health issues would harm their military career. Suicide rates continue to rise, faster in the veteran population than in the non-veteran population, even despite the decrease in the population proportion of veterans. In 2018, almost one in seven suicides in the U.S. was a veteran (“2020 National Veteran Suicide Prevention Annual Report”, 2020). Mental health issues have an effect on substance use disorders as well. Nationwide, the rate of overdose deaths in veterans increased by 65% from 2010 to 2016 (Lewei et al., 2019). The stressors of deployment during wartime that are often difficult to shake off upon return to civilian life, incidences of injuries resulting in severe and often chronic pain, and the nuances of military culture, combined with stigmas associated with OUD, perpetuate a detrimental cycle of addiction for veterans. To address this, we are proposing the development of a novel solution that addresses the mental health of veterans nationally via a first-of-its-kind remote monitoring and intervention software-as-a-service offering. Our system builds upon our technology stack and learnings from clinical studies on individuals with OUD. Given that substance use in the veteran population often precedes a deleterious cycle commonly resulting in serious and persistent mental illness (SPMI) and sometimes even suicide, advanced and real-time remote monitoring of the state of mental health would be an important indicator. This tool provides timely intervention that addresses OUD and further averts the progression of SPMI as well as suicidal tendencies.