Substance Abuse, Post-Traumatic Stress, Chronic Pain in Primary Care Setting

描述（由申请人提供）： 博士Jane Liebschutz是一位普通内科/初级保健的学术医生，她有使用定性和定量方法研究人际暴力对健康影响的经验。她寻求K23奖，成为在初级保健环境中为同时发生的物质使用障碍（SUD）和创伤后应激障碍（PTSD）的人开发治疗方法的领导者。为了推进她的目标，她还将专注于慢性非癌症疼痛，这是一种与SUD和PTSD相关的疾病，也是初级保健环境中患有这些疾病的患者的常见临床表现。作为K23奖的一部分，她将对患有慢性非癌症疼痛的初级保健患者进行横断面研究，以描述共同发生的SUD和PTSD的患病率以及治疗需求。(AIM 1）使用定性研究方法，她将对初级保健医生进行一项焦点小组研究，以探索对同时发生SUD，PTSD和慢性疼痛的患者进行基于初级保健的干预措施的偏好。(AIM 2）她将利用这两个项目中收集的信息，结合SUD和PTSD患者的既定行为疗法，为初级保健环境中同时发生的SUD，PTSD和慢性疼痛制定多学科行为干预。(AIM第三章 该奖项的职业发展活动包括由在成瘾，双重诊断和创伤后应激障碍，定向阅读，研究生水平的课程，沉浸在专业设置（创伤后应激障碍培训中心，药物滥用治疗计划，疼痛康复计划），出席专业会议和研究本身具有丰富的研究经验的个人指导。拟议工作的完成将使Liebschutz博士能够独立调查在初级保健环境中共同发生的物质使用障碍和PTSD的治疗。

DESCRIPTION (provided by applicant): Dr. Jane Liebschutz is an academic physician in general internal medicine/primary care with experience studying health effects of interpersonal violence using both qualitative and quantitative methods. She seeks a K23 award to become a leader in the development of treatment approaches for persons with co-occurring substance use disorders (SUD) and post-traumatic stress disorder (PTSD) in the primary care setting. To advance her goals, she will also focus on chronic non-cancer pain, a condition both associated with SUD and PTSD and a common clinical presentation of patients with these conditions in the primary care setting. As part of her K23 award, she will conduct a cross-sectional study of primary care patients with chronic noncancer pain to describe the prevalence of co-occurring SUD and PTSD and treatment needs. (AIM 1) Using qualitative research methods, she will conduct a focus group study of primary care physicians to explore preferences for primary care based interventions for patients with co-occurring SUD, PTSD and chronic pain. (AIM 2) She will utilize information gathered in these two projects in conjunction with established behavioral therapies for patients with SUD and PTSD to develop a multi-disciplinary behavioral intervention for co-occurring SUD, PTSD and chronic pain for the primary care setting. (AIM 3) Career development activities for this award include mentoring by individuals with extensive research experience in addiction, dual diagnosis and PTSD, directed readings, graduate level coursework, immersion in specialty settings (PTSD training center, substance abuse treatment program, pain rehabilitation program), attendance at specialty conferences, and the research itself. Completion of the proposed work will prepare Dr. Liebschutz to independently investigate the treatment of co-occurring substance use disorder and PTSD in the primary care setting.