Improving outcomes in opiate dependence by understanding barriers and facilitators to opiate detoxification.

2021年，英格兰约有一半的药物中毒死亡涉及阿片类药物，这是有记录以来的最高数字。随着阿片类药物完全脱毒（即减少剂量和停止使用）的减少，迫切需要新的药物来支持禁欲。这一领域的研究资金不足且被忽视。帝国理工学院的成瘾研究小组是英国唯一一个研究阿片类药物依赖治疗新药理学靶点的小组。FORWARDS研究旨在调查巴氯芬支持美沙酮脱毒的安全性和有效性。为了告知和优化新疗法的实施，首先要了解为什么完成戒断的人数在下降，参与者恢复的动机以及戒断的潜在障碍是至关重要的。我的项目旨在确定阿片类药物成瘾治疗的关键促进因素和障碍。它将使用混合方法，分析来自问卷调查、半结构化访谈和当前文献的数据。它希望这项研究能提供一种理解，为什么完成排毒的人数在下降，以及可以做些什么来支持那些希望排毒的人，或者如果禁欲，健康可能会改善的人。这些发现将通过帮助解释疗效数据为试验增加巨大的价值，并且可以嵌入到未来的临床和研究实践中。

In 2021, approximately half of all drug poisoningmortalities in England involved an opiate, the highestnumber since records began. With a decline in completedopioid detoxes (i.e. dose reduction and cessation of use),the need for new medications to support abstinence isurgent. Research in this area is underfunded and neglected.The addiction team at Imperial College is the only group inthe UK conducting research into new pharmacologicaltargets for the treatment of opioid dependence. TheFORWARDS study aims to investigate the safety andefficacy of baclofen to support detoxification frommethadone. To inform and optimise the implementation ofnovel treatments, it is crucial to first understand why thenumber of completed detoxes is declining, participantmotivations for recovery, and potential barriers toabstinence.My project aims to identify key facilitators and barriers tothe treatment of opioid addiction. It would use a mixedmethodapproach, analysing data from questionnaires,semi-structured interviews, and current literature. It ishoped the study would offer an understanding as to whythe number of completed detoxes is declining, and whatcan be done to support those wishing to detox or whosehealth may improve if abstinent. Findings would add hugevalue to the trial by aiding the interpretation of efficacydata, and can be embedded into future clinical and researchpractice.