Reducing Drug Abuse with Individually Tailored Treatment

描述（由申请人提供）： 长期以来，很明显，在开始使用药物、滥用、依赖和复发的风险方面存在个体差异。此外，任何预防和治疗计划的各个方面都存在异质性，无论是在个体之间还是在个体内部。在药物滥用领域的一个令人兴奋的趋势中，研究人员已经意识到，在设计预防和治疗方案时可以利用这种异质性，从而大大提高这些方案的有效性。这是通过个性化的治疗来实现的。在个别定制的治疗中，治疗水平和类型根据个人目前的需要在每个时间点重新调整。这些治疗设计显示出相当大的希望，有助于改善我们国家的药物滥用问题。然而，人们对如何设计个性化的治疗方法以最大限度地发挥其功效和可复制性知之甚少。为了使这些治疗设计发挥其潜力，需要在治疗设计方面进行大量的科学工作。此外，一旦实施了个性化的治疗，对如何分析所得数据知之甚少。 我的长期职业目标是通过设计可以有效利用理论，临床经验和实验/观察数据的方法来影响我们国家的药物问题，以告知药物滥用预防和治疗中随时间变化的治疗的设计和分析。我目前的P-50部分处理随着时间的推移而变化的治疗方法（包括个性化治疗）所带来的一般评价问题。K-02奖将使我能够将这项研究扩展到个性化治疗的设计，并扩展这些治疗的评估方法。

DESCRIPTION (provided by applicant): It has long been evident that there are individual differences in risk of initiation of substance use, abuse, dependence, and relapse. Furthermore, there is heterogeneity in response to various aspects of any prevention and treatment program, both across individuals and within individuals across time. In an exciting trend in the drug abuse field, researchers have come to realize that it is possible to utilize this heterogeneity when designing prevention and treatment programs, thus greatly improving the effectiveness of these programs. This is done via individually tailored treatments. In individually tailored treatments the treatment level and type is readjusted at each time point according to the individual's present need. These treatment designs show considerable promise for helping to ameliorate our nation's drug abuse problem. Yet very little is known about how to design individually tailored treatments so as to maximize both their power and replicability. In order for these treatment designs to fulfill their potential, much scientific work on the design of the treatment is needed. Additionally once an individually tailored treatment is implemented, little is known about how to analyze the resulting data. My long-term career goal is to make an impact on our nation's drug problem by designing methods that can effectively utilize theory, clinical experience and experimental/observational data to inform the design and analysis of time varying treatments in substance abuse prevention and treatment. My present P-50 component addresses general evaluation issues posed by treatments that change with time (including the individually tailored treatment). The K-02 award would enable me to extend this research to the design of individually tailored treatments and to expand the methodology for evaluation of these treatments.