Online Buprenorphine Training for Outreach Workers and Case Managers

描述（由申请人提供）：我们建议为外展工作人员和病例管理人员开发一个低成本、易于获取的丁丙诺啡治疗在线培训课程，他们的职责包括定位、激励、教育和/或参考依赖海洛因和其他阿片类药物的青少年和成人的药物治疗。迫切需要增加海洛因和其他阿片类药物依赖治疗的登记人数。最近的估计显示，美国的海洛因和其他依赖鸦片的使用者人数为98万，这是自20世纪70年代末以来的最高数字。这些数字在所有社会人口群体中都有所上升，在年轻人中翻了一番。近年来，奥施康定（OxyContin）和维柯丁（Vicodin）等处方阿片类药物的滥用显著增加，海洛因和其他药物的注射（通常与海洛因结合使用）仍然与美国三分之一的新艾滋病毒病例和大多数丙型肝炎病毒病例有关。然而，只有20%需要治疗的阿片类依赖吸毒者实际上参加了治疗。幸运的是，国会在2000年颁布的新立法极大地改变了美国治疗阿片类药物依赖的方式。《药物成瘾治疗法案》允许合格的医生使用FDA批准的药物治疗阿片类药物依赖。经过近二十年nida资助的研究和临床试验，一种新药丁丙诺啡于2002年问世。丁丙诺啡的药物辅助治疗有可能通过增加药物治疗的可及性和登记来彻底改变阿片类药物依赖的治疗。然而，为了增加获取和登记，有必要解决一些障碍，包括关于这种新药的知识差距。虽然医生和成瘾专家可以很容易地在网上获得培训，但对于外联工作人员和病例管理人员来说，却没有这样的培训——这些一线工作人员往往是“难以接触”的依赖鸦片的青少年和成年人（包括许多少数民族）的第一个接触者。在线培训课程将包括为特殊人群（如青年、艾滋病毒感染者）使用丁丙诺啡的相关信息。在第一阶段，我们将：(1)开发计算机辅助教学（CAI）格式的课程；(2)创建两个CAI模块的自主交互原型；(3)对两个模块的计算机原型进行了评价。该课程将面向广泛的盈利和非营利组织和机构。

DESCRIPTION (provided by applicant): We propose to develop a low-cost, easily accessible, online training curriculum about buprenorphine treatment for outreach workers and case managers whose responsibilities include locating, motivating, educating, and/or referring to drug treatment youth and adults dependent upon heroin and other opiates. Increasing enrollment in treatment for heroin and other opioid dependency is critically needed. Recent estimates place the population of heroin and other opiate-dependent users in the U.S. at 980,000 -- the highest number since the late 1970's. These numbers have risen across all sociodemographic groups, and have doubled among youth. The abuse of prescribed opiates such as OxyContin(R) and Vicodin(R) has risen remarkably in recent years and the injection of heroin and other drugs (often in combination with heroin) continues to be associated with one-third of all new HIV cases and the majority of HCV cases in the U.S. Yet, only 20 percent of opiate-dependent drug users in need of treatment are actually enrolled in treatment. Fortunately, new legislation enacted in 2000 by Congress has dramatically changed the way opiate dependency can be treated in the U.S. The Drug Addiction Treatment Act permits qualified physicians to treat opiate dependency with drugs approved by the FDA. After nearly two decades of NIDA-sponsored research and clinical trials, a new drug, buprenorphine, was introduced in 2002. Medication-assisted treatment with buprenorphine holds the potential to revolutionize the treatment of opioid dependency by increasing access to and enrollment in drug treatment. However, in order to increase access and enrollment, it is necessary to address a number of barriers, including the knowledge gap regarding this new medication. While physicians and addiction professionals can easily access training online, no such training exists for outreach workers and case managers-- the frontline workers who are often the first contact with "hard-to-reach" opiate dependent youth and adults (including many ethnic minorities). The online training curriculum will include relevant information on the use of buprenorphine for special populations (e.g. youth, HIV+ persons). In Phase I, we will: (1) develop the curriculum in a Computer Assisted Instruction (CAI) format; (2) create a self-directed and interactive prototype of two CAI modules; and (3) evaluate the computerized prototype of the two modules. The curriculum will be marketed to a broad range of profit and non-profit organizations and institutions.