Effective Treatment for Prescription Opioid Abuse

近年来，处方阿片类药物的滥用出现了令人震惊的增长。2002年的数据 例如，关于药物使用和健康的全国调查表明，处方类阿片的滥用增加 在1990至2000年间增长了400%以上。处方阿片类药物滥用的增加与 随着毒品犯罪的增加，许多不利的健康后果和治疗需求。尽管 这些统计数据，我们知道没有发表的研究评估处方阿片类药物滥用的治疗。 本提案是针对NIDA的PA 04-110“处方药滥用”而提出的，并概述了两个 旨在程序化评估联合行为-药理学的实验研究 处方阿片类药物滥用的治疗。平台行为治疗在两种情况下都提供给患者 研究是社区强化方法(CRA)，是促进健康的有效方法 合法和非法吸毒者生活方式的改变。药物治疗将是丁丙诺啡 戒毒后进行纳曲酮治疗。在研究1中，我们提出了一个参数 研究以确定有效的丁丙诺啡剂量-逐渐减少时间表，以防止不良保留 以及高复发率，这往往会破坏戒毒计划。在研究2中，我们提出了一个参数 纳曲酮维持阿片类药物戒断有效方案的研究 在丁丙诺啡戒毒后。 这项建议的首要目标是开发一种机械化、有效的处方治疗方法。 阿片类药物滥用。在这项申请中提出的两项随机临床试验有可能对 重要的新科学和临床知识对开发有效的干预措施至关重要 处方类阿片类药物滥用。该项目的目标也与NIDA的使命直接相关 开发有效的、基于经验的药物依赖治疗方法。最后，提出了本文的研究方向 对总体公共卫生状况有很大的潜在影响。有效药物的开发 针对这一新兴人群的治疗将有助于降低相关的巨大经济和社会成本。 处方类阿片类药物滥用。

There has been an alarming increase in abuse of prescription opioids in recent years. Data from the 2002 National Survey on Drug Use and Health, for example, indicate that abuse of prescription opioids increased by more than 400% between 1990 and 2000. This increase in prescription opioid abuse has been associated with increases in drug-related crime, numerous adverse health consequences and treatment demand. Despite these statistics, we know of no published studies evaluating treatments for prescription opioid abuse. This proposal is submitted in response to NIDA's PA 04-110 "Prescription Drug Abuse" and outlines two experimental studies designed to programmatically evaluate a combined behavioral-pharmacological treatment for prescription opioid abuse. The platform behavioral treatment delivered to patients in both studies is the Community Reinforcement Approach (CRA), an efficacious therapy for promoting healthy lifestyle changes in licit and illicit drug abusers. The pharmacological treatments will be a buprenorphine detoxification followed by a regimen of naltrexone therapy. In Study 1 we propose a parametric investigation to determine an effective buprenorphine dose-tapering schedule that prevents the poor retention and high relapse rates that often undermine detoxification programs. In Study 2 we propose a parametric investigation to determine an effective regimen of naltrexone therapy that can sustain opioid abstinence following the buprenorphine detoxification. The overarching goal of this proposal is to develop a manualized, efficacious treatment for prescription opioid abuse. The two randomized clinical trials proposed in this application have the potential to contribute important new scientific and clinical knowledge critical to the development of effective interventions for prescription opioid abuse. The aims of the project are also directly relevant to NIDA's mission of developing effective, empirically-based treatments for drug dependence. Finally, the proposed research holds significant potential for impacting the status of public health in general. Development of efficacious treatments for this emerging population will help to reduce the vast economic and societal costs associated with prescription opioid abuse.