Integrative Treatment for Achieving Holistic Recovery from Comorbid Chronic Pain and Opioid Use Disorder

项目摘要 慢性疼痛和阿片类药物使用障碍（OUD）是主要的公共卫生问题。尽管令人震惊的增长 在阿片类药物滥用和OUD中，很少有综合治疗同时针对慢性疼痛和OUD。综合整体 迫切需要同时解决疼痛和阿片类药物使用的治疗方法， 疼痛和OUD，并专注于慢性病患者的整体功能和福祉 疼痛和阿片类药物滥用/OUD。新墨西哥州大学（UNM）慢性疼痛的综合管理 和阿片类药物使用障碍的整体恢复（IMPOWR）中心将采取综合和整体的方法， 通过定制的干预方法改善慢性疼痛和阿片类药物滥用/OUD患者的生活， 满足不同社区中不同个体的需求。我们将明确目标，提高生活质量 参与有价值的活动，以文化为中心的干预措施，以满足不同患者的需求， 人口，减少慢性疼痛和阿片类药物滥用和OUD的耻辱。中提出的方法 我们的IMPOWR中心将直接针对慢性病患者的全人功能和健康， 疼痛和误用/OUD。我们的目标是开发、测试和实施可扩展、可推广和可持续的 提供者和患者层面的干预措施，重点是改善功能，并可以在 不同的医疗保健机构。为了最大限度地发挥影响力，我们建立了一个多元化的利益相关者协商机制， 委员会（包括有实际经验的人和其他利益相关者）和科学咨询委员会 （包括慢性疼痛、阿片类药物滥用/OUD和实施科学方面的专家），并旨在建立一个 致力于通过培训改善慢性疼痛和OUD的研究人员和供应商的可持续劳动力 和指导。所有中心的项目都将采用以社区为基础的参与性研究原则， 科学、实施科学、经济评价和开放科学。符合我们以病人为中心 方法，阿片类药物使用和慢性疼痛的评估将与心理社会措施相补充。 功能和其他重要的生活领域，包括耻辱，参与有价值的活动， 生活项目将包括经济评估，以衡量我们的干预措施的成本效益， perspective.具体的研究项目将测试一个 接受丁丙诺啡治疗的慢性疼痛和OUD患者的综合心理社会治疗 门诊OUD治疗诊所，并将使用以社区为基础的参与性研究方法， 以文化为中心的慢性疼痛和OUD筛查和短暂干预的实施干预 美国印第安人/阿拉斯加原住民患者在初级保健环境中。专注于慢性疼痛的试点项目 OUD将由我们的利益相关者咨询委员会选出。UNM IMPOWR中心致力于 数据协调、研究资源共享和提供者培训，以提高覆盖范围、有效性， 采用，实施和维护慢性疼痛和OUD的循证治疗。

PROJECT SUMMARY Chronic pain and opioid use disorder (OUD) are major public health problems. Despite the alarming increases in opioid misuse and OUD, few integrated treatments target both chronic pain and OUD. Integrated holistic treatments are desperately needed that simultaneously address pain and opioid use, the fundamental causes of pain and OUD, and that focus on whole person functioning and well-being among individuals with chronic pain and opioid misuse/OUD. The University of New Mexico (UNM) Integrative Management of chronic Pain and Opioid use disorder for Whole Recovery (IMPOWR) Center will take an integrated and holistic approach to improving the lives of patients with chronic pain and opioid misuse/OUD via tailored intervention approaches to meet the needs of diverse individuals in diverse communities. We will explicitly target increasing quality of life and engagement in valued activities, the cultural centering of interventions to meet the needs of diverse patient populations, and reducing stigma of chronic pain and opioid misuse and OUD. The approaches proposed in our IMPOWR Center will directly target whole person functioning and well-being among individuals with chronic pain and misuse/OUD. Our goals are to develop, test, and implement scalable, generalizable, and sustainable provider- and patient-level interventions that are focused on improving functioning and can be delivered in diverse health care settings. To maximize impact, we have established a diverse Stakeholder Consultation Board (including people with lived experience and other stakeholders) and a Scientific Advisory Board (including experts in chronic pain, opioid misuse/OUD, and implementation science), and aim to build a sustainable workforce of researchers and providers devoted to ameliorating chronic pain and OUD via training and mentoring. All Center projects will embrace principles of community-based participatory research, team science, implementation science, economic evaluation, and open science. Consistent with our patient-centered approach, assessment of opioid use and chronic pain will be complemented with measures of psychosocial functioning and other important life domains, including stigma, engagement in valued activities, and quality of life. Projects will include economic evaluation to measure cost-effectiveness of our interventions from a societal perspective. Specific research projects will test the effectiveness, mechanisms, and implementation of an integrated psychosocial treatment for chronic pain and OUD among individuals receiving buprenorphine from outpatient OUD treatment clinics, and will use community-based participatory research methods to develop a culturally-centered implementation intervention for screening and brief intervention of chronic pain and OUD among American Indian/Alaska Native patients in primary care settings. Pilot projects focused on chronic pain and OUD will be selected by our Stakeholder Consultation Board. The UNM IMPOWR Center is committed to data harmonization, sharing of study resources, and provider training to enhance the reach, effectiveness, adoption, implementation, and maintenance of evidence-based treatments for chronic pain and OUD.