Repeated-dose behavioral intervention to reduce opioid overdose: a two-site randomized-controlled efficacy trial

重复剂量行为干预减少阿片类药物过量：一项两中心随机对照疗效试验

• 批准号: 10374101
• 负责人: PHILLIP O COFFIN
• 金额: $ 69.29万
• 依托单位: PUBLIC HEALTH FOUNDATION ENTERPRISES
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-06-15 至 2024-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10374101
• 关键词: Address; Adult; Affect; Behavior Therapy; Behavioral; Boston; Cessation of life; Client; Computer Assisted; Counseling; Country; Cox Proportional Hazards Models; Data; Dose; Drug usage; Education; Educational Curriculum; Effectiveness; Emergency Situation; Enrollment; Ensure; Epidemic; Event; Fentanyl; Funding; Future; Generations; Health; Heroin; Home; Individual; Intervention; Interview; Knowledge; Medical; Medical Records; Modeling; Motivation; Naloxone; National Institute of Drug Abuse; New England; Opiate Addiction; Opioid; Opioid Analgesics; Overdose; Overdose reduction; Participant; Patients; Persons; Pharmaceutical Preparations; Pilot Projects; Poisoning; Population; Population Intervention; Printed Media; Process; Randomized; Randomized Controlled Trials; Recommendation; Recruitment Activity; Recurrence; Reporting; Resources; Risk; Risk Behaviors; Risk Factors; San Francisco; Site; Substance Use Disorder; Syringes; Testing; Time; Training; United States; Validation; Visit; attentional control; authority; base; behavior change; brief intervention; comparative efficacy; drug use behavior; efficacy trial; experience; follow-up; high risk; illicit opioid; mathematical model; mortality; motivational enhancement therapy; opioid epidemic; opioid mortality; opioid overdose; opioid use; opioid use disorder; opioid user; overdose education; overdose prevention; overdose risk; prevent; programs; randomized trial; reduced substance use; screening; service programs; skills; social media; social stigma; substance use; substance use treatment; synthetic opioid; treatment as usual; treatment services; trend; video session; willingness

Project Summary/Abstract The United States is amidst an epidemic of opioid overdose, including opioid analgesics, heroin, and illicitly- manufactured fentanyl and related synthetic opioids. Multiple interventions to address opioid overdose have been employed, such as lay access to naloxone to reverse opioid overdose, yet the number of people dying each year from opioid overdose continues to increase each year. In addition to efforts to reduce mortality, efforts are needed to reduce the occurrence of any opioid overdose, particularly given the rapidity of synthetic opioid overdoses, which may restrict the time available to intervene once an overdose occurs. Opioid stewardship activities, necessary to avert yet another generation affected by the opioid epidemic, may paradoxically contribute to the illicit opioid epidemic, and expanded access to opioid use disorder treatment, while essential, is limited by resources, stigma, and the willingness of patients to accept the intervention. The NIDA-funded pilot study of REBOOT (repeated dose behavioral intervention to reduce opioid overdose), a motivational interviewing-based brief intervention addressing experienced and witnessed overdose events, resulted in substantial reductions in the occurrence of any opioid overdose, as well as the number of opioid overdoses that occurred during 16 months of follow-up. This full trial of REBOOT includes two regions of the United States – San Francisco, largely unaffected by the fentanyl epidemic – and Boston, at the epicenter of fentanyl use, overdose, and mortality. REBOOT will enroll 300 persons with opioid use disorder who are currently using opioids, have previously received take-home naloxone, and are at high-risk for recurrent overdose. Participants will be randomized to the intervention or attention-control and seen every four months for 16 months, with interval assessments for overdose events, overdose risk factors, engagement in substance use disorder treatment, and substance use. Medical records will be reviewed to capture unreported overdose events, including death. Results will determine if addressing overdose through motivational interviewing can reduce the occurrence of overdose, contributing to efforts to respond to this national emergency.

项目摘要/摘要 美国是阿片类药物过量的流行病，包括阿片类镇痛药，海洛因和非法 - 制造的芬太尼和相关的合成阿片类药物。多种干预措施以解决阿片类药物过量 被雇用，例如使用纳洛酮来逆转阿片类药物过量，但死亡的人数 每年从阿片类药物过量服用的每年都会每年继续增加。除了降低死亡率的努力外， 需要努力来减少任何阿片类药物过量的发生，尤其是考虑到合成的速度 阿片类药物过量，这可能会限制一旦发生过量的时间。 管理活动是避免另一代阿片类药物流行所必需的，可能 自相矛盾的是有助于非法阿片类药物流行，并扩大了接受阿片类药物使用障碍治疗的机会 虽然必不可少，但受到资源，污名和患者接受干预的意愿的限制。这 NIDA资助的重新启动初步研究（重复剂量行为干预以减少阿片类药物过量），A 基于励志访谈的简短干预措施解决经验丰富并见证了过量事件， 导致任何阿片类药物过量的发生以及阿片类药物的数量大大减少 在随访的16个月内发生的过量服用。重新启动的全面试验包括两个区域 美国 - 旧金山，在很大程度上不受芬太尼流行的影响 - 波士顿 芬太尼使用，过量和死亡率。重新启动将注册300人患有阿片类药物使用障碍的人 目前使用阿片类药物，以前已经收到了纳洛酮，并且在高风险中以进行复发 过量。参与者将随机分配干预或注意力控制，并每四个月观看一次 在16个月内，通过间隔评估过量事件，过量风险因素，参与底物 使用障碍治疗和药物使用。病历将进行审查以捕获未报告的过量 事件，包括死亡。结果将确定通过动机面试解决过量用药是否可以 减少用药过量的发生，有助于努力应对这种国家紧急情况。

项目成果

Feasibility and acceptability of a timeline follow-back method to assess opioid use, non-fatal overdose, and substance use disorder treatment.

评估阿片类药物使用、非致命过量和物质使用障碍治疗的时间线随访方法的可行性和可接受性。

• DOI: 10.1016/j.addbeh.2023.107873
• 发表时间: 2024
• 期刊: Addictive behaviors
• 影响因子: 4.4
• 作者: McCann,NicoleC;McMahan,VanessaM;Smith,Rachel;Majeski,Adam;Johns,SarahL;Kosakowski,Sarah;Wolfe,Shae;Brennan,Sarah;Robinson,Mackenzie;Coffin,PhillipO;Walley,AlexanderY
• 通讯作者: Walley,AlexanderY