Predictors of Relapse to Prescription Opioid Abuse Among Pain Patients

疼痛患者处方阿片类药物滥用复发的预测因素

• 批准号: 7126347
• 负责人: Maria A Sullivan
• 金额: $ 45.88万
• 依托单位: NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-25 至 2010-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7126347
• 关键词: analgesics; behavior prediction; behavioral /social science research tag; buprenorphine; clinical research; codeine; combination chemotherapy; drug abuse; drug adverse effect; euphoria; human subject; naloxone; opiate alkaloid; pain; questionnaires; reinforcer; relapse /recurrence; analgesics; behavior prediction; behavioral /social science research tag; buprenorphine; clinical research; codeine; combination chemotherapy; drug abuse; drug adverse effect; euphoria; human subject; naloxone; opiate alkaloid; pain; questionnaires; reinforcer; relapse /recurrence

DESCRIPTION (provided by applicant): The goal of this proposal is to address the growing problem of prescription opioid abuse by examining the effects of oxycodone in a laboratory setting in the presence of clinical pain and following significant pain relief following maintenance on the buprenorphine / naloxone combination (Bup/NX). Participants diagnosed with moderate pain initially will be admitted to hospital and transitioned from their baseline prescription opioid to a standing daily dose of Bup/NX. During the Bup/NX maintenance periods, participants will have the opportunity to self-administer oxycodone and subjective responses to oxycodone as well as analgesic, physiological and performance effects will be measured. In the second phase of this study, the same patients who participated in the inpatient phase will be followed on an outpatient basis while maintained on Bup/NX. Primary outcome variables during the outpatient phase will include percentage of negative urine toxicology samples for opioids and number of weeks in treatment. A major goal of this proposal is to determine which variables collected in the laboratory most reliably predict subsequent relapse to opioid abuse. In addition, the utility of Bup/NX in treating patients diagnosed with both chronic pain and substance abuse will be assessed. Despite the significant increase in prescription opioid abuse over the past 5-10 years, very few studies have systematically examined the issues surrounding prescription opioid abuse in the population of individuals with chronic pain. To our knowledge, no studies to date have examined opioid self-administration in persons with pain who have a history of opioid abuse. Specifically, the current proposal aims to 1) characterize the behavioral effects of oxycodone in Bup/NX-maintained pain patients who are currently abusing their prescription opioids; and 2) examine the relationship between behavioral effects of oxycodone as measured in the laboratory setting, and subsequent relapse to opioid abuse. These studies will provide important information about prescription opioid abuse liability in pain patients and will yield a laboratory model for predicting likelihood to relapse to prescription opioid abuse. These questions are of immediate clinical relevance to the treatment of chronic pain with opioid therapy.

描述（由申请人提供）：该提案的目的是通过检查在存在临床疼痛的情况下在实验室环境中检查处方阿片类药物滥用的日益增长的问题，并在维持对丁丙诺啡 /纳洛宁组合（BUP / NX）后进行明显的疼痛缓解后。最初被诊断出患有中度疼痛的参与者将被送往医院，并将其从基线处方阿片类药物过渡到每日常规剂量的BUP/NX。在BUP/NX维护期间，参与者将有机会自我辅助羟考酮和对羟考酮以及镇痛，生理和性能效应的主观反应。在这项研究的第二阶段中，将在bup/nx上保持在门诊的基础上，参与住院期的相同患者。门诊期间的主要结果变量将包括阿片类药物的负尿毒理学样本的百分比和治疗数周的数量。该提案的主要目标是确定实验室中最可靠地预测随后滥用阿片类药物的变量。此外，将评估BUP/NX在治疗诊断患有慢性疼痛和药物滥用的患者中的效用。尽管在过去的5 - 10年中，处方阿片类药物滥用的大幅增加，但很少有研究系统地检查了慢性疼痛患者人群中围绕处方阿片类药物滥用的问题。据我们所知，迄今为止尚无研究检查阿片类药物的自我管理，患有阿片类药物史的人。具体而言，当前的建议旨在1）表征羟考酮在BUP/NX维护疼痛患者中的行为影响，这些患者目前正在滥用处方阿片类药物； 2）检查在实验室环境中测量的羟考酮的行为效应与随后的阿片类药物滥用之间的关系。这些研究将提供有关疼痛患者处方阿片类药物滥用责任的重要信息，并将产生实验室模型，以预测可能复发到处方阿片类药物滥用的可能性。这些问题与阿片类药物疗法治疗慢性疼痛的治疗直接相关。