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

基本信息

批准号：
7467760
负责人：
Maria A Sullivan
金额：
$ 10.31万
依托单位：
NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC
依托单位国家：
美国
项目类别：
财政年份：
2005
资助国家：
美国
起止时间：
2005-09-25 至 2010-12-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7467760
关键词：
Accident and Emergency department Address Alcohol abuse Amphetamines Analgesics Behavior Behavioral Benzodiazepines Buprenorphine Cannabinoids Chronic Clinic Clinical Condition Daily Data Diagnosis Dose Drug abuse Drug usage Effectiveness Euphoria Future General Population Goals Health Hospitals Individual Inpatients Intervention Knowledge Laboratories Maintenance Measures Medical Methods Mitochondrial Carnitine Palmitoyltransferase Pathway Modeling Naloxone Non-Malignant Numbers Opioid Opioid Analgesics Oral Outcome Outpatients Output Oxycodone Pain Pain management Participant Patient-Controlled Analgesia Patients Pattern Performance Persons Pharmaceutical Preparations Phase Physiological Placebos Population Prevalence Primary Health Care Protocols documentation Rate Recording of previous events Relapse Relative (related person)Reporting Research Research Personnel Sampling Self Administration Self-Administered Source Substance abuse problem Surveys Syndrome Task Performances Testing Toxicology United States Upper arm Urine Visit Water Week base benzoylecgonine chronic pain clinically relevant design drug of abuse opioid abuse prescription document prescription procedure programs response

项目摘要

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.

该提案的目标是通过检查处方阿片类药物滥用来解决日益严重的问题羟考酮在实验室环境中在存在临床疼痛且疼痛显着缓解后的效果维持丁丙诺啡/纳洛酮组合 (Bup/NX) 后。参与者被诊断患有中度疼痛最初将入院并从基线处方阿片类药物过渡到阿片类药物 Bup/NX 的每日固定剂量。在Bup/NX维护期间，参与者将拥有自我施用羟考酮的机会以及对羟考酮和镇痛药的主观反应，将测量生理和性能影响。在本研究的第二阶段，同样参与住院阶段的患者将在门诊进行随访，同时维持在布布/NX。门诊阶段的主要结果变量包括尿液阴性的百分比阿片类药物的毒理学样本和治疗周数。该提案的一个主要目标是确定实验室收集的哪些变量最可靠地预测阿片类药物的后续复发虐待。此外，Bup/NX 在治疗诊断为慢性疼痛和物质的患者中的效用滥用行为将受到评估。尽管处方阿片类药物滥用在过去 5-10 年显着增加多年来，很少有研究系统地研究处方阿片类药物滥用的问题患有慢性疼痛的人群。据我们所知，迄今为止还没有研究检查阿片类药物有阿片类药物滥用史的疼痛患者自行给药。具体来说，当前该提案旨在 1) 描述羟考酮对 Bup/NX 维持疼痛患者的行为影响目前正在滥用处方阿片类药物的人； 2）检查行为之间的关系在实验室环境中测量羟考酮的影响，以及随后阿片类药物滥用的复发。这些研究将提供有关疼痛患者处方阿片类药物滥用倾向的重要信息，并将产生一个实验室模型来预测处方阿片类药物滥用复发的可能性。这些问题与阿片类药物治疗慢性疼痛具有直接的临床相关性。