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：
7794863
负责人：
Maria A Sullivan
金额：
$ 42.17万
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 2012-02-28
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7794863
关键词：
Accident and Emergency department Address Alcohol abuse Amphetamines Analgesics Behavior Behavioral Benzodiazepines Buprenorphine Cannabinoids Chronic Clinic Clinical Data Diagnosis Dose Drug abuse Drug usage Effectiveness Euphoria Future General Population Goals Health Hospitals Individual Inpatients Intervention Knowledge Laboratories Maintenance Measures Medical Methods Modeling Naloxone Non-Malignant Opioid Opioid Analgesics Oral 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 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 Urine Visit Water arm base benzoylecgonine chronic pain clinically relevant design drug of abuse opioid abuse prescription opioid prescription opioid abuse primary outcome programs response

项目摘要

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）：该提案的目标是通过在实验室环境中检查羟考酮在临床疼痛存在下的效果以及维持丁丙诺啡/纳洛酮后显着缓解疼痛来解决处方阿片类药物滥用的日益严重的问题组合（Bup/NX）。最初诊断为中度疼痛的参与者将被送往医院，并从他们的基线处方阿片类药物转变为每日固定剂量的 Bup/NX。在 Bup/NX 维持期间，参与者将有机会自行施用羟考酮，并测量对羟考酮的主观反应以及镇痛、生理和表现效果。在本研究的第二阶段，参与住院阶段的相同患者将在门诊进行随访，同时维持 Bup/NX。门诊阶段的主要结果变量包括阿片类药物尿液毒理学样本阴性的百分比和治疗周数。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滥用的后续复发。此外，还将评估 Bup/NX 在治疗诊断为慢性疼痛和药物滥用的患者中的效用。尽管过去 5-10 年处方阿片类药物滥用显着增加，但很少有研究系统地研究慢性疼痛人群中处方阿片类药物滥用的问题。据我们所知，迄今为止还没有研究检查有阿片类药物滥用史的疼痛患者的阿片类药物自我给药情况。具体来说，当前提案的目的是 1) 描述羟考酮对目前滥用处方阿片类药物的 Bup/NX 维持疼痛患者的行为影响； 2) 检查实验室环境中测量的羟考酮行为影响与随后阿片类药物滥用复发之间的关系。这些研究将提供有关疼痛患者处方阿片类药物滥用倾向的重要信息，并将产生一个实验室模型，用于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。