The Impact of Addressing Loneliness on Opioid Use

解决孤独感对阿片类药物使用的影响

• 批准号: 10425243
• 负责人: LISHAM ASHRAFIOUN
• 金额: $ 19.33万
• 依托单位: UNIVERSITY OF ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-06-15 至 2025-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10425243
• 关键词: Address; Advertising; Affect; Affective; Anxiety; Area; Behavior; Behavioral; Behavioral Mechanisms; Behavioral Model; Belief; Chronic Disease; Clinical; Clinical Trials; Cognitive; Cognitive Therapy; Communities; Data; Education; Emergency Situation; Emotional; Evidence based intervention; Exposure to; Individual; Intervention; Investigation; Link; Loneliness; Manuals; Mental Depression; Mental Health; Morbidity - disease rate; National Institute of Drug Abuse; Opioid; Overdose; Pain; Participant; Pathway interactions; Pattern; Persons; Prevention; Problem Solving; Psychosocial Stress; Randomized; Recovery; Relapse; Reporting; Research; Resistance; Risk; Risk Factors; Sleep disturbances; Social Interaction; Social Perception; Social isolation; Social support; Strategic Planning; Substance Use Disorder; Suicide; Telephone; Testing; Thinking; Work; addiction; comorbidity; coping; effective intervention; efficacy evaluation; efficacy trial; experience; improved; innovation; mortality; negative affect; novel; opioid epidemic; opioid misuse; opioid overdose; opioid use; opioid use disorder; overdose death; psychosocial; psychosocial stressors; recruit; response; skills; social; social contact; social situation; substance use treatment; telehealth; treatment strategy

Loneliness—a subjective emotional state characterized by the perception of social isolation—is a psychosocial stressor that is associated with increased mortality, opioid use, and is associated with precipitants of relapse among individuals with opioid use disorders (OUDs). Importantly, there are effective interventions that can be used to decrease loneliness; however, there are no studies that have directly intervened on loneness among individuals with OUDs, and the mechanisms by which loneliness impacts opioid use need to be elucidated. Cognitive-Behavioral Therapy for Loneliness (CBT-L) intervenes on loneliness by addressing negative beliefs that perpetuate loneliness, increase negative affect, and reduce one’s ability to engage in social activities. For an individual with an OUD, this is critical as addressing negative affect, and having a sense that one has social support and engages social support are key aspects of recovery. The proposed two-year study uses a novel application of a brief, phone-delivered, evidence-based intervention, CBT-L, to decrease loneliness by modifying maladaptive thinking behaviors, increasing engagement in enjoyable and social activities, and improving problem solving skills over just 4 session delivered by phone. Participants will be recruited nationally using online and print advertising. The specific aims are to: (1) assess the efficacy of CBT-L’s impact, relative to an education control, on loneliness, negative affect, and the quality and quantity of social interactions among 125 people with an OUD, and (2) assess the cognitive, affective, and behavioral mechanisms of the impact of CBT-L on opioid use trajectories. We expect that CBT-L will reduce loneliness, negative affect, and the quality and quantity of social interactions, thereby reducing opioid use. This R21 application is in response to PAS-18- 625, Mechanistic investigations of psychosocial stress effects on opioid use patterns sponsored by NIDA. The study team is ideally suited to conduct this research given their extensive experience in conducting research and doing clinical work in individuals with opioid use disorders, clinical trial experience with CBT for a variety of difficult-to-reach and treat individuals, and ability to recruit and retain often treatment-resistant people, including those with substance use disorders. Results from this study will provide critical information to conduct a fully-powered efficacy trial and assessment of cognitive and affective mechanisms of the link between loneliness and OUD.

孤独（以社会隔离感知为特征的主观情绪状态）是一种社会心理 与死亡率增加，阿片类药物使用相关的压力源，并且与退休的沉淀物有关 在患有阿片类药物使用障碍（OUDS）的个体中。重要的是，有效的干预措施可以 用于减少孤独感；但是，没有任何研究直接介入 具有OUD的个体，以及需要阐明孤独感影响阿片类药物使用的机制。 孤独感（CBT-L）的认知行为疗法通过解决负面信念来介入孤独感 这使孤独感，增加负面影响并降低一个人从事社交活动的能力。为了 一个有OUD的人，这对于解决负面影响至关重要，并且有一种社会的感觉 支持和参与社会支持是恢复的关键方面。拟议的两年研究使用了小说 使用简短的，电话传递的，基于证据的干预措施CBT-L，以减少孤独感 修改适应不良的思维行为，增加参与愉快和社交活动，以及 通过电话提供的4个会话，提高了解决问题的技能。参与者将在全国范围内招募 使用在线和打印广告。具体目的是：（1）评估CBT-L影响的效率，相对 对教育控制，孤独，负面影响以及社交互动的质量和数量 125人患有OUD，（2）评估影响的认知，情感和行为机制 CBT-L对绿木药物的使用轨迹。我们预计CBT-L将降低孤独感，负面影响和质量 和数量的社交互动，从而减少了阿片类药物的使用。此R21应用是对PAS-18-的响应 625，对NIDA赞助的阿片类药物使用模式的心理压力影响的机械研究。这 根据他们在进行研究方面的丰富经验，研究团队非常适合进行这项研究 并在阿片类药物使用障碍的个体中进行临床工作，CBT的临床试验经验 难以到达和治疗个人，以及招募和保留经常耐药的人的能力， 包括患有药物使用障碍的人。这项研究的结果将提供关键信息来进行 全力以赴的效率试验和评估的认知和情感机制 孤独和乌德。