A Natural History Study of Buprenorphine Diversion, Self-Treatment, and Use of Drug Abuse Treatment Services

丁丙诺啡转移、自我治疗和药物滥用治疗服务使用的自然史研究

• 批准号: 9175607
• 负责人: Raminta Daniulaityte
• 金额: $ 56.3万
• 依托单位: WRIGHT STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-07-15 至 2020-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9175607
• 关键词: Abstinence; Address; Area; Behavior Therapy; Buprenorphine; Clinical; Communities; Complex; Data; Data Collection; Diagnostic and Statistical Manual of Mental Disorders; Dimensions; Drug Abuse Treatment Services; Drug abuse; Drug usage; Epidemic; Frequencies; HIV; HIV risk; Health; Hepatitis B Virus; Hepatitis C virus; Heroin; Heterogeneity; Individual; Injection of therapeutic agent; Intervention; Interview; Length; Methods; Motivation; Natural History; Nature; Ohio; Opioid; Outcome; Overdose; Pattern; Pharmaceutical Preparations; Pharmacologic Substance; Pharmacotherapy; Phase; Public Health; Qualitative Research; Recording of previous events; Recruitment Activity; Reporting; Research; Risk Behaviors; Sampling; Services; Source; Structure; Testing; Withdrawal Symptom; Work; base; design; follow-up; innovation; insight; instrument; meetings; metropolitan; novel; opioid use; opioid use disorder; opioid withdrawal; overdose death; prescription drug abuse; prospective; substance abuse treatment; therapy design; trend

PROJECT SUMMARY There have been substantial increases in the use of diverted buprenorphine (BUP) in the U.S. Research suggests that increases are driven by people self-treating opioid withdrawal. A growing trend of BUP diversion represents an important, although little understood, part of the larger prescription drug abuse problem in the U.S. that is intertwined with the soaring heroin epidemic. The overall purpose of this natural history study is to describe and analyze the nature and consequences of diverted BUP use among heroin and/or non-medical pharmaceutical opioid (NMPO) users who meet criteria for DSM-5 opioid use disorder. The study will be conducted in the Dayton, Ohio, Metropolitan Area, an emerging epicenter of the heroin epidemic. The study uses a mixed-methods approach. In Phase I (formative research) qualitative data will be collected to inform Phase II data collection. Phase II (sample recruitment and longitudinal follow-up) builds on a sequential explanatory mixed-methods design. We will recruit a community-based sample of 400 people with DSM-5 opioid use disorder who have used diverted BUP in the previous 90 days. The quantitative component will include structured baseline (N=400) and follow-up interviews conducted every six months for two years. The qualitative component will include 60 semi-structured in-depth qualitative interviews with individuals selected from the larger sample based on results of Latent Class Analysis (LCA) of baseline quantitative data. The Specific Aims are to: 1) Describe key dimensions of BUP diversion, motivations and patterns of BUP and other drug use, HIV/HBV/HCV risk behaviors, history of unintentional overdose, and drug abuse treatment use. 2) Identify trajectories of diverted BUP product use over 24 months and analyze their dynamic relationship to health-related outcomes, including opioid use/non-use, HIV/HBV/HCV risk behaviors, unintentional overdose, and drug abuse treatment engagement. Understanding the nature of diverted BUP use and its effects on opioid use and utilization of substance abuse treatment services has important clinical and public health implications. The study is highly significant because it will advance our understanding of crucial scientific research questions on the mechanisms of BUP diversion and relationships between trajectories of diverted BUP use, length of abstinence from other opioids, HIV risk behaviors, unintentional overdose, and drug abuse treatment seeking and engagement. It is highly innovative because it will be the first study to provide a longitudinal, mixed-methods approach to analyze BUP diversion and trajectories of use in the context of complex interactions between self-treatment behaviors and use of drug abuse treatment services. The mixed-method design is also novel because we will use LCA analysis results to select the qualitative sample. Our research questions will provide findings with critical public health impact that could be used to inform the design of interventions to address the NMPO/heroin epidemics and issues of BUP diversion.

项目摘要 在美国研究中，使用转移的丁丙诺啡（BUP）的使用已大大增加 表明增加是由自我治疗的阿片类药物戒断驱动的。 bup转移的趋势不断增长 代表了一个重要的，尽管鲜为人知，但在大型处方药滥用问题中的一部分 美国与海洛因流行病交织在一起的美国。这项自然历史研究的总体目的是 描述和分析海洛因和/或非医学之间转移BUP使用的性质和后果 符合DSM-5阿片类药物使用障碍标准的药物阿片类药物（NMPO）用户。该研究将是 在俄亥俄州的代顿，大都会地区进行，是海洛因流行的新兴中心。研究 使用混合方法方法。在第一阶段（形成性研究）中，将收集定性数据以告知 第二阶段数据收集。 II期（样品募集和纵向随访）建立在顺序的 解释性混合方法设计。我们将招募400名DSM-5人的社区样本 在过去的90天内使用转移BUP的阿片类药物使用障碍。定量组件将 包括结构化基线（n = 400）和每六个月进行两年的后续采访。这 定性组成部分将包括60个半结构化的深入定性访谈 根据基线定量数据的潜在类别分析（LCA）的结果，从较大的样本中。这 具体目的是：1）描述BUP转移，动机和bup和模式的关键维度 其他药物使用，艾滋病毒/HBV/HCV风险行为，无意过量的史和药物滥用治疗的使用。 2）确定在24个月内使用转移BUP产品的轨迹，并分析其动态关系 与健康相关的结果，包括阿片类药物使用/不使用，HIV/HBV/HCV风险行为，无意的过量服用， 和药物滥用治疗参与。了解转移BUP使用的性质及其对阿片类药物的影响 使用和利用药物滥用治疗服务具有重要的临床和公共卫生影响。 这项研究非常重要，因为它将提高我们对关键科学研究的理解 关于bup转移机制以及转移bup使用轨迹之间的关系的问题， 其他阿片类药物的禁欲，艾滋病毒风险行为，无意过量和药物滥用治疗 寻求和参与。它具有很高的创新性，因为它将是第一个提供纵向的研究 混合方法在复杂的背景下分析BUP转移和使用轨迹的方法 自我治疗行为与使用药物滥用治疗服务之间的相互作用。混合方法 设计也很新颖，因为我们将使用LCA分析结果选择定性样本。我们的研究 问题将提供具有关键公共卫生影响的发现，可用于告知设计 解决NMPO/海洛因流行病的干预措施和BUP转移问题。