Adaption of the STAIR-NT Trauma Intervention for Polysubstance Populations

STAIR-NT 创伤干预对多物质人群的适应

基本信息

批准号：
10590166
负责人：
Amanda M Bunting
金额：
$ 72.32万
依托单位：
NEW YORK UNIVERSITY SCHOOL OF MEDICINE
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-09-30 至 2025-09-29
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10590166
关键词：
Abstinence Address Affective Caring Cocaine Communities Drug user Enrollment Evidence based intervention Evidence based treatment Exclusion Feedback Future Goals Health Incidence Individual Intervention Mental disorders Modeling Multiple Trauma Online Systems Opioid Outcome Overdose Participant Patients Pattern Persons Pharmaceutical Preparations Population Post-Traumatic Stress Disorders Process Protocols documentation Public Health Randomized Randomized Controlled Trials Recording of previous events Regulation Research Risk Schedule Severities Site Stimulant Substance Use Disorder Symptoms Therapeutic Intervention Time Trauma Treatment Protocols Treatment outcome Work acceptability and feasibility base comorbidity effective therapy evidence base high risk high risk population illicit opioid implementation outcomes improved individualized medicine innovation methadone treatment multi-site trial opioid overdose opioid treatment program opioid use opioid use disorder overdose risk pediatric trauma polysubstance use programs randomized trial skills training standard care stimulant use stress related disorder substance use symptomatology treatment as usual treatment program

项目摘要

PROJECT ABSTRACT The purpose of this timely and significant R34 proposal is to adapt an evidence-based posttraumatic stress disorder (PTSD) intervention for use among a polysubstance population receiving treatment for opioid use disorder in a methadone maintenance treatment (MMT) program. Polysubstance use of high-risk combinations, such as illicit opioids and stimulants, is a critical public health issue. Individuals who engage in these high-risk combinations are more likely to have histories of childhood trauma, multiple traumas, PTSD, and greater PTSD severity as compared to mono-substance using individuals. Trauma, co-morbid mental health disorders such as PTSD, and polysubstance use complicate treatment outcomes. This innovative pilot will use three aims to adapt an existing evidence-based PTSD intervention, Skills Training in Affective and Interpersonal Regulation with Narrative Therapy (STAIR-NT), via a massed treatment model (i.e., condensed treatment schedule) for patients in MMT who are engaged in illicit opioid-stimulant polysubstance use. The following aims are proposed: (1) to adapt the evidence-based intervention STAIR-NT for polysubstance use populations informed by the ADAPT-ITT framework, (2) to assess the feasibility and acceptability of the provisionally adapted STAIR-NT via an open pilot (n=10) to inform further adaptations, and (3) to conduct a small-scale randomized control pilot using the adapted intervention to examine implementation (i.e., feasibility and acceptability) and short-term polysubstance use and PTSD symptomology outcomes among MMT patients who are engaged in illicit opioid-stimulant polysubstance use. Completion of study aims will result in a fully adapted protocol for use in a multi-site randomized trial of the adapted STAIR-NT approach. The long-term goal of this research is to improve the health and treatment outcomes of populations who engage in high-risk polysubstance use through complementary layering of trauma-informed evidence-based interventions in opioid treatment programs.

项目摘要这项及时而重要的 R34 提案的目的是适应基于证据的创伤后应激障碍用于接受阿片类药物使用治疗的多物质人群的创伤后应激障碍 (PTSD) 干预美沙酮维持治疗 (MMT) 计划中的障碍。高风险组合的多物质使用，非法阿片类药物和兴奋剂等药物是一个重要的公共卫生问题。从事这些高风险活动的个人组合更有可能有童年创伤、多重创伤、创伤后应激障碍 (PTSD) 和严重创伤后应激障碍 (PTSD) 病史与单一物质使用个体相比的严重程度。创伤、共病精神健康障碍，例如创伤后应激障碍（PTSD）和多种物质的使用使治疗结果变得复杂。这一创新试点将通过三个目标适应现有的基于证据的创伤后应激障碍干预措施，情感和人际调节技能培训叙事疗法（STAIR-NT），通过集中治疗模式（即浓缩治疗计划）从事非法阿片类兴奋剂多物质使用的 MMT 患者。以下目标是建议：(1) 针对多种物质使用人群调整循证干预 STAIR-NT 通过ADAPT-ITT框架，（2）评估临时适应的可行性和可接受性 STAIR-NT 通过开放试点 (n=10) 来告知进一步的调整，以及 (3) 进行小规模随机使用经过调整的干预措施来检查实施情况（即可行性和可接受性）的控制试点参与 MMT 患者的短期多物质使用和 PTSD 症状结果非法使用阿片类兴奋剂多物质。完成研究目标将产生完全适应的使用方案在一项采用 STAIR-NT 方法的多中心随机试验中。这项研究的长期目标是通过以下方式改善高风险多物质使用人群的健康和治疗结果阿片类药物治疗计划中基于创伤的循证干预措施的补充分层。