Co-occurring chronic pain and opioid dependence (POD) is one of the most challenging clinical problems facing opioid agonist treatment, primary care, and specialty pain medicine treatment providers, who are often unsure how to effectively evaluate and treat POD. Through his work as Project Director for several NIDA funded studies of opioid dependence over the last four and a half years, Dr. Barry became increasingly aware of and interested in the clinical challenges of treating patients with POD. He has, within the constraints of his current position, initiated some clinical research in this area, which documents the urgent need for treatment addressing POD in opioid agonist programs and the feasibility of introducing such a treatment. To achieve his career goal of becoming an independent clinical researcher in the area of POD treatment development and evaluation, supported by a K23 award over the next five years, Dr. Barry plans to conduct mentored clinical research involving a series of Stage 1 pre-pilot and pilot studies, including a randomized clinical trial, to develop and evaluate a novel integrated cognitive-behavioral therapy (CBT) for POD. In order to gather additional data that may help to inform modifications of this integrated treatment, he proposes to conduct additional studies, involving focus groups with MMT POD patients and treatment providers and comprehensive diagnostic assessment (including DSM-IV-TR Axes I, II, and III) with POD patients seeking MMT. Dr. Barry's career goal and proposed research plan fit well with his background, training and experiences and allow him to weave together his interests in substance use disorders, psychotherapy development, and cultural and gender issues. Dr Barry also plans to participate in a variety of seminars and clinical trainings aimed at increasing his expertise in chronic pain assessment and treatment, psychotherapy development, qualitative research methods, specific advanced statistical approaches, and ethical conduct of scientific research. If awarded, the K23 would provide salary support at a critical juncture in his career, free him up from his considerable Project Director responsibilities, and would allow him to devote approximately 90% of his effort toward a plan of mentored research, didactic activities, and training, thus, equipping Dr. Barry with the necessary skills to obtain R01 funding for a full-scale randomized clinical trial of integrated CBT for POD and to launch a successful independent research career. Given the high prevalence of POD in opioid agonist treatment, primary care, and specialty pain medicine settings, the pernicious consequences of untreated or under-treated POD, and the absence of evidence-based POD interventions, the development of an effective integrated POD treatment would greatly expand and improve available substance abuse services and lead to significant health and economic benefits to our society.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
5K23DA024050-05
Application #
8302434
Study Section
Human Development Research Subcommittee (NIDA)
Program Officer
Lin, Yu
Project Start
2008-08-01
Project End
2014-07-31
Budget Start
2012-08-01
Budget End
2014-07-31
Support Year
5
Fiscal Year
2012
Total Cost
$178,404
Indirect Cost
$13,215
Name
Yale University
Department
Psychiatry
Type
Schools of Medicine
DUNS #
043207562
City
New Haven
State
CT
Country
United States
Zip Code
06520
Beitel, Mark; Peters, Skye; Savant, Jonathan D et al. (2015) The psychometric properties of the iowa personality disorder screen in methadone-maintained patients: an initial investigation. J Pers Disord 29:131-44
Cutter, Christopher J; Schottenfeld, Richard S; Moore, Brent A et al. (2014) A pilot trial of a videogame-based exercise program for methadone maintained patients. J Subst Abuse Treat 47:299-305
Barry, Declan T; Savant, Jonathan D; Beitel, Mark et al. (2014) The feasibility and acceptability of groups for pain management in methadone maintenance treatment. J Addict Med 8:338-44
Fiellin, David A; Barry, Declan T; Sullivan, Lynn E et al. (2013) A randomized trial of cognitive behavioral therapy in primary care-based buprenorphine. Am J Med 126:74.e11-7
Barry, Declan T; Pilver, Corey E; Hoff, Rani A et al. (2013) Pain interference and incident mood, anxiety, and substance-use disorders: findings from a representative sample of men and women in the general population. J Psychiatr Res 47:1658-64
Barry, Declan T; Savant, Jonathan D; Beitel, Mark et al. (2013) Pain and associated substance use among opioid dependent individuals seeking office-based treatment with buprenorphine-naloxone: a needs assessment study. Am J Addict 22:212-7
Barry, Declan T; Pilver, Corey; Potenza, Marc N et al. (2012) Prevalence and psychiatric correlates of pain interference among men and women in the general population. J Psychiatr Res 46:118-27
Tetrault, Jeanette M; Tate, Janet P; McGinnis, Kathleen A et al. (2012) Hepatic safety and antiretroviral effectiveness in HIV-infected patients receiving naltrexone. Alcohol Clin Exp Res 36:318-24
Barry, Declan T; Goulet, Joseph L; Kerns, Robert K et al. (2011) Nonmedical use of prescription opioids and pain in veterans with and without HIV. Pain 152:1133-8
Garnet, Brian; Beitel, Mark; Cutter, Christopher J et al. (2011) Pain catastrophizing and pain coping among methadone-maintained patients. Pain Med 12:79-86

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