Co-Morbid Opioid Addiction and Chronic Pain ABSTRACT The primary goal of this K23 - Mentored Patient-Oriented Research Career Development Award is to provide Dr. Amy Wachholtz, a clinical health psychologist, with the advanced research training, protected time for research, and mentored experiences necessary for her to become an independent researcher in developing and evaluating innovative treatments for opioid addiction and co-morbid pain that are integrative (pharmacotherapy and psychosocial treatment) and novel (CBT and Self-Regulation Techniques). The candidate proposes a program of research and training to meet this career goal including: 1) developing knowledge about the psychological and physiological interactions between opioid addiction and pain , 2) increasing her knowledge about psychological and pharmacological treatment approaches to addiction, 3) building skills in psycho-social treatment development, 4) enhancing her understanding of advanced statistical techniques, and 5) building expertise in grant writing and grant administration. Dr. Wachholtz will be guided by her primary mentor, Gerardo Gonzalez, MD, and two co-mentors, Douglas Ziedonis, MD, MPH, and Martin Cheatle, PhD. Dr. Wachholtz will conduct two distinct studies in the area of co-morbid pain and opioid addiction. The first study (Pain Reactivity Study) is a laboratory study of 120 participants;90 with opioid addiction and chronic pain to identify the unique physiological, psychological, and behavioral responses to induced pain among those on methadone opioid maintenance treatment for opioid addiction (30 participants);on buprenorphine opioid maintenance treatment (30 participants), with an opioid addiction history but prolonged abstinence (6+ months) from opioids (30 participants), and 30 opioid naive participants. Based on findings from the first study, the second study (Intervention Study) will develop and pilot test 30 subjects in an integrated CBT + Self-Regulation psycho-social treatment for co-morbid opioid addiction and pain to decrease substance use, reduce pain, and decrease physiological reactivity to pain and distress. Results will inform a future R01 application to test an integrated treatment for co-morbid pain and opioid addiction. Successful completion of this K23 award will advance Dr. Wachholtz into a career as an independent researcher with the expertise to conduct clinical research trials to improve treatment for co-morbid opioid addiction and pain.

Public Health Relevance

Opioid addiction and pain are common co-morbidities, and pain is strongly related to opioid addiction relapse, yet there is limited knowledge about the unique pain reactions among those with opioid addiction and few treatments. These studies will add to the current knowledge by 1) identifying unique bio-psycho-social responses to pain in those on opioid maintenance;and 2) using this information to develop a novel CBT+ self- regulation intervention to provide a much needed empirically validated treatment option for individuals with co- morbid opioid addiction and pain.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
5K23DA030397-04
Application #
8711413
Study Section
Human Development Research Subcommittee (NIDA)
Program Officer
Aklin, Will
Project Start
2011-08-15
Project End
2016-07-31
Budget Start
2014-08-01
Budget End
2015-07-31
Support Year
4
Fiscal Year
2014
Total Cost
$137,281
Indirect Cost
$10,169
Name
University of Massachusetts Medical School Worcester
Department
Psychiatry
Type
Schools of Medicine
DUNS #
603847393
City
Worcester
State
MA
Country
United States
Zip Code
01655
Lee, Jieun; Kim, EunYoung; Wachholtz, Amy (2016) The effect of perceived stress on life satisfaction : The mediating effect of self-efficacy. Chongsonyonhak Yongu 23:29-47
Han, Samuel; Kheder, Joan; Bocelli, Lisa et al. (2016) Smoking Cessation in a Chronic Pancreatitis Population. Pancreas 45:1303-8
Bhattacharya, Rituparna; Shen, Chan; Wachholtz, Amy B et al. (2016) Depression treatment decreases healthcare expenditures among working age patients with comorbid conditions and type 2 diabetes mellitus along with newly-diagnosed depression. BMC Psychiatry 16:247
Lee, Jieun; Bhowmick, Amrita; Wachholtz, Amy (2016) Does complementary and alternative medicine (CAM) use reduce negative life impact of headaches for chronic migraineurs? A national survey. Springerplus 5:1006
Park, Crystal L; Masters, Kevin S; Salsman, John M et al. (2016) Advancing our understanding of religion and spirituality in the context of behavioral medicine. J Behav Med :
Dharmawardene, Marisa; Givens, Jane; Wachholtz, Amy et al. (2016) A systematic review and meta-analysis of meditative interventions for informal caregivers and health professionals. BMJ Support Palliat Care 6:160-9
Wachholtz, Amy B; Fitch, Christina E; Makowski, Suzana et al. (2016) A Comprehensive Approach to the Patient at End of Life: Assessment of Multidimensional Suffering. South Med J 109:200-6
Wachholtz, Amy; Foster, Simmie; Cheatle, Martin (2015) Psychophysiology of pain and opioid use: implications for managing pain in patients with an opioid use disorder. Drug Alcohol Depend 146:1-6
Porche, Michelle V; Fortuna, Lisa R; Wachholtz, Amy et al. (2015) Distal and Proximal Religiosity as Protective Factors for Adolescent and Emerging Adult Alcohol Use. Religions (Basel) 6:365-384
Lee, Jieun; Kim, Jung K; Wachholtz, Amy (2015) The benefit of heart rate variability biofeedback and relaxation training in reducing trait anxiety. Hanguk Simni Hakhoe Chi Kongang 20:391-408

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