Office-based buprenorphine treatment promises to expand treatment access for opioid dependent individuals. Yet physicians have been reluctant to begin prescribing the medication, indicating a compelling need to develop innovative strategies to train physicians and integrate buprenorphine treatment into medical practice. The goal of this mentored clinical scientist award is to enhance the developing clinical research skills of Erik Gunderson, M.D. through research on integrating buprenorphine treatment of opioid dependence in primary care. After completing a substance abuse fellowship, Dr. Gunderson joined the faculty in the Division as an Assistant Clinical Professor of Medicine in Psychiatry, working both in a primary care clinic and at a specialty buprenorphine treatment program. His pilot data on integrated opioid dependence treatment provide preliminary support for the feasibility and effectiveness of buprenorphine in primary care. Dr. Gunderson has received funding through a pilot study program of the Division's NIDA-funded center grant and an private foundation to study medical education on substance abuse. However, to become an independent clinical researcher, he will need formal course work, mentoring, and release of time from his extensive clinical and administrative responsibilities. During the next several years, Dr. Gunderson plans to conduct mentored formative research and a clinical trial on integrated buprenorphine treatment in primary care versus a specialty clinic setting. This research and additional training will prepare him to meet his long term research career goal of improving and expanding treatment of substance abuse in primary care. Under the sponsorship and guidance of Dr. Frances Levin, together with other faculty, Dr. Gunderson's training plan combines formal course work with clinical research experience. He will work closely with preceptors to receive training in the following areas: methods of integrating opioid dependence treatment into primary care, clinical treatment trial study design and interpretation, and biostatisties. Specifically, his research plan includes a demonstration project to determine the feasibility and effectiveness of buprenorphine maintenance delivered by general internists in a primary care clinic. Findings from this project will be used to inform development of a randomized trial of the effectiveness of buprenorphine maintenance delivered in primary care versus a specialty clinic. The combined mentoring, training and research plan will provide Dr. Gunderson with unique training enabling him to develop an independent research career focused on integrating substance abuse treatment in primary care.
