As indicated in the PA (PA-00-004), one of the main objectives of the Mentored Patient-Oriented Career Development Award (K23) is to increase the pool of clinical researchers able to translate findings generated through basic biomedical research into clinical research and treatment. This application is designed to advance the candidate's long-term career goal of becoming an independent, patient-oriented researcher in the area of stress and addiction, able to translate research findings from basic science laboratories in clinically relevant human laboratory studies and clinical trials. During her training, Dr. Back will participate in formal coursework and multidisciplinary didactics focused on increasing her knowledge in the neurobiology of addictions, particularly opiate dependence and prescription drug abuse, and stress response. Experiential activities will include hands-on training in animal models of opiate addiction and reinstatement, and patientoriented research with individuals dependent on prescription opiates. Dr. Back will also receive training in the responsible conduct of research and grant writing, and will submit an independent research grant toward the end of the award period. Under the mentorship of experienced investigators, Dr. Back will conduct a translational research study involving a patient-oriented human laboratory component and a complementary animal model component. The proposed research will 1) identify the effects of acute psychological stress (i.e., the Trier Social Stress Task) on conditioned cue response in 55 prescription opiate-dependent individuals and 2) identify the effects of acute footshock stress on conditioned drug-paired cue response in rats. Together, these studies will provide a comprehensive examination of the potentiative effects of stress on conditioned cues in opiate dependence and will test whether stress increases the incentive salience of drug cues in human and animals. The research findings from this study will lead directly to treatment and relapse prevention strategies for opiate dependence. Results of this study will also help direct future treatment research in which therapies (including pharmacotherapies) are combined based on their ability to attenuate stress- and cue-induced opiate relapse. Dr. Back's immediate goals are 1) to learn about basic neurobiology, the neurobiology of stress, the neurobiology of opiate dependence, and neuroendocrine systems;2) to learn about animal models of addictions, 3) to learn about basic science, translational work and clinical research in the area of prescription opiate dependence, 4) to learn state-of-the-art approaches to human laboratory studies and translational research, 5) to continue training in research ethics and good research practice, and 6) to attain the knowledge and skills necessary to apply for and obtain independent research support in patient-oriented drug abuse research. Ultimately, this research is aimed at improving the treatment of individuals with prescription opiate dependence and advancing the health of the nation.
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