This Stage I research involves the early therapy development of behavioral interventions previously applied to alcohol and cocaine disorders in the United States to be tailored for the novel treatment of opiate injection drug use (IDU) disorders n the Ukraine. This application responds to the International Research Collaboration on Drug Addiction (PAS-03-023) program announcement from NIDA. It is a product of a 2001 Fogerty ICOHRTA award to the University of Alabama at Birmingham (UAB) and a three-year joint collaboration between UAB, the Regional Narcological Dispensary in Vinnitsya (vin'-yeet-sa), Ukraine, and the Vinnitsya State Pirogov Medical University. Effective pharmacotherapy and evidenced-based behavioral interventions for IDU are not practiced in most areas of Ukraine despite evidence that opiate IDU and a related infectious disease are increasing at epidemic proportions. This research intends to set the stage for future combined pharmacotherapy and behavioral treatment for opiate IDU by building a foundation of motivational and behavioral therapies in a Regional Narcological Dispensary in resource-poor central Ukraine. The goals of this research are to systematically transport and sustain the delivery and efficacy of evidence-based behavioral treatments for opiate IDU and to increase treatment engagement and successful treatment outcomes of IDUs in central Ukraine.
The specific aims are: 1) train psychologists from the Dispensary to conduct evidence-based, manual-driven behavioral interventions modified for opiate IDU; 2) pilot test the delivery of culturally-centered behavioral interventions and research protocols with 20 opiate IDUs and certify staff competency; and 3) test the efficacy of transported behavioral interventions on treatment engagement, treatment adherence, opiate abstinence, risk behaviors, and life functioning with 150 opiate IDUs using a randomized experimental vs. standard treatment controlled design. The significance of this research is that it will transport evidence-based strategies to reduce demand for illicit drugs in a resource-poor country and improve our basic understanding of opiate IDU addiction and its treatment in Eastern Europe. This research is innovative in that it will integrate new motivational and behavioral interventions with primarily medical detoxification treatment for opiate IDU and will adapt evidence-based behavioral interventions found effective for alcohol and cocaine addiction in the US to engage and treat opiate IDUs in central Ukraine. The investigators are committed to a long-term collaboration with the Director of the Narcological Dispensary, President of the Vinnitsya State Pirogov Medical University, and the Mayor of Vinnitsya (Birmingham's sister city) to sustain effective treatment and facilitate independent research for opiate IDU in Ukraine and Eastern Europe.
