Document text
Principal Investigator: Ryan W Carpenter
Organization: UNIVERSITY OF NOTRE DAME
Fiscal Year: 2024
Award: $94,010
Funding agency: National Institute on Alcohol Abuse and Alcoholism
7. Project Summary/Abstract
This K23 Mentored Patient-Oriented Research Career Development Award involves complementary research
and training plans to develop and then pilot a modified motivational enhancement therapy and cognitive
behavioral therapy (MET-CBT) intervention tailored to target alcohol use in patients with alcohol use disorder
(AUD) in opioid agonist treatment (OAT). Alcohol use is an under-recognized contributor to the opioid crisis,
greatly increasing the risk of overdose when used together with opioids. Further, alcohol use and related
problems are prevalent among patients in OAT and significantly increase the risk of opioid relapse and
treatment dropout. Office-based buprenorphine treatment, a fast-growing form of OAT, is effective at treating
opioid use disorder and decreasing risk of opioid overdose, but relapse rates are high in the first year of
treatment. With nearly 130 individuals dying each day from an opioid overdose and evidence of recent
increases in overdoses during the COVID-19 pandemic, there is an urgent need to increase treatment
retention. Reducing alcohol use and use-related problems in patients receiving buprenorphine may have a
significant indirect effect on improving buprenorphine outcomes. However, past randomized clinical trials
(RCTs) have found no condition effect for brief alcohol-focused intervention for patients in OAT, despite
considerable evidence that these interventions are generally effective at reducing alcohol use. Critically, past
work examined standard alcohol interventions that were not tailored to individuals in OAT, suggesting that
there are unique and significant challenges to alcohol intervention in patients receiving buprenorphine. This
K23 project will first qualitatively interview patients with AUD in their first year of office-based buprenorphine
treatment and buprenorphine providers to directly inform modifications to an existing MET-CBT protocol,
tailoring the intervention to fit the needs and challenges of buprenorphine treatment. Following treatment
development and refinement, 60 participants will be randomized to receive two MET-CBT sessions or
treatment as usual in a proof-of-concept RCT. Key RCT outcomes will be the feasibility and acceptability of the
modified MET-CBT intervention. Sustained benefit will also be evaluated at 1- and 3-month follow-ups in
exploratory analyses. Through addressing AUD in people receiving OAT, this proposal is closely aligns with
national priorities to improve OAT-related outcomes and to respond to the opioid overdose crisis.
Terms: <Active Follow-up><Address><Alcohol Chemical Class><Alcohol Drinking><Alcohol abuse><Alcohol consumption><Alcohols><Attention><Behavior Conditioning Therapy><Behavior Modification><Behavior Therapy><Behavior Treatment><Behavioral Conditioning Therapy><Behavioral Modification><Behavioral Therapy><Behavioral Treatment><Buprenorphine><COVID crisis><COVID epidemic><COVID pandemic><COVID-19 crisis><COVID-19 epidemic><COVID-19 era><COVID-19 global health crisis><COVID-19 global pandemic><COVID-19 health crisis><COVID-19 pandemic><COVID-19 period><COVID-19 public health crisis><COVID-19 years><Clinic><Cognition Therapy><Cognitive Psychotherapy><Cognitive Therapy><Cognitive treatment><Conditioning Therapy><Counselor><Development><Dropout><Enrollment><EtOH abuse><EtOH drinking><EtOH use><Feedback><Focus Groups><Goals><Individual><Intervention><Intervention Strategies><Intervention Studies><Interview><Investigators><K23 Award><K23 Mechanism><K23 Program><Knowledge><Lead><Letters><Mentored Patient-Oriented Research Career Development Award><Mentored Patient-Oriented Research Career Development Award (K23)><Mentors><Methods><Modification><Nurse Practitioners><Opiates><Opioid><Outcome><Overdose><Participant><Patient Self-Report><Patients><Pb element><Persons><Physicians><Population><Professional counselor><Protocol><Protocols documentation><Provider><Public Health><Randomized><Relapse><Reporting><Research><Research Personnel><Research Resources><Researchers><Resources><Risk><Rural><SARS-CoV-2 epidemic><SARS-CoV-2 global health crisis><SARS-CoV-2 global pandemic><SARS-CoV-2 pandemic><SARS-coronavirus-2 epidemic><SARS-coronavirus-2 pandemic><Sampling><Self-Report><Severe Acute Respiratory Syndrome CoV 2 epidemic><Severe Acute Respiratory Syndrome CoV 2 pandemic><Severe acute respiratory syndrome coronavirus 2 epidemic><Severe acute respiratory syndrome coronavirus 2 pandemic><Specialist><Structure><Therapeutic Intervention><Time><Training><Treatment outcome><United States><Variant><Variation><Work><acceptability and feasibility><active followup><addiction><addictive disorder><alcohol co-abuse><alcohol ingestion><alcohol intake><alcohol intervention><alcohol problem><alcohol product use><alcohol related problem><alcohol use><alcohol use disorder><alcoholic beverage consumption><alcoholic drink intake><behavior intervention><behavioral intervention><buprenorphine treatment><care as usual><cognitive behavior intervention><cognitive behavior modification><cognitive behavior therapy><cognitive behavioral intervention><cognitive behavioral modification><cognitive behavioral therapy><cognitive behavioral treatment><coronavirus disease 2019 crisis><coronavirus disease 2019 epidemic><coronavirus disease 2019 global health crisis><coronavirus disease 2019 global pandemic><coronavirus disease 2019 health crisis><coronavirus disease 2019 pandemic><coronavirus disease 2019 public health crisis><coronavirus disease crisis><coronavirus disease epidemic><coronavirus disease pandemic><coronavirus disease-19 global pandemic><coronavirus disease-19 pandemic><cost><customized therapy><customized treatment><develop therapy><developmental><drinking><effective therapy><effective treatment><enroll><ethanol abuse><ethanol consumption><ethanol drinking><ethanol ingestion><ethanol intake><ethanol product use><ethanol use><ethanol use disorder><follow up><follow-up><followed up><followup><hazardous alcohol use><heavy metal Pb><heavy metal lead><improved><individualized medicine><individualized patient treatment><individualized therapeutic strategy><individualized therapy><individualized treatment><innovate><innovation><innovative><intervention development><intervention effect><intervention research><intervention therapy><interventional research><interventional strategy><interventional study><interventions research><motivational enhancement therapy><motivational interview><opiate consumption><opiate crisis><opiate drug use><opiate intake><opiate overdose><opiate related overdose><opiate use><opiate use disorder><opioid agonist therapy><opioid agonist treatment><opioid consumption><opioid crisis><opioid drug overdose><opioid drug use><opioid epidemic><opioid induced overdose><opioid intake><opioid intoxication><opioid medication overdose><opioid overdose><opioid poisoning><opioid related overdose><opioid toxicity><opioid use><opioid use disorder><overdose risk><patient specific therapies><patient specific treatment><peer support><problem alcohol use><problem drinking><problematic alcohol consumption><problematic alcohol use><randomisation><randomization><randomized, clinical trials><randomly assigned><recruit><reduced alcohol use><severe acute respiratory syndrome coronavirus 2 global health crisis><severe acute respiratory syndrome coronavirus 2 global pandemic><suburb><suburban><suburbia><tailored medical treatment><tailored therapy><tailored treatment><theories><therapy development><treatment as usual><treatment development><treatment risk><unique treatment><urban environment><urban setting><usual care>