Despite the potential benefits of opioid therapy for patients with pain, the rise in the use of opioids has been accompanied by escalating rates of prescription opioid misuse, opioid addiction, and opioid overdose deaths in these patients. To date, the factors responsible for prescription opioid misuse and addiction in patients with pain remain poorly understood. There is also a lack of treatment interventions that can be used for preventing opioid use problems among patients with pain.
The first aim of the proposed research program is to examine the psychological and biological factors that contribute to opioid misuse and addiction over the course of opioid therapy. Patients will undergo laboratory procedures, complete electronic diaries, and undergo clinical interviews at fixed time points (i.e., 3, 6, 9, 12 months) over a 12-month period.
The second aim is to examine the determinants of opioid craving (i.e., the subjective desire to use opioids). Patients prescribed opioids will be asked to complete electronic diaries and to provide saliva samples, at home, for a period of 10 consecutive days. We will be specifically interested in examining the contribution of psychological and neuroendocrine (i.e., hormonal) factors to prescription opioid craving.
The third aim is to test the effectiveness of a treatment intervention, delivered through a smartphone "app", for reducing the incidence of opioid misuse and addiction among "high-risk" patients with pain prescribed opioids. This treatment will specifically focus on stress/negative affect regulation, helping patients cope with opioid cravings, and on enhancing patients' motivation to abstain from misusing opioids.
Findings from the proposed research program will be novel, timely, and will have direct implications for clinicians involved in pain management. Findings from the proposed research program might also ultimately help reduce the growing rates of opioid misuse and addiction among chronic pain patients prescribed opioids.