This is a subaward to an R34 awarded to Dr. Melissa Lewis at University of North Texas Health Science Center (UNTHSC). This project develops and tests an intervention for young adults that focuses on motivations for and quality of alcohol and marijuana protective behavior strategy use, including a daily-level examination of these processes.
Targeted Condition: Substance use disorders/misuse
Changing our paths: well-being and recovery among Native Americans with opioid use disorder
This project will characterize an indigenized opioid use disorder “cascade of care” and identify corresponding measures to quantify services and outcomes defined by it.
Determining if activity in LHb projections to the RMTg promotes cued reinstatement to fentanyl seeking through indirect inhibition of VTA dopamine neurons
The main goals of this proposal are twofold: 1) to develop and optimize a general behavioral and technical platform for studying the functional neurocircuitry underlying opioid use disorder, and 2) to determine if activity in LHb projections to the RMTg promotes cued reinstatement to fentanyl seeking through indirect inhibition of VTA dopamine neurons.
Determining if activity in specific lateral habenula output pathways motivates avoidance of synthetic opioid withdrawal or cue induced reinstatement
Opioid abuse has reached epidemic proportions in the United States and is responsible for more than 40,000 overdose deaths each year. Avoidance of withdrawal and drug-associated cues are key deterrents to voluntary abstinence in humans. By studying the neural circuits responsible for motivating avoidance of physical and emotional pain, as well as those that process drug-cues, we may be able to produce targeted pharmacotherapies or genetic therapies that reduce the likelihood of opioid relapse in humans. A reduction withdrawal avoidance or cue sensitivity will make it easier for those suffering from opioid use disorder to remain abstinent.
Validating a DSM-5 Substance Use Disorder (SUD) symptom checklist
This research will test the psychometric performance of a patient-report questionnaire that assesses DSM-5 substance use disorder symptoms as part of routine primary care.
Understanding mental health problems and health risk behaviors among LGBT Veterans
LGBT Veterans have faced a long history of stigma, discrimination, and exclusionary policies that were intended to exclude them from military service. Despite recent shifts in policy and increased staff trainings, existing evidence suggests that this group is at high risk for health disparities, particularly with respect to mental health and health risk behaviors. While informative, the research to date has been limited in several respects: cross-sectional designs, collapsing LGBT subgroups, severe lack of data on some subgroups, problems with identifying a comparison group, and lack of data on risk and protective factors and care experiences. This prospective cohort study will fill these gaps, recruiting and conducting surveys online with 1,600 Veterans to identify health disparities, test a conceptual model of prospective risk and protective factors, and assess VA utilization, barriers to care, and treatment preferences. Data from this study will inform future intervention efforts to achieve health equity for LGBT Veterans.
Staying in Touch and Engaged Project (STEP)
The “Staying in Touch and Engaged Project” (STEP) aimed to support Housing First residents in staying in touch with researchers and in engaging in meaningful activities during the COVID-19 outbreak and social distancing directives. A 16-week, two-group randomized controlled pilot trial compared remote assessment of substance-use and health-related quality of life assessment paired with immediate versus delayed provision of remotely delivered meaningful activities. The aim of this project was to test whether the meaningful activities package (MAP) engages residents and improves their mood, substance-use outcomes, and physical and mental health-related quality of life.
The project team mailed study invitations to residents in five housing programs (estimated mailed N=538). To date, 32 Housing First residents reached out to consent to participate, responding via mailed consent forms, phone, video conferencing or online survey completion. Of those who consented, 26 have completed baseline assessments, and 11 have completed one-month follow-ups. The study highlighted the difficulties in reaching residents, partly due to the lack of communication technologies.
The team found that the technological divide has grown deeper and more consequential during the pandemic and must be bridged to facilitate social connection, physical and mental health, and basic communication for people marginalized by the lived experience of homelessness and psychiatric, medical and substance use disorder. The team is working to locate additional funds through the UW and WSU to continue participant recruitment and evaluation efforts, achieve the originally proposed sample size and further improve follow-up rates.
Innovative training for suicide prevention in addiction treatment settings
Although suicide is one of the leading causes of death for people with substance use disorders (SUDs), no widespread suicide prevention intervention exists for delivery in community addiction treatment settings. The effectiveness and feasibility of delivering Preventing Addiction Related Suicide (PARS), a group-based psychoeducational program that provides evidence-based suicide prevention and safety strategies, was recently demonstrated by the UW Center for Suicide Prevention and Recovery.
To enhance widespread implementation and dissemination of PARS, this project will develop online training and implementation tools. PARS-Web will be created in collaboration with key state agencies and suicide prevention professionals to meet the new training requirements for Washington State Chemical Dependency Professionals. The goal is to integrate PARS as a part of standard care in addiction treatment agencies nationwide.
Impact of medical and recreational marijuana laws on cannabis, opioids and psychiatric medications: national study of VA patients, 2000 – 2024
We will analyze Veterans Health Administration electronic medical record data to determine the effects of medical marijuana laws (MML) and recreational marijuana laws (RML) on cannabis (use and cannabis use disorder); opioids (prescriptions, fatal and non-fatal overdoses, opioid use disorders); and psychotropic medication prescriptions, providing important information on MML and RML effects in VA patients and in others with similar vulnerability factors to researchers, policy makers, health professionals and the public.
Preventing addiction related suicide
To evaluate the use of an existing selective suicide prevention intervention, Preventing Addiction Related Suicide (PARS), for use with Veterans by: 1) adapting and tailoring content to Veteran populations and 2) conducting an open trial within a VA substance use disorder intensive outpatient program.
