Randomized Controlled Trial of Cognitive Behavioral Therapy for Anxiety and Opioid Dependence
The purpose of this study was to develop and test a novel integrated cognitive behavioral treatment (ICBT) for opioid dependence and anxiety disorders. This Stage 1A/B treatment development trial tested the feasibility and initial efficacy of this treatment compared to an existing evidence-based treatment (Individual Drug Counseling).
This study was funded by the National Institute on Drug Abuse
Distress Intolerance and Prescription Opioid Use in Chronic Pain
The identification of risk factors for the misuse of opioids in people with chronic pain is crucial to identifying those who may require additional monitoring or preventative interventions. The purpose of this study was to examine whether distress intolerance — the perceived inability to tolerate unpleasant somatic and emotional states — predicted heightened sensory, affective, and craving responses to pain and whether it is associated with (a) chronic pain and (b) opioid misuse in chronic pain patients.
This study was funded by the National Institute on Drug Abuse
Opioid Cues and Craving
Craving is a core feature of substance use disorders and can be a powerful motivator of substance use. Although exposure to a drug itself often elicits a craving response, environmental cues and contexts that are repeatedly paired with drug use can themselves yield strong affective and craving responses. The overarching aim of this study was to examine affective and craving reactivity to opioid images among patients seeking treatment for opioid dependence. The purpose of this study was two-fold: (1) evaluate the validity of images for eliciting opioid craving in opioid-dependent inpatients, and (2) evaluate whether cue-induced craving for heroin- and prescription opioid-specific stimuli differs based on individuals’ drug of choice.
This research was supported by the Livingston Award from Harvard Medical School.
Behavioral Strategies to Reduce Stress Reactivity in Substance Use Disorders
Heightened response to stress is associated with relapse among people with substance use disorders. Alcohol and drugs are highly reinforcing, not only through their rewarding effects, but also through their ability to provide relief. Thus, stress reactivity is a key potential mechanistic target for improving outcomes in substance use disorders. However, effective treatments for reducing stress reactivity have not yet been established in this population. The purpose of this study is to test cognitive behavioral strategies for reducing stress reactivity in adults with substance use disorders.
This study was funded by the National Institute of Drug Abuse (R21 DA046937)
Vulnerabilities for Benzodiazepine Misuse in Women
The prevalence of nonmedical use of benzodiazepines has increased significantly in recent years. Preliminary data from our group indicate that there are significant sex differences in the prevalence and correlates of benzodiazepine misuse, which suggest that women are at heightened risk relative to men. The objective of this study is to characterize sex differences in benzodiazepine misuse patterns, motives and cue reactivity.
This study was supported by the Sarles Young Investigator Award from McLean Hospital
Explicit and Implicit Suicidal Cognition and Opioid Overdose
This study aims to advance our understanding of the association between suicidal cognition and opioid overdose in adults with opioid use disorder. Opioid overdose deaths tend to be categorized as either intentional (suicidal) or accidental. However, this categorization may underestimate the role of suicidal cognition in opioid overdose. We aim to quantify the association between suicidal thoughts and opioid overdose history and to identify common risk factors for opioid overdose and suicidal thoughts and behaviors.
This study was funded by the National Institute of Drug Abuse