The Center on Alcohol, Substance use and Addictions (CASAA) is helping to improve lives and promote well-being one research study at a time.
Two key issues are getting a focused investigation this semester, led by CASAA Director Katie Witkiewitz and Assistant Professor Margo Hurlocker. With a keen focus on reducing harms related to alcohol and opioid use, these two studies are aiming to help New Mexicans HOPE and THRIVE.
TeleHealth Resources for IndiVidualizEd goals (THRIVE)
Witkiewitz is recruiting for her study on long-term recovery and treatment for harmful alcohol use, titled TeleHealth Resources for IndiVidualizEd goals (THRIVE.)
Thanks to a five-year grant from the National Institutes of Health (NIH), Witkiewitz will recruit and work with 430 people across three years on their relationship with alcohol use.
"The THRIVE in Alcohol Recovery Study is evaluating the effectiveness of a mindfulness-based group treatment program delivered over Zoom, as compared to referral to online mutual support groups," she said. "This is for supporting long-term reductions in drinking and improvements in health and functioning."
This virtual component makes this study not only unique but incredibly accessible.
"To address the public health burden of harmful alcohol use, there is a tremendous need for options to support long-term recovery from alcohol use disorder that are focused on well-being and reductions in drinking or abstinence and are accessible in all communities nationwide," Witkiewitz said.
Those chosen who have problems related to alcohol use or want to cut down or abstain from alcohol use will be assigned to either a mindfulness-based treatment or a mutual support group strategy. Witkiewitz's team will touch base with every one of these hundreds of participants every six months across three years.
"Most individuals with alcohol use disorder never receive treatment and the primary reasons for not seeking treatment include not wanting to stop drinking, lack of access to treatment, and concerns about stigma," she said. "This study will provide a program to help people reduce their drinking across the United States and, if effective, could greatly reduce the burden of alcohol use disorder nationwide."
New Mexico participants are ripe for the study as well, as our state has the highest mortality rates of alcohol-attributable causes; 1 in 3 deaths among 20 to 49 years old are attributable to alcohol. It's important to recognize, Witkiewitz says, that it's not just the people who drink excessively, constantly that we should be looking at.
"There is a huge misperception that only those with very high levels of drinking have problems related to alcohol; but in reality, there is a continuity of severity for people with alcohol use disorder, including people with lower levels of drinking who could still benefit from programs to support drinking reductions," she said. "There is also a misconception that if you have an alcohol use disorder then you need to abstain completely forever and never drink again, but research shows that drinking reductions, short of total abstinence, are still associated with improvements in health."
If you're interested in being part of the THRIVE study, you can click here. You must be at least 18 years old, have a valid U.S. address and access to the internet, and either want to reduce, stop, or fix problems with drinking. You'll not only receive free treatment but up to $535 in gift cards for research participation.
Healing Opioid misuse and Pain through Engagement (HOPE) Trial
Hurlocker is also focusing on the role of treatment in substance use reduction. She is analyzing the impact of integrated behavioral treatment on pain interference and at-risk opioid use for individuals with co-occurring chronic pain and opioid use disorder. The Healing Opioid misuse and Pain through Engagement (HOPE) is also funded thanks to the NIH.
"Since many people who seek treatment for chronic pain also engage in at-risk opioid use (and vice versa), our primary goal is to develop and evaluate a treatment that can address both conditions simultaneously," she said.
Her goal, like Witkiewitz's, is to compare different behavioral treatment strategies. In her case, it's how to get patients to not overuse opioids, despite pain so severe it hinders their everyday activities. Something that could make or break that connection, for example, are additional mental or physical hindrances these patients may already have.
"My program of research was initially inspired by a curiosity around why some individuals can manage their substance use better than others. I quickly learned that mental and physical health concerns often occur alongside at-risk substance use. Treating substance use will also require attention to other health issues," Hurlocker said.
Patients already in community-based clinics taking a specific medication will be randomly assigned to either an integrated behavioral treatment or an education-control session on pain interference and at-risk opioid use. These sessions will take place virtually and participants will also fill out surveys immediately after treatment and up to one year after treatment.
"By recruiting clients from community-based clinics that treat opioid use or chronic pain, a secondary goal is to identify what these clinics may need to implement this treatment within their clinics," Hurlocker said.
This community engagement component is something particularly special to Hurlocker. She believes research like this can't just happen in a vacuum.
"The stigma attached to substance use disorder is widespread and pervasive, affecting not only the individuals who use substances but the individuals who can influence prevention, treatment, and legislation to address it," she said. "I think our society can better address substance use disorder if we bridge gaps between research, practice, and legislation, which would require listening to each other's experiences and incorporating each other's recommendations into their respective system of work."
Those interested in joining HOPE must be over 18, have been prescribed the same dose of buprenorphine for at least a month, have had chronic pain for at least 6 months and are enrolled in one of the following participating clinics (University of New Mexico Addiction and Substance Abuse Program, Turquoise Lodge Hospital, University of Michigan Healthcare System, Meridian Health Services.) You will be contacted if eligible.
"It is paramount to understand and address substance use among younger generations who are at risk," Hurlocker said. "The long-term ramifications of risky substance use, particularly on physical and mental health, is what drives me and other researchers to study the risk and protective factors of substance use among younger populations, and strategies to prevent at-risk substance use."
