Behavioral Research to Improve Medication-Based Treatment
The Research Need
Medication-based treatment is an established and effective intervention for people with opioid use disorder (OUD). Medications for people with OUD include methadone, buprenorphine/naloxone, buprenorphine, and naltrexone. However, the people who would benefit from these medications often do not receive them or stay on them only a short time, which limits their chances for long-term recovery.
About the Program
The goal of the Behavioral Research to Improve Medication-Based Treatment (BRIM) program is to support research that assesses whether behavioral interventions can improve outcomes of medication-based treatment.
Specifically, the BRIM program seeks to test the effectiveness of combining medications with a wide range of evidence-based behavioral interventions in diverse groups of patients, including veterans, young adults, low-income individuals, and Latina and Native American women. The behavioral interventions include yoga and mindfulness, cognitive behavioral therapy, multidisciplinary rehabilitation, and mobile health technology.
Researchers hope to determine whether using these interventions in combination with medication improves adherence to medication, improves treatment outcomes, and reduces relapse in individuals seeking treatment for OUD.
To date, through the Helping to End Addiction Long-term® Initiative, or NIH HEAL Initiative®, NIH has funded 11 awards for this program, totaling $38.4 million.
Some of the research projects will be carried out in the context of treatment services that the Substance Abuse and Mental Health Services Administration provides for OUD, layering additional research into state efforts to expand access to evidence-based treatment and recovery support services.
Research to be undertaken includes:
- Refining and adapting a successful telephone-based psychosocial pain management intervention in veterans with OUD and then evaluating its effectiveness in combination with medication
- Testing mindful awareness in body-oriented therapy as an adjunct to medication in three clinical settings
- Distributing OUD medication at nontraditional locations, such as emergency departments, jails, and homeless shelters, to improve outcomes and reach underserved individuals
- Employing peer recovery coaches to support retention in medication-based treatment for low-income, minority individuals with OUD who live in urban settings
- Developing a novel treatment model that uses psychoeducation, physical exercise, and relaxation training to address OUD and chronic pain in a medication-based treatment center
- Adapting a cognitive behavioral therapy-based text message system to assist patients with OUD with medication adherence and treatment retention
- Developing, testing, and comparing two behavioral economics interventions to promote adherence in patients initiating medication-based treatment
- Evaluating the effects of assisted exercise and cognitive behavioral therapy as adjunctive treatments to medication in adults with OUD and chronic pain who are enrolled in residential treatment programs