Scientists from the UCLA Integrated Substance Abuse Programs will lead a $25 million study funded by the National Institutes of Health to test treatments for opioid addiction in rural America.
A separate grant of $3.3 million from the NIH was awarded to another UCLA researcher from the substance abuse programs who will study the effectiveness of using text messages to help people with opioid addiction adhere to their treatment regimens.
The grants, announced today, will be distributed over five years. They are both part of the NIH’s Helping to End Addiction Long-term Initiative, also known as the HEAL Initiative.
Yih-Ing Hser, who will lead the research on approaches for people in rural regions, said the study will take place at more than 40 primary care clinics in five to six U.S. states. Hser is a distinguished research professor of psychiatry and biobehavioral sciences at the David Geffen School of Medicine at UCLA. Specific locations have not yet been chosen for the study, but Hser said researchers are considering potential sites in California, Idaho, Maine, Maryland, New Mexico, Utah, Vermont, Washington and West Virginia. Researchers are looking specifically at rural regions because the percentage of deaths from opioid overdoses is higher and there is typically less access to physicians than in urban areas, according to the Centers for Disease Control and Prevention.
"We'll build up the infrastructure to get the clinics ready to test the use of medication and behavioral therapies, so that we can conduct the study in as close to real-world settings as possible," she said. "A second phase of the study will look at the use of telemedicine to help overcome treatment barriers, such as the long travel time it sometimes takes to reach clinics in rural areas."
The study's co-lead investigator is Dr. Larissa Mooney, director of the UCLA Addiction Psychiatry Clinic at the Semel Institute. She said the funding builds on ongoing research that she, Hser and colleagues have conducted as part of the National Institute on Drug Abuse's Clinical Trials Network.
"This study has the potential to expand access to life-saving treatments for opioid addiction in communities that have been significantly impacted by the opioid epidemic, and for new models of treatment to be sustainable even after the study is over," Mooney said.
Shirley Simson, a National Institute on Drug Abuse representative, said a "significant amount" of the $25 million grant, including $3.6 million for the first year of the study, will be directed to UCLA. The remainder of the grant will go to collaborating institutions.
The study on text messaging will be led by Suzette Glasner, an associate professor-in-residence at the UCLA School of Nursing, and of psychiatry at the David Geffen School of Medicine at UCLA. Glasner also is a principal investigator of the Integrated Substance Abuse Programs. That research will assess whether using texts to deliver cognitive behavioral therapy will help patients stick to their opioid treatment medication regimens.
Cognitive behavioral therapy is a technique that is used to help people change their behaviors by altering the way they think about and approach challenges. Glasner's text messaging therapy is different from other message-based approaches in that it delivers actual behavioral therapy rather than simple reminder messages.
"Medications for opioid use disorders are the gold standard treatment, and they continue to save and transform lives," said Glasner, who also has studied the use of text messaging to help people adhere to treatment regimens for HIV. "But they only work if you take them, and adherence is low. My hope is that our work will help reverse this trend by providing a low-cost intervention."