Concept: Psychosocial Support as an Adjunct to Medication Assisted Treatment for Opioid Use Disorders in the Context of the SAMHSA

Council Date: April 6, 2017        

Program Director: Robin Boineau, M.D.

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Background 

This is an initiative to fund research related to the 21st Century Cures Act funding opportunity announcement for State Targeted Opioid Crisis Grants (T1-17-014) called “Opioid STR.” The purpose of the 21st Century Cures Act funding to the Substance Abuse and Mental Health Services Administration (SAMHSA) aims to address the opioid crisis by increasing access to treatment, reducing unmet treatment need, and reducing opioid overdose related deaths through the provision of prevention, treatment, and recovery activities for opioid use disorder (OUD). The grants will go to states and territories to distribute the funds for evidence-based treatments for OUD and will permit funding for medications and psychological interventions. About 80 percent of the SAMHSA funding (about $500,000,000 a year for 4 years) is for U.S. Food and Drug Administration-approved funding for Medication Assisted Therapy (MAT) for OUD.

Purpose of Proposed Initiative

The NCCIH initiative will be a companion to a National Institute on Drug Abuse (NIDA) initiative that will leverage the Opioid STR investment to explore research questions related to improving uptake of MAT. 

NCCIH has an interest in the mind and body interventions for the treatment of chronic pain and substance use. Chronic pain (occurring in 20 to 30 percent of adult population) is frequently a comorbidity in patients who develop OUD after being prescribed opioids to treat acute or chronic pain conditions. A recent state-of-the-art conference on nonpharmacologic approaches to chronic musculoskeletal pain management highlighted areas of knowledge and gaps related to mind and body treatments for chronic pain including mindfulness meditation, cognitive behavior therapy, biofeedback, hypnosis, relaxation therapies, and acupuncture. 

Objectives

There are multiple potential mind and body approaches that may be utilized for treatment of OUD as an adjunct to MAT that may be included in individual state's plans to reduce the burden of OUD. NCCIH aims to harness this opportunity to fund three to four awards to evaluate mind and body interventions as adjunct to MAT. These will be phased awards with a pilot phase followed by a phase of full implementation.