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Preventing Risky Drinking in Veterans Treated with Prescription Opioids
Technical Report,01 Apr 2016,31 Mar 2017
University of Pennsylvania Philadelphia United States
Pagination or Media Count:
Veterans who are taking prescription opioids for chronic pain and are engaging in risky drinking are at heightened risk for drug interactions, including overdose and other negative effects, particularly if they are also using benzodiazepines. In this application, we propose to test an integrated prevention intervention, designed to reduce rates of risky drinking in veterans receiving prescription opioids to treat their chronic pain. This adaptive, patient-centered intervention provides integrated clinical assessment, brief intervention, monitoring, and extended prevention services delivered through a combination of clinical visits, telephone calls, and text messages. We propose to conduct a study in which returning OEFOIF individuals and other veterans receiving medical care at the Philadelphia VAMC N300 who are on daily doses of prescription opioids and screen positive for risky alcohol use will be randomized to receive 12 months of an adaptive integrated prevention intervention IPI or to standard care SC, which consists of a Brief Intervention BI with 2 follow-up contacts. Potential participants will be veterans at the Philadelphia VAMC who, based on pharmacy records, are using opioids daily to treat chronic pain. An initial evaluation will identify individuals who also engage in risky alcohol use based on NIAAA-recommended guidelines and meet other inclusion criteria to be enrolled in the study. The evaluation will also identify the use of other medications e.g., benzodiazepines that could interact negatively with opioid use. For veterans randomized to the IPI condition, a BI is first provided to reduce alcohol to non-hazardous levels and the effects are monitored for one month. Veterans who reduce alcohol use to non-hazardous levels during this one-month period continue in a monitoring track, consisting of tailored text messages and brief monthly telephone contacts. Veterans who continue to drink at risky levels are instead placed in a track that pro
APPROVED FOR PUBLIC RELEASE