Table 5.
Addiction research priorities.
| Question/Priority area | Methodology considerations |
|---|---|
| PREVENTION OF SUD | |
| What are the physiological markers, genetic history, adverse childhood experiences, socioeconomic factors or co-occurring conditions (chronic pain or depression) that increase an adolescent's risk to a SUD and how could these measurable factors be weaved into proactive skills training | Prospective research that can both identify risk of SUD as well as intervene before onset for those with known risk factors, such as adverse childhood experiences or emerging risks, such as exposure to prescription medications in the home |
| What are the potential skills training and lifestyle medicine interventions that young people can enhance though grade school or college, if their risk of an SUD can be identified prior to exposure to alcohol and other substances | Expand research, using longitudinal timeframes, on cognitive skills training, such as improving executive functioning or strengthening emotional regulation in adolescents and young adults to assist them in effectively navigating through the exposure of alcohol and other substances |
| EARLY DETECTION OF MISUSE PATTERNS OR EARLY ONSET OF SU | |
| How is substance misuse interrelated with other lifestyle factors, such as the quality of sleep, exposure to stress, social support, nutrition, physical activity or sense of safety | Develop interventions that can measure and enhance a person's social and physical environments for those who already have high risk markers, such as adolescents or college students exposed to stress behaviors |
| How can technology be used, such as fit-bit like devices or smart-phone apps to provide individuals with real-time messaging, nudges or warnings around urges to use alcohol or other substances or identify relapse risks in time for effective problem-solving strategies | Expand the use of self-guided technology, phone-based applications, and web-based interventions for individuals with misuse patterns, who would likely benefit from low-touch interventions and do not need high-touch services, such as a SUD outpatient |
| Can big data be harnessed for real-time predictive modeling of patients who are at risk of or already displaying unhealthy behaviors around substance use or showing signs of prescription medication misuse | Explore the potential of machine learning for rapid identification of SUD risks that can be used for proactive interventions; so far, the research has been used on historical data sets, but has yet to be applied to early interventions |
| Can lifestyle medicine be applied to the treatment of people with chronic pain, such as expanding interventions around nutrition, physical activity, stress, sleep, social connection both before and after the onset of an OUD | Develop and test value-based payments and other alternative payments to expand the use of lifestyle medicine interventions in the treatment of chronic pain, as there appears to be a need for a cultural and financial change in how people with chronic pain are treated over time |
| Is substance misuse a problem or a solution to solving another problem, such as managing physical or emotional pain. stigma, social disconnection or caused by impulsive and adversarial behaviors (frontal lobe dysfunction or immaturity plus chemical effects) | Identify personality traits, such as impulsiveness and sociological factors, such as stigma or social isolation, that can be used in developing alternative treatments for youth who are at risk of a SUD |
| TIMELY APPLICATION OF EFFECTIVE TREATMENTS FOR INDIVIDUALS WITH A SUD—EXAMPLE OUD | |
| How can the impact of stigma be reduced across the healthcare system, including its impact on racial minorities, pregnant women and those being discharged from incarceration who have an OUD | A research priority is measuring institutionalized stigma associated with people who have an OUD or other SUD and how stigma is hindering the application of effective treatments or increasing disengagement from effective care |
| Can we develop flexible, stepped SUD treatment interventions that can be modified over several months, based on a patient's response to each incremental stage of treatment | Develop RCTs that include a two-staged process to accurately assess the incremental impact of psychosocial interventions beyond medications, based on an individual's response to medications and TAU impact, |
| How can we design flexible, integrated models of care for people with an OUD using effective protocols in healthcare, such collaborative or measurement-based care, or telehealth and e-therapy that can both engage individuals over years while providing care in either office or home-based settings | Identify metrics, technological monitors and telehealth interventions that can be used for effective triage of SUD treatment; these metrics or technologies could be used for both triage as well as for home-based monitoring or treatment for those living in rural locations |
| What is needed in treatment funding or innovation to weave in the healing powers of the community, including the digital support network that individuals with a SUD could utilize to improve outcomes. | Deign research projects as well as alternative funding models that can measure and incorporate elements of recovery capital, including the growing network of digital social support (DSS) to improve SUD outcomes |