Karen J. Derefinko, PhD, assistant professor in the Department of Preventive Medicine at the University of Tennessee Health Science Center (UTHSC), received a $3.3 million grant from the National Institutes of Health (NIH) to develop psychological methods designed to help individuals with opioid use disorder through medication assisted treatment.
The United States Department of Health and Human Services estimates that over 130 people die every day from opioid-related drug overdoses. Although treatment for opioid addiction is available, more than half of patients struggle to adhere to buprenorphine-naloxone, a form of medication assisted treatment, particularly during the early stages.
Dr. Derefinko’s study centers around two treatment techniques designed to increase the likelihood that the patient will adhere to medication assisted treatment. The first technique will provide gift cards for patients who attend physician visits and test positive for buprenorphine-naloxone. The other technique will provide counseling focused on helping patients overcome the short-term challenges of opioid withdrawal with the goal of long-term sobriety. Dr. Derefinko said her project is unique because treatment options are flexible, which isn’t seen in similar scientific studies.
“For individuals who are struggling during treatment initiation, we have the ability to switch their treatment or offer both forms of treatment at the same time in this study,” Dr. Derefinko said. “What we’re doing is making sure that treatment gets tailored for the patient, and that it’s adaptive based on their needs.”
Dr. Derefinko’s research program, the Get Solid Initiative, also includes a series of projects focused on the prevention of opioid exposure and misuse. According to the 2018 National Survey on Drug Use and Health, 10.3 million people in the United States misused prescription opioids, with the majority of them abusing doctor-prescribed doses of hydrocodone and oxycodone. Dr. Derefinko believes her work in educating the public about the risks of opioid exposure is critical because of how easy it is to develop an addiction to opioids.
“Opioid use disorder can start with simple exposure from a medical procedure,” Dr. Derefinko said. “Although most patients use prescribed opioid medication appropriately at the start, a life stressor can influence some individuals to take a pill to help ease their emotional pain. This is the start of ‘misuse’ of opioid medication, and this misuse can lead to long-term use and even addiction.”
Her project entitled “Testing the Effects of Contingency Management and Behavioral Economics on Buprenorphine-Naloxone Treatment Adherence Using a Sequential Multiple Assignment Randomized Trial (SMART) Design” is being funded by the NIH for five years. Dr. Derefinko earned her PhD in Clinical Psychology from the University of Kentucky in 2010 and has been an assistant professor at UTHSC since 2014.