As the Vice Chair of Addiction Sciences, Theresa Winhusen, PhD, oversees all three branches of UC College of Medicine’s Division of Addiction Sciences—clinical, education and research. But her primary focus is on addiction research related to the opioid epidemic.
Early in her career, Winhusen focused on testing potential treatments for cocaine and tobacco use disorders but switched her focus to opioids once she recognized the size and severity of the epidemic. Currently, Winhusen is conducting four studies testing interventions at different points in the addiction cycle—from initial opioid exposure to increasing retention in medication-assisted treatment (MAT) for individuals with opioid use disorder.
Winhusen is conducting an NIH R01-funded multi-site clinical trial evaluating the ability of a web-based chronic pain management program to reduce opioid usage, while also decreasing pain, in 400 chronic pain patients receiving long-term opioid therapy in primary care.
“If the web-based intervention is found to be efficacious, we will have a tool to help chronic pain patients decrease their exposure to opioids while managing their pain, which should reduce their risk of becoming addicted and also reduce the number of prescription opioids available for potential diversion,” said Winhusen. “I chose this intervention to study because I am focused on interventions that can be disseminated widely if they are found to efficacious. This is a low-cost intervention that can be accessed from anywhere with an internet connection, which eliminates critical treatment barriers.”
Removing barriers to treatment is key to Winhusen’s research efforts. She’s seen first-hand through her work with addiction treatment programs in the National Drug Abuse Treatment Clinical Trials Network that many treatment centers don’t have the funds, staff or training to implement more complicated or costly interventions.
“After being in the Clinical Trials Network for several years, I decided to focus on interventions that are low cost and easy to disseminate and, thus, likely to be utilized clinically if research finds them to be efficacious.”
In fact, Winhusen and her team have developed two low-cost, easy to disseminate interventions. One is a computer-guided, peer-delivered intervention called TTIP-PRO designed to reduce the risk of future overdoses in patients who have already experienced an opioid overdose by providing education and encouraging them to enter MAT. MAT includes the use of methadone, buprenorphine, or naltrexone in conjunction with behavioral treatment to treat opioid use disorder. In TTIP-PRO, peers who have personal experience with opioid overdose, but are now successfully engaged in MAT, provide a telephone intervention with participants to address inaccurate, negative beliefs about MAT. An NIH R34-funded trial testing of TTIP-PRO began in 2016 and will continue through 2019.
In addition, Winhusen and her team developed another intervention called RETAIN, which is self-administered through a mobile device, such as a tablet, and is designed to improve treatment retention for people entering MAT by providing information about common MAT misconceptions and videos of success stories from patients engaged in MAT. RETAIN is currently being tested in a small feasibility study.
Winhusen has 20 years of experience with testing medications for substance use disorders and is putting her expertise to use in evaluating a new treatment for pregnant women with opioid use disorder. Specifically, Winhusen and her team have developed a protocol for a national, multi-site clinical trial to compare a new formulation of a MAT medication, extended-release buprenorphine, that may improve mother-infant outcomes compared to a medication currently in clinical use, sublingual buprenorphine. Once Winhusen’s protocol receives final approval from the FDA and NIDA, she plans to begin a 12-site clinical trial to compare the medications.
“Whether measured in human suffering or by its financial toll, addiction is one of the most significant public health issues facing the world today. It is exciting to conduct research that may improve treatment for this complex and chronic set of disorders.”