The Quebec-Maritimes Node working groups provide an efficient structure to leverage the appropriate expertise for moving projects forward more efficiently in selected research areas. Currently, we are focusing on the development, evaluation, and dissemination of interventional research data along 4 main themes:
Theme 1: Substance-specific and polysubstance misuse
Co-Chairs: Didier Jutras-Aswad, MD, MSc and Joël Tremblay, PhD
Several meta-analyses and literature reviews support the notion that the use of psychosocial and pharmacological approaches efficiently reduces or stops drug misuse behaviors in a significant portion of patients who suffer from addictive disorders. However, for the remainder oft the patients, these treatments fail to induce significant behavioral changes or even to reduce drug consumption. This highlights the need for developing new interventions and for innovation to provide patients with better treatment options.
Thus, projects within this theme will promote research on novel treatment targets and interventions for persons suffering from substance use disorders. This includes mainly clinical trials designed to assess the effectiveness of newly developed evidence-based interventions and of innovative model of care using psychosocial and pharmacological approaches to reduce or stop drug misuse.
Theme 2: Substance misuse and mental health comorbidities
Co-Chairs: Patricia Conrod, MD, MSc and Sherry Stewart, PhD
Projects within this theme focus mainly on the issue of psychiatric comorbidities in addiction, spanning from the development of novel service delivery programs to the identification of novel cognitive, neural, and genetic targets for intervention in dual diagnosis cases.
The Quebec-Maritimes Node members have extensive expertise in treating addicted patients with psychiatric comorbidities. Through numerous randomized controlled trials, researchers from this Node have convincingly demonstrated that substance misuse can be reduced, delayed, or prevented by targeting the personality traits associated with risk for addiction and comorbid psychiatric disorders. These personality risk factors include impulsivity, hopelessness, anxiety sensitivity, and sensation seeking. Projects within this this theme will benefit from the availability of integrated addiction and mental health services in Montreal and Halifax. These clinical services have a history of conducting high quality research in collaboration with Node members. Such integrated care has been identified by many as the necessary precondition for the delivery of evidence-based interventions for dual-diagnosis patients.
Theme 3: Substance misuse and and pain
Co-Chairs: Gilles Lavigne, DMD, MSc, PhD and Mary Lynch, MD
Regardless of the cause, chronic pain has devastating physical, psychological and social consequences that greatly impact patients’ quality of life. Chronic pain is reported by about 20% of the Canadian adult population; within that same group, about 20% use prescription opioids, and close to 5% of them report the non-medical use of opioids.
Projects within this theme focus on interventional research in substance misuse, mainly prescription opioids, amongst chronic pain patients. More specifically, projects in the substance misuse and pain theme lie at the interface of substance misuse, pain, and mental health, in relation to novel treatment interventions for people living with substance misuse.
Theme 4: Substance misuse and medical comorbidities
Co-Chairs: Élise Roy, MD, MSc and Marie-Thérèse Lussier, MD, BSc, MSc
Many health problems are direct consequences of chronic and intense drug misuse, including memory and cognitive problems, several chronic heart, lung and liver diseases. In particular, people with an intensive consumption profile such as those who smoke crack or inject drugs have an elevated risk of these conditions in addition to HIV and HCV infections, and drug overdoses.
Through different types of intervention and study designs at different stages of the drug misuse trajectory, researchers from this Node have demonstrated that intensification of substance misuse and its health consequences can be prevented among vulnerable groups, working on both individual high risk behaviours and environmental risk factors. This Working Group will focus on intervention research related to the detection of substance misuse in primary care settings, and to the reduction of medical co-morbidities, including HIV and HCV, among people living with substance misuse.