Improving existing treatment by understanding brain processes underlying behaviour

First published: 10 May 2019 | Last updated: 20 May 2019

How treatments for behavioral disorders such as addiction are delivered can have a large impact on the effectiveness of the treatment.  Misunderstanding or ignorance of the neural or behavioral mechanisms underlying a treatment’s effect can lead to practices which limit treatment effectiveness.  As a neurobiologist and mental health services researcher, my research and quality improvement efforts have often focused around improving use of existing treatments by making use of neurobiological evidence regarding how they work.  Here, I will present examples of my research in this area, spanning basic science studies of drug function to medical informatics development and national program evaluation initiatives.  Examples discussed may include (1) clinical implications from reexamining the neurobiological mechanisms by which opioids produce analgesia at the level of the spinal cord; (2) results of a longitudinal patient outcomes study examining the clinical impact of differing strategies of use of methadone maintenance for treatment of opioid dependence (i.e. prevention of withdrawal symptoms versus antagonism of short-acting opioid effects); (3) design of computerized decision support software to address behavioral barriers that discourage clinical use of safe and effective opioid prescribing practices in primary care; (4) evaluation of a primary care program to address psychological contributions to chronic pain in HIV patients at high risk for medication misuse; and (5) benefits and pitfalls of using performance metrics to motivate quality improvement and guide policy initiatives.  In all cases, I will discuss how findings from behavioral neuroscience can be used to predict and improve intervention outcomes, with a focus on prevention of and care for substance use disorders and chronic pain syndromes.

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Dr Jodie Trafton