Randomized Trial of ACT and a Care Management App in Primary Care-based Buprenorphine Treatment

The proposed IMPOWR Research Center at Montefiore-Einstein (IMPOWR-ME) will create a multidisciplinary and synergistic program of research to test multimodal treatments that address both chronic pain and opioid use disorder. IMPOWR-ME will generate critical knowledge about the effectiveness, implementation, and cost effectiveness of providing Acceptance and Commitment Therapy and/or a care management smartphone app for individuals in primary care-based buprenorphine treatment. Patients with lived experience with chronic pain and/or opioid use disorder, patient and policy advocates, payors, and health system partners will be engaged in all stages of the research. IMPOWR-ME is well-positioned to become a long-lasting hub for stakeholder-engaged research with multidisciplinary senior and early stage investigators focused on reducing overdose through better treatments for OUD and CP.

Inclusion Criteria: 1. 18 years old or older; 2. English or Spanish proficiency; 3. receiving BUP treatment for OUD for at least 14 days (thus a stabilized BUP dose); and 4. CP with at least moderate pain severity (score greater than or equal to 4 on Pain, Enjoyment of Life and General Activity (PEG) scale). Comorbid psychiatric conditions and use of psychotropic medications will be allowed Exclusion Criteria: 1. Acute exacerbation of psychiatric conditions precluding the ability to participate in the study (e.g., acute mania, active suicidality/homicidality, psychosis); 2. psychotropic medication changes within the past three months prior to enrollment; 3. CP related to malignancy; 4. received ACT or similar therapeutic intervention in the past; 5. initiated psychotherapy within the past three months; 6. neurocognitive conditions that may prevent participants from accessing telehealth services; 7. current use of a smartphone health platform similar to the Valera app; 8. are unable or unwilling to provide signed consent for participation