Personality-Targeted Interventions for Addressing Polysubstance Use among Opioid-Addicted Clients Undergoing Opioid Substitution Therapy: A Feasibility Study

We are amid a severe opioid crisis, worsened by the COVID-19 pandemic. In Canada, prescription opioid use and opioid overdoses/mortality were soaring pre-pandemic, reaching epidemic levels, with opioid-related deaths only increasing since the pandemic. Powerful and dangerous synthetic opioids (e.g., Fentanyl) are increasingly being used to cut street drugs given disruptions to the drug supply chain with pandemic border closures. More effective interventions for addressing opioid use disorder are sorely needed. An effective mainstay treatment for opioid use disorder in Canada is opioid substitution therapy (OST; e.g., methadone, buprenorphine). However, OST clients frequently have other problems that are not well served by OST alone such as high OST drop-out and continued polysubstance use during OST. The latter can include "topping up" with opioids, using substances that are dangerous when combined with OST (e.g., sedatives), and risky administration routes (e.g., injection). We have recently shown that personality traits that predict risk for mental health/behavioral problems also predict risky forms and routes of substance use in OST clients. We will use our expertise in brief cognitive-behavioral interventions and clinical research methods to test the feasibility of personality-targeted substance use interventions in OST clients. We are currently using our existing personality model along with interviews already collected from OST clients and service providers to adapt our personality-targeted interventions. For the proposed grant, in collaboration with our knowledge user partners, we will aim to try 4 personality-targeted interventions with clients across 4 OST clinics, evaluate feasibility, and provide a first test of their impacts on clients' polysubstance use and OST retention. We will examine feasibility from the perspectives of clients, therapists, and clinic directors to see if the personality targeted approach should be pursued further in this population.