When you consider that tens of thousands of research studies are conducted each year, it’s a daunting task to keep track of what research has been done, is currently being done, and still needs to be done. So how do researchers select the most important topics to pursue? And how do funding agencies prioritize research investments?
One way of grappling with this behemoth is through the annual Prioritized Research Gaps Report produced by the Psychological Health Center of Excellence. Each year, we conduct a rigorous exploration of current and recent research studies to determine some of the most important gaps in psychological health research. The goal of our effort is to identify and prioritize research topics that have the potential to improve care and inform evidence-based practices in the Military Health System (MHS).
For 2017, substance use disorder was deemed a research priority within the MHS and was selected as the theme for the Prioritized Research Gaps Report. Based on feedback from numerous stakeholders, we specifically focused on alcohol use disorder and comorbid conditions, prescription opioids, and novel synthetic drugs. For information on how we sorted through the vast research literature to pinpoint some of the key topics that we perceived as still needing to be addressed by future research – what we call research gaps – please read or download the full Prioritized Research Gaps Report for Selected Substance Use Disorder Topics Calendar Year 2017.
Key Gaps Identified
Alcohol use disorder and comorbid conditions. Alcohol abuse has been an active topic of research for many years and continues to be a serious concern within the military. In 2017, our goal was to determine what questions still needed to be answered, keeping a particular eye on comorbid psychiatric conditions and military-specific issues. Broadly, our gap analysis showed that research is still lacking on how factors related to military culture and leadership, group identity, and social identity (e.g., gender and ethnicity) affect problem drinking and treatment. For example, the gap identified as a top research priority within alcohol use disorders was: Examine the effects of leadership attitudes, group characteristics, and group identification factors on drinking in the military.
Prescription opioids. The United States is currently facing an opioid epidemic, with prescription opioid use as a main culprit. Prescription opioid use is common among service members, many of whom come back from the battlefield dealing with injuries and suffering from chronic pain. In our gap analysis, we found that more research is needed on treatments for chronic pain that do not involve opioids. Indeed, our highest-priority prescription opioid gap was: Investigate treatments for chronic pain other than conventional opioids that reduce risk for prescription opioid use, abuse, and misuse.
Novel synthetic drugs. Unlike alcohol, novel synthetic drug (NSD) research is an emerging field and many basic questions remain unanswered. NSDs are synthetic versions of common recreational drugs and include synthetic cannabis (e.g.,“Spice”), cathinone stimulants (e.g.,“bath salts”), and synthetic opioids such as carfentanyl. NSDs may be particularly attractive to service members because they are readily available and are often undetected by drug tests. Providers may have difficulty differentiating acute NSD intoxication from other medical or psychiatric conditions, leading to a potentially dangerous misdiagnosis. Our gap analysis found that military providers require additional knowledge about symptoms, presentation, and effective treatment options. Our highest-priority NSDs gap was: Develop and/or evaluate interventions to improve provider knowledge and practices regarding screening, diagnosing, and management of patients using synthetic cathinones, synthetic cannabinoids, and novel synthetic opioids.
Our gap analysis is one example of how research and clinical practice intersect. Gaps in evidence-based practices can and should guide what research is prioritized within the MHS, and research findings should, in turn, inform evidence-based practices. Our gap analysis relies on the input of our MHS stakeholders and leaders. As we expand our stakeholder involvement, we encourage feedback from all stakeholders, particularly providers and service members and their families.
We are currently in the process of identifying topics for the 2018 gaps analysis and we would love to hear from a broad and diverse audience. Please tell us in the comments section below: What do you think are important issues within psychological health that future research needs to address?
Dr. Marija Kelber is a contracted health research methodologist at the Psychological Health Center of Excellence. She has a doctorate in social psychology and has conducted research on emotions and group dynamics as predictors of ethnic conflict, intergroup aggression, and gang violence.
Dr. Maria Morgan is a contracted senior research psychologist at the Psychological Health Center of Excellence. She has a doctorate in experimental psychology/behavioral neuroscience and a master’s degree in clinical psychological science.
The views expressed in Clinician's Corner blogs are solely those of the author and do not necessarily reflect the opinion of the Psychological Health Center of Excellence or Department of Defense.