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Peggy Compton

August 20, 2013

Describe your research interests and how you chose this area of research.

I’m very interested in the neurological and clinical overlap between pain and addiction, and the centrality of opioids in both. Opioids are not only powerful analgesics, but are a staple in the management of acute and chronic pain.  Yet, opioids are also inherently rewarding to the degree that some individuals develop difficulty controlling their use as is indicative of addictive disease.  My work has primarily focused on the pain responses of patients who abuse or are maintained on opioids for the treatment of addiction (i.e., methadone, buprenorphine), describing opioid-induced hyperalgesia in this population, as well as testing medications to treat their hyperalgesic state. Our most current work has explored the role of pro-inflammatory immune system response to pain and opioids and the interaction among them. A secondary focus of my work is in examining indicators of addiction in patients prescribed opioid therapy for the management of chronic pain, and we continue to validate a tool we developed to assess for addictive disease in this patient population.

It is from my nursing perspective and practice that my research questions arose.   While in PhD study, I worked part-time in a methadone clinic, and continued my practice as a clinical nurse specialist on a medical-surgical unit. Not uncommonly would a patient of mine from the methadone clinic be hospitalized with a painful condition, and I would watch their pain being undermanaged or not managed at all because they were “addicts” and already on high does of methadone.  I found next to nothing in the literature about how to best manage pain in patients with opioid addiction, and quickly came to appreciate that although pain investigators were studying opioids, and addiction investigators were studying opioids, they were not speaking to one another about how to use opioids in patients suffering with both.  As a nurse, I am educated to approach and care for the patient in his or her totality – I do not have the luxury of treating just one or the other as if they are separate conditions; when pain and addiction co-occur in a patient, they must be addressed as integral phenomena.

How does GHUCCTS help you to achieve your research goals and advance your career in clinical and translational research? How will the CTSA program help to advance knowledge and treatments for patients with the diseases you study?

Both the GHUCCTS and CTSA are critical to the successful execution of my study.  The research resources provided by these centers are extensive and of high quality, and thus greatly facilitate my work.  Specifically, I benefit from the services of the research pharmacy, toxicology laboratory, clinical research unit, humans subjects consultation, and the data management and analysis expertise provided by the GHUCCTS and CTSA.  With their support, we will complete a double-blind randomized clinical trial evaluating the efficacy of pregabalin to treat opioid-induced hyperalgesia and chronic pain in buprenorphine-maintained prescription opioid abusers. 

Why is it important to have disciplinary and ethnic/cultural diversity in medical research? How does diversity contribute to your research? How does diversity enhance scientific discovery? (examples from your own career would be particularly useful)

Being a nurse, I consider disciplinary diversity essential to the development of meaningful health science.  Each profession brings a unique perspective and set of skills to the table, all of which are necessary for truly patient-centered care.  In the case of addiction, for example, physicians contribute necessary and valuable skills (i.e., medical management, detoxification) to the treatment plan, but these are only part of the solution.  Behavioral and support interventions are critical, and these are the skills a nurse brings to the situation.  Complete recovery cannot occur with a treamtne plan wedded to a single discipline.  Humans are holistic – the care we provide should to holistic too. 

How does clinical translational research benefit our community, both directly and indirectly? (examples from your own research program would be particularly useful)

Clinical translational research benefits our communities by bringing state-of-the-art treatment interventions to patients sooner.  Exciting scientific discoveries and breakthroughs with implications for healthcare are occurring in basic science labs around the world, but if these are not translated into treatment in the clinical setting, they really aren’t of much value to human health.  A decade ago, research done in basic science labs benefited and informed further basic science, but the goal of bringing this knowledge to the patient bedside was not valued.  Clinical translational research ensures that basic and clinical scientists find avenues to communicate and collaborate to ultimately improve the health of our communities.