LAAM WITH BEHAVIORAL TREATMENT FOR OPIOID/COCAINE ABUSE

LAAM 接受阿片类药物/可卡因滥用行为治疗

• 批准号: 6174804
• 负责人: Alison Oliveto
• 金额: $ 16.35万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1996
• 资助国家: 美国
• 起止时间: 1996-09-01 至 2002-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6174804
• 关键词: behavior modification; behavioral /social science research tag; clinical research; cocaine; combination therapy; depression; drug abuse; drug abuse therapy; drug administration rate /duration; drug withdrawal; functional ability; human subject; human therapy evaluation; interview; methadylacetate; opiate alkaloid; posttraumatic stress disorder; sex behavior; urinalysis

DESCRIPTION: (Applicant's Abstract) Although levo-alpha-acetylmethadol (LAAM), a derivative of methadone, has been successfully used as an alternative to methadone maintenance in opioid addicts, its effect on concurrent opioid and cocaine abuse has not been ascertained. Thus, this study proposes to examine the clinical efficacy of low- and high-dose LAAM maintenance on opioid and cocaine use in opioid-dependent cocaine abusers. In addition, since contingency management procedures have demonstrated some success in decreasing cocaine use in cocaine-abusing individuals. This study also proposes to examine the clinical efficacy of the presence or absence of contingency management procedures targeting illicit drug use. One hundred sixty male and female opioid-dependent cocaine abusers will be stratified by sex and randomly assigned to one of four treatment groups according to a 2 x 2 experimental design: low-dose LAAM (99 mg/wk) with adjunct contingency management procedures; low-dose LAAM (99 mg/wk) without adjunct contingency management procedures; high-dose LAAM (330 mg/wk) with adjunct contingency management procedures; and high-dose LAAM (330 mg/wk) without adjunct contingency management procedures. The duration of the study will be 24 weeks, with LAAM being administered on a thrice-weekly (MWF) basis. Subjects are inducted onto LAAM during weeks 1-3 and then maintained on their assigned maintenance dose (99 mg/wk or 330 mg/wk) through week 24. During maintenance, the Friday dose will be 1.3 times greater than the Monday and Wednesday dose. At the conclusion of the study, subjects undergo detoxification from LAAM over a 4-week period. For those in the contingency management procedure group, each drug-free urine submitted will result in a voucher worth a certain monetary value that increases for consecutively drug-free urines (weeks 1-12) or a monetary voucher with a fixed value (weeks 13-24). Subjects not assigned to the contingency management procedure will receive monetary vouchers (weeks 1-24) according to a yoked-control schedule (that is, not contingent upon illicit drug abstinence). Vouchers can be exchanged for mutually agreed upon goods and services at any time during the study. Outcome measures will include treatment retention, 2) illicit drug use, 3) self-reported adverse and opioid withdrawal symptoms, and 4) psychosocial functioning. Follow-up interviews at nine months and/or one year post-study entry will be conducted to determine status post-treatment. Prognostic factors (i.e., sex, post-traumatic stress disorder, and depression), will also be examined in relation to treatment outcome and post-treatment status. These Findings will assist in developing more effective strategies in treating individuals with combined cocaine and opioid dependence.

描述：(申请人摘要) 尽管美沙酮的衍生物左旋α-乙酰美沙醇(LAAM)具有 已成功用于阿片类药物中美沙酮的替代维持 它对阿片类药物和可卡因同时滥用的影响并没有 已经确定了。因此，本研究建议检查该药的临床疗效 小剂量和大剂量LAAM对阿片类药物和可卡因使用的维持 依赖阿片的可卡因滥用者。此外，由于应急管理 程序已经证明在减少可卡因使用方面取得了一些成功。 吸食可卡因的人。这项研究还建议研究 有无应急管理的临床效果 针对非法药物使用的程序。160男160女 依赖阿片类药物的可卡因滥用者将按性别和随机分组 根据2x2实验分配到四个处理组中的一个 设计：低剂量LAAM(99毫克/周)，附带应急管理 程序；小剂量LAAM(99毫克/周)，无辅助应急管理 程序；大剂量LAAM(330毫克/周)，附带应急管理 程序；和大剂量LAAM(330毫克/周)，无附带应急 管理程序。研究持续时间为24周， LAAM每周给药三次(MWF)。主题是 在1-3周内引入LAAM，然后在分配给他们的 维持量(99毫克/周或330毫克/周)至24周。在.期间 维护，周五的剂量将比周一大1.3倍， 周三剂量。在研究结束时，受试者要经历 在4周内从LAAM脱毒。对于那些处于应急状态的人 管理程序组，每提交一次无药物尿液将导致 价值一定货币价值、连续增值的凭证 无毒小便(第1-12周)或固定价值的货币代金券 (第13-24周)。未分配给应急管理的对象 程序将收到货币代金券(第1-24周)，根据 枷锁控制时间表(即，不以非法药物为条件 节欲)。代金券可以兑换双方商定的商品和 在学习期间的任何时间提供服务。成果衡量标准将包括 治疗保留，2)非法药物使用，3)自我报告的不良反应和 阿片类药物戒断症状；4)心理社会功能。跟进 将在学习后九个月和/或一年内进行面试 以确定治疗后的状态。影响预后的因素(即性别、 创伤后应激障碍和抑郁症)，也将在 与治疗结果和治疗后状态的关系。这些发现 将帮助制定更有效的治疗个人的策略 有可卡因和阿片类药物的联合依赖。

项目成果

Effect of PTSD diagnosis and contingency management procedures on cocaine use in dually cocaine- and opioid-dependent individuals maintained on LAAM: a retrospective analysis.

PTSD 诊断和应急管理程序对 LAAM 上可卡因和阿片类药物双重依赖个体使用可卡因的影响：回顾性分析。

• DOI: 10.1111/j.1521-0391.2009.00025.x
• 发表时间: 2010
• 期刊: The American journal on addictions
• 作者: Mancino,MichaelJ;McGaugh,Janette;Feldman,Zachary;Poling,James;Oliveto,Alison
• 通讯作者: Oliveto,Alison