New approaches to addiction treatment

成瘾治疗的新方法

基本信息

  • 批准号:
    10699664
  • 负责人:
  • 金额:
    $ 87.57万
  • 依托单位:
  • 依托单位国家:
    美国
  • 项目类别:
  • 财政年份:
  • 资助国家:
    美国
  • 起止时间:
  • 项目状态:
    未结题

项目摘要

One of our major projects, in collaboration with a small pharmaceutical company. is a human laboratory study to test the safety and efficacy of a biased mu agonist for prevention and relief of opioid withdrawal in people with OUD. This is initial proof of concept for what we hope will be an addition to the choices now available for opioid maintenance treatment of OUD. The niche for a biased agonist is that it could have the easy induction and no-ceiling effectiveness of methadone while also being comparatively free of side effects such as constipation, sedation, and respiratory suppression. The protocol was delayed by the Covid-19 pandemic, but is now in progress. Another project is a laboratory-session-based interventional study of heavy social drinkers, with real-world outcome measures. We are harnessing a property of memory called reconsolidation, whereby recently activated memories become briefly vulnerable to disruption. The "memories" in this instance are the Pavlovian associations that link alcohol-related cues to the responses of craving and drinking. In a procedure called retrieval-extinction, we reactivate those associations through actual intoxication (using each participants favorite drink); then we disrupt them with repeated exposure to personalized drinking-related stimuli. Data from other investigators, in smokers and heroin users, have shown that this procedure can lead to a remarkably generalizable unlinking of cues from craving even after people leave the laboratory setting and return to their usual environments. We are testing that with the smartphone-based daily assessments that have become our units specialty. The protocol is ongoing. Another major project is to develop Just-in-Time Adaptive Interventions (JITAIs) for treatment of substance-use disorders. This is the next major outgrowth of our work with ambulatory assessment of heroin and cocaine users - an ambulatory treatment via smartphone app. For JITAIs, the first goal is to hone content of the intervention. We are preparing to do that with perhaps the most purely psychotherapeutic protocol ever conducted at the NIDA IRP, using both cognitive-behavioral therapy and a mindfulness-based approach called ACT (Acceptance and Commitment Therapy). Our use of these psychotherapies comes with two innovations, one technological (delivery mostly via text on smartphones) and the other methodological (delivery is microrandomized, such that we can test which approach is most immediately helpful under which circumstances in daily life). The protocol is SRC-approved and IRB-approved, and we are contracting with a vendor for programming. We will start with a formative-research phase in which we interview opioid and cocaine users about their preferences for a mobile-treatment app. This will lead to a clinical trial. A postdoc, to be hired, will lead the formative interviews and the ongoing content development. The other major component of a JITAI is predictive analytics, so that momentary interventions can be "pushed" when and where the patient needs them. The next step is to collect more momentary data that we can feed into our machine-learning models to generate more accurate predictions. Another project, in collaboration with Dr. Patrick Finan at the Hopkins Psychiatry Department is a human laboratory study to assess the effects of sleep disruption on opioid abuse liability in people with chronic pain. This is a step toward a new approach toward prevention of iatrogenic OUD, using sleep disruption as a modifiable ongoing risk factor. Another project, in collaboration with a small technology company., is a combined human laboratory study and field trial for a wearable respiration monitor that may be able to detect psychological stress. This would be integrated with our predictive-analytic work to help push JITAI content at appropriate moments. We are transitioning this from a substudy to a stand-alone protocol. During the pandemic, we continued to analyze and publish treatment-relevant or translationally relevant data from our prior cohorts of outpatient participants.
我们的一个主要项目,与一家小型制药公司合作。是一项人体实验室研究,旨在测试偏倚mu激动剂预防和缓解OUD患者阿片类药物戒断的安全性和有效性。这是概念的初步证明,我们希望这将是对现有的阿片类药物维持治疗选择的补充。偏倚激动剂的优势在于它具有美沙酮的易于诱导和无上限的有效性,同时也相对没有便秘、镇静和呼吸抑制等副作用。该议定书因Covid-19大流行而被推迟,但现在正在进行中。

项目成果

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David Epstein其他文献

David Epstein的其他文献

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{{ truncateString('David Epstein', 18)}}的其他基金

Quantifying Exposure to Illicit Drugs & Psychosocial Stress in Real Time
量化非法药物的暴露程度
  • 批准号:
    10928564
  • 财政年份:
  • 资助金额:
    $ 87.57万
  • 项目类别:
Optimizing HIV-care-continuum engagement and outcomes among opioid users
优化阿片类药物使用者的艾滋病毒护理持续参与和结果
  • 批准号:
    10267559
  • 财政年份:
  • 资助金额:
    $ 87.57万
  • 项目类别:
New approaches to addiction treatment
成瘾治疗的新方法
  • 批准号:
    10928581
  • 财政年份:
  • 资助金额:
    $ 87.57万
  • 项目类别:
Quantifying Exposure to Illicit Drugs & Psychosocial Stress in Real Time
量化非法药物的暴露程度
  • 批准号:
    10699649
  • 财政年份:
  • 资助金额:
    $ 87.57万
  • 项目类别:
Mapping and predicting HIV-transmission hotspots with phylogenetics and geospatial machine learning
利用系统发育学和地理空间机器学习绘制和预测 HIV 传播热点
  • 批准号:
    10267558
  • 财政年份:
  • 资助金额:
    $ 87.57万
  • 项目类别:
New approaches to addiction treatment
成瘾治疗的新方法
  • 批准号:
    10267562
  • 财政年份:
  • 资助金额:
    $ 87.57万
  • 项目类别:

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  • 财政年份:
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  • 批准号:
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  • 财政年份:
    2023
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AMPKa agonist in attenuating CPT1A inhibition and alcoholic chronic pancreatitis
AMPKa 激动剂减轻 CPT1A 抑制和酒精性慢性胰腺炎
  • 批准号:
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  • 财政年份:
    2023
  • 资助金额:
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Investigating mechanisms underpinning outcomes in people on opioid agonist treatment for OUD: Disentangling sleep and circadian rhythm influences on craving and emotion regulation
研究阿片类激动剂治疗 OUD 患者结果的机制:解开睡眠和昼夜节律对渴望和情绪调节的影响
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    10784209
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    2023
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    $ 87.57万
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A randomized double-blind placebo controlled Phase 1 SAD study in male and female healthy volunteers to assess safety, pharmacokinetics, and transient biomarker changes by the ABCA1 agonist CS6253
在男性和女性健康志愿者中进行的一项随机双盲安慰剂对照 1 期 SAD 研究,旨在评估 ABCA1 激动剂 CS6253 的安全性、药代动力学和短暂生物标志物变化
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A novel nanobody-based agonist-redirected checkpoint (ARC) molecule, aPD1-Fc-OX40L, for cancer immunotherapy
一种基于纳米抗体的新型激动剂重定向检查点 (ARC) 分子 aPD1-Fc-OX40L,用于癌症免疫治疗
  • 批准号:
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  • 批准号:
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  • 资助金额:
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