Applying behavioral economics to screen medications for alcohol use disorder

应用行为经济学筛选酒精使用障碍药物

• 批准号: 10473518
• 负责人: Steven J Nieto
• 金额: $ 4.69万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-01 至 2023-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10473518
• 关键词: Alcohol consumption; Alcohols; Behavioral; Bulla; Characteristics; Choice Behavior; Clinical; Clinical Research; Clinical Trials; Cocaine Dependence; Compulsive Behavior; Decision Making; Development; Disease; Distant; Dose; Double-Blind Method; Fostering; Funding; Future; Human; Impairment; Individual; Laboratories; Laboratory Study; Measures; Mediating; Methods; Modeling; Naltrexone; National Research Service Awards; Outcome; Parents; Participant; Pathologic; Pathology; Patients; Pharmaceutical Preparations; Pharmacology Study; Pharmacotherapy; Placebo Control; Placebos; Prediction of Response to Therapy; Procedures; Process; Psychology; Questionnaires; Randomized; Reporting; Research; Research Personnel; Rewards; Scientist; Telephone; Testing; Titrations; Training; Training Activity; Translations; Treatment outcome; Visit; Woman; addiction; alcohol cue; alcohol demand; alcohol reinforcement; alcohol screening; alcohol use disorder; behavioral economics; behavioral pharmacology; chronic alcohol ingestion; cognitive process; cost; cue reactivity; discounting; drinking; drinking behavior; drug efficacy; economic behavior; efficacy evaluation; efficacy study; experimental study; indexing; intrinsic motivation; men; non-drug; novel; novel strategies; pre-clinical; precision medicine; preclinical study; preference; prognostic indicator; reinforcer; response; three-arm study; varenicline; virtual; virtual visit

ABSTRACT Maladaptive decision-making processes are a hallmark of alcohol use disorder (AUD). A behavioral economic approach to AUD synthesizes concepts and methods from psychology and microeconomics to understand cognitive processes that contribute to overconsumption of alcohol. The excessive delay discounting of temporally distant rewards and increased alcohol demand is characteristic of individuals with AUD and provide support for dysfunctional decision-making processes. Thus, there is critical need to develop and identify treatments that can shift decision-making biases toward more adaptive choices. The multiple-choice procedure (MCP) was developed to efficiently investigate the relationship between drug preferences and alternative reinforcers. While the MCP has been used to examine the efficacy of medications for cocaine dependence, it has yet to be used to screen medications for AUD. The objective of this F32 NRSA application is to foster my development as an independent researcher with a focus on behavioral pharmacology for AUD and behavior economics applied to AUD. This application seeks to leverage an R21 human laboratory paradigm to screen AUD medications by adding an MCP. This addition will allow the applicant valuable training in conducting a behavioral pharmacology study, while using a robust behavioral economic approach to assess the clinical utility of medication effects on choice behaviors. A total of 64 men and women with current AUD and reporting intrinsic motivation to change their drinking, will be randomly assigned to receive naltrexone (50 mg QD), varenicline (1 mg BID), or matched placebo. Post-randomization, all participants will complete an alcohol cue- reactivity paradigm prior to the initial dose of study medication. After a week-long medication titration period, participants are asked to come into the laboratory to receive their second medication blister pack and to begin a 7-day practice quit attempt, during which they will have daily virtual (online and phone) visits where they will report on their alcohol. Additionally, a second cue-reactivity paradigm will be conducted 90 minutes following study drug administration on the final day of the practice quit attempt (Day 14). After the cue-reactivity paradigm, participants will complete the MCP, wherein participants choose between a standard alcohol drink immediately or a monetary reinforcer in one week, a delay discounting task, and a hypothetical purchase task to assess alcohol demand. Aim 1 tests the hypothesis that naltrexone and varenicline will decrease alcohol choice compared to placebo. Aim 2 tests the hypothesis that alcohol drinking during the practice quit attempt will predict alcohol choice and that medication effects will moderate this relationship. This represents an important step in: 1) evaluating the efficacy of AUD medications on alcohol choice over an alternative reinforcer and 2) my scientific development and maturity as an independent translational alcohol researcher with a focus on behavioral pharmacology and behavioral economics to study AUD.

抽象的 适应不良的决策过程是酒精使用障碍 (AUD) 的一个标志。行为经济学 AUD 方法综合了心理学和微观经济学的概念和方法来理解 导致过度饮酒的认知过程。过度延迟折扣 暂时遥远的奖励和增加的酒精需求是持有 AUD 的个人的特征，并提供 支持功能失调的决策过程。因此，迫切需要开发和识别 可以将决策偏差转向更具适应性的选择的治疗方法。多项选择程序 （MCP）的开发是为了有效地研究药物偏好和替代品之间的关系 强化物。虽然 MCP 已被用于检查治疗可卡因依赖药物的疗效，但它 尚未用于筛选 AUD 药物。此 F32 NRSA 应用程序的目的是培养我的 作为独立研究人员的发展，重点关注 AUD 和行为的行为药理学 经济学适用于澳元。该应用程序旨在利用 R21 人类实验室范例来筛选 添加 MCP 的 AUD 药物。这一补充将为申请人提供宝贵的培训，以进行 行为药理学研究，同时使用稳健的行为经济学方法来评估临床 药物效用对选择行为的影响。共有 64 名男性和女性持有当前澳元并进行报告 改变饮酒的内在动机，将被随机分配接受纳曲酮（50 mg QD）， 伐尼克兰（1 mg BID），或匹配的安慰剂。随机化后，所有参与者都将完成酒精提示- 研究药物初始剂量之前的反应范例。经过一周的药物滴定期后， 参与者被要求进入实验室领取第二个药物泡罩包装并开始 为期 7 天的戒烟尝试练习，在此期间，他们将进行每日虚拟（在线和电话）访问，他们将 报告他们的饮酒情况。此外，第二次提示反应范式将在 90 分钟后进行 在戒烟尝试的最后一天（第 14 天）研究药物管理。提示反应后 范例，参与者将完成 MCP，其中参与者选择标准酒精饮料 立即或一周内的货币强化、延迟折扣任务和假设购买任务 评估酒精需求。目标 1 检验纳曲酮和伐尼克兰能够减少酒精含量的假设 与安慰剂相比的选择。目标 2 检验在尝试戒烟期间饮酒的假设 将预测酒精选择，而药物作用将缓和这种关系。这代表了一个 重要的一步：1) 评估 AUD 药物相对于替代药物对酒精选择的功效 强化物和 2) 我作为独立转化酒精研究员的科学发展和成熟 重点研究行为药理学和行为经济学来研究 AUD。

项目成果

Cannabis use and subjective response to alcohol in the human laboratory.

• DOI: 10.1016/j.drugalcdep.2022.109481
• 发表时间: 2022-07-01
• 期刊: DRUG AND ALCOHOL DEPENDENCE
• 影响因子: 4.2
• 作者: Nieto, Steven J.;Venegas, Alexandra;Hudson, Jazzlyne;Ray, Lara A.
• 通讯作者: Ray, Lara A.

Are medication effects on subjective response to alcohol and cue-induced craving associated? A meta regression study.

• DOI: 10.1007/s00213-023-06409-4
• 发表时间: 2023-09
• 期刊: PSYCHOPHARMACOLOGY
• 影响因子: 3.4
• 作者: Ray, Lara A.;Nieto, Steven J.;Meredith, Lindsay R.;Burnette, Elizabeth;Donato, Suzanna;Magill, Molly;Du, Han
• 通讯作者: Du, Han

Applying the Addictions Neuroclinical Assessment to derive neurofunctional domains in individuals who use methamphetamine.

• DOI: 10.1016/j.bbr.2022.113876
• 发表时间: 2022-06-03
• 期刊: BEHAVIOURAL BRAIN RESEARCH
• 影响因子: 2.7
• 作者: Nieto, Steven J.;Ray, Lara A.
• 通讯作者: Ray, Lara A.