CPDD 72nd Annual Meeting • Scottsdale, Arizona - The College on ...

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IMPLEMENTING RESEARCH IN TRADITIONAL
COMMUNITY TREATMENT PROGRAMS: FINDINGS FROM
A CTN TRIAL.
Allan J Cohen 1 , D George 3 , c Langlois 1 , A Moreno 1 , D Yomjinda 3 , C Boubion 3 ,
J Martin 1 , R Donovick 3 , C Vimieiro 1 , C Thomas 2 , A Hasson 2 , M Hillhouse 2 , W
Ling 2 ; 1 Research/Training, Bay Area Addiction, Research and Treatment, Inc.,
San Francisco, CA, 2 ISAP, UCLA, Los Angeles, CA, 3 Matrix, Los Angeles, CA
Aims: <strong>The</strong> dissemination and adoption of new evidence-based treatment into
traditional treatment settings continues to be fraught with many obstacles and
challenges.
<strong>The</strong> NIDA Clinical Trials Network was established to provide a mechanism for
bridging the gap between research and practice, by conducting clinical trials
research in community treatment programs (CTP), as well as to facilitate the
adoption of evidence-based treatment in these settings. An example is provided
for this presentation by a recently completed CTN project, “Starting Treatment
with Agonist Replacement <strong>The</strong>rapies” (START; CTN 0027) designed to evaluate
the hepatic safety of two medications, Suboxone and methadone, used in the
treatment of opioid dependence. Discussed will be the organizational experiences
of two of the eight participating CTPs, both affiliated with the CTN
Pacific Regional Node; Bay Area Addition, Research and Treatment (BAART)in
San Francisco and Matirx Institute on Addictions in Los Angeles, in implementing
a new evidence-based technology, Suboxone, into programs best
described as “traditional methadone” settings. Descriptions of both programs
their patients, organizational cultures and treatment philosophy, staff and
research experience are presented. <strong>The</strong> presentation will focus on individual and
shared experiences including; study implementation, recruitment and retention
challenges, study impact on existing program culture and the clincial and programatic
benefits the study afforded, expanding patient access to treatment,
increased staff and patient knowledge related to partial agonist treatment and
and sustainability considerations.
Conclusions: Clincial trials research can be successfully conducted in community
treatment program settings and may facilitate the diffusion and may serve in
the adoption of new treatments into traditional treatment programs.
Financial Support: No financial support is associated with this presentation or
submission.
119
REPEATED ADMINISTRATION OF A LONGER ACTING
MUTANT COCAINE ESTERASE: INTERACTIONS WITH THE
ACUTE CARDIOVASCULAR EFFECTS OF COCAINE AND
IMMUNE RESPONSES IN FREELY MOVING RHESUS
MONKEYS.
Gregory T Collins, D Narasimhan, K A Carey, A A Berlin, N W Lukacs, R K
Sunahara, J H Woods, M C Ko; University of Michigan Medical School, Ann
Arbor, MI
Aims: Cocaine (COC) is the most common illicit drug related to emergency
room visits, with the majority of cases due to chest pain resulting from increases
in blood pressure (BP) and heart rate (HR). <strong>The</strong>se studies were aimed at characterizing
1) the capacity of a mutant COC esterase (T172R/G173Q; DM CocE)
to ameliorate the cardiovascular effects of COC, and 2) the development of anti-
CocE antibodies following repeated dosing with DM CocE in rhesus monkeys.
Methods: Four rhesus monkeys (2 male and 2 female) were implanted with telemetric
probes (DSI; D70-PCT) capable of continuous measurement of BP and
HR. DM CocE (0, 0.032, 0.1, 0.32, 1.0, or 3.2 mg/kg; IV) was administered 10
min after an IV dose of 3.2 mg/kg (n=3), or 1.0 mg/kg (n=1) COC, with BP and
HR recorded for an additional 110 min. Blood was collected 24h prior to test
sessions to allow for anti-CocE antibody titer determinations.
Results: In general, IV COC resulted in persistent increases in BP and HR. DM
CocE produced dose-dependent and rapid decreases in BP in all four monkeys,
with BP returning to control levels within the first 5-10 min following doses of
0.32, 1.0, or 3.2 mg/kg DM CocE. Similar decreases in HR were observed in 3
of the 4 monkeys, although these changes occurred over a longer time course.
Repeated dosing of DM CocE failed to produce significant increases in anti-
CocE antibody titers.
Conclusions: <strong>The</strong>se studies demonstrate that DM CocE is capable of producing
a rapid, and robust amelioration of COC-induced elevations in BP, and to a lesser
degree HR, in rhesus monkeys. In addition, the effectiveness of DM CocE to
reverse the cardiovascular effects of COC was unaffected by repeated dosing, and
occurred in the absence of significant immune responses. Together, these results
suggest that DM CocE may provide a novel and effective therapeutic for the
treatment of acute COC toxicity.
Financial Support: NIDA grants DA023213 & DA021416
<strong>CPDD</strong> <strong>72nd</strong> <strong>Annual</strong> <strong>Meeting</strong> <strong>•</strong> <strong>Scottsdale</strong>, <strong>Arizona</strong>
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118
DISTRESS TOLERANCE AND ADOLESCENT SMOKING
CESSATION.
Anahi Collado-Rodriguez, W Francis, K Young, J Gottlieb, C W Lejuez, L
MacPherson; University of Maryland - <strong>College</strong> Park, <strong>College</strong> Park, MD
Aims: More than half of adolescent smokers report attempts to quit each year
(YRBS, 2005; Riedel et al., 2002) but only a small percentage actually succeed
(Moss, Allen, Giovino & Mills, 1992; Zhu et al., 1999). In efforts to understand
the underlying reasons for failed cessation attempts, the current study investigated
negative emotionality and resulting avoidant coping styles, specifically distress
intolerance, as a contributing factor to relapse. Low psychological distress
tolerance is defined as the inability to persist in goal-directed behavior in the face
of affective distress and has predicted poor cessation outcomes among adult
smokers.
Methods: <strong>The</strong> study is currently in the data collection process. <strong>The</strong> available
sample consists of 22 adolescent daily smokers who reported a desire to quit
smoking within 30 days upon enrollment (mean age =16.8, 57.1% male, 61.9%
White, mean cigarettes per smoking day (CPSD) = 8.7). Outcome variables were
assessed during baseline, quit date, and at 7-day intervals over the period of a
month post-quit date. Psychological distress tolerance in the current study was
measured using computer-based behavioral tasks, including the Mirror Tracing
Persistence Task (MTPT) and the Paced Auditory Attention Serial Task
(PASAT).
Results: To date, 82% of participants reported making a quit attempt (mean
duration = 15.6 days) and 91% of participants indicated a reduction of CPSD.
Lower distress tolerance was associated with younger age of smoking onset, higher
baseline CPSD, and heaviest lifetime smoking. Prospective analyses indicated
that lower distress tolerance predicted shorter quit attempt duration and smaller
reductions in CPSD across the follow-up period, after accounting for baseline
smoking.
Conclusions: Preliminary results of the current study elucidate processes that
may predispose adolescents to fail in their smoking cessation attempts. Low psychological
distress tolerance should be considered as a basic mechanism to target
in smoking cessation treatments for adolescents.
Financial Support: NIDA K23 DA23143
120
DRUG-SEEKING IN RESPONSE TO A PRIMING INJECTION
OF MDMA IN RATS: RELATIONSHIP TO INITIAL
SENSITIVITY TO SELF-ADMINISTERED MDMA AND
DORSAL STRIATAL DOPAMINE.
Joyce Colussi-Mas, R J Wise, S Schenk; School of Psychology, Victoria
University of Wellington, Wellington, New Zealand
Aims: In laboratory animals, exposure to priming injections of 3,4-methylenedioxymethamphetamine
(MDMA) produced drug seeking following extinction
of MDMA self-administration. <strong>The</strong> present study aimed to evaluate whether the
magnitude of drug seeking was related to latency to acquisition of MDMA selfadministration
and increases in striatal dopamine.
Methods: Rats (n=23) were given daily access to MDMA self-administration
until they earned a total of 240 infusions (total intake of 165 mg/kg MDMA).
An additional group of rats (n=7) were yoked to some of the rats that self-administered
MDMA so that they passively received the same amount of MDMA. Two
days later, drug-seeking tests were conducted and all animals received a MDMA
(10.0 mg/kg, i.p.) priming injection while changes in extracellular dopamine in
the dorsal striatum were measured by in vivo microdialysis.
Results: Fourteen of the 23 rats acquired self-administration within the temporal
limits of the study and the latency to meet the criterion ranged from 9-37
days. An experimenter administered injection of MDMA produced drug seeking
in these rats, and the number of responses was significantly higher than responses
produced by rats that failed to meet the criterion or by yoked control rats. For
rats that met the criterion, drug seeking was negatively correlated with the number
of days to self-administer the criterion number of MDMA infusions and positively
correlated with MDMA-produced dopamine in the dorsal striatum.
Importantly, MDMA-produced dopamine overflow was greater for the rats that
met the criterion.
Conclusions: <strong>The</strong>se findings suggest that drug seeking is influenced by initial
sensitivity to the reinforcing effects of MDMA and related to drug-produced
increases in striatal dopamine.
Financial Support: Neurological Foundation of New Zealand and Wellington
Medical Research Foundation.