CPDD 78th Annual Scientific Meeting Program

SYMPOSIA
Tuesday, June 14
VII.
5HT2A and 5HT2C ligands as potential therapeutics for substance use
disorders
Chairs: Jane B. Acri and Leonard Howell
We will present and discuss data relevant to the clinical advancement of 5HT2 ligands
as substance use treatment medications. There are no approved medications for
cocaine, methamphetamine, or THC use disorders, and these results may suggest
clinical efficacy for substance use disorders. The 5HT system can influence the abuserelated
effects of cocaine and other drugs of abuse through its direct and indirect
interactions with dopaminergic systems in key brain areas. The regional distribution
of 5HT2A and 5HT2C involve the prefrontal cortex, the nucleus accumbens and the
ventral tegmental area. The two receptor systems can functionally oppose each other
in terms of their regulation of the dopaminergic signaling. Several selective ligands
have recently been developed by pharma for different indications; lorcaserin a 5HT2C
agonist is in clinical use for weight reduction, and pimavanserin, a 5HT2A antagonist
may soon be approved for the treatment of psychosis in Parkinson’s Disease. Clinical
availability of selective ligands will greatly enhance our ability to translate these
findings in human clinical trials. These compounds have recently been evaluated in
drug self-administration models using non-human primates trained to self-administer
cocaine, methamphetamine, or THC, using FR, PR, or choice models. These results will
be presented and discussed in terms of relevance to the treatment of substance use
disorders.
VIII. Neonatal Abstinence Syndrome: Context and consequences in 2016
Chairs: Karol Kaltenbach and Hendree Jones
Under the banner of fetal protection, judges and prosecutors have implemented
punitive approaches against women who use prescribed and non-prescribed opioids
during pregnancy. Policy makers mirror such punitive approaches in laws passed that
focus on women who use drugs while pregnant. The symposium will review the current
situation for women who use substances during pregnancy and their NAS-diagnosed
babies. These actions in the judicial-political sphere suggest that the science of NAS is
well understood. While there are numerous reports in the empirical literature
documenting efforts to assess and treat NAS over the past 50 years, rigorous studies
testing the best ways to assess and treat these infants are relatively recent as are
studies that identify factors that exacerbate or mitigate the severity of NAS. The state
of the science in assessment; efficacy of medication used to treat NAS; and protocols
for initiation of treatment and weaning will be described. Factors that have been
recently been identified that exacerbate the severity and length of treatment as well as
changes in hospital policies and practices that been shown to be effective in reducing
NAS severity will be discussed. These presentations will outline how a diagnosis of
NAS is not a diagnosis of maternal substance use disorder; an indication of a negative
relationship between substance use and fetal outcome