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Effects of a New Behavioral Intervention on Alcohol Craving and Drinking

Primary Purpose

Alcohol Drinking, Alcohol Drinking Related Problems

Status
Recruiting
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Retrieval-extinction
Extinction
Retrieval
Sponsored by
National Institute on Drug Abuse (NIDA)
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Alcohol Drinking focused on measuring Reconsolidation

Eligibility Criteria

21 Years - 65 Years (Adult, Older Adult)All SexesAccepts Healthy Volunteers
  • INCLUSION CRITERIA:
  • age between 21 and 65 years inclusive;
  • Drinking at high levels for at least 10 different weeks during the last 90 days. High-level drinking for a given week can be either of the following::

    --For women, more than 3 drinks on any single day that week, or more than 7 drinks that week;

  • For men, more than 4 drinks on any single day that week, or more than 14 drinks that week;
  • a score greater than or equal to 8 and less than or equal to 15 on the self-report version of the Alcohol Use Disorders Identification Test (AUDIT), with endorsement of at least one item other than 1-3, because 1-3 assess only consumption, not concern or consequences;
  • self-report of liking or having neutral feelings about the sight and smell of alcoholic beverages;
  • for women, practicing an effective method of birth control before entry and throughout the study (or postmenopausal for at least one year, or surgically sterile); negative urine pregnancy test at each visit. Effective methods of birth control are those approved by the Food and Drug Administration (FDA) used as described in the FDA Birth Control Guide These methods are: (1) intrauterine device (IUD) copper; (2) IUD with progestin; (3) implantable rod; (4) contraceptive shot/injection; (5) oral contraceptives (combined pill, progestin-only pill, or extended/continuous-use combined pill); (6) contraceptive patch; (7) vaginal contraceptive ring; (8) diaphragm with spermicide; (9) sponge with spermicide; (10) cervical cap with spermicide; (11) male condom; (12) female condom; (13) male partner with a vasectomy. Abstinence from sexual intercourse is also an effective method of birth control.

EXCLUSION CRITERIA:

-risk of alcohol withdrawal, as determined by any of the following: a score greater than or equal to 8 on the Clinical Institute Withdrawal Assessment for Alcohol, Revised (CIWA-Ar) following a negative breath test for alcohol (i.e., BAC of 0.0), lifetime history of delirium tremens or seizures (related to alcohol or not), endorsement of a drinking to avoid withdrawal symptom on the SCID or M.I.N.I. (M.I.N.I. Section I, Alcohol Use Disorder, items k1 and/or k2 answered affirmatively with counselor s evaluation to verify that symptoms indicated in item k1 are related to the individual s cutting down on drinking and/or the response to item k2 refers to

withdrawal symptoms and not hangover);or physician s judgment.

  • currently trying to quit drinking, or planning to quit or reduce alcohol drinking via formal treatment or support-group attendance in the next six months;
  • for women: pregnancy, breastfeeding, or planning to become pregnant during the experiment;
  • current liver disease or dysfunction, assessed by physical examination and medical history; and hepatitis C, chronic hepatitis B, or other current liver disease or dysfunction as assessed by physical examination and medical history or as reflected in blood levels more than 5 times the upper limit of normal in any of the following: aspartate transaminase (AST), alanine transaminase (ALT), or gamma-glutamyltransferase (GGT)
  • any other medical illness or condition that in the judgment of the investigators is incompatible with alcohol consumption;
  • current use of prescription or over-the-counter medications or herbal products for which drinking alcohol is strictly prohibited. When the metabolic half-life of the medication/product is known, we will require at least 7 half-lives to have elapsed before any session involving alcohol consumption. If the half-life is not known (as might be the case for some herbal preparations), we will require at least 7 days to have elapsed since the last use before any session involving alcohol consumption;
  • substance-use disorder for any drug(s) other than alcohol or nicotine in the previous 12 months;
  • past or present diagnosis of bipolar disorder or any psychotic disorder; any history of suicide attempt or current suicidal ideation; present diagnosis of uncontrolled or untreated mood or anxiety disorder;
  • cognitive impairment severe enough to preclude informed consent or valid self-report

Sites / Locations

  • National Institute on Drug AbuseRecruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Active Comparator

Active Comparator

Arm Label

1

2

3

Arm Description

alcohol retrieval / alcohol extinction

soft-drink retrieval / alcohol extinction

alcohol retrieval / soft-drink extinction

Outcomes

Primary Outcome Measures

Self-reported alcohol craving in the laboratory sessions before and after the retrieval-extinction procedure, and GMA reports of alcohol craving and drinking in daily life.
The co-primary outcome measures are: self-reported alcohol craving in the laboratory sessions before and after retrieval-extinction, and GMA reports of alcohol craving and drinking.

Secondary Outcome Measures

(1) self-reported alcohol craving and drinking at the 30-day follow-up, (2) physiological reactivity during laboratory sessions, and (3) biomarkers for alcohol consumption detected in urine samples collected during laboratory sessions.
(1) self-reported alcohol craving and drinking at 30-day follow-up, (2) physiological reactivity during sessions, and (3) urine biomarkers for alcohol consumption.

Full Information

First Posted
July 9, 2016
Last Updated
October 20, 2023
Sponsor
National Institute on Drug Abuse (NIDA)
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1. Study Identification

Unique Protocol Identification Number
NCT02831049
Brief Title
Effects of a New Behavioral Intervention on Alcohol Craving and Drinking
Official Title
Effects of a New Behavioral Intervention on Alcohol Craving and Drinking
Study Type
Interventional

2. Study Status

Record Verification Date
September 22, 2023
Overall Recruitment Status
Recruiting
Study Start Date
May 5, 2017 (Actual)
Primary Completion Date
December 31, 2025 (Anticipated)
Study Completion Date
February 1, 2026 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
National Institute on Drug Abuse (NIDA)

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
Background: Sights, sounds, and smells can be associated with alcohol and tempt people to drink. The connection between encountering cues and wanting to drink might be reduced by behavioral techniques, like giving the cues at certain times, in certain circumstances. Objective: To see if visual imagery and behavioral techniques can reduce alcohol craving and drinking. Eligibility: Healthy people ages 21 65 who are mildly concerned about their drinking and have had these habits in the past 3 months: Women: More than 3 drinks any single day and more than 7 drinks per week Men: More than 4 drinks any single day and more than 14 drinks per week Design: Participants will be screened with medical history, physical exam, blood tests, alcohol breath tests, hepatitis tests, and alcohol and drug use questionnaires. Participants will get a smartphone to carry throughout the study. They will use it to report on their drinking, moods, and activities daily. The phone s GPS will record their locations throughout each day. There will be 6 study visits over 4 weeks. Visits will last up to 4 hours, but the final visit lasts up to 7 hours. Visits include the following: Not drinking alcohol or using illicit or over-the-counter drugs at least 24 hours before each visit Providing urine and breath samples. Exposure to various cues. Participants reactions will be monitored by measuring heart rate, blood pressure, and skin temperature. Drinking alcohol or soft drinks. For visits with alcohol, transportation to and from the visit will be provided. About a month after the last visit, participants will be called to ask about their drinking and cravings.
Detailed Description
Objective: To evaluate alcohol memory retrieval-extinction, a novel behavioral procedure for reduction of craving and drinking, in problem drinkers. Study population: We will collect evaluable data from up to 75 participants. Participants are evaluable if they complete geographical momentary assessment (GMA, described below). All participants will be adult alcohol drinkers (men: > 14 drinks/week or > 4 drinks/day; women: > 7 drinks/week or > 3 drinks/day) whose drinking scores as hazardous on the Alcohol Use Disorders Identification Test. Participants will not be seeking treatment for an alcohol-use disorder, be physiologically dependent on alcohol, or have other drug use disorders. Design: A randomized study with three groups. Participants will use smartphones to provide geotagged reports of alcohol craving and drinking in daily life (GMA reports) before, between, and after a series of laboratory sessions. During sessions, participants will drink an alcoholic beverage (individualized to produce a 0.06 g/dL blood alcohol content) or a soft drink. Participants will then be repeatedly presented with alcohol- or soft-drink-associated cues without further drinking. These are the memory retrieval and extinction portions, respectively, of memory retrieval-extinction. Previous studies suggest this procedure can robustly reduce Pavlovian associations between cues and responses such as craving. The mechanism seems to involve memory reconsolidation, in which freshly retrieved associations (e.g., drink cues and consumption - pleasant effects ) become more vulnerable to disruption by extinction. Three groups will be tested: (1) alcohol retrieval / alcohol extinction will be compared to (2) soft-drink retrieval / alcohol extinction and (3) alcohol retrieval / soft-drink extinction. Before and after retrieval-extinction, participants will be tested for alcohol craving and cue-induced physiological responses in laboratory sessions. Retrieval-extinction will be followed by 1 week of follow-up GMA reporting, with telephone contact 30 days thereafter. Outcome parameters: The co-primary outcome measures are: self-reported alcohol craving in the laboratory sessions before and after retrieval-extinction, and GMA reports of alcohol craving and drinking. Daily-life responses are important because the version of retrieval-extinction we will be using, with retrieval induced by drinking alcohol itself, rather than alcohol cues alone, may be especially likely to have effects that generalize from the laboratory to daily life. Secondary outcome measures are: (1) self-reported alcohol craving and drinking at 30-day follow-up, (2) physiological reactivity during sessions, and (3) urine biomarkers for alcohol consumption.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Alcohol Drinking, Alcohol Drinking Related Problems
Keywords
Reconsolidation

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
Participant
Allocation
Randomized
Enrollment
100 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
1
Arm Type
Experimental
Arm Description
alcohol retrieval / alcohol extinction
Arm Title
2
Arm Type
Active Comparator
Arm Description
soft-drink retrieval / alcohol extinction
Arm Title
3
Arm Type
Active Comparator
Arm Description
alcohol retrieval / soft-drink extinction
Intervention Type
Behavioral
Intervention Name(s)
Retrieval-extinction
Intervention Description
Retrieval-extinction
Intervention Type
Behavioral
Intervention Name(s)
Extinction
Intervention Description
extinction
Intervention Type
Behavioral
Intervention Name(s)
Retrieval
Intervention Description
Retrieval
Primary Outcome Measure Information:
Title
Self-reported alcohol craving in the laboratory sessions before and after the retrieval-extinction procedure, and GMA reports of alcohol craving and drinking in daily life.
Description
The co-primary outcome measures are: self-reported alcohol craving in the laboratory sessions before and after retrieval-extinction, and GMA reports of alcohol craving and drinking.
Time Frame
Before and after retrieval-extinction
Secondary Outcome Measure Information:
Title
(1) self-reported alcohol craving and drinking at the 30-day follow-up, (2) physiological reactivity during laboratory sessions, and (3) biomarkers for alcohol consumption detected in urine samples collected during laboratory sessions.
Description
(1) self-reported alcohol craving and drinking at 30-day follow-up, (2) physiological reactivity during sessions, and (3) urine biomarkers for alcohol consumption.
Time Frame
1 week of follow-up GMA reporting, with telephone contact 30 days thereafter.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
21 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
INCLUSION CRITERIA: age between 21 and 65 years inclusive; Drinking at high levels for at least 10 different weeks during the last 90 days. High-level drinking for a given week can be either of the following:: --For women, more than 3 drinks on any single day that week, or more than 7 drinks that week; For men, more than 4 drinks on any single day that week, or more than 14 drinks that week; a score greater than or equal to 8 and less than or equal to 15 on the self-report version of the Alcohol Use Disorders Identification Test (AUDIT), with endorsement of at least one item other than 1-3, because 1-3 assess only consumption, not concern or consequences; self-report of liking or having neutral feelings about the sight and smell of alcoholic beverages; for women, practicing an effective method of birth control before entry and throughout the study (or postmenopausal for at least one year, or surgically sterile); negative urine pregnancy test at each visit. Effective methods of birth control are those approved by the Food and Drug Administration (FDA) used as described in the FDA Birth Control Guide These methods are: (1) intrauterine device (IUD) copper; (2) IUD with progestin; (3) implantable rod; (4) contraceptive shot/injection; (5) oral contraceptives (combined pill, progestin-only pill, or extended/continuous-use combined pill); (6) contraceptive patch; (7) vaginal contraceptive ring; (8) diaphragm with spermicide; (9) sponge with spermicide; (10) cervical cap with spermicide; (11) male condom; (12) female condom; (13) male partner with a vasectomy. Abstinence from sexual intercourse is also an effective method of birth control. EXCLUSION CRITERIA: -risk of alcohol withdrawal, as determined by any of the following: a score greater than or equal to 8 on the Clinical Institute Withdrawal Assessment for Alcohol, Revised (CIWA-Ar) following a negative breath test for alcohol (i.e., BAC of 0.0), lifetime history of delirium tremens or seizures (related to alcohol or not), endorsement of a drinking to avoid withdrawal symptom on the SCID or M.I.N.I. (M.I.N.I. Section I, Alcohol Use Disorder, items k1 and/or k2 answered affirmatively with counselor s evaluation to verify that symptoms indicated in item k1 are related to the individual s cutting down on drinking and/or the response to item k2 refers to withdrawal symptoms and not hangover);or physician s judgment. currently trying to quit drinking, or planning to quit or reduce alcohol drinking via formal treatment or support-group attendance in the next six months; for women: pregnancy, breastfeeding, or planning to become pregnant during the experiment; current liver disease or dysfunction, assessed by physical examination and medical history; and hepatitis C, chronic hepatitis B, or other current liver disease or dysfunction as assessed by physical examination and medical history or as reflected in blood levels more than 5 times the upper limit of normal in any of the following: aspartate transaminase (AST), alanine transaminase (ALT), or gamma-glutamyltransferase (GGT) any other medical illness or condition that in the judgment of the investigators is incompatible with alcohol consumption; current use of prescription or over-the-counter medications or herbal products for which drinking alcohol is strictly prohibited. When the metabolic half-life of the medication/product is known, we will require at least 7 half-lives to have elapsed before any session involving alcohol consumption. If the half-life is not known (as might be the case for some herbal preparations), we will require at least 7 days to have elapsed since the last use before any session involving alcohol consumption; substance-use disorder for any drug(s) other than alcohol or nicotine in the previous 12 months; past or present diagnosis of bipolar disorder or any psychotic disorder; any history of suicide attempt or current suicidal ideation; present diagnosis of uncontrolled or untreated mood or anxiety disorder; cognitive impairment severe enough to preclude informed consent or valid self-report
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
NIDA IRP Screening Team
Phone
(800) 535-8254
Email
researchstudies@nida.nih.gov
First Name & Middle Initial & Last Name or Official Title & Degree
David H Epstein, Ph.D.
Phone
(443) 740-2328
Email
depstein@intra.nida.nih.gov
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
David H Epstein, Ph.D.
Organizational Affiliation
National Institute on Drug Abuse (NIDA)
Official's Role
Principal Investigator
Facility Information:
Facility Name
National Institute on Drug Abuse
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21224
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Shannon Pfistner
Phone
443-740-2283
Email
pfistners@mail.nih.gov

12. IPD Sharing Statement

Plan to Share IPD
No

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Effects of a New Behavioral Intervention on Alcohol Craving and Drinking

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