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Medication Development for Opioid and Alcohol Abuse

Primary Purpose

Opioid-use Disorder, Alcohol Use Disorder

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Gabapentin
Sponsored by
New York State Psychiatric Institute
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional basic science trial for Opioid-use Disorder

Eligibility Criteria

21 Years - 59 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. DSM-5 criteria for moderate-severe opioid use disorder with physical dependence.
  2. DSM-5 criteria for moderate-severe alcohol use disorder without physical dependence.
  3. No current major mood, psychotic, or anxiety disorder.
  4. Physically healthy.
  5. Able to perform study procedures.
  6. 21-59 years of age.
  7. Normal body weight/Within 20% of body weight (for appropriate frame) according to 1983 Metropolitan Weight tables.
  8. Current or history of illicit opioid use.
  9. Current use of opioids in amounts and/or frequencies that meet or exceed those used in the proposed study (e.g., 3-4 tablets of a Rx opioid medication per day or 1-2 bags of heroin per day). Not seeking treatment for opioid use disorder (neutral attitude or not wanting treatment only).
  10. Participants will consume alcohol at least 3 times per week (15 drinks per week for men and 8 drinks per week for women). In addition, they will drink alcohol and use opioids simultaneously.

Exclusion Criteria:

  1. DSM-5 criteria for substance use disorder (moderate to severe) on drugs other than opioids, alcohol, nicotine or caffeine (must be less than 500 mg caffeine daily).
  2. Participants requesting treatment.
  3. Pregnancy or lactation.
  4. Current or recent history of significant violent or suicidal behavior and/or suicidal/homicidal risk.
  5. Cannot read or understand the self-report assessment forms unaided, or are so severely disabled that they cannot comply with the requirements of the study.
  6. Elevated liver function tests (i.e., AST and ALT > 3 times the upper limit of normal) or impaired renal function (creatinine must be within normal limits).
  7. Physical disorders that might make participation hazardous such as AIDS, cancer, hypertension (blood pressure > 140/90), uncontrolled diabetes, pulmonary hypertension or heart disease (please note that participants will be asked about previous visits to a cardiologist, chest pain, or strong palpitations; if these exist, they will be referred to a cardiologist and excluded unless cleared for participation by a cardiologist).
  8. Current major Axis I psychopathology, other than OUD and AUD (e.g., mood disorder with functional impairment, schizophrenia), that might interfere with ability to participate in the study.
  9. Sensitivity, allergy, or contraindication to opioids, alcohol, gabapentin or similar medications.
  10. Taken an investigational drug within the past 30 days.
  11. Current or history of chronic pain within the past 3 months.
  12. Taking prescription psychotropic medications that would potentially interfere with study procedures.

Sites / Locations

  • New York State Psychiatric Institute in the Division on Substance Use Disorders

Arms of the Study

Arm 1

Arm 2

Arm Type

Placebo Comparator

Active Comparator

Arm Label

Gabapentin 0 mg

Gabapentin 1800 mg

Arm Description

once daily at 8am

once daily at 8am

Outcomes

Primary Outcome Measures

Peak Positive Subjective Responses to Placebo.
Self-reported "High" measured on a 0-100 self-report visual analog scale. 0= Not-At-All 100=Extremely
Peak Positive Subjective Responses to Oxycodone (30mg) + Low Alcohol Dose.
Self-reported "High" measured on a 0-100 self-report visual analog scale. 0= Not-At-All 100=Extremely
Peak Positive Subjective Responses to Oxycodone (30mg) + High Alcohol Dose.
Self-reported "High" measured on a 0-100 self-report visual analog scale. 0= Not-At-All 100=Extremely
Peak Positive Subjective Responses to Oxycodone (15mg) + High Alcohol Dose.
Self-reported "High" measured on a 0-100 self-report visual analog scale. 0= Not-At-All 100=Extremely
Peak Positive Subjective Responses to Oxycodone (15mg) + Low Alcohol Dose.
Self-reported "High" measured on a 0-100 self-report visual analog scale. 0= Not-At-All 100=Extremely
Peak Positive Subjective Responses to Low Alcohol Dose.
Self-reported "High" measured on a 0-100 self-report visual analog scale. 0= Not-At-All 100=Extremely
Peak Positive Subjective Responses to High Alcohol Dose.
Self-reported "High" measured on a 0-100 self-report visual analog scale. 0= Not-At-All 100=Extremely
Peak Positive Subjective Responses to Oxycodone (30mg)
Self-reported "High" measured on a 0-100 self-report visual analog scale. 0= Not-At-All 100=Extremely
Peak Positive Subjective Responses to Oxycodone (15mg)
Self-reported "High" measured on a 0-100 self-report visual analog scale. 0= Not-At-All 100=Extremely

Secondary Outcome Measures

Full Information

First Posted
March 8, 2017
Last Updated
September 29, 2022
Sponsor
New York State Psychiatric Institute
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1. Study Identification

Unique Protocol Identification Number
NCT03205423
Brief Title
Medication Development for Opioid and Alcohol Abuse
Official Title
Medication Development for Opioid and Alcohol Abuse: Laboratory Study in Humans
Study Type
Interventional

2. Study Status

Record Verification Date
September 2022
Overall Recruitment Status
Completed
Study Start Date
August 1, 2017 (Actual)
Primary Completion Date
June 30, 2021 (Actual)
Study Completion Date
December 30, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
New York State Psychiatric Institute

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
The present proposal will evaluate the ability of gabapentin maintenance to reduce the abuse liability of alcohol, oxycodone, and alcohol in combination with oxycodone in participants with both Opioid Use Disorder and Alcohol Use Disorder.
Detailed Description
Currently, the abuse of prescription opioid medications is a pervasive problem in the U.S. In addition, co-abuse of opioids and alcohol represents a significant problem from the perspective of increased toxicity and decreased success in treatment. Surprisingly few studies have examined the effects of combined administration of opioids and alcohol in humans, and no clinical studies have examined the reinforcing effects of this combination. The current 8-9-week inpatient study will systematically evaluate gabapentin because it shows promise for treating both opioid and alcohol use disorders (OUD and AUD). The guiding principle is that a medication's effects on positive subjective responses and reinforcing effects are the best laboratory procedures to date in predicting its clinical efficacy. We will examine the ability of gabapentin (0 mg or 1800 mg) to alter opioid-, alcohol-,and combined opioid/alcohol-mediated responses. Participants will meet DSM-5 criteria for moderate-severe OUD and be physically dependent on opioids. In addition, participants will meet DSM-5 criteria for moderate-severe AUD, but they will not be physically dependent on alcohol. All of the participants will be maintained on oral morphine throughout the study and different doses of gabapentin will be evaluated.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Opioid-use Disorder, Alcohol Use Disorder

7. Study Design

Primary Purpose
Basic Science
Study Phase
Phase 2
Interventional Study Model
Crossover Assignment
Model Description
Participants will be randomized to receive one of two treatment conditions: gabapentin 0 mg or gabapentin 1800 mg/day first. Participants crossover to the 2nd gabapentin condition following a washout period.
Masking
ParticipantOutcomes Assessor
Allocation
Randomized
Enrollment
17 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Gabapentin 0 mg
Arm Type
Placebo Comparator
Arm Description
once daily at 8am
Arm Title
Gabapentin 1800 mg
Arm Type
Active Comparator
Arm Description
once daily at 8am
Intervention Type
Drug
Intervention Name(s)
Gabapentin
Intervention Description
Maintenance medication under investigation for its ability to alter the subjective and reinforcing effects of experimenter-administered doses of oxycodone and alcohol.
Primary Outcome Measure Information:
Title
Peak Positive Subjective Responses to Placebo.
Description
Self-reported "High" measured on a 0-100 self-report visual analog scale. 0= Not-At-All 100=Extremely
Time Frame
Assessed every 15 minutes following drug administration,for a total of 360 minutes. "Peak" drug effect is the highest rating throughout the entire testing session.
Title
Peak Positive Subjective Responses to Oxycodone (30mg) + Low Alcohol Dose.
Description
Self-reported "High" measured on a 0-100 self-report visual analog scale. 0= Not-At-All 100=Extremely
Time Frame
Assessed every 15 minutes following drug administration, for a total of 360 minutes. "Peak" drug effect is the highest rating throughout the entire testing session.
Title
Peak Positive Subjective Responses to Oxycodone (30mg) + High Alcohol Dose.
Description
Self-reported "High" measured on a 0-100 self-report visual analog scale. 0= Not-At-All 100=Extremely
Time Frame
Assessed every 15 minutes following drug administration, for a total of 360 minutes. "Peak" drug effect is the highest rating throughout the entire testing session.
Title
Peak Positive Subjective Responses to Oxycodone (15mg) + High Alcohol Dose.
Description
Self-reported "High" measured on a 0-100 self-report visual analog scale. 0= Not-At-All 100=Extremely
Time Frame
Assessed every 15 minutes following drug administration, for a total of 360 minutes. "Peak" drug effect is the highest rating throughout the entire testing session.
Title
Peak Positive Subjective Responses to Oxycodone (15mg) + Low Alcohol Dose.
Description
Self-reported "High" measured on a 0-100 self-report visual analog scale. 0= Not-At-All 100=Extremely
Time Frame
Assessed every 15 minutes following drug administration, for a total of 360 minutes. "Peak" drug effect is the highest rating throughout the entire testing session.
Title
Peak Positive Subjective Responses to Low Alcohol Dose.
Description
Self-reported "High" measured on a 0-100 self-report visual analog scale. 0= Not-At-All 100=Extremely
Time Frame
Assessed every 15 minutes following drug administration, for a total of 360 minutes. "Peak" drug effect is the highest rating throughout the entire testing session.
Title
Peak Positive Subjective Responses to High Alcohol Dose.
Description
Self-reported "High" measured on a 0-100 self-report visual analog scale. 0= Not-At-All 100=Extremely
Time Frame
Assessed every 15 minutes following drug administration, for a total of 360 minutes. "Peak" drug effect is the highest rating throughout the entire testing session.
Title
Peak Positive Subjective Responses to Oxycodone (30mg)
Description
Self-reported "High" measured on a 0-100 self-report visual analog scale. 0= Not-At-All 100=Extremely
Time Frame
Assessed every 15 minutes following drug administration, for a total of 360 minutes. "Peak" drug effect is the highest rating throughout the entire testing session.
Title
Peak Positive Subjective Responses to Oxycodone (15mg)
Description
Self-reported "High" measured on a 0-100 self-report visual analog scale. 0= Not-At-All 100=Extremely
Time Frame
Assessed every 15 minutes following drug administration, for a total of 360 minutes. "Peak" drug effect is the highest rating throughout the entire testing session.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
21 Years
Maximum Age & Unit of Time
59 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: DSM-5 criteria for moderate-severe opioid use disorder with physical dependence. DSM-5 criteria for moderate-severe alcohol use disorder without physical dependence. No current major mood, psychotic, or anxiety disorder. Physically healthy. Able to perform study procedures. 21-59 years of age. Normal body weight/Within 20% of body weight (for appropriate frame) according to 1983 Metropolitan Weight tables. Current or history of illicit opioid use. Current use of opioids in amounts and/or frequencies that meet or exceed those used in the proposed study (e.g., 3-4 tablets of a Rx opioid medication per day or 1-2 bags of heroin per day). Not seeking treatment for opioid use disorder (neutral attitude or not wanting treatment only). Participants will consume alcohol at least 3 times per week (15 drinks per week for men and 8 drinks per week for women). In addition, they will drink alcohol and use opioids simultaneously. Exclusion Criteria: DSM-5 criteria for substance use disorder (moderate to severe) on drugs other than opioids, alcohol, nicotine or caffeine (must be less than 500 mg caffeine daily). Participants requesting treatment. Pregnancy or lactation. Current or recent history of significant violent or suicidal behavior and/or suicidal/homicidal risk. Cannot read or understand the self-report assessment forms unaided, or are so severely disabled that they cannot comply with the requirements of the study. Elevated liver function tests (i.e., AST and ALT > 3 times the upper limit of normal) or impaired renal function (creatinine must be within normal limits). Physical disorders that might make participation hazardous such as AIDS, cancer, hypertension (blood pressure > 140/90), uncontrolled diabetes, pulmonary hypertension or heart disease (please note that participants will be asked about previous visits to a cardiologist, chest pain, or strong palpitations; if these exist, they will be referred to a cardiologist and excluded unless cleared for participation by a cardiologist). Current major Axis I psychopathology, other than OUD and AUD (e.g., mood disorder with functional impairment, schizophrenia), that might interfere with ability to participate in the study. Sensitivity, allergy, or contraindication to opioids, alcohol, gabapentin or similar medications. Taken an investigational drug within the past 30 days. Current or history of chronic pain within the past 3 months. Taking prescription psychotropic medications that would potentially interfere with study procedures.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Sandra D. Comer, PhD.
Organizational Affiliation
New York State Psychiatric Institute / Columbia University Medical Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
New York State Psychiatric Institute in the Division on Substance Use Disorders
City
New York
State/Province
New York
ZIP/Postal Code
10032
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Medication Development for Opioid and Alcohol Abuse

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