Cognitive Behavioral Stress Management for HIV+ Drug Abusers
HIV/AIDSDrug Abuse1 moreThe primary purpose of this 5-year study is to determine whether a Cognitive Behavioral Stress Management (CBSM) intervention, demonstrated to be effective in reducing distress, enhancing coping, and maintaining health among HIV+ non-drug abusers (see Schneiderman and Antoni, 2000), can be effectively adapted for our target population of culturally diverse, HIV+, low-income "Recovering Drug Abusers" (RDAs). Since the late 1980s, members of our research team (i.e., Schneiderman, Antoni, Klimas, Fletcher) have been developing, refining and evaluating the effects of CBSM among HIV+ Men who have Sex with Men (MSM). In the early/mid 90s, we began to adapt and evaluate the effects of CBSM in other non-drug abusing subgroups that were emerging with increasing levels of HIV seroprevalence (e.g., pregnant women, African American and Hispanic men and women). After accumulating considerable support for the effectiveness of CBSM in these subgroups in the late 90s, our research team (i.e., Malow, Schneiderman, Antoni, Klimas, Page) turned its attention to developing the CBSM for one of the most neglected and understudied populations affected by the HIV/AIDS epidemic in this country: "inner city" minority drug abusers. With supplemental funding on two NIH grants to conduct formative stage1 pilot research, our project team has been able to develop and document the feasibility and potential promise of the CBSM approach adapted/translated for RDAs (CBSM-RDA). This application proposes to take the next logical step in continuing this work: conducting a 3, 6, 8, 10, and 12 month follow-up outcome study comparing CBSM-RDA with a matched attention, time and interest value Health Promotion Comparison (HPC) condition, in 225 male and 225 female HIV+ RDAs with respect to key biopsychosocial health endpoints: distress (i.e., depressive symptoms, and mood state), quality of life, drug abuse relapse, unsafe sex, Combination Antiretroviral Therapy (CART) medication adherence and health status indicators (e.g., Viral Load, CD4 count, physical symptoms).
Contingency Management Treatment Duration
Alcohol Abuse310 alcohol abusing or dependent patients beginning intensive outpatient day treatment at community-based clinics will be randomly assigned to one of four conditions: (a) standard treatment as usual (ST) at the clinic without contingency management (CM); (b) standard treatment with contingency management for 12 weeks with a 0.5 probability of winning prizes for each negative sample submitted; (c) standard treatment with contingency management for 24 weeks with a 0.34 probability of winning prizes for each negative sample submitted; or (d) standard treatment with contingency management for 24 weeks with a 0.5 probability of winning prizes for each negative sample submitted. We expect that contingency management will decrease alcohol use to a greater extent than non-contingency management treatment, and that availability of contingency management for 24 weeks may result in longer term benefits than 12 week exposure to contingency management. This study will be the first to evaluate the effects of probability of winning prizes on response to contingency management.
VIVITROL as a Treatment for Cocaine and Alcohol Dependence
Cocaine DependenceAlcohol DependenceTo evaluate the efficacy of VIVITROL (naltrexone for extended-release injectable suspension) for the treatment of co-occurring cocaine and alcohol dependence
ALK29-002: A Study of Baclofen Formulations in Healthy Adults
Alcohol DependenceThe purpose of this study is to determine the pharmacokinetics, safety, and tolerability of different baclofen formulations.
Genetic and Brain Mechanisms of Naltrexone's Treatment Efficacy for Alcoholism
Alcohol DependenceThe overarching aim of this trial is to evaluate naltrexone's efficacy in light of genetic variation and brain response to alcohol cues utilizing a neuroimaging paradigm. This trial has four specific aims. First, this trial will evaluate whether the presence of the OPRM1 Asp40 allele substitution is associated with improved treatment response to naltrexone in treatment-seeking alcoholics. Second, it will evaluate whether there is a difference in the naltrexone dampening of the alcohol cue-induced brain activation dependent on OPRM1 genotype. Third, it will explore whether alcohol cue-induced brain activation dampening by naltrexone might be a mediating factor in the treatment effects of naltrexone, the OPRM1 gene, or their interaction that might be observed in the first aim. Finally, this trial will evaluate the effect of medication compliance, or adverse effects, on the observed medication by genotype treatment response. A secondary aim will measure medication compliance and side effects based on OPRM1 genotype.
Gabapentin for Abstinence Initiation in Alcohol Dependence
Alcohol DependencePrimary Hypotheses: 1. Gabapentin will significantly reduce alcohol consumption and promote abstinence as compared to placebo. The primary outcome measure will be the number of the heavy drinking days (defined as any day where the number of standard drinks was at least 5 for men and at least 4 for women) per week as measured by the timeline follow-back method. Secondary Hypotheses: 1. Gabapentin will be superior to placebo in reducing alcohol use as measured by percent days abstinent.
Human Behavioral Pharmacology Laboratory (HBPL) Study of Varenicline's Impact on Cocaine and Alcohol...
Alcohol DependenceCocaine DependenceThis is a Phase II within-subjects double-blind placebo-controlled human laboratory study. The purpose of the study is to determine the efficacy of varenicline (Chantix) for reducing cue-induced cocaine and alcohol craving.
CRAFT Behavior Therapy: Treatment Entry Component
Drug AddictionStimulant Dependence3 moreThis research compares the benefits of the original treatment, Community Reinforcement and Family Training (CRAFT), with the Treatment Entry Training (TEnT) component of CRAFT to determine if TEnt alone can produce the primary outcome of CRAFT -- treatment entry of the drug user. We also look at the impact on the well-being of the concerned significant other and the drug use of their loved one.
Varenicline (Chantix™) for the Treatment of Alcohol Dependence
AlcoholismThe purpose of this study is to determine the efficacy of varenicline (Chantix™) for the treatment of alcohol dependence.
Modification of Cognitive Processing Therapy (CPT-C) for PTSD and Alcohol Dependence
Alcohol DependencePTSDObjective: To develop a detailed treatment manual that modifies the existing CPT-C treatment protocol to allow for concurrent treatment of PTSD and AD, and to obtain some pilot data regarding its efficacy. Hypothesis: We predict that CPT-C will significantly reduce the number of drinking days (measured by the Timeline Follow Back Method [TLFB]) and reduce the symptoms of PTSD (measured by the [CAPS and PCL] scores). Design: This is a non-randomized, prospective study in which all participants will receive the modified CPT-C for 12 weeks by trained CPT-C clinicians, with each session lasting approximately 1-1.5 hours). Modifications to CPT-C include psychoeducation about alcohol use as an avoidance of PTSD symptoms integrated throughout treatment, integration of coping skills training for AD, weekly breathalyzer tests to measure blood alcohol level, and use and collection of daily dairies of alcohol use.