Mobile Medication Adherence Platform for Buprenorphine-Naloxone During Treatment of Opioid Use Disorder:...
Opioid-use DisorderThe investigators will conduct a phase I study involving 41 participants selected randomly among patients prescribed buprenorphine-naloxone for opioid misuse as a feasibility trial of the study of the Pillsy device. The study will track the effectiveness of the Pillsy technology and associated smartphone application by measuring adherence to buprenorphine-naloxone therapy and patient satisfaction with the application and the Pillsy device.
Effects of Buprenorphine/Naloxone Dose on Experimental Stress Reactivity and Opioid Abstinence
Heroin DependenceOpioid Use DisorderThis research deals with behaviors that are part of opioid dependence. The purpose is to study how stress and medication dose can affect opioid drug use.
Expanded HIV Care in Opioid Substitution Treatment (EHOST) Trial
Opioid Use DisorderHIVOpioid Substitution Treatment (OST) provides a critical opportunity for HIV testing and linkage to antiretroviral treatment. The EHOST study will evaluate a prescriber-focused intervention to increase HIV testing rates, and optimize antiretroviral treatment, re-engagement and retention outcomes among individuals engaged in OST. 46 OST sites in British Columbia will be randomly allocated into three clusters. Clusters will initiative the intervention at different time points, or steps, with every cluster receiving the intervention.
Electronic Compliance Monitoring in Opioid Substitution Treatment
Opiate DependenceThe purpose of this study is to improve unsupervised dosing of opioid substitution medications. The aim of the study is to examine whether electronic compliance monitoring provides some advantages to patients'treatment and what kind of patients especially benefit from monitoring. We would also like to know if electronic compliance monitoring can prevent the abuse/diversion of medications and how implementing this method to wider treatment facilities succeeds.
Medication-Assisted Treatment Implementation in Community Correctional Environments (MATICCE)
Opioid-Related DisordersAlcohol-Related DisordersThe goal of this study is to see whether or not a strategic planning process is able to introduce and sustain improvements in the working relationship between probation/parole departments and community-based addiction treatment agencies that provide medication assisted therapy (MAT) for individuals with opioid or alcohol dependence. In addition, this study seeks to improve probation/parole agency personnel's knowledge and perceptions about MAT, and increase the number of appropriate referrals to community treatment agencies that provide MAT. There are three phases to this study. Phase 1 includes a pilot study to determine the quality and availability of client level records and the collection of baseline data (the pilot study protocol was previously submitted to TMH IRB). Phase 2 will consist of a Knowledge, Perceptions and Information (KPI) intervention during which probation/parole agencies will undergo training to increase knowledge about the effectiveness of MAT, and complete a post training assessment to evaluate the effectiveness of the KPI intervention. During Phase 3, probation/parole agencies will be randomly assigned to a 12-month Organizational Linkage Intervention (OLI) condition or to control (no further intervention). Agencies assigned to the OLI will establish a Pharmacotherapy Exchange Council (PEC) that consists of staff from both the probation/parole and community treatment agencies. The PEC will undergo a strategic planning process to increase the availability of MAT for opiate and/or alcohol dependent individuals who are on probation/parole.
Navigation Services to Avoid Rehospitalization (NavSTAR)
Opioid-use DisorderCocaine Use Disorder1 moreThis study will examine the clinical effectiveness and health economic profile of services to link hospital patients with substance use disorders to addiction treatment, promote their medical stabilization, and reduce hospital re-admissions.
The Effects of Minocycline in Opioid-maintained Patients
Opioid DependencePainOpioids are the most commonly utilized pharmacological treatment for moderate to severe pain. However, their clinical value is hindered by the development of opioid-induced hyperalgesia (OIH). OIH manifests as heightened pain sensitivity, and is an increasingly challenging drawback to the efficacy of opioid treatment. Although the mechanism of action modulating OIH is not completely understood, previous animal studies suggest that this phenomenon is a result of proinflammatory responses. Thus, administering an adjunct anti-inflammatory agent may attenuate OIH. Minocycline is one such agent; it is a tetracycline derivative antibiotic that inhibits microglia activation, nitric oxide (NO) production, and the release of pro-inflammatory cytokines and chemokines. In fact, recent evidence suggests that minocycline may attenuate the neuroinflammatory effects of opioids while enhancing their antinociceptive effects. Therefore, the investigators will determine if minocycline will mitigate OIH in methadone-maintained patients.
A Clinical Study To Characterize The Pharmacokinetics And The Effects Of Food On Oxycodone In Healthy...
AnalgesiaAcute Pain3 moreThis is an open-label (both the physician and healthy volunteer know which medication will be administered), single-dose, 5-dosing period study to characterize the pharmacokinetics (process by which oxycodone is absorbed, distributed, metabolized, and eliminated by the body) and the effects of food on the pharmacokinetics of oxycodone. The study will take place over approximately two and a half months and will consist of three phases: a screening visit to determine eligibility for the study, a 5-dosing period treatment phase, and an end-of-study visit.
Sevoflurane vs Nitrous Oxide Inhalation at Subanesthetic Concentrations - 11
Opioid-Related DisordersSubstance-Related DisordersThe purpose of this study is to conduct experiments to examine subjective and reinforcing effects of nitrous oxide. Mood altering and psychomotor effects will be tested on non-drug abusers and preference procedures will be used to assess reinforcing effects. Comparisons between nitrous oxide, opiates, and benzodiazepine antagonists will be made. To examine sevoflurane versus isoflurane inhalation at subanesthetic concentrations on mood, pain, and psychomotor performance.
The Effectiveness of Deep Brain Stimulation for Opioid Relapse Prevention
Opiate AddictionThe nucleus accumbens (NAcc) has a significant role in the process of opiate addiction and the initiation of relapse after detoxification. There is evidence that deep brain stimulation (DBS) of the NAcc exerts a positive effect on individuals with severe heroin addiction via inhibitory action . The investigators hypothesise that bilateral stimulation of the NAcc will significantly reduce withdrawal symptoms and thus enable the patients to substantially decrease their Levomethadone usage.