This is a proposal to renew and to expand an existing drug abuse treatment research Center that focuses on the human behavioral pharmacology of addiction treatment. The Center will emphasize two themes: The first is evaluation of the soon-to-be-FDA-approved opioid maintenance pharmacotherapy LAAM (1-alpha-acetyl-methadol), which has been under development for several decades. Research on this theme will provide important human laboratory data and controlled outpatient clinical trial data concerning how and when to use this newly-available treatment medication most effectively. The second theme is assessment of psychiatric comorbidity and of the relationship to treatment response of these individual differences in patient characteristics. Research on this theme will identify important individual-difference modulators of treatment response and will aid in the pursuit of strategies for optimal patient- treatment matching. The Center consists of four components. The Core component provides essential central shared resources to all components; these include psychiatric assessment, computer, statistical, subject recruiting, pharmacy, urinalysis, secretarial, and administrative support services. Psychiatric assessments will permit stratification of clinical trials according to presence/absence of antisocial personality disorder, so that potential differential response of this important subgroup may be examined. The Human Laboratory component will conduct rigorously controlled, double blind, dose-response studies of LAAM's effects and of procedures for optimizing induction onto LAAM treatment The BPRU Research Clinic component will conduct rigorously controlled outpatient clinical trials of LAAM's dose-response relation and of its treatment efficacy in comparison to other available treatment medications (methadone and buprenorphine). The SEBDTP Treatment Clinic component will conduct, in a community treatment clinic, randomized clinical trials of the structured non-pharmacological treatments that accompany methadone and LAAM pharmacotherapy. These studies will provide critical data to guide practitioners in the successful incorporation of LAAM into routine clinical treatment of opioid drug abuse and in the appropriate recognition and treatment of drug abusers with antisocial personality disorder. Effective LAAM treatment and effective behavioral treatment adjuncts should contribute to reduction of HIV infection and AIDS.
Showing the most recent 10 out of 44 publications
