This is a new proposal to establish a Treatment Research Unit with the capacity to treat and maintain a pool of 100 to 120 patients available for controlled clinical studies of treatment effectiveness to improve the treatment strategies for intravenous drug users, especially those of heroin and cocaine. The overall objective is to reduce the incidence of drug use and needle sharing in this group of patients, as well as to bring about changes in sexual and other behavior that places these patients at high risk for HIV infection. The eventual goal is to prevent the spread of AIDS and HIV infection through more effective treatment of intravenous drug users. Several studies are proposed: Studies of buprenorphine as a detoxification agent; an inpatient study of the ability of LAAM to prevent withdrawal symptoms; treatment of co-morbidity during methadone treatment This TRU has the potential to conduct early drug evaluation in a controlled inpatient unit and the experience to participate in or coordinate multi-center studies of importance to NIDA Each research project will be measured for its effect on the improved efficacy of treatment for addicts as a surrogate measure of its effectiveness in reducing HIV infection. Some projects, for instance those involving educating patients on the nature of HIV infection and its mode of transmission and danger of needle sharing and risky sexual behavior, etc., will be measured by comparing baseline practice to those of post treatment. The longterm goal of this unit is to establish an able staff and well run clinical unit which will continue to examine and define different treatment strategies as means of improving treatment thereby reducing the risk of HIV infection among addicts and their families into the next decade. The research results will be publicized both by means of communication to NIDA Project Officer and presentation at various scientific meetings and through formal publications in refereed journals.
