First two weeks critical for success in meth treatment

A new UCLA SARx study was published highlighting the critical importance of the first two weeks of treatment for methamphetamine dependence. The study looked at success (still in treatment and a urine test negative for methamphetamine) at the end of 12 weeks of treatment and whether you could predict success in treatment from the patient's performance in the first two weeks. Patients visited the clinic three times a week during treatment to provide a urine drug screen. Patients who were unable to provide at least three methamphetamine negative urine tests (of the six possible) during the first two weeks had a 90% chance of treatment failure at the end of 12 weeks.

New treatments that can achieve results more quickly are clearly needed and will be the topic of future research for UCLA SARx! The abstract of the paper is below. The study was published in the journal Drug and Alcohol Dependence.

A retrospective analysis of two randomized trials of bupropion for methamphetamine dependence: Suggested guidelines for treatment discontinuation/augmentation. 

Brensilver M, Heinzerling KG, Swanson AN, Shoptaw SJ.
Department of Family Medicine, David Geffen School of Medicine at UCLA, CA 90095, USA.

BACKGROUND: Two clinical trials have shown efficacy for bupropion in treating methamphetamine (MA) dependence among those with moderate baseline MA use. However, treatment response is highly variable and it is unclear what duration of treatment is necessary to determine if maintaining the treatment course is indicated or if discontinuation or augmentation is appropriate. The present study assessed the relationship among early bupropion treatment response for moderate MA users and end-of-treatment (EOT) abstinence. These data provide estimates of the duration of treatment and the degree of responsiveness required to persist in bupropion treatment.

METHODS: Participants with moderate baseline MA use in the bupropion condition of two randomized double-blind placebo controlled trials were included. The relationship between early treatment response and EOT outcomes was assessed with Receiver Operating Characteristic (ROC) curves.

RESULTS: With thrice weekly urine drug testing, excellent predictive power was established in the first two weeks of treatment. The inability to achieve at least three MA negative samples in the first two weeks is associated with greater than 90% likelihood of treatment failure. More closely approximating clinical settings, once-weekly testing featured reliable predictive power within three weeks, suggesting that the failure to produce at least two clean samples in the first three weekly visits confers high risk of treatment failure.

DISCUSSION: The findings provide preliminary evidence to guide clinical decisions for moderate MA users receiving bupropion. The results are consistent with data from the smoking cessation literature and may highlight the importance of early response in addiction treatment.

Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

New UCLA Meth Study now recruiting

We have a new meth treaatment study that is now recruiting participants who want to quit meth. We are studying the smoking cessation medication Chantix (varenicline). Chantix can help a person quit smoking cigarettes by partially blocking the brain nicotine system and also providing a gentle boost to the brain's dopamine system. We believe that this may also help in patients trying to quit meth. Initial studies suggest varenicline may help with other addictions including cocaine and alcohol. We've done the initial safety testing for meth at UCLA and the current study is designed to provide the first information as to whether Chantix works for meth addiction. Click here for more info about the current meth study.

Baseline Findings from the HPTN 061 BROTHERS Project: Participant Characteristics

The Los Angeles HIV Research & Community Colloquia Series, hosted by UCLA Center for HIV Identification, Prevention, and Treatment Services (CHIPTS) and the Los Angeles County HIV Prevention Planning Committee (PPC), invites you to attend:

Baseline Findings from the HPTN 061 BROTHERS Project: Participant Characteristics

PRESENTERS:    

Dr. Steven Shoptaw, Professor and Vice Chair Academic Affairs, Dept of Family Medicine

Dr. John K. Williams, Assistant Professor and Associate Director of UCLA Sexual Health Program  UCLA-Semel Institute for Neuroscience & Human Behavior

Date/Time:  Thursday, May 3, 2012, 12:00pm - 1:00pm

Location:             

St. Anne's Maternity Home - Foundation Conference Room

155 N. Occidental Blvd.

Los Angeles, CA 90026

ABSTRACT

Black men who have sex with men (BMSM) in the United States have disproportionately high rates of HIV prevalence and infection (CDC, 2010).  The HIV Prevention Trials Network HPTN 061 BROTHERS Project was a community-level feasibility study of a multi-component intervention for BMSM in 6 U.S. cities.  The UCLA Vine Street Clinic site enrolled 284 Black MSMW for 1 year, of which 257 were eligible for baseline data collection and two 6-month follow-up visits including HIV/STI risk reduction counseling, testing and ACASI collection.  Findings from baseline regarding reported experiences with childhood sexual abuse (CSA), with sexual risk behaviors, with symptoms of depression, and with intimate partner violence (IPV) will be presented for BMSM and for BMSM who also have sex with women.

ABOUT THE PRESENTERS

Dr. Steven Shoptaw is a full professor in two departments at UCLA: Family Medicine and Psychiatry. Steve’s main research interests involve the identification and evaluation of medical and behavioral treatments for drug dependence, particularly for individuals who encounter HIV transmission associated with their drug use. He is the Principal Investigator of projects funded by the National Institute on Drug Abuse to develop new medications for treating methamphetamine abuse. Dr. Shoptaw also volunteers as the Executive Director for Safe House, a high-tolerance residential facility he started for persons living with HIV/AIDS, mental illness and/or chemical dependency, who are homeless or at risk for homelessness. Dr Shoptaw is the Director of the UCLA Center for Behavioral and Addiction Medicine and the UCLA Substance Abuse Pharmacotherapy Unit (UCLA SARx).

Dr. Williams has been conducting cutting-edge quality HIV biobehavioral research since 1999.  In addition to his training in cross cultural psychiatry, he has completed a 2-year National Institute of Mental Health (NIMH)-funded Post Doctoral Fellowship and was in the first cohort of trainees for the Centers for Disease Control and Prevention (CDC) Minority AIDS Research Initiative (MARI) training program.  Dr. Williams has also participated in the National Institutes of Health (NIH) African American Mental Health Research Scientists (AAMHRS) training program.  Through these opportunities, he have been able to increase his knowledge and hone his research skills in culturally congruent biobehavioral HIV interventions for African American men who have sex with men (MSM) and African American women with a focus on sexual abuse and trauma and mental health disparities.  As an HIV interventionist, his research explores psychological and socio-cultural factors that affect positive behavior change, as well as historical barriers and challenges for ethnic and sexual minorities. 

Meth Treatment Study Looking for Patients NOW

Just a reminder that if you want help for a meth problem, want to quit or even just cut down, you may be able to receive treatment in one of our clinical trials. For more info check out the study details by clicking HERE or just call us at 866-449-UCLA.

Meth Use Frequency Higher in Women and May be Related to BDNF Gene

A new study from UCLA SARx scientists was published in the journal Gender Medicine examining frequency of methamphetamine use among treatment-seeking men versus women with methamphetamine dependence. Meth use frequency was significantly higher in women than men, mirroring previous research in both animals and humans showing that response to psychostimulants including cocaine and methamphetamine differ by sex. In particular, the highest frequency of methamphetamine use was among women with a variant of the gene for brain-derived neurotrophic factor (BDNF), which plays an important role in the survival and functioning of dopaminergic neurons in the brain. Although the results are preliminary, they suggest that women with methamphetamine dependence may be more severely dependent than men and that interactions between BDNF and sex, possibly estrogen which is also known to be a neuroprotectant, may play a role in these differences. Additional studies are needed to confirm these results and to understand how they may be used to develop personalized treatments for methamphetamine dependent men and women.

Cocaine and amphetamine positive tests increase in the workplace.

Dr. Shoptaw of UCLA SARx was quoted in the Orange County Register regarding updated results from a recent study of workplace drug testing in "safety sensitive" jobs.

On October 1, 2010, the U.S. Department of Transportation (DOT) harmonized with the U.S. Department of Health and Human Services (DHHS) decision to institute lower initial and confirmation cutoff levels for amphetamines and cocaine, and added other substances, such as heroin and ecstasy, to the required drug testing panel. Workers subject to these new requirements include private-sector workers for whom routine drug testing is mandated by the DOT as well as those Federal employees in testing-designated positions.As a result of these more sensitive cut-offs, the rate of cocaine and amphetamine positive tests has gone up. Dr. Shoptaw points out that workers may be using stimulants in an attempt to improve productivity.

Read the entire report here.

New UCLA SARx study on genetics of meth treatment response released

UCLA SARx researchers performed an exploratory study examining variations in several genes related to brain dopamine and reward systems and success in treatment for methamphetamine dependence. The study was published in the Journal of Clinical Psychopharmacology this month. A variant in the gene for Brain Derived Neurotrophic Factor (BDNF) was associated with success in quitting methamphetamine in Caucasian but not Hispanic participants. Also, a variant in the gene for COMT, an enzyme that metabolizes dopamine in the brain, was associated with response to the medication modafinil for methamphetamine dependence, but only in Hispanics. These results are exciting but are highly exploratory and preliminary. They may be useful in guiding future research studies that examine the role of these genes in success in quitting methamphetamine.