Opioid-Related Disorders Clinical Trial
Official title:
Reducing Cocaine/Heroin Abuse With SR-Amphetamine and Buprenorphine: Study 1
The purpose of this study is to determine whether maintenance on different oral doses of sustained release d-amphetamine (SR-AMP) combined with constant-dose sublingual buprenorphine (BUP) is safe and well tolerated and decreases self-administration of cocaine alone or combined with hydromorphone (HYD). Secondary aims are to determine whether SR-AMP attenuates the subjective and physiological effects of cocaine during drug sampling periods prior to choice opportunities.
Heroin abusers also frequently abuse cocaine, and concurrent use of these drugs is
associated with more severe drug dependence and associated psychiatric and medical problems,
greater risk for HIV infection, worse drug abuse treatment outcome, and creates a public
health burden. New methods and solutions are needed for this problem.
While human laboratory models exist to study choice of cocaine or opioids individually,
studies have not examined choice of cocaine alone or cocaine/opioid combinations by heroin
dependent individuals, nor have there been interventions to reduce such drug use. We
recently developed a sensitive laboratory-based choice progressive ratio procedure to study
drug-seeking behavior for opioids. This study will extend this procedure, in the form of
drug combination vs. money choices, to obtain a novel human laboratory model of
cocaine/opioid abuse. The purpose of this study is to determine whether maintenance on
different doses of sustained release d-amphetamine (SR-AMP) combined with constant-dose
buprenorphine (BUP) is safe and well tolerated and decreases self-administration of cocaine
alone or combined with HYD. Secondary aims are to determine whether SR-AMP attenuates the
subjective and physiological effects of cocaine during drug sampling periods prior to choice
opportunities.
One goal of this new study is to develop a human laboratory model of polydrug abuse by
allowing participants (who abuse both heroin and cocaine) to choose between drug
combinations or money. The second goal of this study is to develop medication treatments to
reduce cocaine use by opioid dependent individuals.
Participants in this observational study will take part in multiple trials in which they
have the opportunity to choose between drug combinations (cocaine alone or combined with
HYD; relative to HYD alone and dual placebo) or money. On the morning of each session, prior
to the choice procedure, participants will receive a sample of the drug dose that can be
chosen. Participants will be asked to attend to the effects produced by the drug combination
because they will be able to choose this relative to money in the choice task in the
afternoon session. During the choice procedure, participants will have 12 opportunities to
choose either drug or money. Participants will use a computer to earn choices. Respiration
rate, oxygen saturation, heart rate, and blood pressure will be monitored throughout the
study. Self-report questionnaires will be completed at different times during the study.
Participants will be maintained on a constant dose of BUP throughout the study, with a
minimum 2-week lead before the experiment, and a fixed 3-week detoxification after study
completion. During the experiment they will be maintained on different doses of SR-AMP and
on a constant dose of BUP.
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Observational Model: Case-Only, Time Perspective: Prospective
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