Archive for November, 2011

Presentation on CTN-0029 at APHA 2011

November 21, 2011

apha2011This year’s American Public Health Association annual meeting (Oct. 28 – Nov. 2, 2011 in Washington DC) featured two presentations from the CTN, including one by Pacific Northwest node member Andrew Saxon about CTN-0027 (START):

Community-Based Clinical Trials: Site Variation and Adoption of Innovation by Dennis McCarty and colleagues from the Western States Node examined site differences in five CTN trials and found that variation can affect protocol implementation and influence client outcomes.

Protocol NIDA-CTN-oo27: Starting Treatment with Agonist Replacement Therapies (START) by Walter Ling and Andrew Saxon described the outcomes of that study, which compared liver health in opioid-dependent patients after six months of methadone maintenance or six months of buprenorphine/naloxone.  Worsening of liver health was rare and did not differ by medication condition, but participants in the bup/nal group had poorer treatment retention than those on methadone.

For information about upcoming conferences where you could present about the CTN, visit the CTN Dissemination Library’s National/International Conferences calendar.


Primary Outcomes from POATS (CTN-0030) Published

November 8, 2011

No randomized trials have examined treatments for prescription opioid dependence, despite its increasing prevalence. This paper, in-press at Archives of General Psychiatry and written by Roger D. Weiss, Jennifer Sharpe Potter, David A. Fiellin, and colleagues, reports on the primary outcomes article from the CTN protocol on this subject, CTN-0030.

This study was a multisite, randomized clinical trial evaluating the efficacy of brief and extended buprenorphine-naloxone treatment, with different counseling intensities, for patients dependent on prescription opioids.  The Pacific Northwest Node’s CTP Providence Behavioral Health Services  served as one of the sites for this study, with William Dickinson, DO one of the paper’s co-authors.

The study found that while prescription opioid-dependent patients are most likely to reduce opioid use during buprenorphine-naloxone treatment, when tapered off the medication, even after 12 weeks of treatment, the likelihood of an unsuccessful outcome is high, regardless of type or amount of counseling.

Read the NIH Press Release about this paper:

Citation: Weiss RD, Potter JS, Fiellin DA, et al. Adjunctive Counseling During Brief and Extended Buprenorphine-Naloxone Treatment for Prescription Opioid Dependence: A 2-Phase Randomized Controlled Trial. Archives of General Psychiatry 2011 (in press).

Find it in the CTN Dissemination Library!

Beyond Drug Use: Other Outcomes in Treatment Evaluation

November 3, 2011

Ron Jackson, MSW, director of the Pacific Northwest Node community treatment program Evergreen Treatment Services, recently served on a panel of substance abuse treatment and research experts convened by NIDA to discuss appropriate outcome measures for clinical trials of substance abuse treatments.

Across the addictions field, the primary outcome in treatment research has been reduction in drug consumption. Despite a compelling rationale for moving beyond drug use as the sole standard for evaluating addiction treatment, the field has yet to adopt any core set of other measures that are routinely incorporated into treatment research.

This report from the panel, currently in-press in Addiction, provides an overview of previous recommendations and outlines specific guidelines for consideration of candidate outcomes. A list of outcomes meeting those guidelines is described with two strongly recommended for inclusion: craving and quality of life. The paper ends with ideas on how to move ahead with incorporating these outcomes into treatment research.

Citation: Tiffany ST, Friedman L, Greenfield SF, Hasin DS, Jackson R. Beyond Drug Use: A Systematic Consideration of Other Outcomes in Evaluations of Treatments for Substance Use Disorders. Addiction 2011 (in press). doi: 10.1111/j.1360-0443.2011.03581.x