Archive for August, 2012

Special Issue of ADA on AI/AN Research Includes Paper on CTN-0033-Ot-3 from PN Node

August 31, 2012

American Journal of Drug and Alcohol Abuse (ADA) just published a special issue focused on “Building Bridges: Advancing American Indian/Alaska Native Substance Abuse Research: A State of the Science and Grant Development Workshop” that includes an article from CTN protocol CTN-0033-Ot-3, “Methamphetamine: Where Does It Fit in the Bigger Picture of Drug Use of American Indian and Alaska Native Communities and Treatment Seekers?”, led by the Pacific Northwest Node

The paper, by Sandra Radin, Caleb Banta-Green, Lisa Rey Thomas, and  colleagues from the Pacific Northwest Node, is titled “Substance Use, Treatment Admissions, and Recovery Trends in Diverse Washington State Tribal Communities.”

It reports on outcomes from an element of CTN-0033-Ot-3, in which 29 federally recognized AI/AN tribes in Washington state were invited to participate in health directors interviews and state treatment admissions data analyses.

Analyses of the interviews and state treatment admissions data suggested that some diverse AI/AN communities in WA share similar substance use/abuse, treatment, and recovery trends and continuing needs. Outcomes also demonstrated the need for respectful and flexible approaches when conducting research with AI/AN communities.


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CTN-0027 Outcomes Paper Published!

August 29, 2012

This paper, currently in press at Drug and Alcohol Dependence and written by Andrew Saxon, Walter Ling, Maureen Hillhouse, and colleagues, reports on the primary outcomes from CTN-0027 (Starting Treatment with Agonist Replacement Therapies (START))Evergreen Treatment Services, a CTP in the Pacific Northwest Node, participated in this study.

Buprenorphine/naloxone (BUP) and methadone (MET) are efficacious treatments for opioid dependence, although concerns about a link between BUP and drug-induced hepatitis have been raised. CTN-0027, Project START, was a randomized controlled trial of 1269 opioid-dependent participants seeking treatment at 8 federally licensed opioid treatment programs and followed up for 32 weeks between May 2006 and August 2012.

Results determined that changes in transaminase levels did not differ by medication condition. Baseline infection with hepatitis C or B was the only significant predictor of moving from low to high transminase levels. MET participants were retained longer than the BUP participants, however the 24-week retention rates for the BUP group in this study were in the range seen in prior studies. In fact, because of its superior safety profile and excellent clinical responses to BUP in previous studies, BUP could be considered a first line treatment agent for opioid dependence, with MET reserved for those who do not respond well to BUP.

Conclusions: This study demonstrated no evidence of liver damage during the initial 6 months of treatment with either BUP or MET, providing further encouragement to physicians to use buprenorphine as an effective treatment option for opioid addiction.

Citation: Saxon AJ, Ling W, Hillhouse M, et al. Buprenorphine/Naloxone and Methadone Effects on Laboratory Indices of Liver Health: A Randomized Trial. Drug and Alcohol Dependence 2012 (in press).


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Effect of Gender-Specific HIV Prevention Interventions on Heterosexual Anal Sex

August 8, 2012

Substance abusers are at risk for HIV and other STIs, with heterosexual anal intercourse (HAI) riskier than vaginal intercourse, and more risky for women than for men. This poster from the 2012 International AIDS Conference (Washington, DC, July 2012), by Pacific Northwest Node scientists Don Calsyn and Mary Hatch-Maillette, as well as colleagues Aimee Campbell, Christina Meade, and Susan Tross, reports on a study that aimed to evaluate the effectiveness of the five session CTN gender-specific HIV prevention interventions, Real Men Are Safe (REMAS) (CTN-0018) and Safer Sex Skill Building (SSSB) for women (CTN-0019), vs. single session information only control, on decreasing heterosexual anal intercourse (HAI) and increasing condom use for HAI.

Results of the study found that the percent of men, but not women, engaging in HAI decreased from baseline to 3 month follow-up, with the decrease for men similar for both REMAS and control condition participants. Although condom use for HAI remained infrequent, the percentage of both women and men reporting any use of condoms for HAI increased between baseline and follow-up. Women attending SSSB were more likely to change from no condom use to some condom use than women attending the control intervention. A similar non-significant trend was noticed for men attending REMAS as well.

Citation: Calsyn DA, Campbell ANC, Meade CS, Hatch-Maillette MA, Tross S. The Effect of Gender-Specific HIV Prevention Interventions on Heterosexual Anal Sex Among Men and Women in Substance Abuse Treatment. Poster presented at the International AIDS Society (IAS) Conference, Washington, DC, July 22-27, 2012.


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