Bringing New Medications to the Treatment of Addiction
By Frank Vocci, Ph.D.
May 1, 2003
Dr. Vocci is director of the Division of Treatment Research and Development at NIDA, part of the NIH, U.S. Department of Health and Human Services.
As part of its treatment research portfolio, NIDA supports a national research infrastructure that can test research-based behavioral and pharmacological treatments in diverse patient and community treatment settings. The National Drug Abuse Treatment Clinical Trials Network (CTN) was established in 1999 to rapidly translate new science-based treatment components into practice.
Utilizing the model set by other National Institutes of Health institutes, the CTN is a cooperative undertaking of NIDA, university scientists studying drug abuse and community treatment providers to test research-based treatments in community settings. The CTN consists of research "nodes," comprising regional research and training centers based in university medical and research facilities. The centers partner with community-based treatment programs that represent a variety of treatment settings and patient populations available in the region. From its original five sites in 1999, the CTN has grown to now include 17 regional nodes spread across the county (encompassing 27 states), including three new sites to be operational in fall 2003 (Southwest node, California/Arizona node and a northern New England node) (Figure). Each node works with five to 10 community treatment programs to deliver evidence-based treatments at the community level. Currently there are 115 community treatment programs involved in the CTN.
In addition to supporting eight active treatment protocols in the CTN, NIDA is committed to enrolling over 8,000 patients for the 18 new protocols that are in various stages of development. These new protocols will include studies of pregnant drug-abusing women, adolescent drug abusers, drug-abusing women with posttraumatic stress disorder, a study conducted in Spanish for Spanish-speaking drug abusers, several HIV risk-reduction interventions and a cigarette smoking cessation intervention for in-treatment drug addicts. Readers who would like additional information on the latest research findings can visit NIDA's Web site at <www.drugabuse.gov>.
Carroll KM, Nich C, Ball SA et al. (1998), Treatment of cocaine and alcohol dependence with psychotherapy and disulfiram. Addiction 93(5):713-727.
George TP, Chawarski MC, Pakes J et al. (2000), Disulfiram versus placebo for cocaine dependence in buprenorphine-maintained subjects: a preliminary trial. Biol Psychiatry 47(12):1080-1086.
Glowa JR, Wojnicki FHE, Matecka D et al. (1995a), Effects of dopamine reuptake inhibitors on food and cocaine-maintained responding. I: Dependence on unit dose of cocaine. Exp Clin Psychopharmacol 3:219-231.
Glowa JR, Wojnicki FH, Matecka D et al. (1995b), Effects of dopamine reuptake inhibitors on food and cocaine-maintained responding. II: Comparisons with other drugs and repeated administrations. Exp Clin Psychopharmacol 3:232-239.
Kampman K, Volpicelli JR, Alterman AI et al. (2000), Amantadine in the treatment of cocaine-depen-dent patients with severe withdrawal symptoms. Am J Psychiatry 157(12):2052-2054.
Kampman KM, Volpicelli JR, McGinnis DE et al. (1998), Reliability and validity of the Cocaine Selective Severity Scale. Addict Behav 23(4):449-461.
Kampman KM, Volpicelli JR, Mulvaney F et al. (2001), Effectiveness of propranolol for cocaine dependence treatment may depend on cocaine withdrawal symptom severity. Drug Alcohol Depend 63(1):69-78.
Kampman KM, Volpicelli JR, Mulvaney F et al. (2002), Cocaine withdrawal severity and urine toxicology results from treatment entry predict outcome in medications trials for cocaine dependence. Addict Behav 27(2):251-260.
Kosten TR, Rosen M, Bond J et al. (2002), Human therapeutic cocaine vaccine: safety and immunogenicity. Vaccine 20(7-8):196-204.
McCance-Katz EF, Kosten TR, Jatlow P (1998), Chronic disulfiram treatment on intranasal cocaine administration: initial results. Biol Psychiatry 43(7):540-543.
Petrakis IL, Carroll KM, Nich C et al. (2000), Disulfiram treatment for cocaine dependence in methadone-maintained opioid addicts. Addiction 95(2):219-228.
Pilla M, Perachon S, Sautel F et al. (1999), Selective inhibition of cocaine-seeking behaviour by a partial dopamine D3 receptor agonist. [Published erratum Nature 401(6751):403.] Nature 400(6742):371-375 [see comment].
SAMHSA (2002), Results from the 2001 National Household Survey on Drug Abuse: Volume I. Summary of National Findings (Office of Applied Studies, NHSDA Series H-17, DHHS Publication No. SMA 02-3758). Rockville, Md.
Schmitz JM, Stotts AL, Rhoades HM, Grabowski J (2001), Naltrexone and relapse prevention treatment for cocaine-dependent patients. Addict Behav 26(2):167-180.
Stafford D, Rice KC, Lewis DB, Glowa JR (2000), Response requirements and unit dose modify the effects of GBR 12909 on cocaine-maintained behavior. Exp Clin Psychopharmacol 8(4):539-548.
Tsukada H, Harada N, Nishiyama S et al. (2000), Dose response and duration effects of acute administrations of cocaine and GBR12909 on dopamine synthesis and transporter in the conscious monkey brain: PET studies combined with microdialysis. Brain Res 860(1-2):141-148.
Vorel SR, Ashby CR Jr, Paul M et al. (2002), Dopamine D3 receptor antagonism inhibits cocaine-seeking and cocaine-enhanced brain reward in rats. J Neurosci 22(21):9595-9603.