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Influence of bupropion on smoking abstinence in opioid-maintained smokers
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Abstracts / Drug and Alcohol Dependence 140 (2014) e169–e251
ficiency in these individuals that could contribute to difficulty in making appropriate choices. Financial support: NIDA 5P20DA027843. http://dx.doi.org/10.1016/j.drugalcdep.2014.02.476 Disseminating prevention through cultural adaptation research with Latino populations Ruben Parra-Cardona, J.C. Anthony Michigan State University, East Lansing, MI, United States Aims: To compare and contrast the levels of cultural acceptability and feasibility in two differentially culturally adapted parenting interventions being disseminated among low-income Latino immigrants. Methods: This NIMH-funded RCT study was developed to compare and contrast two differentially culturally adapted versions of the evidence-based intervention known as Parent management Training-the Oregon Model. Participants were randomized into one of three conditions: (a) CAPAS-Original, (b) CAPAS-Enhanced, or (c) a wait-list control group. Measurements of parent–child interactions, parenting skills, and child internalizing and externalizing behaviors are being taken at baseline, intervention completion, and 6-month follow-up. A total of 87 families have participated in the study. Results: The RCT phase of this investigation is just being completed and collection of outcome data will be completed by Fall 2013. Preliminary RCT phase of the study will be presented consisting of initial quantitative and qualitative satisfaction indicators. Preliminary findings indicate high participant satisfaction with both culturally adapted versions of the intervention. No statistical differences were found between CAPAS-Original and CAPAS-Enhanced on any of the weekly session satisfaction ratings. According to qualitative data, however, participants in both interventions considered critical to increase the number of culturally focused sessions on immigration and biculturalism. Conclusions: Current findings indicate that the value of cultural adaptation research lies in its potential to identify which elements of an original intervention as well as which culturally adapted components are considered by target populations to be most relevant. Financial support: This investigation was supported by Award Number R34MH087678 from the National Institute of Mental Health. http://dx.doi.org/10.1016/j.drugalcdep.2014.02.477 Influence of bupropion on smoking abstinence in opioid-maintained smokers Mollie E. Patrick, Stacey C. Sigmon, Andrew C. Meyer, Sarah H. Heil, Stephen T. Higgins Psychiatry, University of Vermont, Burlington, VT, United States Aims: Rates of smoking among opioid-maintained patients are 3-fold that of the general population and smoking cessation interventions in this population have shown modest outcomes. We have developed an efficacious behavioral intervention to promote smoking abstinence among methadone- and buprenorphine-maintained smokers. While not a primary focus, we offer bupropion (Zyban) as an optional pharmacotherapy for interested and eligible patients. In the present analyses, we evaluated the contribution of bupropion to smoking abstinence, retention and nicotine withdrawal among smokers receiving financial incentives contingent on abstinence.
Methods: All participants received a 2-week intervention that included daily visits, biochemical verification of smoking status and reinforcement of abstinence. Results: Participants (35 Bupropion (B), 49 No Bupropion (NB)) were 41% male, 33 yrs, and reported smoking 18.6 cigarettes/day. Overall levels of smoking abstinence were generally high, with participants providing 54% abstinent samples during the study. Smoking outcomes did not differ between B and NB groups, with 60% and 51% abstinent samples provided during the study, respectively (p = .23). There was a trend toward longer treatment retention in the B vs. NB group, with 80% and 61% of participants retained at the end of study, respectively (p = .07). No significant differences were seen between groups on severity or timecourse of nicotine withdrawal (p > .05). Conclusions: There was no significant contribution of bupropion on smoking-related outcomes in the present study, though our ability to evaluate this could be limited by the potency of the behavioral intervention itself. These data are consistent with prior studies showing modest effects of smoking pharmacotherapies in this population, perhaps due to the complex interactions between nicotine and the endogenous opioid system. However, the efficacy of our behavioral intervention suggests that this challenging population of smokers is sensitive to reinforcement-based interventions. Financial support: R01 DA019550, T32 DA007242. http://dx.doi.org/10.1016/j.drugalcdep.2014.02.478 Substance use in adolescents with environmental lead exposure in childhood Antonio Pascale 1 , Cristina B. Bares 2 , A. Sosa 1 , M.J. Moll 1 , S. Couto 1 , D. Pose 1 , A. Laborde 1 1 Department of Toxicology, School of Medicine, Montevideo, Uruguay, United States 2 School of Social Work, Virginia Commonwealth University, Richmond, VA, United States
Aims: Lead has long been established as a potent neurotoxin, damaging the developing nervous system in children and potentially interfering with their long-term behavioral development. Cross-sectional studies have reported an association between early lead exposure and behavior problems as well as psychiatric comorbidity in later childhood and adolescence, but little is known about environmental lead exposure in childhood and later drug abuse. In 2001 a small cohort of children were identified with elevated blood lead levels (BLL) in Montevideo, Uruguay. The present study investigated whether 2001 BLL or current BLL (2011) collected had an effect on drug use in this group of adolescents. Methods: Children with elevated BLL’s in 2001 were reidentified and tested for current BLL using atomic absorption spectrometry in 2011. A total of 89 adolescents who agreed to participate in the study completed an assessment focused on social and demographic variables including educational status, grade in school, health comorbidities, and patterns of substance use. The CRAFFT screening tool was administered to the adolescents in 2011. To examine the influence of lead levels in childhood and adolescence on substance use as measured by the CRAFFT logistic regression analyses were conducted. Results: Over 90% of the sample had BLL above 10 g/dl in 2001 (mean BLL in 2001 were 14.2 g/dl). During adolescence (mean age 14.6, 57% male) mean BLL were 5.04 g/dl. About 5% of the adolescents reported smoking, 41.6% reported using alcohol, 9% used marijuana and 5% of the sample received a score of 2 or higher on the CRAFFT. Logistic regression analyses revealed that lead levels in 2011 increased the odds of adolescents using tobacco by 2.27, controlling for the effect of covariates and lead levels in 2001.
Abstracts / Drug and Alcohol Dependence 140 (2014) e169–e251
ficiency in these individuals that could contribute to difficulty in making appropriate choices. Financial support: NIDA 5P20DA027843. http://dx.doi.org/10.1016/j.drugalcdep.2014.02.476 Disseminating prevention through cultural adaptation research with Latino populations Ruben Parra-Cardona, J.C. Anthony Michigan State University, East Lansing, MI, United States Aims: To compare and contrast the levels of cultural acceptability and feasibility in two differentially culturally adapted parenting interventions being disseminated among low-income Latino immigrants. Methods: This NIMH-funded RCT study was developed to compare and contrast two differentially culturally adapted versions of the evidence-based intervention known as Parent management Training-the Oregon Model. Participants were randomized into one of three conditions: (a) CAPAS-Original, (b) CAPAS-Enhanced, or (c) a wait-list control group. Measurements of parent–child interactions, parenting skills, and child internalizing and externalizing behaviors are being taken at baseline, intervention completion, and 6-month follow-up. A total of 87 families have participated in the study. Results: The RCT phase of this investigation is just being completed and collection of outcome data will be completed by Fall 2013. Preliminary RCT phase of the study will be presented consisting of initial quantitative and qualitative satisfaction indicators. Preliminary findings indicate high participant satisfaction with both culturally adapted versions of the intervention. No statistical differences were found between CAPAS-Original and CAPAS-Enhanced on any of the weekly session satisfaction ratings. According to qualitative data, however, participants in both interventions considered critical to increase the number of culturally focused sessions on immigration and biculturalism. Conclusions: Current findings indicate that the value of cultural adaptation research lies in its potential to identify which elements of an original intervention as well as which culturally adapted components are considered by target populations to be most relevant. Financial support: This investigation was supported by Award Number R34MH087678 from the National Institute of Mental Health. http://dx.doi.org/10.1016/j.drugalcdep.2014.02.477 Influence of bupropion on smoking abstinence in opioid-maintained smokers Mollie E. Patrick, Stacey C. Sigmon, Andrew C. Meyer, Sarah H. Heil, Stephen T. Higgins Psychiatry, University of Vermont, Burlington, VT, United States Aims: Rates of smoking among opioid-maintained patients are 3-fold that of the general population and smoking cessation interventions in this population have shown modest outcomes. We have developed an efficacious behavioral intervention to promote smoking abstinence among methadone- and buprenorphine-maintained smokers. While not a primary focus, we offer bupropion (Zyban) as an optional pharmacotherapy for interested and eligible patients. In the present analyses, we evaluated the contribution of bupropion to smoking abstinence, retention and nicotine withdrawal among smokers receiving financial incentives contingent on abstinence.
Methods: All participants received a 2-week intervention that included daily visits, biochemical verification of smoking status and reinforcement of abstinence. Results: Participants (35 Bupropion (B), 49 No Bupropion (NB)) were 41% male, 33 yrs, and reported smoking 18.6 cigarettes/day. Overall levels of smoking abstinence were generally high, with participants providing 54% abstinent samples during the study. Smoking outcomes did not differ between B and NB groups, with 60% and 51% abstinent samples provided during the study, respectively (p = .23). There was a trend toward longer treatment retention in the B vs. NB group, with 80% and 61% of participants retained at the end of study, respectively (p = .07). No significant differences were seen between groups on severity or timecourse of nicotine withdrawal (p > .05). Conclusions: There was no significant contribution of bupropion on smoking-related outcomes in the present study, though our ability to evaluate this could be limited by the potency of the behavioral intervention itself. These data are consistent with prior studies showing modest effects of smoking pharmacotherapies in this population, perhaps due to the complex interactions between nicotine and the endogenous opioid system. However, the efficacy of our behavioral intervention suggests that this challenging population of smokers is sensitive to reinforcement-based interventions. Financial support: R01 DA019550, T32 DA007242. http://dx.doi.org/10.1016/j.drugalcdep.2014.02.478 Substance use in adolescents with environmental lead exposure in childhood Antonio Pascale 1 , Cristina B. Bares 2 , A. Sosa 1 , M.J. Moll 1 , S. Couto 1 , D. Pose 1 , A. Laborde 1 1 Department of Toxicology, School of Medicine, Montevideo, Uruguay, United States 2 School of Social Work, Virginia Commonwealth University, Richmond, VA, United States
Aims: Lead has long been established as a potent neurotoxin, damaging the developing nervous system in children and potentially interfering with their long-term behavioral development. Cross-sectional studies have reported an association between early lead exposure and behavior problems as well as psychiatric comorbidity in later childhood and adolescence, but little is known about environmental lead exposure in childhood and later drug abuse. In 2001 a small cohort of children were identified with elevated blood lead levels (BLL) in Montevideo, Uruguay. The present study investigated whether 2001 BLL or current BLL (2011) collected had an effect on drug use in this group of adolescents. Methods: Children with elevated BLL’s in 2001 were reidentified and tested for current BLL using atomic absorption spectrometry in 2011. A total of 89 adolescents who agreed to participate in the study completed an assessment focused on social and demographic variables including educational status, grade in school, health comorbidities, and patterns of substance use. The CRAFFT screening tool was administered to the adolescents in 2011. To examine the influence of lead levels in childhood and adolescence on substance use as measured by the CRAFFT logistic regression analyses were conducted. Results: Over 90% of the sample had BLL above 10 g/dl in 2001 (mean BLL in 2001 were 14.2 g/dl). During adolescence (mean age 14.6, 57% male) mean BLL were 5.04 g/dl. About 5% of the adolescents reported smoking, 41.6% reported using alcohol, 9% used marijuana and 5% of the sample received a score of 2 or higher on the CRAFFT. Logistic regression analyses revealed that lead levels in 2011 increased the odds of adolescents using tobacco by 2.27, controlling for the effect of covariates and lead levels in 2001.