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The research in addiction medicine scholars program-developing researchers in addiction fellowships
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Abstracts / Drug and Alcohol Dependence 171 (2017) e2–e226
for use throughout each day. Latent trajectory analysis was used to compare empirical subtypes to animal models of addiction. Results: Five classes were extracted, two of which were stable dosing groups: one using multiple (5 or more) combustible products per day (10% of users) and another (15%) mixing in combustible products and vaporizers. Three classes, representing the majority of the sample, were characterized by variable dosing and product selection. Edibles were used rather infrequently (10% of the patients), largely as a means to consume in places where use is stigmatized. Income was the strongest predictor of trajectory classes (ORs 1.9–3.9) involving non-stable consumption. Qualitative interviews suggested that pay periods were important drivers of usage frequency, and additional analyses of the diary data showed frequency was highest in the 48 h period on dates commonly associated with pay periods, e.g., 48 h starting from the 1st to the 2nd of the month, 15th to the 16th of month. Approximately 25% of the events were used exclusively to self-treat pain, the rest being mixed (53%) or exclusively euphoria/relaxation (22%). Conclusions: The ability to pay for cannabis appeared to a major driver of consumption among pain patients. The natural environment’s role in consumption has important implications for testing animal models of addiction. Financial support: NIDA R01 DA038427 PII Novak. http://dx.doi.org/10.1016/j.drugalcdep.2016.08.424 The research in addiction medicine scholars program-developing researchers in addiction fellowships Patrick O’Connor 3,∗ , Judith I. Tsui 2 , Danna Gobel 1 , Belle Brett 5 , Carly Bridden 1 , Jeffrey H. Samet 4,1 1
Boston Medical Center, Boston, MA, United States Internal Medicine, University of Washington School of Medicine, Seattle, WA, United States 3 Yale University, New Haven, CT, United States 4 Boston University, Boston, MA, United States 5 Brett Consulting Group, Somerville, MA, United States 2
Aims: Addiction physician investigators are a limited resource. Given the creation of the American Board of Addiction Medicine and new Addiction Medicine fellowship programs, efforts to develop addiction physician researchers gained added urgency. The Research in Addiction Medicine Scholars (RAMS) Program was created to provide an infrastructure to supplement the training and mentoring of Addiction Medicine and Addiction Psychiatry fellows from North America so as to develop a cadre of addiction physician clinical investigators. Methods: The RAMS Program began in 2012 with NIDA support and aims to develop skills in addiction research among physicians from addiction fellowship programs. Annual recruitment seeks 5 scholars, and in the first 4 years, 19 fellows were selected (11 Addiction Medicine and 8 Addiction Psychiatry). The 2-year program provides mentoring, training and funds, all to supplement the development of research projects and training for scholars to advance on their path to a clinical research career. Scholars participate in two annual retreats over each of 2 years in Boston and at the CPDD conference. These include group seminars, one-onone mentoring, and workshops on research methods and career development paths. The program also includes monthly faculty or scholar-driven webinars. Results: To date, the 19 scholars are from 9 institutions. All admitted scholars have completed the program. Of the first cohort
(n = 4) of RAM scholars, all accepted academic faculty positions. Scholars have published over 20 publications since enrolling in the program and are recipients of four grants. Conclusions: The Research in Addiction Medicine Scholars (RAMS) Program is positioned to make important contributions to the development of the next generation of addiction physician researchers. Financial support: Supported by R25DA033211. http://dx.doi.org/10.1016/j.drugalcdep.2016.08.425 Within-subject evaluation of interim buprenorphine vs. waitlist on illicit opioid use Taylor A. Ochalek 3,∗ , Jacob D. Pusey 3 , Bryce Hruska 1 , Sarah Hughes Heil 1 , Stephen Higgins 1 , Gail Rose 1 , Brent A. Moore 2 , Stacey C. Sigmon 1 1 Psychiatry, The University of Vermont, Burlington, VT, United States 2 Psychiatry, Yale University School of Medicine, New Haven, CT, United States 3 Psychology, University of Vermont, Burlington, VT, United States
Aims: Despite the effectiveness of agonist maintenance for opioid dependence, patients can remain on waitlists for months before treatment is available. We are conducting a randomized trial evaluating interim buprenorphine treatment (IBT) vs. continued waitlist control (WLC) for waitlisted opioid abusers. IBT includes buprenorphine dispensed via computerized device (Med-O-Wheel Secure, Addoz, Finland), daily monitoring via a phone-based interactive voice response (IVR) system and IVR-generated random call-backs. WLC participants who have not entered treatment by week 12 are offered an opportunity to cross over to IBT, permitting an additional within-subject evaluation of IBT effects. This presentation will focus on this within-subject comparison of participants originally randomized to WLC who then cross over to receive the full IBT intervention. Methods: Thus far, 23 opioid-dependent adults have been randomized to WLC. Of those, 14 have crossed over at Week 12 to receive IBT. We examine participants’ biochemically-verified illicit opioid abstinence and self-reported IV opioid use during each phase. We hypothesize that illicit opioid abstinence will be greater during participants’ IBT vs. WLC phase. Results: On average, participants are submitting 0% illicit opioid negative urine specimens during their initial WLC phase, followed by 45% during IBT crossover. Self-reported IV opioid use averages 7 + 13.0 days out of the past 30 during WLC vs. 0.2 + 0.45 during IBT. Outcomes from the full WLC-to-IBT crossover sample will be presented at the June meeting. Conclusions: Providing interim buprenorphine treatment with minimal other support to waitlisted patients may significantly reduce individual and societal risks during delays to comprehensive opioid treatment, even among those originally randomized to a waitlist control condition. Financial support: R34 DA3730385-01, T32 DA007242. http://dx.doi.org/10.1016/j.drugalcdep.2016.08.426
Abstracts / Drug and Alcohol Dependence 171 (2017) e2–e226
for use throughout each day. Latent trajectory analysis was used to compare empirical subtypes to animal models of addiction. Results: Five classes were extracted, two of which were stable dosing groups: one using multiple (5 or more) combustible products per day (10% of users) and another (15%) mixing in combustible products and vaporizers. Three classes, representing the majority of the sample, were characterized by variable dosing and product selection. Edibles were used rather infrequently (10% of the patients), largely as a means to consume in places where use is stigmatized. Income was the strongest predictor of trajectory classes (ORs 1.9–3.9) involving non-stable consumption. Qualitative interviews suggested that pay periods were important drivers of usage frequency, and additional analyses of the diary data showed frequency was highest in the 48 h period on dates commonly associated with pay periods, e.g., 48 h starting from the 1st to the 2nd of the month, 15th to the 16th of month. Approximately 25% of the events were used exclusively to self-treat pain, the rest being mixed (53%) or exclusively euphoria/relaxation (22%). Conclusions: The ability to pay for cannabis appeared to a major driver of consumption among pain patients. The natural environment’s role in consumption has important implications for testing animal models of addiction. Financial support: NIDA R01 DA038427 PII Novak. http://dx.doi.org/10.1016/j.drugalcdep.2016.08.424 The research in addiction medicine scholars program-developing researchers in addiction fellowships Patrick O’Connor 3,∗ , Judith I. Tsui 2 , Danna Gobel 1 , Belle Brett 5 , Carly Bridden 1 , Jeffrey H. Samet 4,1 1
Boston Medical Center, Boston, MA, United States Internal Medicine, University of Washington School of Medicine, Seattle, WA, United States 3 Yale University, New Haven, CT, United States 4 Boston University, Boston, MA, United States 5 Brett Consulting Group, Somerville, MA, United States 2
Aims: Addiction physician investigators are a limited resource. Given the creation of the American Board of Addiction Medicine and new Addiction Medicine fellowship programs, efforts to develop addiction physician researchers gained added urgency. The Research in Addiction Medicine Scholars (RAMS) Program was created to provide an infrastructure to supplement the training and mentoring of Addiction Medicine and Addiction Psychiatry fellows from North America so as to develop a cadre of addiction physician clinical investigators. Methods: The RAMS Program began in 2012 with NIDA support and aims to develop skills in addiction research among physicians from addiction fellowship programs. Annual recruitment seeks 5 scholars, and in the first 4 years, 19 fellows were selected (11 Addiction Medicine and 8 Addiction Psychiatry). The 2-year program provides mentoring, training and funds, all to supplement the development of research projects and training for scholars to advance on their path to a clinical research career. Scholars participate in two annual retreats over each of 2 years in Boston and at the CPDD conference. These include group seminars, one-onone mentoring, and workshops on research methods and career development paths. The program also includes monthly faculty or scholar-driven webinars. Results: To date, the 19 scholars are from 9 institutions. All admitted scholars have completed the program. Of the first cohort
(n = 4) of RAM scholars, all accepted academic faculty positions. Scholars have published over 20 publications since enrolling in the program and are recipients of four grants. Conclusions: The Research in Addiction Medicine Scholars (RAMS) Program is positioned to make important contributions to the development of the next generation of addiction physician researchers. Financial support: Supported by R25DA033211. http://dx.doi.org/10.1016/j.drugalcdep.2016.08.425 Within-subject evaluation of interim buprenorphine vs. waitlist on illicit opioid use Taylor A. Ochalek 3,∗ , Jacob D. Pusey 3 , Bryce Hruska 1 , Sarah Hughes Heil 1 , Stephen Higgins 1 , Gail Rose 1 , Brent A. Moore 2 , Stacey C. Sigmon 1 1 Psychiatry, The University of Vermont, Burlington, VT, United States 2 Psychiatry, Yale University School of Medicine, New Haven, CT, United States 3 Psychology, University of Vermont, Burlington, VT, United States
Aims: Despite the effectiveness of agonist maintenance for opioid dependence, patients can remain on waitlists for months before treatment is available. We are conducting a randomized trial evaluating interim buprenorphine treatment (IBT) vs. continued waitlist control (WLC) for waitlisted opioid abusers. IBT includes buprenorphine dispensed via computerized device (Med-O-Wheel Secure, Addoz, Finland), daily monitoring via a phone-based interactive voice response (IVR) system and IVR-generated random call-backs. WLC participants who have not entered treatment by week 12 are offered an opportunity to cross over to IBT, permitting an additional within-subject evaluation of IBT effects. This presentation will focus on this within-subject comparison of participants originally randomized to WLC who then cross over to receive the full IBT intervention. Methods: Thus far, 23 opioid-dependent adults have been randomized to WLC. Of those, 14 have crossed over at Week 12 to receive IBT. We examine participants’ biochemically-verified illicit opioid abstinence and self-reported IV opioid use during each phase. We hypothesize that illicit opioid abstinence will be greater during participants’ IBT vs. WLC phase. Results: On average, participants are submitting 0% illicit opioid negative urine specimens during their initial WLC phase, followed by 45% during IBT crossover. Self-reported IV opioid use averages 7 + 13.0 days out of the past 30 during WLC vs. 0.2 + 0.45 during IBT. Outcomes from the full WLC-to-IBT crossover sample will be presented at the June meeting. Conclusions: Providing interim buprenorphine treatment with minimal other support to waitlisted patients may significantly reduce individual and societal risks during delays to comprehensive opioid treatment, even among those originally randomized to a waitlist control condition. Financial support: R34 DA3730385-01, T32 DA007242. http://dx.doi.org/10.1016/j.drugalcdep.2016.08.426