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What predicts continued substance use among probationers?
Abstracts / Drug and Alcohol Dependence 146 (2015) e118–e201
Sex-differences in cognition and behaviors in children with family history of substance use disorders Kristin Lee 1 , Lexi Pritchett 1 , Gro Løhaugen 2,3 , Shannon Kogachi 1 , Erin Fukaya 1 , Antonette Hernandez 1 , Caroline Jiang 1 , Daniel Alicata 1 , Thomas Ernst 1 , Linda Chang 1 1 Medicine, University of Hawaii, Honolulu, HI, United States 2 Pediatrics and Child Rehabilitation, Norwegian University of Science and Technology, Arendal, Norway 3 Laboratory Medicine, Norwegian University of Science and Technology, Trondheim, Norway
Aims: Substance use disorder (SUD) is highly heritable, but it is unclear whether SUD-related cognitive and behavioral deficits are inherited and if they are sexually dimorphic. Polymorphisms in catechol-O-methyltransferase (COMT) genes have been associated with sex-specific deficits associated with SUD. The aim is to determine the association between two COMT genotype variants, sex, and family history of SUD (FSUD) on behavioral measures and cognition in typically developing children. Methods: FSUD, externalizing behavior and total ADHD scores were reported by parents of 226 children ages 3–20 years (85 SUD: 10.1 ± 0.5 years, 48 boys; 141 CON: 10.0 ± 0.4 years, 74 boys). Cognitive performance was assessed by full scale IQ (FSIQ) and the NIH Toolbox® . Saliva samples were genotyped for two functional COMT single nucleotide polymorphisms (SNPs): rs4680 (Val158Met) and rs165599 (near the 3’UTR region). Results: On 3-way (SNP, sex, FSUD) ANOVAs, rs165599 tended to have negative effects on ADHD scores (p = 0.08) and externalizing behaviors (p = 0.06), with male AA-carriers with FSUD having higher ADHD scores (p = 0.10) and externalizing behaviors (p = 0.03). COMT rs165599 variant tended to have a negative effect on FSIQ (p = 0.08) and IQ processing speed (p = 0.07), with male AAcarriers with FSUD having the lowest scores. Regardless of FSUD, males with the rs4680 variant tended to have lower FSIQ (p = 0.06), but significantly lower processing speed scores (p = 0.003). Conclusions: The COMT genetic variants appear to have a greater negative influence on boys. FSUD boys with the rs165599 AA-genotype had greater ADHD symptoms and externalizing behaviors as well as lower FSIQ and slower processing speed. Both behaviors and cognitive function may be influenced by these genes involved in dopamine metabolism in a sex-specific manner. Financial Support: NIH (RC2-DA029475, 2K24-DA16170, U54NS56883, G12-MD007601). http://dx.doi.org/10.1016/j.drugalcdep.2014.09.386 Implementation of drug and HIV risk counseling in MMT programs in Taiwan Tony Szu-Hsien Lee 1 , Marek C. Chawarski 2 , C. Peng 1 , C. Hung 3 , D. Metzger 4 1
National Taiwan Normal University, Taipei, Taiwan Psychiatry, Yale School of Medicine, New Haven, CT, United States 3 Taichung Veteran General Hospital, Taichung, Taiwan 4 University of Pennsylvania, Philadelphia, PA, United States 2
Aims: Few methadone maintenance treatment (MMT) programs in Taiwan offer drug counseling and data on program
e173
implementation have rarely been reported. This study aims to examine the feasibility of Behavioral Drug and Risk Counseling (BDRC) as a component of MMTP and documents its implementation in Taiwan. Methods: 90 MMT patients were randomly assigned to treatment as usual (n = 45, MMT only) or MMT + BDRC (n = 45). Patients in the BDRC group receive weekly counseling in the first month, bi-weekly in months 2 and 3, and monthly in months 4 to 7 after enrollment. BDRC sessions offer education on biological and pharmacological mechanisms of heroin and methadone, skills to reduce/avoid HIV risk behaviors, maintaining or improving medication adherence, and establishing non-drug related activities supporting recovery. BDRC utilizes health education, setting small and achievable goals, positive feedback, and developing plans and skills to improve treatment participation and prolonged drug recovery. BDRC counselors (n = 4) received a 5-day training workshop at the program onset. Clinical supervision, including case discussions, is conducted monthly and lead by an experienced psychotherapist. Counselors maintain content checklists and notes from each session. Results: Content analysis of the checklists and counseling notes showed that counselors were able to deliver the BDRC but fidelity of counseling intervention varies between sites and counselors. Factors influencing intervention fidelity include: counselor’s professional background and past training, and site/organizational characteristics (e.g., availability of separate and confidential counseling space, coordination between case managers and counselors) and frequency of clinical supervision. Conclusions: Our preliminary findings support the potential of integrating behavioral counseling into regular MMT as a component of a comprehensive treatment in Taiwan. Financial Support: Supported by National Science Council (NSC100-2628-H-003-002-MY3). http://dx.doi.org/10.1016/j.drugalcdep.2014.09.387 What predicts continued substance use among probationers? Jennifer Lerch 1 , F. Taxman 1 , Scott Walters 2 1
George Mason University, Fairfax, VA, United States University of North Texas Health Science Center, Fort Worth, TX, United States 2
Aims: Probation supervision is designed to motivate drug users to suppress illicit substance use during supervision. The probation suppression effect has not been adequately tested. This study examines predictors of continued illicit substance use among probationers in two urban areas. Methods: 142 substance-using probationers participating in an ongoing randomized control trial. Probationers completed baseline and 2-month follow-up (2MFU) interviews. Probationers averaged 37 years old and were predominately male (72.5%) and AfricanAmerican (68.9%). The measures examined include age, criminal justice (e.g., lifetime arrests), treatment/use (e.g., recent hard drug use), and psychosocial (e.g., problem recognition) factors. Hard drug use includes opiates, cocaine, barbiturates, amphetamines, hallucinogens, and inhalants, which are statistically significant independent predictors of criminal behavior. Bivariate correlations and logistic regression models examined the relationship between individual factors and continued drug use (any) and hard drug use. Results: Bivariate analysis revealed homelessness, recent polysubstance use, recent hard drug use, substance use with family members, and peer substance use were associated with 2MFU overall drug use. Prior substance abuse treatment, age of first drug
e174
Abstracts / Drug and Alcohol Dependence 146 (2015) e118–e201
use, recent poly-substance use, recent hard drug use, lifetime hard drug use, problem recognition, and substance use with family were associated with 2MFU hard drug use. Logistic regression results reveal that homelessness (OR = 3.1, 95% CI = 1.0–9.6, p = .05) and recent hard drug use (OR = 2.7, 95% CI = 1.1–6.4, p = .02) increased the odds of 2MFU drug use. Recent hard drug users (OR = 4.3, 95% CI = 1.2–15.4, p = .02) had increased odds of 2MFU hard drug use. Conclusions: Probation has a limited suppression effect for people with severe substance use disorders. Recent hard drug use predicts future drug use and future hard drug use. The identification of probationers most at risk for failure due to continued substance use should assist probation agencies in targeting probationers for behavioral health services. Financial Support: NIDA R01DA029010-01A1. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.388 Is high fructose corn syrup addictive? Studies of operant intraoral self-administration in rats Francesco Leri, Anne Marie Levy Psychology, University of Guelph, Guelph, ON, Canada Aims: The numerous similarities between obesity and drug dependence suggest that some foods and drugs of abuse may share the ability to reinforce addictive behaviors. The current experiments in male Sprague-Dawley rats employed operant intraoral self-administration and taste reactivity to study and compare the hedonic and reinforcing effects of high fructose corn syrup (HFCS), saccharin and sucrose. Methods: Animals surgically implanted with intraoral cannulas were tested for orofacial reactions to different sweet solutions and allowed to press a lever to receive infusions of these solutions on continuous ratio (CR) and progressive ratio (PR) schedules of reinforcement. Results: Experiment 1 (n = 22) revealed that self-administration of HFCS on a CR schedule is sensitive to changes in concentration/infusion (10%, 25% and 50%), and that higher concentrations maintain higher breakpoints (BPs) on the PR schedule. Experiment 2 (n = 22) indicated that intake of HFCS escalates over 3 weeks of self-administration (3 h a day) because rats develop binge-like patterns of intake. Experiments 2 and 3 (n = 22) clearly indicated that various concentrations of saccharin do not substitute for HFCS, even when hedonic orofacial reactions are equated. Finally, Experiments 4 (n = 20) and 5 (n = 24) revealed that HFCS produces higher hedonic reactions than sucrose, and that at equicaloric concentrations, HFCS is more potent than sucrose (lowers responding on the CR schedule, and supports higher BPs on the PR schedule). Conclusions: These data in rats suggest that HFCS has unique hedonic and reinforcing characteristics that may cause addictivelike consumption of foods/drinks that contain it. Financial support: Studies supported by the Natural Sciences and Engineering Research Council of Canada (NSERC). http://dx.doi.org/10.1016/j.drugalcdep.2014.09.389
Immunization increases the reinforcement threshold but not elasticity of demand for nicotine in an animal model of nicotine reduction policy Mark G. LeSage 1,2 , Mylissa Staley 1 , Paul R. Pentel 1,2 1 Medicine, Minneapolis Medical Research Foundation, Minneapolis, MN, United States 2 Medicine, University of Minnesota, Minneapolis, MN, United States
Aims: Reducing the nicotine content in tobacco products is being considered by the FDA as an industry-wide policy to reduce the addictiveness of tobacco products. Medications could enhance the impact of such policy by helping smokers quit or significantly reduce their smoking at higher cigarette nicotine concentrations. By reducing or slowing nicotine distribution to brain, immunotherapy (vaccines or monoclonal antibodies) could increase the reinforcement threshold or elasticity of demand for nicotine, thereby raising the nicotine dose needed to maintain smoking. The purpose of the present study was to examine this issue in an animal model of nicotine reduction policy. Methods: Rats were trained to self-administer nicotine (0.06 mg/kg) during daily 2 h sessions. After NSA stabilized, the unit dose was reduced weekly until extinction levels of responding were achieved. Eight rats received weekly infusions of the nicotinespecific monoclonal antibody Nic311 during the dose reduction phase, while eight rats in a control group received infusions of control antibody. Exponential demand-curve analysis was conducted to compare the sensitivity of immunized and control rats to increases in the unit price (FR/unit dose) of nicotine (i.e. elasticity of demand). Results: Compared to controls, the dose response curve was shifted to the right and the threshold reinforcing nicotine dose was significantly higher in immunized rats (3.1 vs 11.7 ffJg/kg, p < 0.05). Although intensity of demand (intake at zero price, Q0) was greater in immunized rats (2.5 vs 1.1 mg/kg, p < 0.01), there was no difference in elasticity of demand (a). Conclusions: These findings show that immunization can attenuate the reinforcing effects of nicotine and might compliment nicotine reduction policy by increasing the reinforcement threshold for nicotine. Financial support: NIDA R01-DA026444 (LeSage, PI) http://dx.doi.org/10.1016/j.drugalcdep.2014.09.390 Examining HCV and other risks among rural women offenders Carl Leukefeld 1 , Kathi L.H. Harp 1 , Matthew Webster 1 , Michele Staton-Tindall 2 , Carrie B. Oser 3 , Jennifer R. Havens 1 1
Behavioral Science, University of Kentucky, Lexington, KY, United States 2 Social Work, University of Kentucky, Lexington, KY, United States 3 Sociology, University of Kentucky, Lexington, KY, United States Aims: Drug users are at heightened risk for Hepatitis C (HCV), which is intensified among the increasing number of women offenders. The prevalence of drug use and risky behavior among women offenders is also higher than males. This study adds to the limited information on rural women offenders by examining
Sex-differences in cognition and behaviors in children with family history of substance use disorders Kristin Lee 1 , Lexi Pritchett 1 , Gro Løhaugen 2,3 , Shannon Kogachi 1 , Erin Fukaya 1 , Antonette Hernandez 1 , Caroline Jiang 1 , Daniel Alicata 1 , Thomas Ernst 1 , Linda Chang 1 1 Medicine, University of Hawaii, Honolulu, HI, United States 2 Pediatrics and Child Rehabilitation, Norwegian University of Science and Technology, Arendal, Norway 3 Laboratory Medicine, Norwegian University of Science and Technology, Trondheim, Norway
Aims: Substance use disorder (SUD) is highly heritable, but it is unclear whether SUD-related cognitive and behavioral deficits are inherited and if they are sexually dimorphic. Polymorphisms in catechol-O-methyltransferase (COMT) genes have been associated with sex-specific deficits associated with SUD. The aim is to determine the association between two COMT genotype variants, sex, and family history of SUD (FSUD) on behavioral measures and cognition in typically developing children. Methods: FSUD, externalizing behavior and total ADHD scores were reported by parents of 226 children ages 3–20 years (85 SUD: 10.1 ± 0.5 years, 48 boys; 141 CON: 10.0 ± 0.4 years, 74 boys). Cognitive performance was assessed by full scale IQ (FSIQ) and the NIH Toolbox® . Saliva samples were genotyped for two functional COMT single nucleotide polymorphisms (SNPs): rs4680 (Val158Met) and rs165599 (near the 3’UTR region). Results: On 3-way (SNP, sex, FSUD) ANOVAs, rs165599 tended to have negative effects on ADHD scores (p = 0.08) and externalizing behaviors (p = 0.06), with male AA-carriers with FSUD having higher ADHD scores (p = 0.10) and externalizing behaviors (p = 0.03). COMT rs165599 variant tended to have a negative effect on FSIQ (p = 0.08) and IQ processing speed (p = 0.07), with male AAcarriers with FSUD having the lowest scores. Regardless of FSUD, males with the rs4680 variant tended to have lower FSIQ (p = 0.06), but significantly lower processing speed scores (p = 0.003). Conclusions: The COMT genetic variants appear to have a greater negative influence on boys. FSUD boys with the rs165599 AA-genotype had greater ADHD symptoms and externalizing behaviors as well as lower FSIQ and slower processing speed. Both behaviors and cognitive function may be influenced by these genes involved in dopamine metabolism in a sex-specific manner. Financial Support: NIH (RC2-DA029475, 2K24-DA16170, U54NS56883, G12-MD007601). http://dx.doi.org/10.1016/j.drugalcdep.2014.09.386 Implementation of drug and HIV risk counseling in MMT programs in Taiwan Tony Szu-Hsien Lee 1 , Marek C. Chawarski 2 , C. Peng 1 , C. Hung 3 , D. Metzger 4 1
National Taiwan Normal University, Taipei, Taiwan Psychiatry, Yale School of Medicine, New Haven, CT, United States 3 Taichung Veteran General Hospital, Taichung, Taiwan 4 University of Pennsylvania, Philadelphia, PA, United States 2
Aims: Few methadone maintenance treatment (MMT) programs in Taiwan offer drug counseling and data on program
e173
implementation have rarely been reported. This study aims to examine the feasibility of Behavioral Drug and Risk Counseling (BDRC) as a component of MMTP and documents its implementation in Taiwan. Methods: 90 MMT patients were randomly assigned to treatment as usual (n = 45, MMT only) or MMT + BDRC (n = 45). Patients in the BDRC group receive weekly counseling in the first month, bi-weekly in months 2 and 3, and monthly in months 4 to 7 after enrollment. BDRC sessions offer education on biological and pharmacological mechanisms of heroin and methadone, skills to reduce/avoid HIV risk behaviors, maintaining or improving medication adherence, and establishing non-drug related activities supporting recovery. BDRC utilizes health education, setting small and achievable goals, positive feedback, and developing plans and skills to improve treatment participation and prolonged drug recovery. BDRC counselors (n = 4) received a 5-day training workshop at the program onset. Clinical supervision, including case discussions, is conducted monthly and lead by an experienced psychotherapist. Counselors maintain content checklists and notes from each session. Results: Content analysis of the checklists and counseling notes showed that counselors were able to deliver the BDRC but fidelity of counseling intervention varies between sites and counselors. Factors influencing intervention fidelity include: counselor’s professional background and past training, and site/organizational characteristics (e.g., availability of separate and confidential counseling space, coordination between case managers and counselors) and frequency of clinical supervision. Conclusions: Our preliminary findings support the potential of integrating behavioral counseling into regular MMT as a component of a comprehensive treatment in Taiwan. Financial Support: Supported by National Science Council (NSC100-2628-H-003-002-MY3). http://dx.doi.org/10.1016/j.drugalcdep.2014.09.387 What predicts continued substance use among probationers? Jennifer Lerch 1 , F. Taxman 1 , Scott Walters 2 1
George Mason University, Fairfax, VA, United States University of North Texas Health Science Center, Fort Worth, TX, United States 2
Aims: Probation supervision is designed to motivate drug users to suppress illicit substance use during supervision. The probation suppression effect has not been adequately tested. This study examines predictors of continued illicit substance use among probationers in two urban areas. Methods: 142 substance-using probationers participating in an ongoing randomized control trial. Probationers completed baseline and 2-month follow-up (2MFU) interviews. Probationers averaged 37 years old and were predominately male (72.5%) and AfricanAmerican (68.9%). The measures examined include age, criminal justice (e.g., lifetime arrests), treatment/use (e.g., recent hard drug use), and psychosocial (e.g., problem recognition) factors. Hard drug use includes opiates, cocaine, barbiturates, amphetamines, hallucinogens, and inhalants, which are statistically significant independent predictors of criminal behavior. Bivariate correlations and logistic regression models examined the relationship between individual factors and continued drug use (any) and hard drug use. Results: Bivariate analysis revealed homelessness, recent polysubstance use, recent hard drug use, substance use with family members, and peer substance use were associated with 2MFU overall drug use. Prior substance abuse treatment, age of first drug
e174
Abstracts / Drug and Alcohol Dependence 146 (2015) e118–e201
use, recent poly-substance use, recent hard drug use, lifetime hard drug use, problem recognition, and substance use with family were associated with 2MFU hard drug use. Logistic regression results reveal that homelessness (OR = 3.1, 95% CI = 1.0–9.6, p = .05) and recent hard drug use (OR = 2.7, 95% CI = 1.1–6.4, p = .02) increased the odds of 2MFU drug use. Recent hard drug users (OR = 4.3, 95% CI = 1.2–15.4, p = .02) had increased odds of 2MFU hard drug use. Conclusions: Probation has a limited suppression effect for people with severe substance use disorders. Recent hard drug use predicts future drug use and future hard drug use. The identification of probationers most at risk for failure due to continued substance use should assist probation agencies in targeting probationers for behavioral health services. Financial Support: NIDA R01DA029010-01A1. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.388 Is high fructose corn syrup addictive? Studies of operant intraoral self-administration in rats Francesco Leri, Anne Marie Levy Psychology, University of Guelph, Guelph, ON, Canada Aims: The numerous similarities between obesity and drug dependence suggest that some foods and drugs of abuse may share the ability to reinforce addictive behaviors. The current experiments in male Sprague-Dawley rats employed operant intraoral self-administration and taste reactivity to study and compare the hedonic and reinforcing effects of high fructose corn syrup (HFCS), saccharin and sucrose. Methods: Animals surgically implanted with intraoral cannulas were tested for orofacial reactions to different sweet solutions and allowed to press a lever to receive infusions of these solutions on continuous ratio (CR) and progressive ratio (PR) schedules of reinforcement. Results: Experiment 1 (n = 22) revealed that self-administration of HFCS on a CR schedule is sensitive to changes in concentration/infusion (10%, 25% and 50%), and that higher concentrations maintain higher breakpoints (BPs) on the PR schedule. Experiment 2 (n = 22) indicated that intake of HFCS escalates over 3 weeks of self-administration (3 h a day) because rats develop binge-like patterns of intake. Experiments 2 and 3 (n = 22) clearly indicated that various concentrations of saccharin do not substitute for HFCS, even when hedonic orofacial reactions are equated. Finally, Experiments 4 (n = 20) and 5 (n = 24) revealed that HFCS produces higher hedonic reactions than sucrose, and that at equicaloric concentrations, HFCS is more potent than sucrose (lowers responding on the CR schedule, and supports higher BPs on the PR schedule). Conclusions: These data in rats suggest that HFCS has unique hedonic and reinforcing characteristics that may cause addictivelike consumption of foods/drinks that contain it. Financial support: Studies supported by the Natural Sciences and Engineering Research Council of Canada (NSERC). http://dx.doi.org/10.1016/j.drugalcdep.2014.09.389
Immunization increases the reinforcement threshold but not elasticity of demand for nicotine in an animal model of nicotine reduction policy Mark G. LeSage 1,2 , Mylissa Staley 1 , Paul R. Pentel 1,2 1 Medicine, Minneapolis Medical Research Foundation, Minneapolis, MN, United States 2 Medicine, University of Minnesota, Minneapolis, MN, United States
Aims: Reducing the nicotine content in tobacco products is being considered by the FDA as an industry-wide policy to reduce the addictiveness of tobacco products. Medications could enhance the impact of such policy by helping smokers quit or significantly reduce their smoking at higher cigarette nicotine concentrations. By reducing or slowing nicotine distribution to brain, immunotherapy (vaccines or monoclonal antibodies) could increase the reinforcement threshold or elasticity of demand for nicotine, thereby raising the nicotine dose needed to maintain smoking. The purpose of the present study was to examine this issue in an animal model of nicotine reduction policy. Methods: Rats were trained to self-administer nicotine (0.06 mg/kg) during daily 2 h sessions. After NSA stabilized, the unit dose was reduced weekly until extinction levels of responding were achieved. Eight rats received weekly infusions of the nicotinespecific monoclonal antibody Nic311 during the dose reduction phase, while eight rats in a control group received infusions of control antibody. Exponential demand-curve analysis was conducted to compare the sensitivity of immunized and control rats to increases in the unit price (FR/unit dose) of nicotine (i.e. elasticity of demand). Results: Compared to controls, the dose response curve was shifted to the right and the threshold reinforcing nicotine dose was significantly higher in immunized rats (3.1 vs 11.7 ffJg/kg, p < 0.05). Although intensity of demand (intake at zero price, Q0) was greater in immunized rats (2.5 vs 1.1 mg/kg, p < 0.01), there was no difference in elasticity of demand (a). Conclusions: These findings show that immunization can attenuate the reinforcing effects of nicotine and might compliment nicotine reduction policy by increasing the reinforcement threshold for nicotine. Financial support: NIDA R01-DA026444 (LeSage, PI) http://dx.doi.org/10.1016/j.drugalcdep.2014.09.390 Examining HCV and other risks among rural women offenders Carl Leukefeld 1 , Kathi L.H. Harp 1 , Matthew Webster 1 , Michele Staton-Tindall 2 , Carrie B. Oser 3 , Jennifer R. Havens 1 1
Behavioral Science, University of Kentucky, Lexington, KY, United States 2 Social Work, University of Kentucky, Lexington, KY, United States 3 Sociology, University of Kentucky, Lexington, KY, United States Aims: Drug users are at heightened risk for Hepatitis C (HCV), which is intensified among the increasing number of women offenders. The prevalence of drug use and risky behavior among women offenders is also higher than males. This study adds to the limited information on rural women offenders by examining