Clinicians associated with the Veterans Administration looked more favorably upon contingency management after attending training workshops on the use of the intervention. Despite being highly effective at decreasing drug use, contingency management is one of the least used among proven substance abuse treatments.
Two recent studies suggest that genotyping may enable clinicians to base therapies on individual patients’ potential responsiveness to opioid drugs’ therapeutic effects and vulnerability to their harmful effects.
One of NIDA’s goals is to try to understand the individual differences that contribute to whether or not someone who takes a drug will become addicted to it. Dr. Rutter’s research focuses on three types of differences: Environmental, developmental, and genetic and epigenetic.
Intensified screening for HIV among injection drug users receiving opioid agonist therapy could prevent more than twice as many new infections as current screening practice. A recent study based on mathematical modeling found that screening every 6 months instead of annually, and adding viral RNA testing to the currently used HIV antibody testing, could improve both effectiveness and cost-effectiveness.
Active drug use before incarceration was associated with decreased engagement in HIV treatment among HIV-infected jail detainees. The severity of drug dependence correlated with worsening measures of engagement in HIV treatment. The study concludes that evidence-based treatment for drug abuse in jails may result in improved HIV treatment outcomes, which in turn could help slow HIV-transmission rates in the United States.
Microneedles are an innovative technique for delivering medications through the skin, a route that could particularly benefit patients receiving naltrexone therapy for opioid and alcohol dependence. Researchers have found a way to use the transdermal technique to deliver a single treatment of naltrexone that lasts for 7 days.
Study patients with HIV–hepatitis C coinfection progressed to successive degrees of severity of liver fibrosis 9 years sooner than those infected with HCV alone. Further findings from the study suggest that suppressing HIV with antiretroviral medications may slow HCV-related liver fibrosis.
A trial of buprenorphine/naloxone (Bup/Nx) showed no evidence that the medicine was associated with liver damage. The drug gave results similar to those of methadone. The study data indicate that although most patients can be treated safely with either methadone or Bup/Nx without major concern for liver injury, clinicians are advised to continue to monitor the liver health of their patients who are on methadone or Bup/Nx therapy.
More than half of heroin-addicted patients treated with naltrexone via an implanted delivery device maintained abstinence throughout a 6-month clinical trial in Saint Petersburg, Russia. The implant device, which releases a steady dose of naltrexone continuously for 2 months, averted relapse to heroin use three times as effectively as daily oral doses of the medication.