ISAP in the News (2010)
Compiled by UCLA Health Sciences Media Relations.
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ISAP Study Finds Promising Results in Treating Opioid Dependence with Buprenorphine Implant
Results from a Phase III randomized, placebo-controlled clinical trial of Probuphine (subcutaneous implant form of buprenorphine) treatment for opioid addiction were published Oct. 13, 2010, in the Journal of the American Medical Association (JAMA). ISAP Director Walter Ling, M.D., is the lead author of the article. All the major news networks interviewed Dr. Ling regarding the publication of these important results, and the study was featured in Reuters, the Los Angeles Times, BusinessWeek, Bloomberg News, U.S. News & World Report, HealthDay News, MedPage, Medscape Today, Canadian Press, HealthDay News, and Agence France-Presse (see below for links to news articles).
ISAP’s Outpatient Clinical Research Center was one of the sites involved in the multi-site, 163-patient trial, which showed that patients receiving the Probuphine implant had significantly less illicit opioid use, experienced fewer symptoms of withdrawal and craving, stayed in treatment longer, and had greater overall improvement when compared to placebo patients over the course of the 24-week study.
"The introduction of buprenorphine into clinical practice is arguably the most significant improvement in the treatment of opioid addiction in the last decade,” said Dr. Ling. “However, physicians excited with the clinical success of buprenorphine are also rightfully concerned about medication adherence and diversion—and potential for abuse—of the sublingual formulations of buprenorphine. Probuphine does away with these concerns by eliminating the need for take-home doses. Additionally, by providing a sustained blood level of active medication, Probuphine helps diminish the daily fluctuation of the medication effects—and potentially side effects—and reduces the total exposure of buprenorphine over time."
Notable results of the publication, "Buprenorphine Implants for Opioid Dependence: A Randomized Controlled Trial," include:
- Patients receiving Probuphine had a mean percentage of urine samples that tested negative for illicit opioids across the full 24 weeks of 36.%; those in the placebo group had a mean of 22.4% (p=0.01)
- Nearly 66%of patients receiving Probuphine completed the study vs. the 31% who received placebo implants (p<0.001)
- Probuphine patients experienced fewer clinician-rated (p<0.001) and patient-rated (p=0.004) withdrawal symptoms
- Probuphine patients reported lower ratings of craving (p<0.001)
- The most common adverse events were minor implant site reactions, which were consistent across the Probuphine and placebo groups
ISAP’s OCRC is continuing to investigate Probuphine.
The following are links to media coverage of this study:
“A Potentially Better Way to Treat Opioid Addiction”
“An Implant to keep Heroin Addicts Off Street Drugs?”
“Drug Implant for Opioid Addiction Looks Effective”
“Implants Help Heroin Addicts Kick Habit”
The Benefits of Drumming Therapy
Daniel Dickerson, a research psychiatrist with ISAP, was quoted in an Aug. 10 Florida Ledger article on the psychological and physiological benefits of Native American drumming.
From the article:
The physicality, the sounds and the social dynamics of drumming have intrigued many beyond the original inhabitants of North America, said Dr. Daniel Dickerson, a research psychiatrist with UCLA's Integrative Substance Abuse Program.
New age practitioners and counselors of many ethnicities have looked at the effects of drumming, he said in his Thursday morning talk. They have found suggestions that it can increase brain waves associated with relaxation, drowsiness and meditative states. In some circumstances, drumming may reduce anxiety or stress.
Dickerson encouraged his listeners, who included substance abuse counselors from around the country, to talk about how drumming might become part of a clinical program, prescribed alongside Prozac or other medications.
He outlined some of the tougher issues: What about Christians who feel drumming clashes with their religion? What about gender roles, since some cultures forbid women to drum while others encourage it?
Dickerson has applied for a federal grant to fine-tune what he calls "drum-assisted recovery therapy" and to run a pilot program on its efficacy.
“Messages of Honor, Tradition and Health Come from Drumming”
Scientific Research Lacking for Ibogaine as an Addiction Treatment
Richard Rawson, professor of psychiatry at the Semel Institute and associate director of UCLA's ISAP, was quoted July 5 by the Omaha World-Herald about ibogaine, a hallucinogenic extract sometimes used to treat drug addictions.
From the article:
A leading researcher in the treatment of addictions, Richard Rawson, associate director of the UCLA Integrated Substance Abuse Programs, said researchers have serious concerns about the safety of the powerful drug, which can induce 30-hour, dream-like reactions.
“Ibogaine appears to damage at least one critical set of neurons in the brain, and in some of the treatment trials outside the U.S., there have been unexplained deaths during ibogaine treatments,” Rawson said.
“Well-controlled scientific research” is lacking, he said.
“Omahan: Drug Breaks Meth's Grip”
Richard Rawson, professor of psychiatry and associate director of ISAP at the Semel Institute, was quoted in a May 2 article in the Providence Journal (Rhode Island) about doctor shopping and obtaining prescription drugs illegally.
From the article:
Adults are also savvy medicine cabinet shoppers. Richard A. Rawson, Ph.D., a professor at the Semel Institute at the Department of Psychiatry of the University of California at Los Angeles, has 35 years experience in this field, and related an extreme case of a young woman addicted to 90 Vicodin pills a day.
He said, “She had such a sophisticated habit that she worked nearly full time at keeping index cards of doctors whom she saw. Each card documented the reason she gave the doctor for requiring the drug with the name of the pharmacy where she filled the prescription.”
Dr. Rawson explained that this Realtor made a point of attending open houses. She would ask to use the bathroom, head for the medicine cabinet and pilfer whatever painkiller prescriptions she found there. “By checking the name on the prescription bottle, she also found a new resource who dispensed Vicodin,” he said.
Dr. Rawson believes that the majority of physicians dispensing prescription drugs do so believing that they are acting in the best interest of the patient, unlike “Candyman,” a California doctor recently sentenced to four years in prison for knowingly handing out large quantities of drugs.
It appears that we hear more stories about physicians in California involved in facilitating pill popping than elsewhere in the nation. This may relate to a policy statement from the California Medical Association. Dr. Rawson noted, “It says in effect that under-treating pain violates standards of care. So we have doctors trying to respond to patient needs. Yet it is hard to know when patients are crossing that fine line between pain relief and addiction.”
“Rita Watson: Pill Popping and Doctor Shopping”
Researchers Examine Possible Link Between Tanning and Addictive Behavior
Suzette Glasner-Edwards, clinical psychologist and a member of ISAP, was quoted April 19 on ABCNews.com about criteria determining whether a behavior can be termed an addiction.
From the report:
"It takes a long time to formally classify something as an addiction," said Suzette Glasner-Edwards, a clinical psychologist and researcher in UCLA's integrated substance abuse programs. "Typically it takes a lot of research studies to see if all the symptoms ... really conform to how we understand addiction to other things. It's a pattern of progressively losing control over a behavior. There are a lot of different ways we assess whether a person has lost control over drinking or drug use."
Glasner-Edwards explained that behavior would have to go beyond self-destructive and impair other areas of their life as well, such as social interaction and recreational activities.
"If they don't have impairment in their life as a result of it, then they won't get that diagnosis," she said.
"Study Shows Links between Tanning and Addictive Behavior"
Dealing with a Drug-Addicted Child
Richard A. Rawson, an associate director of ISAP, appeared Feb. 16 in an ABC World News series that explored options parents have for helping a drug-addicted child.
From the series:
The “tough love” approach took off in the 70s and 80s: when all else fails, crack down. It can work, but experts caution that, if handled wrong, tough love can also do harm.
"We found that the major impacts of treatments that involve a lot of confrontation and tough love are to drive people away from treatment," said Richard Rawson, associate director of UCLA Integrated Substance Abuse Programs. "It's exactly the opposite of what we want to do."
“Family in Crisis, at the Breakpoint”
Computer Program Shows Teens Possible Effects of Meth Use on Their Appearance
Larissa Mooney, assistant clinical professor of psychiatry at the Semel Institute, commented Jan. 7 on ABCNews.com about a new anti-drug program to prevent teens from taking methamphetamine. The program uses a camera and software to show teens how the drug might alter their appearance for the worse within a few years.
“Face2Face Computer Program Shows Kids Consequences of Meth Use”
Strategies for Making Changes in Our Lives and Keeping New Year’s Resolutions
Suzette Glasner-Edwards, a research psychologist at ISAP in the Semel Institute, appeared Dec. 31 on KPCC 89.3 FM’s “AirTalk” program. She discussed strategies to make changes in our lives and keep New Year’s resolutions.
“New Year’s Resolutions: How to Quit a Vice”