Ctntexasnode.utsouthwestern.edu
T xas Node Newsletter
Trivedi's Thoughts
Dear Texas Node,
This is the time where we all have undoubtedly reflected upon our
accomplishments of the past year and are now in the midst of working
Volume 2, Issue 1
toward our goals for this year. I'd like to take this opportunity to provide a ‘State of the Node' update.
Last year was eventful and productive on many fronts. Study
activities continuing into this year include four protocols (CTN-0037 STRIDE, CTN-0048 CURB, CTN-0049 Project HOPE, and CTN-0052 BRAC)
at five sites. STRIDE at Memorial Hermann Prevention and Recovery Center, STRIDE at Nexus Recovery Center, and CURB at the South Texas
Node Highlights
VA will be closing in the next few months.
Looking forward, BRAC at Nexus and Project HOPE at Parkland will
continue this year and undoubtedly our sites will perform superbly. We will
Protocols in
also complete our commitment as the STRIDE Lead Team this year.
Progress
Finally, four CTN studies are on the horizon and their timing is dependent upon the current financial climate that is likely impacting all of us, whether
CTP Scoop
we are performing research or direct patient care.
Other indicators of the Node's performance include dissemination of
Bridging the Gap
information related to addiction treatment advances. Our publication record last year continued its upward trend. Our goal is to continually improve on this metric. We expect to publish significantly more this year,
Training & CEUs
especially related to data collected in the STRIDE trial that we are leading. We hosted a successful conference last spring in Dallas in which free CEUs
Upcoming Events
were provided to treatment providers. Given the current climate of research funding, we are fortunate to have the support of excellent colleagues whose willingness to donate their time will allow us to offer the
conference again this April.
I want to thank and recognize all of you for your tremendous
support of our common goal of improving addiction treatment outcomes. Without your collaboration, this work would not be possible.
Many Regards,
Page 2
Node Highlights
Stay tuned for more information about the conference, including free CEUs!
Sponsored by Nexus Recovery Center, Inc. and the Texas Node.
Congratulations to these elected CTN Leaders from our Node:
Executive Committee
Research Development Committee
PI Representatives:
CTP Representatives:
Kathleen Brady, Dennis Donovan, Edward
Becca Crowell, Al Cohen, Larry DeMarzo,
Nunes, and Madhukar Trivedi
John Gardin, Nancy Hamilton
CTP Representatives:
PI Representatives:
Kathy Burlew, Marc Fishman, Louise Haynes,
John Rotrosen, Maxine Stitzer, Roger
and Candance Hodgkins
Weiss, Theresa Winhusen, George Woody
Page 3
Protocols in Progress
CTN-0037 Stimulant
CTN-0048 Cocaine Use Reduction with
Reduction
Buprenorphine (CURB)
Intervention using
Dosed Exercise
CURB's aim is to investigate the safety and
(STRIDE)
effectiveness of buprenorphine in the
presence of naltrexone for the treatment
This trial will determine if exercise vs.
of cocaine dependence in individuals
health education, both of which are
meeting diagnostic criteria for cocaine dependence and
added to treatment as usual, improves
either past-year opioid dependence, abuse, or use with a
substance abuse treatment outcomes
history of opioid dependence.
in people with stimulant abuse or
dependence.
The South Texas VA has stayed busy over the past few
months pushing for a strong finish to the CURB trial.
Happy New Year Texas Node! We hope
Recruitment for the CURB study ended with our site
you all had a wonderful holiday season
contributing 22 randomizations and a site treatment
and an even better new year! As you
exposure rate of 81%.
can see from our pictures, we made a point to bring the holiday spirit to
The final active phase visit occurred on December 14,
Nexus and to all of our participants.
2012, and we have five participants in the follow-up
Memorial Hermann completed their
phase as of January. Our staff is actively in
final participant visit in January. They
communication with our remaining available participants
finished STRIDE with an impressive
to ensure finishing the trial with a high follow-up
96% primary outcome availability rate.
attendance rate.
Congratulations!
We had a routine monitoring visit in January and our final
participant follow-up visit is scheduled for March 5th.
Nexus is in the home stretch now,
Many members of our staff have joined the manuscript
working hard to keep our remaining
groups that will begin teleconferences in February so that
participants in good attendance for the
our site may contribute to the planned CURB publications.
rest of the study.
Contributed by Alex Carrizales
Availability of primary outcome data for
Nexus continues to be high at 89% and Nexus. And Nexus has increased its follow-up attendance by another one percent! Go team!
CTN-0048-A-1 CURB Genetics Protocol
As both sites prepare for study close-out, we have been working diligently to
The CURB Genetics Study's primary aim is to
review all of our data with a fine-
determine what role genes play in the
toothed comb. As a result, both sites'
effectiveness of buprenorphine and
latest interim Monitoring Visits
naltrexone as a potential treatment for
conducted by Emmes were a great
cocaine dependence.
success! Retention of the final
participants (for Nexus) and data
As of January, 280 samples have been collected from the
quality is the main focus now, and
302 randomized CURB participants, representing a 93%
we're happy to report that both areas
recruitment rate. Close-out of the Genetics study is
are doing quite well. Excellent job,
occurring now and only requires sites to return or
destroy the sample collection kits and ensure the final
data is complete and clean.
Contributed by Mora Kim
Contributed by Dr. Robrina Walker
Page 4
CTN-0049 Project HOPE (Hospital
CTN-0052 A
Visit as Opportunity for Prevention
Randomized
and Engagement) for HIV-Infected
Controlled
Drug Users
Evaluation of
Buspirone for
Relapse-Prevention in Adults with Cocaine
Project Hope will evaluate the effectiveness
Dependence (BRAC)
of a brief intervention in achieving viral
suppression when delivered to HIV-infected
The BRAC study's main objective is to evaluate
drug users recruited from the hospital setting.
the efficacy of buspirone, relative to placebo, in
The Project HOPE team screened 167
preventing relapse in cocaine-dependent adults
participants and randomized 42 into the study,
in residential treatment who are planning to
reaching the halfway point of recruitment in
enter outpatient treatment upon discharge.
Dallas had a beautiful white Christmas, but
As we add more participants to the study, our Patient Navigators are working diligently to
unfortunately Old Saint Nick did not get the
engage each of their participants into HIV and
message and failed to deliver the kind of white
substance use treatment. Each participant on
crackly Christmas that CTN0052 needs (female
their caseload has a unique set of challenges
crack users in Nexus' residential program). Since
mythical figures are failing to help our
Orlando & Deneen
recruitment rate, Lisa Stephenson, Hamsa
Kumar, and John Tillitski are taking it to the
Interviewing, the
streets and posting recruitment flyers in shelters,
Patient Navigators
churches, and community gathering points.
encourage participants to move
Nexus is currently renovating the old adolescent
towards positive
dormitory and will expand the adult women's
changes in their lives. When they are
program by 17 beds. We anticipate this will
not meeting with their participants in person,
increase our recruitment rate. We are also
Orlando House and Deneen Robinson are
considering having Hamsa record a radio spot to
answering calls from their participants,
advertise the study – she'll be bringing back
researching new services or attempting to re-
Hammertime because we're too legit to quit.
engage participants who are lost to follow up. All of their hard work is paying off and the
On the positive side, our first four participants
Parkland site is #1 for completion of Month 1
have successfully completed the study without
intervention visits and #3 in Month 2-3!
missing a visit! We will miss working with them
The entire team continues to receive praise
as they brought a lot of joy and humor to our
from the Lead Team for our excellent
work. Finally, we
recruitment rate and the site coordinator Stacy
welcome our new local
Abraham was asked to share recruitment
Hamsa, Lisa, Mora, & John
strategies on a national call. Credit for our
quality assurance
success also goes to Research Assistant Kate
monitor, Stacy Jackson,
Dzurilla and Outreach Worker Gerald
to the team. She's been
holding our feet to the
We completed a successful monitoring visit in
fire and I have heard
January with minimal findings and were
rumblings about having
applauded for attention to detail in completing
an iron maiden installed
all aspects of the study, specifically the
as "just a reminder."
informed consent process which has been challenging for this inpatient population.
Contributed by John
Contributed by Stacy Abraham, MPH
Tillitski
Page 5
CTN Scoop
To share your news, please send information to
Nexus Officially Opens New Youth Hall
The construction of the new 12,500 square-foot Youth Hall was completed with the
open house for the community held on December 12th. On December 31st, an
excited group of adolescents and counselors moved in. Some of its features
include 32 beds, an exercise room, a group room, a living area, Dallas
Independent School District classrooms where adolescents will attend school while in treatment, a computer lab, and counselor offices.
In 1993, Nexus reached out to this group by opening its adolescent program. In 2013, it remains the only provider in Texas that offers a pregnant/postpartum treatment program for adolescents. The previous adolescent dorm is being converted into additional adult women and detoxification beds.
A very large gift was donated to Nexus in December, and the building will be named for that donor. The official ribbon cutting ceremony was held on January 29. The "donor recognition sign" will be revealed after the ribbon is cut. Congratulations, Nexus, on this impressive achievement for the community!
fers FREE webinars throughout the year that are available to
people within and outside of the NIDA CTN
The 2013 schedule will be announced soon.
2012 and earlier webinars now archived for viewing include:
Page 6
Bridging the Gap
Dr. Karen Chartier Presented at the National Summit on Health Disparities
Karen G. Chartier, Ph.D. participated on a panel at the Summit on the Science of Eliminating
Health Disparities, in National Harbor, MD on December 18, 2012. The 2012 Summit involved
many NIH institutes and centers, including NIDA and brought together clinicians, researchers, and
community, business, and policy leaders around national and international efforts to eliminate
health disparities.
Dr. Chartier's panel was titled "Social Determinants of Alcohol-related Disparities: Epidemiology,
Etiology, and Treatment." Her presentation summarized epidemiologic data on differences across
U.S. ethnic groups in drinking, alcohol related social and health harms, and treatment use. Dr.
Chartier currently serves as the Site PI for CTN-0052 at Nexus Recovery Center, Inc. in Dallas.
As part of the CTN's Minority Interest Group, Dr. Chartier also to the poster "Lessons Learned on
Treating Racial/Ethnic Minority Substance Abusers" at the Summit. The poster summarized
secondary analysis results from four CTN analyses addressing racial/ethnic minorities (listed
below). Dr. Chartier's co-authors included biostatistician Thomas Carmody, former Research
Coordinator Maleeha Akhtar, and collaborators Scott Walters and Diane Warden.
L. Montgomery, A.K. Burlew, A. Kosinski, and A. Forcehimes – "Motivational Enhancement Therapy
(MET) for African American Substance Users"
A.K. Burlew, L. Montgomery, A. Kosinski, and A. Forcehimes – "Does Treatment Readiness
Enhance the Response of African American Substance Users to MET?"
K. Chartier, T. Carmody, M. Akhtar, S. Walters, and D. Warden – "Hispanic National Group
Differences in Substance Use, Cultural Factors and Treatment Outcomes among Treatment-Seeking
Adults"
L.M. Ruglass, D.A. Hien, and M. Hu – "Racial/Ethnic Match and Treatment Outcomes for Women
with PTSD and Substance Use Disorders Receiving Community-Based Treatment"
3 FREE NAADAC and NBCC credit hours:
Addressing Sexual Issues in Addictions Treatment Workshop
What: 2.5 hour workshop developed by the CTN's Research Utilization Committee. 1. Read the Counselor magazine article "Addressing Sexual Issues in Addictions Treatment." 2. View videos: Introduction (3 min.); The Real Men are Safe (REMAS) Clinical Trial (40
min.); and HIV/STD Safer Sex Skills Building (SSB) Groups for Women in Methadone Maintenance or Drug-Free Outpatient Treatment (50 min.)
3. Take a quiz. Clickto jump directly to the CEU page for all the materials and more information.
Page 7
Recent Publications
*click first author for abstracts**
L., Trello-Rishel, K., Riggs, P., Nakonezny, P. A., Acosta, M., Bailey, G., &
Winhusen, T. (2013). Predictors of treatment response in adolescents with comorbid
substance use disorder and attention-deficit/hyperactivity disorder. Journal of Substance
Abuse Treatment. doi: 10.1016/j.jsat.2012.07.001
K. G., Hesselbrock, M. N., Hesselbrock, V.M. (2013). Ethnicity and gender
comparisons of health consequences in adults with alcohol dependence. Substance Use
and Misuse. doi:10.3109/10826084.2013.747743
D. M., Daley, D. C., Brigham, G. S., Hodgkins, C. C., Perl, H. I., Garrett, S.
B.,.Seamans, C.L. . Zammarelli, L. (2013). Stimulant abuser groups to engage in 12-
Step: A multisite trial in the National Institute on Drug Abuse Clinical Trials Network.
Journal of Substance Abuse Treatment, 44(1), 103-114. doi: 10.1016/j.jsat.2012.04.004
A., Griffin, M. L., Frost, K., Augenstern, J., Fitzmaurice, G., Potter, J. S., . .
Weiss, R. D. (2013). Patient characteristics that predict treatment outcome for
prescription opioid dependence: Results from a multisite study. Drug and Alcohol
Dependence. doi: 10.1016/j.drugalcdep.2012.12.010
Feldstein, E., Walters, S. T., & Baer, J. S. (2012). Adolescents and young adults In C.
Wagner & K. Ingersoll (Eds.), Motivational interviewing in groups. New York: Guilford
Press.
R. K., DeVito, E. E., Dodd, D., Carroll, K. M., Potter, J. S., Greenfield, S. F., .
. Weiss, R. D. (2013). Gender differences in a clinical trial for prescription opioid
dependence Journal of Substance Abuse Treatment. doi: 10.1016/j.jsat.2012.12.007.
C. M., Chartier, K. G., Caetano, R., & Harris, T. R. (2012). Alcohol availability
and neighborhood poverty and their relationship to binge drinking and related problems
among drinkers in committed relationships. Journal of Interpersonal Violence, 27(13),
2703-2727. doi: 10.1177/0886260512436396.
M., Rethorst, C. D., Fuzat, G., Greer, T. L., . . Trivedi, M. H. (2012).
STimulant Reduction Intervention using Dosed Exercise (STRIDE) – Description of the
exercise intervention and behavioral program to ensure adherence. Mental Health and
Physical Activity, 5(2), 175-182. doi: 10.1016/j.mhpa.2012.08.003
A. N., Nakonezny, P. A., Winhusen, T. M., Adinoff, B., & Vongpatanasin,
W. (2013). Risk of methylphenidate-induced prehypertension in normotensive adult
smokers with ADHD. The Journal of Clinical Hypertension, 15(2), 124-132. doi: 10.1111/
jch.12039.
T. M., Somoza, E. C., Lewis, D. F., Kropp, F. B., Horigian, V. E., & Adinoff, B.
(2013). Frontal systems deficits in stimulant-dependent patients: Evidence of pre-illness
dysfunction and relationship to treatment response. Drug and Alcohol Dependence, 127(1-
3), 94-100. doi: 10.1016/j.drugalcdep.2012.06.017.
To have your pubs included in the next issue, please send to
Page 8
Recent Publications (cont'd)
Brooks, A., Lokhnygina, Y., Meade, C. S., Potter, J. S., Calsyn, D. A., &
Greenfield, S. F. (In Press). Ethnic differences in the rates and correlates
of HIV risk behaviors among drug abusers. American Journal on
Feb. 22nd
Chartier, K. G., Vaeth, P. A. C., & Caetano, R. (In Press). Ethnicity and
Texas Research
the social and health harms from drinking. Alcohol Research & Health.
Society on Alcoholism
*Denton, W., Adinoff, B., Lewis, D., Walker, R., Winhusen, T. (In
Press). Family discord in association with increased substance use for
Mar. 13th-16th
pregnant substance users. Substance Use and Misuse.
Society for Research
on Nicotine & Tobacco
Leahy, M. M., Jouriles, E. N., & Walters, S. T. (In Press). An examination
of college students' receptiveness to alcohol-related information and
advice: A psychometric evaluation. Journal of College Student
Mar. 13th-16th
Development.
American
Psychosomatic Society
*Potter, J. S., Marino, E. N., Hillhouse, M. P., Nielsen, S., Wiest, K.,
Canamar, C. P., Martin, J. A., Ang, A., Baker, R., Saxon, A. J., Ling, W. (In
Press). Buprenorphine and methadone maintenance treatment outcomes
Mar. 17th-20th
for opioid analgesic, heroin, and combined users: Findings from Starting
American Academy of
Treatment with Agonist Replacement Therapies (START). Journal of
Health Behavior
Studies on Alcohol and Drugs.
*Potter, J. S., & Marino, E. (In Press). Chronic Pain Perspectives:
Mar. 20th-23rd
Practical strategies for identifying and monitoring opioid misuse risk in
Society of Behavioral
clinical practice. Journal of Family Practice.
Medicine
San Francisco, CA
*Winhusen, T. M., Lewis, D. F., Adinoff, B. H., Brigham, G., Kropp, F. B.,
Donovan, D. M., Seamans, C. L.,. . Somoza, E. C. (In Press).
Mar. 20th-24th
Impulsivity is Associated with Treatment Non-Completion in Cocaine- and
American Counseling
Methamphetamine-Dependent Patients but Differs in Nature as a Function
Association
of Stimulant-Dependence Diagnosis. Journal of Substance Abuse
Treatment doi: 10.1016/j.jsat.2012.12.005.
Apr. 2nd-4th
National Rx Drug
*Directly from research conducted within the CTN.
Abuse Summit
Apr. 26th
Texas Addiction
A brief encounter with a stranger who
Research to Practice
acknowledges a person leads people
Conference
to feel more socially connected than
people who were deliberately ig-nored? Next time, try a smile and you may make someone's day. LiveScience, May 25, 2012:
Source: http://ctntexasnode.utsouthwestern.edu/information_links/newsletter_5.pdf
Dietary Guidelines Goals and Recommendations Physicians Committee for Responsible Medicine Authors: Susan Levin, M.S., R.D. Neal Barnard, M.D. Preamble The U.S. Government has promulgated dietary guidance in various forms throughout much of the last century. In recent decades, two major trends have occurred: First, the dietary problem of undernutrition has been eclipsed by an epidemic of overnutrition. More Americans are now overweight or obese than at any time in history. Diabetes, cardiovascular disease, and cancer are now commonplace, exacting costs that are both personal and financial. Abundant scientific information has established the role of nutrition in health, but much of this information has yet to be incorporated into practical dietary guidance for the benefit of the public. Although scientific knowledge has moved swiftly forward, nutritional guidelines have progressed only sluggishly. We therefore sought to establish a set of dietary guidance materials that serve the current needs of the public, based on current scientific knowledge. We first established eight general objectives for the guidance document. We then sought evidence-based materials that quantify nutritional needs and examined the most healthful sources of the essential nutrients.
Università degli Studi di Catania Scuola Superiore di Catania International PhD Investigation of Cancer Stem Cells (CSCs)-derived exosomes and their influence on the tumor microenvironment Coordinator of PhD Tutor Prof. Daniele Condorelli Prof. Ruggero De Maria a.a. 2008/2011 Agli uomini della mia vita Valerio e Riccardo