- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01377610
Improved Strategies for Outpatient Opioid Detoxification
Long-acting Injectable Naltrexone Induction: A Randomized Trial of Outpatient Opioid Detoxification With Naltrexone vs. Buprenorphine
The investigators will randomize 210 opioid-dependent participants to one of two outpatient detoxification strategies: (1) a standard 7-day buprenorphine induction and gradual taper from 8 mg to 0 mg vs. (2) 7-day oral naltrexone induction; both groups will receive a single administration of a Vivitrol injection: at Day 8 for the naltrexone induction group and Day 15 for the buprenorphine group. The naltrexone arm is a modification of our current inpatient naltrexone induction procedure, consisting of a single day of buprenorphine followed by a washout day and 4 days of ascending oral naltrexone doses, prior to administering a dose of injectable naltrexone on Day 8. All participants will receive an intensive behavioral therapy for five weeks and will be followed for the subsequent 8 weeks to assess the longer-term outcome of the initial treatment. The primary outcome will be percentage of patients in each group successfully inducted onto Vivitrol. Key secondary outcomes will be 2-week abstinence at Weeks 4-5 (3rd and 4th weeks after Vivitrol injection), rates of completion of the 8-day detoxification, and percentage of patients in each group who return for additional Vivitrol injections in post-study follow-up. The main goal of this Stage 1a pilot study is to develop an improved outpatient opioid detoxification strategy, with particular relevance to newly diagnosed heroin addicts and prescription opioid abusers not seeking long-term agonist maintenance.
Specific Aim #1: To develop procedures for outpatient opioid detoxification which include naltrexone to facilitate detoxification.
Specific Aim #2: To compare injectable naltrexone induction rates between the naltrexone and buprenorphine groups following short-term outpatient opioid detoxification approach for initiating treatment for opioid dependence.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Study Type
Enrollment (Actual)
Phase
- Phase 1
Contacts and Locations
Study Locations
-
-
New York
-
New York, New York, United States, 10032
- Substance Treatment and Research Service (STARS), Columbia University
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Meets DSM-IV criteria for current opiate dependence disorder of at least six months duration, supported by urine toxicology OR COWS score > or =6 OR Naloxone Challenge .
- Seeking treatment for opioid dependence.
- In otherwise good health based on complete medical history and physical examination
- Able to give written informed consent.
Exclusion Criteria:
- Methadone maintenance treatment or regular use of illicit methadone (> 30 mg per week).
- Maintenance on, or regular use of buprenorphine or other long-acting narcotic agonists
- Active medical illness which might make participation hazardous, such as untreated hypertension, acute hepatitis with AST or ALT > 3 times normal, AIDS, unstable diabetes.
- Severe psychiatric illness (psychotic disorder, major depression, suicide risk or 1 or more suicide attempts within the past year.)
- Physiologically dependent on alcohol or sedative-hypnotics
- History of allergic or adverse reaction to buprenorphine, naltrexone, naloxone, clonidine, or clonazepam.
- Chronic pain requiring opioid analgesia or anticipated surgery necessitating opioid medications
- AIDS dementia or other chronic organic mental disorder
- Pregnancy, lactation, failure to use contraception
- History of accidental drug overdose in the last 3 years as defined as an episode of opioid-induced unconsciousness or incapacitation, whether or not medical treatment was sought or received.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Buprenorphine
Standard 7-day buprenorphine induction and gradual taper from 8 mg to 0 mg followed on day 15 by Vivitrol injection
|
Following detoxification with buprenorphine [8-mg buprenorphine (Day 1) tapering to 0 mg (Day 7)] participants will receive Vivitrol injection on Day 15.
Behavioral therapy sessions will be offered for five weeks.
dose of long-acting injectable naltrexone (Vivitrol 380 mg i.m.
Injection)
Other Names:
|
Active Comparator: Oral naltrexone
The naltrexone arm is a modification of our current inpatient naltrexone induction procedure, consisting of a single day of buprenorphine followed by a washout day and 4 days of ascending oral naltrexone doses.
Followed on day 8 by Vivitrol injection.
|
Following detoxification with buprenorphine [8-mg buprenorphine (Day 1) tapering to 0 mg (Day 7)] participants will receive Vivitrol injection on Day 15.
Behavioral therapy sessions will be offered for five weeks.
dose of long-acting injectable naltrexone (Vivitrol 380 mg i.m.
Injection)
Other Names:
Following detoxification with buprenorphine (one dy of 8 mg) followed by oral naltrexone (ascending taper to 25 mg), participants will receive Vivitrol injection on Day 8. Behavioral therapy sessions will be offered for five weeks.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Percentage of patients in each group successfully inducted onto Vivitrol
Time Frame: Completion of 7-day detoxification
|
Comparison of the percentage of patients assigned to each detoxification group (oral naltrexone vs. buprenorphine) who receive Vivitrol at the completion of detoxification.
|
Completion of 7-day detoxification
|
Collaborators and Investigators
Collaborators
Investigators
- Principal Investigator: Adam Bisaga, M.D., Columbia University and NYSPI
Publications and helpful links
Helpful Links
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Mental Disorders
- Chemically-Induced Disorders
- Substance-Related Disorders
- Narcotic-Related Disorders
- Opioid-Related Disorders
- Physiological Effects of Drugs
- Central Nervous System Depressants
- Peripheral Nervous System Agents
- Analgesics
- Sensory System Agents
- Analgesics, Opioid
- Narcotics
- Narcotic Antagonists
- Alcohol Deterrents
- Buprenorphine
- Naltrexone
Other Study ID Numbers
- #6374/7250R
- 2R01DA010746-09A1 (U.S. NIH Grant/Contract)
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Opioid Dependence
-
National Development and Research Institutes, Inc.Unknown
-
MindLight, LLCMclean HospitalRecruitingOpioid Dependence | Opioid Use | Opioid Abuse | Opiate Dependence | Opioid Use, Unspecified | Opioid Use Disorder, ModerateUnited States
-
Milton S. Hershey Medical CenterRecruitingOpioid Dependence FentanylUnited States
-
New York State Psychiatric InstituteNational Institute on Drug Abuse (NIDA)Completed
-
Orexo ABWorldwide Clinical TrialsCompletedOpioid Dependence, on Agonist TherapyUnited States
-
National Development and Research Institutes, Inc.St. Luke's-Roosevelt Hospital CenterUnknownOpioid-Dependence Among AdolescentsUnited States
-
University of PennsylvaniaNational Institute on Drug Abuse (NIDA)CompletedOpioid Dependence | Opioid-use Disorder | Opiate DependenceUnited States
-
Orexo ABWorldwide Clinical TrialsCompletedOpioid Dependence, on Agonist TherapyUnited States
-
Indivior Inc.CompletedOpioid Dependence | Cocaine Dependence | Opioid Related DisordersUnited States
-
NYU Langone HealthNational Institute on Drug Abuse (NIDA)Completed
Clinical Trials on Buprenorphine
-
Montefiore Medical CenterRecruiting
-
Steve N. Caritis, MDEunice Kennedy Shriver National Institute of Child Health and Human Development...TerminatedPregnancy | Opiate AddictionUnited States
-
Indivior Inc.CompletedOpioid Use Disorder | Opioid-related DisordersUnited States
-
Indivior Inc.Completed
-
New York State Psychiatric InstituteNational Institute on Drug Abuse (NIDA)SuspendedExtended-Release Buprenorphine vs. Sublingual Buprenorphine for the Treatment of Opioid Use DisorderOpioid-use DisorderUnited States
-
Friends Research Institute, Inc.National Institute on Drug Abuse (NIDA)Completed
-
Duke UniversityNational Institute on Drug Abuse (NIDA); The Emmes Company, LLCCompletedOpioid Use DisorderUnited States
-
Orexo ABWorldwide Clinical TrialsCompletedOpioid-Related Disorders | Opiate DependenceUnited States