Medication and Counseling for Controlled Drinking (ProjectSMART)
Naltrexone and CBT for Problem-Drinking MSM
Problem drinking gay and bisexual men who try to quit drinking are at risk for relapse to heavy or problematic drinking because their social lives and social outlets are often strongly associated with alcohol. These men are most receptive to interventions focused on moderation of drinking rather than abstinence. However moderation-oriented cognitive-behavior therapy (CBT) and naltrexone (NTX) are both well established treatments for problem drinkers who wish to moderate, rather than stop, drinking. Research suggests that combining these treatments may enhance their efficacy.
This study combines moderation-oriented CBT with NTX in the treatment of problem drinking gay and bisexual men, who do not wish to abstain from alcohol, to evaluate their efficacy alone and in combination. We also propose to utilize new data collection technology, Interactive Voice Response, to collect data on daily relations among drinking, sexual behavior and psychological variables thought to mediate treatment response. Our objectives are to evaluation the efficacy of 12 weeks of randomly assigned treatment, with 100 mg of NTX or placebo, combined with brief supportive therapy or modified, behavioral self-control therapy specifically tailored to gay/bisexual men; to evaluate conditional relationships between heavy drinking and likelihood of HIV risk behavior; and to evaluate daily associations among mood, craving, self-efficacy, motivation, and drinking. Assessments will include baseline, 3, 6, & 9 month follow-up. A substudy of the treatment trial will be conducted to collect and bank samples from blood for research aimed at associating naturally occurring differences in DNA with patient response to NTX, and with potential mediational mechanisms of action of NTX. Information gathered on genes or gene products may be used in conjunction with data on clinical psychological factors obtained as part of the clinical trial to evaluate relationships among genetic variants, drug effects, and mechanisms of treatment response. Patients will be asked to give a blood sample at Week 0 of the clinical trial for the purpose of carrying out genetic research.
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Undersøgelsestype
Undersøgelsestype
Tilmelding (Faktiske)
Tilmelding
Fase
Fase
- Fase 3
Kontakter og lokationer
Studiesteder
-
-
New York
-
New York, New York, Forenede Stater, 10019
- Columbia Addiction Services and Psychotherapy Intervention Research
-
-
Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria:
- Currently sexually active with other men
- Report drinking at levels substantially in excess of established guidelines for non-hazardous drinking
- Willing to reduce drinking to non-hazardous levels
- English literate (8th grade level)
Exclusion Criteria:
- Current physical disease or condition making participant inappropriate for a medication trial, including total bilirubin elevation >110% AST or ALT elevations >300%
- History of serious psychiatric illness (psychotic disorder, bipolar disorder, or psychiatric illness requiring hospitalization)
- Recent (past three month) initiation of psychotropic medication or psychotherapy, or recent change in psychotropic medication treatment
- Current DSM-IV diagnosis of drug (other than nicotine) dependence, or lifetime diagnosis of opioid dependence
- DSM-IV alcohol dependence diagnosis judged clinically severe, history or present evidence of significant alcohol withdrawal symptoms, or recurrent use of alcohol to alleviate withdrawal
- Regular use of opioids in the past month
- History of of hypersensitivity to NTX
- Considered by study physician not to be suitable for receipt of an investigational drug
- Likely to require treatment with opiate pain medication during the course of the study
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Faktoriel opgave
- Maskning: Tredobbelt
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
|
Eksperimentel: active medication + psychotherapy
|
Moderations- og kognitiv-adfærdsbaseret psykoterapi.
Behandlingsmål om moderation af alkoholforbrug.
12 ugentlige sessioner af 1 times varighed.
100 mg oral dosage daily for 12 weeks
|
|
Eksperimentel: placebo + psychotherapy
|
Placebo
Moderations- og kognitiv-adfærdsbaseret psykoterapi.
Behandlingsmål om moderation af alkoholforbrug.
12 ugentlige sessioner af 1 times varighed.
|
|
Eksperimentel: active medication+brief supportive counseling
|
100 mg oral dosage daily for 12 weeks
Brief supportive counseling to enhance compliance with medication and encourage goal-setting concerning alcohol consumption.
|
|
Eksperimentel: placebo + brief supportive counseling
|
Placebo
Brief supportive counseling to enhance compliance with medication and encourage goal-setting concerning alcohol consumption.
|
Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Tidsramme |
|---|---|
|
Mængde af alkoholforbrug
Tidsramme: 9 måneder
|
9 måneder
|
|
Hyppighed af binge drinking
Tidsramme: 9 måneder
|
9 måneder
|
Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Tidsramme |
|---|---|
|
Hyppighed af HIV-risikoadfærd
Tidsramme: 9 måneder
|
9 måneder
|
Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Datoer for undersøgelser
Studer store datoer
Studiestart
Studiestart
Primær færdiggørelse (Faktiske)
Primær færdiggørelse
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Skøn)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Skøn)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Nøgleord
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- AA015553-01A1S1
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