Effects of buprenorphine and an alternative nondrug reinforcer, alone and in combination on smoked cocaine self-administration in monkeys

Rodefer, Joshua S.; Mattox, Adande J.; Thompson, Sherry S.; Carroll, Marilyn E.

doi:10.1016/s0376-8716(97)01341-0

Cited by 30 publications

(28 citation statements)

References 28 publications

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“…Although increasing the dose of methadone could be a useful strategy to significantly reduce cocaine use in heroin-and cocaine-dependent patients as reported in a prospective study with 421 methadone-maintained patients [55] , methadone and MM do not seem intrinsically efficacious for the treatment of cocaine addiction in dual-opiate-dependent patients. Moreover, there are important and complex pharmacokinetic interactions between cocaine and methadone; cocaine abuse has been described as decreasing methadone blood concentrations, possibly by inducing CYP3A4 and by accelerating methadone elimination [49][50][51] .…”

Section: Discussionmentioning

confidence: 99%

Suboxone® (Buprenorphine/Naloxone) as an Agonist Opioid Treatment in Spain: A Budgetary Impact Analysis

Martı́nez-Raga

Saiz²,

Pascual³

et al. 2009

Eur Addict Res

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Objective: To evaluate the economic impact of buprenorphine/naloxone (B/N) as an agonist opioid treatment for opiate dependence. Methods: A budgetary impact analysis model was designed to calculate the annual costs (drugs and associated costs) to the Spanish National Healthcare System of methadone versus B/N. Data for the model were obtained from official databases and expert panel opinion. Results: It was estimated that 86,017 patients would be in an agonist opioid treatment program each of the 3 years of the study. No increase in the number of patients is expected with the introduction of B/N combination. The budgetary impact (drugs and associated costs) for agonist opiate treatment in the first year of the study would be 89.53 million EUR. In the first year of B/N use, the budgetary impact would rise by 4.39 million EUR (4.6% of the total impact), with an incremental cost of 0.79 million EUR (0.9% of the total impact). The budgetary increase would be 0.6% (0.48 million EUR increase) and 0.6% (0.49 million EUR increase) in the second and third years of use, respectively. The mean cost per patient in the first year with and without B/N would be EUR 1,050 and 1,041, respectively. The most influential variables in the sensitivity analysis were logistics and production costs of methadone and the percentage use of B/N. Conclusion: With an additional cost of only EUR 9 per patient, B/N is an efficient addition to the therapeutic arsenal in the drug treatment of opiate dependence, particularly when considering clinical aspects of novel pharmacotherapy.

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Section: Discussionmentioning

confidence: 99%

Suboxone® (Buprenorphine/Naloxone) as an Agonist Opioid Treatment in Spain: A Budgetary Impact Analysis

Martı́nez-Raga

Saiz²,

Pascual³

et al. 2009

Eur Addict Res

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“…Third, subjects were not treatment seeking which has been a criticism of laboratory studies examining various smoking cessation medication effects (see Perkins et al 2006). However, money was provided as an alternative reinforcer in order to provide some incentive for not smoking and to enhance the likelihood that the effects of alcohol on the relative reinforcing value of tobacco would be detected (see Higgins, 1997;Rodefer et al, 1997). Perkins et al (2006) and others (Stitzer et al, 1986;Gilbert et al, 1999) acknowledge that motivation to abstain can be temporarily raised through the use of monetary reinforcement.…”

Section: Discussionmentioning

confidence: 99%

“…Money was provided as an alternative reinforcer in order to provide some incentive for not smoking and to enhance the likelihood that the effects of alcohol on the relative reinforcing value of tobacco would be detected (see Higgins, 1997;Rodefer et al, 1997). We predicted that alcohol would reduce the ability to resist the first cigarette and would increase subsequent smoking.…”

Section: Nih-pa Author Manuscriptmentioning

confidence: 99%

“…Once subjects 'gave in' and decided to smoke (or alternatively, waited the full 50 minutes), the tobacco self-administration session consisted of a one-hour period, in which subjects could choose to smoke their preferred brand of cigarettes using a smoking topography system or receive monetary reinforcement for cigarettes not smoked. Money was provided as an alternative reinforcer in order to provide some incentive for not smoking and to enhance the likelihood that the effects of alcohol on the relative reinforcing value of tobacco would be detected (see Higgins, 1997;Rodefer et al, 1997). We predicted that alcohol would reduce the ability to resist the first cigarette and would increase subsequent smoking.…”

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confidence: 99%

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Modeling the effect of alcohol on smoking lapse behavior

et al. 2006

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The primary aim of this project was to examine the role of alcohol use in smoking lapse behavior, as alcohol consumption is a known risk factor for poor smoking cessation outcomes. We have developed a novel human laboratory model to examine two primary aspects of alcohol-mediated tobacco relapse: 1) Does alcohol facilitate the initiation of the first cigarette? 2) Once the first cigarette is initiated, does alcohol facilitate subsequent smoking? Using a within-subject design, 16 daily smokers who were also heavy social drinkers received a priming drink (0.03 g/dl or taste masked placebo) and then had the option of initiating a tobacco self-administration session or delaying initiation by five minute increments for up to 50 minutes in exchange for monetary reinforcement. Subsequently, the tobacco self-administration session consisted of a one-hour period, in which subjects could choose to smoke their preferred brand of cigarettes using a smoking topography system or receive monetary reinforcement for cigarettes not smoked. Alcohol craving, tobacco craving, subjective reactivity to alcohol, and nicotine withdrawal were assessed as secondary outcomes. Results demonstrated that after consuming the alcohol beverage, subjects were less able to resist the first cigarette and initiated their smoking sessions sooner, and smoked more cigarettes compared to the placebo beverage. These findings have implications for smoking cessation in alcohol drinkers and model development to assess smoking lapse behavior. Keywordssmoking; lapse behavior; alcohol; craving; human laboratory; monetary reinforcement It is well established that alcohol consumption and tobacco use are highly correlated in both clinical and non-clinical samples. Among alcoholics, 80% to 95% are smokers (DiFranza & Guerrera, 1990;Hughes, 1993;Kalman et al., 2005;Patten et al., 1996;Sobell et al., 1990), as compared to 23% in the general population (CDC, 2003 (DiFranza & Guerrera, 1990;Grant et al., 2004;Hurt et al., 1994) and the severity of alcohol and tobacco dependence is positively correlated (Ellingstad et al., 1999;Gulliver et al., 1995). Smoking is also highly correlated with drinking in nonalcoholic individuals (Carmody et al., 1985;Istvan & Matarazza, 1984), particularly among those who are heavy drinkers. Both laboratory studies and naturalistic observations have demonstrated that alcohol consumption is strongly associated with increased rates of smoking (Glautier et al., 1996;Mitchell et al., 1995;Shiffman et al., 1994). Additionally, there is evidence for cross-substance craving from both clinical and non-clinical samples (Drobes et al., 2000;Tiffany, 1995). Given the high co-occurrence of alcohol and tobacco use, it is not surprising that alcohol has been identified as a risk factor for poor smoking cessation outcomes (Baer & Lichenstein, 1988;Shiffman 1986;Zimmerman et al., 1990). For example, Shiffman (1986) found that 20% of all relapse episodes in smokers involved alcohol consumption. In a real-time examination of first lapse episodes, ...

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“…We enrolled individuals with heavier patterns of alcohol and cigarette use (15-25 cigarettes per day; at least nine drinks per week for females; at least 12 drinks per week for males) than the Acheson et al (2006). Similar to the Acheson et al (2006) we used an alcohol self-administration paradigm that has demonstrated sensitivity for detecting medication effects (see O'Malley et al 2002), that includes money as an alternative reinforcer to provide some incentive for not drinking and to enhance the likelihood that the effects of nicotine on the relative reinforcing value of alcohol would be detected (see Higgins 1997;Rodefer et al 1997). …”

Section: Introductionmentioning

confidence: 99%

Effect of transdermal nicotine replacement on alcohol responses and alcohol self-administration

et al. 2007

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Rationale-Nicotine replacement is commonly used to treat tobacco use in heavy-drinking smokers. However, few studies have examined the effect of nicotine replacement on subjective and physiological responses to alcohol and alcohol drinking behavior.Objective-The primary aim of this within-subject, double-blind study was to examine whether transdermal nicotine replacement (0 mg vs 21 mg/day) altered response to a low-dose priming drink and subsequent ad libitum drinking behavior.Materials and methods-Subjects (n=19) were non-treatment-seeking, non-dependent heavy drinkers who were daily smokers. Six hours after transdermal patch application, subjective and physiological responses to a priming drink [designed to raise blood alcohol levels (BALs) to 0.03 g/ dl] were assessed. This was followed by a 2-h self-administration period where subjects could choose to consume up to eight additional drinks (each designed to raise BALs by 0.015 g/dl) or to receive monetary reinforcement for drinks not consumed.Results-We found that 6 h after patch application, tobacco craving associated with withdrawal relief was decreased, and systolic blood pressure and heart rate were increased in the active patch condition compared to the placebo patch condition. Subjective intoxication in response to the priming drink was attenuated in the active nicotine patch condition compared to 6 h of nicotine deprivation (i.e., placebo patch). During the self-administration period, subjects had longer latencies to start drinking and consequently appeared to consume fewer drinks when administered the active patch compared to the placebo patch.Conclusions-In heavy drinkers, transdermal nicotine replacement compared to mild nicotine deprivation attenuated subjective and physiological alcohol responses and delayed the initiation of drinking.

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Effects of buprenorphine and an alternative nondrug reinforcer, alone and in combination on smoked cocaine self-administration in monkeys

Cited by 30 publications

References 28 publications

Suboxone® (Buprenorphine/Naloxone) as an Agonist Opioid Treatment in Spain: A Budgetary Impact Analysis

Suboxone® (Buprenorphine/Naloxone) as an Agonist Opioid Treatment in Spain: A Budgetary Impact Analysis

Modeling the effect of alcohol on smoking lapse behavior

Effect of transdermal nicotine replacement on alcohol responses and alcohol self-administration

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