The UCLA Integrated Substance Abuse Programs (ISAP) conducts research,
provides research training and clinical training, and arranges treatment
for substance abuse disorders in coordination with the UCLA Department
of Psychiatry and Biobehavioral Sciences and in affiliation with other
community-based treatment providers. ISAP efforts span the spectrum of
scientific and clinical activities pertinent to the investigation and
amelioration of substance abuse and related consequences. ISAP work ranges
from epidemiological and policy studies to basic science and human laboratory
programs to clinical trials of treatments involving innovative behavioral
and pharmacological approaches.
UCLA Integrated Substance Abuse Programs
Methamphetamine Studies
Updated November 2006
- Methamphetamine Abuse, Inhibitory Control: Implications for Treatment
- HIV Prevention for Heterosexual Methamphetamine Users in Drug Treatment
- Methamphetamine Abuse: Natural History, Treatment Effects
- Women, Methamphetamine, and Sex
- Methamphetamine Dependence: Treating Neurocognitive Impairment
- Double-Blind, Placebo-Controlled Trial of PROMETA© Pharmacotherapy
for the Treatment of Methamphetamine - Phase I, Double-Blind, Placebo-Controlled
Assessment of Potential Interactions Between Intravenous Methamphetamine
and Aripiprazole - Phase I, Interaction Clinical Trial
with Bupropion and Methamphetamine - Phase II, Double-Blind, Placebo Controlled
Trial of Bupropion for the Treatment of Methamphetamine Dependence - UCLA Medication Development Unit for
Stimulant Abuse - Methamphetamine Abuse Treatment–Special
Studies - (Remaining Topics Continued on Next Page – Click to Continue)
Methamphetamine Abuse, Inhibitory Control: Implications for Treatment
September
2006 – April 2010
Edythe D. London, PhD, Principal Investigator
Despite advances in the
scientific understanding of drug abuse and dependence, effective treatments
are lacking, and new therapies for these disorders are urgently needed.
The proposed P20-funded Developmental Center for Translational Research
on Addictions will address this need by integrating preclinical studies
to directly inform clinical research on drug addiction, and complementarily,
leveraging clinical insights to help target basic science approaches.
The proposed Center links basic scientists who have made significant
contributions to knowledge of the neurobiological components of addiction
with clinical investigators who are at the forefront in treatment research.
The theme of the developmental center will be impaired inhibitory control
as a therapeutic target for methamphetamine (MA) dependence. We made
this choice because of: a) the magnitude of the MA abuse problem worldwide;
b) the severity of its consequences; c) the lack of an effective treatment
for MA dependence; d) the importance of impaired inhibitory control to
drug addiction; and e) our leadership in advancing the understanding
and treatment of MA abuse. With this initial focus, we propose four interrelated
projects to characterize impairments in response inhibition consequent
to methamphetamine (MA) exposure at behavioral, neural systems, and neurochemical
levels in both human and animal models, and to assess the pharmacological
modulation of these deficits. The four research projects in this P20
Center aim: 1) to delineate the neural circuitry underlying deficits
in inhibitory control in MA-dependent human subjects; 2) to relate deficits
in inhibitory control to drug-taking behavior using a human laboratory
model of MA self-administration; 3) to establish and characterize (behaviorally
and neurochemically) a non-human primate model for investigating inhibitory
control deficits characteristic of MA abuse; and 4) to characterize regional
brain neurochemical effects of pharmacological manipulations aimed at
modulating response inhibition in a rodent model for MA dependence. The
four projects are integrated in a way that would not be feasible if each
project had been designed to be a discrete study, outside the Center
environment. The Center will support these scientific projects with the
over-arching goals of creating an environment for interdisciplinary translational
research, whereby the flow of information from basic research in animal
models and human laboratory studies can be rapidly applied to development
of treatments for drug abuse, and developing a program of research career
development that will coordinate and enhance existing training programs,
providing multiple, excellent opportunities for pre- and postdoctoral
fellows and faculty to initiate new projects focusing on translational
approaches to studies of the neurobiology of drug abuse.
HIV Prevention for Heterosexual Methamphetamine Users in Drug
Treatment
September 2005 – August 2007
Mary-Lynn Brecht, Principal Investigator
This study is using personal interviews to collect data on HIV and injection
risk behaviors, risk-related information/skills, risk-seeking, impulsivity,
and resistance to coercion in a sample of 400 methamphetamine-using offenders
referred to drug treatment in Kern County, CA. Analyses will describe
HIV risk behaviors and test relationships between these behaviors and
psychosocial factors, risk-seeking, impulsivity, and resistance. Because
drug treatment offers a prime opportunity for intervention aimed at prevention
of HIV risk behavior, this pilot study is examining patterns of these
behaviors in order to form a basis for developing interventions tailored
for this population.
Methamphetamine Abuse: Natural History, Treatment Effects
February 1998 – July 2005
Mary-Lynn Brecht, Principal Investigator
This study addresses specific aims in three areas: (1) assessment of
methamphetamine (MA) use patterns over time and the long-term consequences
of MA use, including the conditional impact of demographic, background,
and health characteristics, and the relationships of MA-use histories
to other substance use, HIV/AIDS risk behaviors, and criminal behaviors;
(2) examination of long-term treatment outcomes (including differential
effects for ethnicity, gender, modality, and other user characteristics)
and patterns of treatment utilization for MA users; and (3) description
of motivation, addiction severity, and other barriers limiting treatment
access for MA users who have not participated in treatment. Using the
Natural History Interview (NHI), the study interviewed a sample of 365
MA users admitted to treatment for MA use in 1995-1997 to publicly funded
outpatient and residential programs in Los Angeles County; a 3-year follow-up
interview was also completed on this treated sample in order to understand
longer-term treatment outcomes.
Women, Methamphetamine, and Sex
April 2006 – March 2011
Alison H. Brown, Principal Investigator
This is a mixed methods study of women methamphetamine (MA) users’ sexual
experiences and behaviors. It involves longitudinal in-depth qualitative
interviews with 30 women MA users and secondary analysis of data on risk
behaviors among women MA users. Considering that women who abuse substances
such as MA typically have multiple factors (e.g., histories of violence
and abuse) placing them at risk for poor sexual decision-making, a more
in-depth understanding of how women MA users conceptualize their sexual
behaviors and experiences could assist in developing interventions for
this group of women.
Methamphetamine Dependence: Treating Neurocognitive Impairment
September 2005 – September 2006
Ari Kalechstein, Principal Investigator
Over the past several years, investigators of the UCLA Integrated Substance
Abuse Programs (ISAP) have built upon clinical experience gained from
providing treatment for methamphetamine-dependent individuals to develop
a human laboratory program aimed at assessing the neurobiological consequences
of methamphetamine exposure. Current research designs at ISAP and
other research groups focus on the evaluation of methamphetamine-dependent
individuals following abstinence initiation. While these studies
are important, they do not utilize neurocognitive impairment as a marker
for determining the extent of methamphetamine-associated neurotoxicity. Because
impaired neurocognitive functioning is associated with poorer functional
outcomes (e.g., employment status, treatment outcome), reversal of these
impairments could enhance the quality of treatments for methamphetamine
dependence.
Double-Blind, Placebo-Controlled Trial of PROMETA© Pharmacotherapy
for the Treatment of Methamphetamine
March 2005 – January 2007
Walter Ling, Principal Investigator
This study assesses the efficacy of the PROMETA© pharmacotherapy
compared to placebo for initiating abstinence and for preventing relapse
to methamphetamine use in treatment-seeking individuals meeting criteria
for methamphetamine abuse in multiple treatment locations. The
study design includes random assignment to pharmacotherapy condition,
and both participants and study personnel are blinded to assigned condition.
Screening verifies participant eligibility and collects demographic,
drug use, psychiatric and neuropsychological information, before participants
are randomly assigned to either the PROMETA© pharmacotherapy condition
(n=45) or to the placebo condition (n=45).
Phase I, Double-Blind, Placebo-Controlled Assessment
of Potential Interactions Between Intravenous Methamphetamine and Aripiprazole
January 2003 – January 2008
Thomas Newton, Principal Investigator
Phase I, Interaction Clinical Trial with
Bupropion and Methamphetamine
January 2003 – January 2008
Thomas Newton, Principal Investigator
Phase II, Double-Blind, Placebo Controlled Trial
of Bupropion for the Treatment of Methamphetamine Dependence
January 2003 – January 2008
Richard A. Rawson, Principal Investigator
The NIDA Methamphetamine Clinical Trials Group (MCTG) established five
clinical research sites coordinated by UCLA researchers where medications
with potential value for methamphetamine (MA) users will be tested. This
study is a preliminary assessment of the efficacy and safety of bupropion
in reducing MA use in subjects with MA dependence. It is hypothesized
that bupropion treatment, compared to placebo, will be associated with
fewer days of MA use as measured by quantitative urine analysis for MA.
Results are in review for publication.
UCLA Medication Development Unit for
Stimulant Abuse
September 2004 – February 2010
Walter Ling, Thomas Newton, Richard Rawson, Steven Shoptaw, Principal Investigators
The UCLA Medication Development Unit for Stimulant Abuse is a NIDA-funded research
center dedicated to the development of medications to treat methamphetamine dependence.
The center supports several research clinics throughout the Los Angeles area
as well as a biostatistical/clinical trials methodology core. Phase I and phase
II clinical trials of prospective medications that have been completed by the
center or are currently underway include trials of amantadine, baclofen, gabapentin,
selegiline, cabergoline, sertraline, DHEA, bupropion, vigabatrin, and modafinil.
Methamphetamine Abuse Treatment–Special
Studies
September 2001 – March 2007
Patricia Marinelli-Casey, Principal Investigator
This is a collection of research studies that examines the long-term
consequences of methamphetamine dependence, the temporal trends in adherence
to a manualized treatment model, and the costs of various treatment approaches.
The MAT-SS project builds on the work conducted by the Methamphetamine
Treatment Project (MTP), the largest randomized clinical trial of treatments
for methamphetamine dependence to date. The MTP was conducted as an eight-site
outpatient trial, with ISAP serving as the Coordinating Center. There
are three separate studies included in the current MAT-SS project:
• The Multiyear Follow-up
Study assesses a cohort of participants who were enrolled in
the MTP by conducting follow-up interviews at 3-years post-intake.
The purpose of the study is to examine patterns and consequences
of methamphetamine abuse over time.• The Treatment Adherence
Study contributes to knowledge about integrating research-based
therapies into practice by assessing adherence to a manualized treatment
as a function of time.• The Cost Analysis Study evaluates
and compares the cost of a manualized treatment approach (Matrix Model)
to other locally available treatment approaches studied in the MTP.