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November 30, 2017   

Primary Outcomes from CTN-0051: X:BOT Published



The primary outcomes paper from CTN-0051, Extended-Release Naltrexone vs. Buprenorphine for Opioid Treatment (X:BOT), made the national news this month, with articles in the New York Times, Washington Post, the Wall Street Journal, CNN, and more.

The study aimed to estimate the difference in opioid relapse-free survival between extended-release naltrexone (XR-NTX) and buprenorphine-naloxone (BUP-NX).

CTN-0051 was a 24-week, open-label, randomized controlled, comparative effectiveness trial held in 8 U.S. community-based inpatient services, with outpatient follow-up for participants, all of whom were users or heroin or prescription-type opiates.

Half of the participants (n=283) were randomized to receive XR-NTX (Vivitrol), a monthly injection, with the other half (n=287) assigned to receive BUP-NX (Suboxone), which came as a film patients placed under their tongues. Participants were followed for 24 weeks of outpatient treatment.

As expected, participants randomized to XR-NTX had a substantial induction hurdle: XR-NTX can trigger severe withdrawal in patients if they have not detoxed from opioids first (treatment with Suboxone can be initiated sooner). As a result, fewer participants successfully initiated treatment with XR-NTX (72%) than with BUP-NX (94%).

Of the 474 participants who did successfully begin treatment, however, researchers found that both medications were equally safe and effective, exciting news for those engaged in combating the nation's opioid epidemic.

Citation: Lee JD, et al. Comparative Effectiveness of Extended Release Naltrexone versus Buprenorphine-Naloxone for Opioid Relapse Prevention (X:BOT): A Multicentre, Open-Label, Randomised Controlled Trial. The Lancet 2017 (in press). Find this paper in the CTN Library!

Also New in the Library:

Age Differences in Outcomes Among Patients in the "Stimulant Abuser Groups to Engage in 12-Step" (STAGE-12) Intervention. Garrett SB, et al. Journal of Substance Abuse Treatment 2018;84:21-29. Read more about this paper in the CTN Library!

CTN Trial Progress

GraphStudy results for Open Studies as of the November 29 trial Progress Report.

CTN-0064 - Linkage to HCV Care. Enrolled 113

CTN-0068 - ADAPT-2 for Methamphetamine Use Disorder. Enrolled 94

CTN-0069 - OUD in the Emergency Department. Enrolled 77

CTN-0073 - Detecting Cocaine Use Using Smartwatches. Enrolled 11

Total Enrolled in all Studies: 24,401

This project is supported by a grant from the National Institute on Drug Abuse to the University of Washington Alcohol and Drug Abuse Institute, but the information on this site has not been reviewed by NIDA and does not necessarily reflect the views of the Institute.

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CTN Annual Scientific Meeting, March 20-22, 2018

Registration is open!

The National Drug Abuse Treatment Clinical Trials Network will hold their 2018 Annual Scientific and Steering Committee Meeting on March 20-22, at the Bethesda North Marriott Hotel & Conference Center in North Bethesda, Maryland.

The meeting will provide a forum for knowledge exchange of current substance abuse treatment research findings and their policy implications. Topics will include updates on best practices in the science of addiction and substance abuse disorders.

Who Should Attend?

Members of the CTN, substance abuse treatment providers, researchers, and policy makers; as well as those who work in related fields and share an interest in improving substance abuse treatment and advancing the science of addiction.

Meeting website: https://apps.leedmci.com/nida/ctn/meetings/

Please register soon! Registration will close on March 5, 2018.

Posters wanted!

Sharing of the results, experiences, techniques, and observations from performing our trials is a critical and exciting part of the CTN experience. To that end, CTN members are encouraged to submit posters for display at the 2018 CTN Annual Scientific Meeting Poster Session to be held on March 21, 2018.

Poster submissions should be relevant to the CTN either directly (i.e. reporting on CTN studies, data, etc.) or indirectly (i.e. information that informs potential future CTN projects). As in previous years, the conference committee will consider new posters, as well as posters that were presented at meetings over the past year.

The deadline for poster submissions is January 15, 2018.

Find guidelines and submission instructions here. . .

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News from the Nodes


The Mid-Southern Node is pleased to announce a newly approved study sponsored by the Patient-Centered Outcomes Research Institute (PCORI) entitled Integrated Health Services to Reduce Opioid Use While Managing Chronic Pain.

This study is a collaboration between RTI International, the University of North Carolina Health System, the Duke University Health System, and the Vanderbilt University Health System.

Dr. Li-Tzy Wu is the Principal Investigator (PI) at Duke and Dr. Rowena Dolor and Dr. Alex Cho are co-investigators at Duke.

More information on this study can be found on PCORI’s website.

Find a list of recent publications from the Mid-Southern Node here.

Ohio Valley

The Ohio Valley Node hosted CTN Director Dr. Betty Tai and NIDA senior advisor Geoffrey Laredo on November 27-28 to visit OVN offices and associated treatment programs at the University of Cincinnati.

The visit included a public symposium on Tackling the Ohio Opioid Crisis: Harnessing the Power of Science to Break the Cycle, for which Dr. Tai presented the keynote address "Collision Of PAIN & OPIOID Epidemics: Challenges & Solutions."

Over 400 attendees received information on efforts by local legislative bodies, state-level policy makers, academic health systems, providers, and researchers to more effectively address the current opioid crisis in Ohio.

Dr. Theresa Winhusen, OVN PI, thanks Dr. Tai and Mr. Laredo for taking the time out of their busy schedules to meet with us here in the OVN!

Find more photos from this event here!

Pacific Northwest

Grant News: The Alcohol & Drug Abuse Institute at the University of Washington, home of the CTN Pacific Northwest Node, is pleased to join the Addiction Technology Transfer Centers Network as the new Northwest Regional ATTC, serving Alaska, Idaho, Oregon, and Washington.

The work of the NWATTC will encompass information dissemination, training and technical assistance, and systems consultation for SUD and healthcare organizations and their personnel -- all intended to increase awareness and implementation of empirically-supported behavioral health treatment and recovery practices.

Read more about the ATTC Network and its new initiatives.

People News: The PNW Node says farewell and good luck to Elizabeth Witwer, MPH, relocating to the East Coast for a research position at the Guttmacher Institute, where she had worked previously.

During her time with the PNW Node, Ellie worked with colleagues on the new Practice Based Research Network SIG that aims to expand the number of NIDA CTN protocols relevant to and engaging primary care practices, and to increase the ability of community-based practices to participate in CTN studies. Drs. Laura-Mae Baldwin (Pacific Northwest Node) and Rowena Dolor (Mid-Southern Node) are co-chairs.

Read more about the PBRN SIG.

In A Conversation with Michelle Peavy CTN researcher and psychologist Michelle Peavy discusses the role of research in improving the delivery of effective treatment to clients at Evergreen Treatment Services, an opioid treatment program in Seattle.

Dr. Peavy is one of the co-authors of the recent primary outcomes article for CTN-0051, the X:BOT study.

Find a list of recent publications from the PN Node here.

Northeast Node

In a November 2017 webinar from the Northeast Node’s Science Series, Dr. Mary Brunette presented on smoking cessation in young adults with a Serious Mental Illness (SMI).

In "What’s age got to do with it? Addressing smoking in young adults with comorbidity," Dr. Brunette discussed the high prevalence of smoking in young people, how smoking is linked with comorbid mental illness and addiction, and effective strategies to help young people quit smoking, with a goal of preventing the development of smoking-related disease and early mortality.

So what’s different about young adult smokers with a serious mental illness (SMI)? In a study Dr. Brunette conducted, she found that young adults with SMI had lower rates of tobacco dependence, breath carbon monoxide, and quit attempts in the past 3 months compared to smokers aged 31 and above. Dr. Brunette also compared a web-based motivational decision support tool, called Let’s Talk About Smoking (LTAS), to standard information from the American Lung Association website. The study found that young adult smokers with SMI, although having endorsed some quitting behavior, were not interested in initiating cessation treatment. Rather, self-reported treatments such as talking to a friend about quitting were most utilized. Interestingly, participants who used LTAS were more likely to be abstinent (verified by breath carbon monoxide) at 3-months post baseline.

Dr. Brunette also offered some tips and strategies for addressing smoking among young adults with SMI, including a video of three quit stories that providers can use. You can view Dr. Brunette’s slide-show, which includes more tips and strategies for treating tobacco use in young adults with SMI on the Northeast Node’s website.

In January 2018, the Science Series will present "Initiating Treatment of Opioid Use Disorder in Emergency Departments," by Dr. Ryan McCormack from New York University. The Emergency Department (ED) is a critical venue to initiate opioid use disorder (OUD) interventions. ED patients have a disproportionately high prevalence of substance use disorders, are at an elevated risk of overdose, and many do not access healthcare elsewhere. Despite this, OUD interventions are rarely initiated in EDs. Lack of training, time, and definitive referral opportunities are frequently cited barriers. Research is urgently needed to clearly identify, develop and implement the elements essential to initiating OUD treatment and referral in EDs in ways that are effective, practical and sustainable across settings and that are acceptable to patients, families, providers, healthcare agencies and payers. Dr. McCormack will present on ED-based interventions and pharmacotherapy for opioid use disorder. Specifically, he will discuss design and implementation of NIDA CTN-0079: ED Connection to Care with Buprenorphine for Opioid Use Disorder in Rural and Urban Settings (ED CONNECT), a multi-center study anticipated to begin recruitment in early 2018 at Bellevue Hospital Center (NY, NY), Catholic Medical Center (Manchester, NH) and Valley Regional Healthcare (Claremont, NH).

For more information, or to get on the Science Series mailing list, please email Bethany.M.McLeman@Dartmouth.edu.

Western States

CTN-0067, the Comparing Treatments for HIV-Positive Opioid Users in an Integrated Care Effectiveness Study (CHOICES): Scale-Up study, plans to randomize 350 patients with opioid use disorder in 7 geographically diverse HIV clinics to receive extended-release naltrexone versus treatment as usual for opioid use disorder.

Primary outcomes are HIV viral suppression, with secondary outcomes including other measures of HIV care engagement and opioid use. Site investigators and research team members convened in Portland, Oregon for national protocol training, October 2 and 3, 2017, with plans to open for enrollment in December 2017. Participating HIV clinic sites include Tarzana, CA, Lexington, KY, Orlando, FL, Miami, FL, Chicago, IL, Washington DC, and Baltimore, MD.

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New Opportunities

Call for Papers: Addictive Behaviors

CTN0079 iconAddictive Behaviors is now accepting submissions for a special issue, Improving the Implementation of Quantitative Methods in Addiction Research. There is an increasing focus on developing more transparent and robust approaches to conducting science, including pre-registration of hypotheses, open sharing of protocols, sharing of analytic syntax and data, and collaborative efforts to replicate prior research. Considerable evidence suggests that best-practice recommendations for the application of quantitative methods are rarely followed in applied research. Yet there have been few efforts to understand or improve this research-to-practice gap for quantitative methods.

This proposed series is an attempt to improve the research-to-practice gap in quantitative methods for addictions research. In general, submissions should present research focused on how to improve the practice of commonly used statistical models in applied research on addictions.

The deadline for manuscript submission is March 31, 2018. Prior to submitting a manuscript, the authors are encouraged to submit a brief letter of intent to Guest Editors Kevin King (kingkm@uw.edu) and Kristina Jackson (kristina_jackson@brown.edu) to ensure that their topic fits within the scope of this special issue.

Read more about the submission process here. . .

Pragmatic Trials Collaboratory Training Workshop

CTN0079 iconThe goal of the NIH Health Care Systems Research Collaboratory is to strengthen the national capacity to implement cost-effective, large-scale research studies that engage healthcare delivery organizations as research partners. The Collaboratory Coordinating Center (CC) disseminates Collaboratory-endorsed policies, best practices, and lessons learned to inform broad participation of healthcare systems and their patients, practitioners, and staff in research.

To augment these efforts, the CC will be hosting a 2-day in-person training workshop February 20-21, 2018, in Durham, NC.

The participants who will benefit the most from this training workshop include clinical investigators at the mid and senior levels who are in the process of focusing their research careers on the development and conduct of innovative pragmatic trials embedded in healthcare systems. Travel, lodging, and food costs for the attendees will be covered. Applications are due December 15, 2017.

Read more about the workshops and how to apply here. . .

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News from the ATTC

ATTC Network Workforce Report 2017: A National Qualitative Report: Offers a national perspective on the workforce to help better understand current strategies that states and provider agencies are using to address their workforce needs. Read about it in the latest ATTC Messenger. . .

The Latest ATTC/NIATx Blog posts:

Also of Interest

Upcoming Conference Deadlines!
If you're thinking doing a conference presentation in 2018, note that deadlines to submit abstracts are coming up soon for several major conferences of relevance to the CTN! Here are a few you might be planning to attend and their submission deadlines:



Published by the CTN Dissemination Library of the Pacific Northwest Node
Alcohol & Drug Abuse Institute, University of Washington

This project is supported by a grant from the National Institute on Drug Abuse to the University of Washington Alcohol & Drug Abuse Institute, but the information on this site has not been reviewed by NIDA and does not necessarily reflect the views of the Institute.

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