NIDA Director Meets with President of Iceland

On October 3rd, NIDA Director Dr. Nora Volkow met with Iceland President Gudni Th Johannesson at Bessastadir, the official residence of the president, where the two discussed the science of substance use disorders.

Dr. Volkow was in Iceland to participate in the Society of Alcoholism and Other Addictions’ (SAA) 40th Anniversary Conference on Drug Addiction Treatment and formal opening of the new SAA treatment center in Reykjavik, Iceland. Her presentation was titled "Addiction is a Chronic Brain Disease – What we Know Today." The SAA is an NGO that is the leading provider of addiction treatment and addiction medicine services in Iceland.

Jag Khalsa Retires after 30 Years of Service to NIDA

Dr. Jag Khalsa, Chief of the Medical Consequences of Drug Abuse and Co-occurring Infections Branch in the Division of Therapeutics and Medical Consequences, retired last month after 30 years at NIDA.

During his tenure, he collaborated with many scientists at NIDA and developed several highly important programs of clinical research related to maternal drug abuse and fetal consequences, adolescent drug abuse, and medical consequences, that have included nearly all biochemical and physiological systems impacted by substance use and co-occurring infections such as HIV, HCV, STIs, TB and others.

Prior to joining NIDA, he worked on drug development at SmithKline, environmental toxicology at Stanford Research Institute, mining safety at the National Institute of Occupational Safety and Health, and in food additives and drug safety at the Food and Drug Administration. He has published in pharmacology, toxicology, epidemiology and medical journals and has served on the editorial boards of Journal of Addiction Medicine, HIV/AIDS-Research and Palliative Care, Frontiers of Neuroscience, and Clinical Infectious Diseases. Dr. Khalsa holds Bachelor’s degrees in Chemistry and Pharmacy, a Master’s degree in Pharmacology and Pharmacognosy, and a Ph.D. in NeuroPharmacology.

CTN Trial Progress

Study results for Open Studies as of the October 30 trial Progress Report.

CTN-0064 - Linkage to HCV Care. Enrolled 113

CTN-0068 - ADAPT-2 for Methamphetamine Use Disorder. Enrolled 71

CTN-0069 - OUD in the Emergency Department. Enrolled 61

CTN-0073 - Detecting Cocaine Use Using Smartwatches. Enrolled 8

Total Enrolled in all Studies: 24,359

News from the Nodes

Mid-Southern

The Pharm-OUD-Care study (CTN-0076) is examining the feasibility and acceptability of transitioning office-based buprenorphine maintenance treatment for patients with opioid use disorder (OUD) from physicians to pharmacists.

Information generated from this pilot study will be used to design a potential randomized controlled study in the NIDA CTN that tests the effectiveness of a physician-pharmacist collaborative care model to manage patients with OUD. Dr. Li-Tzy Wu, ScD and Dr. Paolo Mannelli, MD of the Mid-Southern Node are the PI and Co-PI of the study, respectively.

The latest updates for the study are as follows:

• The pre-study Organizational Readiness Survey, which assesses the participating sites’ potential facilitators and barriers of a physician-pharmacist collaboration to manage patients with OUD, has been completed by 75% of participants so far.
• Physician-led pharmacist coaching has begun for all sites. This phase of the study involves weekly meetings with study physicians and pharmacists to improve pharmacists’ ability and competence in the evaluation of OUD.

Following the Pharmacist Coaching Phase, patient recruitment is expected to begin in December. The Mid-Southern Node thanks the NIDA CCTN, DSC, and CCC for their continued support and contributions to this important study to potentially increase access to OUD treatment as one strategy to address the opioid epidemic in the United States.

Texas Node

The CTN-0068 ADAPT-2 study currently has 64 participants randomized, and 8 participants are in the follow-up phase.

The Lead Node has been impressed with the level of collaborative discussion amongst the sites during Recruitment & Retention calls, especially around the use of different social networking platforms. A few sites have even implemented creative and non-conventional ways to re-engage participants who have missed appointments.

For example, the UTHealth team provided IRB approved care packages as a “Welcome Back!” for participants who were displaced during the hurricane. Additionally, the staff at SURC in New York have made appointments to meet participants out in the community to make contact and re-engage them in the study. It is clear our sites are working diligently to connect with our study population.

Mora Kim, Lead Node Project Manager, has now visited all the sites. The dedication and perseverance our sites have towards reaching our overall study goals has been wonderful! We wish to recognize the UTHealth team in Houston for their excellent rebound from Hurricane Harvey -- they reached their 4 per month target before the end of October!

Northeast Node

In early October, the Northeast Node of the National Drug Abuse Treatment Clinical Trials Network traveled to its partner network, Penobscot Community Health Care (PCHC), in Bangor, Maine, to collect qualitative data for Phase 1 of the CTN-0062-Ot-A1 study, Implementing the Tobacco, Alcohol, Prescription medication, and Substance use/misuse (TAPS) Tool in rural federally-qualified health centers: An ancillary study of the “CDE-EHR-PC” (CTN-0062-Ot) Study.

Alongside its partners at PCHC, the Northeast Node was joined by study team members from the parent CTN trial (CTN-0062-Ot) Jennifer McNeely (Lead Investigator) and Sarah Farkas (Study Coordinator) from the Greater New York Node of the CTN.

The overall aim of this study is to facilitate integrated care for substance use disorders by leveraging electronic health records (EHRs) to support the delivery of screening and interventions in rural primary care settings using the TAPS Tool (the focus of CTN-0059).

The Northeast Node spent four days at three PCHC federally-qualified health center (FQHC) sites participating in the study, observing provider and medical assistant workflow, patient flow, and the current screening and referral systems.

Alongside LI McNeely, the Northeast Node team also conducted focus groups with patients, medical providers, and medical assistants to identify potential barriers and facilitators to the adoption of the TAPS Tool and obtained important feedback on how to best integrate the screening tool and lean decision support into the health system’s EHR.

This data will prove valuable for usability testing and implementation in Phase 2 of this ancillary study.

News from the ATTC

Learn about the new 2017-2022 ATTC Network in the October 2017 issue of ATTC Messenger. The new five-year grant cycle launched on October 1st, and features 10 domestic regional centers and 6 international HIV centers. Find out about the changes to ATTC Network and its mission and goals for the next 5 years.  Read it here. . .

The Latest ATTC/NIATx Blog posts:

• Cultural competence and organizational change: Meet the researcher, Dr. Erick Guerrero
• Immediate help in Puerto Rico: National Hispanic and Latino ATTC training first responders

Also of Interest

Data/Statistics: Key Substance Use and Mental Health Indicators in the United States: Results from the 2016 National Survey on Drug Use and Health (NSDUH). Report published September 2017. Find it here. . .

Webinar: Digital Therapeutics for Substance Use Disorders: The latest in the CSAT/CTN Webinar series. Find the archived webinar recording here. . .

Research: Substance Use Disorders Are Associated with Major Medical Illnesses and Mortality Risk in a Large Integrated Health Care System. NIDA Notes, October 24, 2017. Read it here. . .