Books

Miller, P.G., Strang, J., & Miller, P.M. (Eds.) (2010) Addiction Research Methods. Oxford, England: Wiley-Blackwell.

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Miller, P. M. (Ed.) Evidence-Based Addiction Treatment (2009). San Diego Academic Press

With the addictions treatment field becoming the subject of increased scrutiny, there is greater emphasis being placed on treatment accountability and cost effectiveness. Substance abuse treatment programs are now required to provide evidence-based treatments, with funding and insurance reimbursement dependent upon compliance with these guidelines. Evidence-Based Addiction Treatment presents detailed descriptions of assessments and treatment practices that have proven to be effective. It provides a comprehensive and practical guide to evidence based practices for students, clinicians, and substance abuse counselors.

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Journal Articles

Gabapentin Versus Lorazepam in the Treatment of Alcohol Dependence

Traditionally, alcohol withdrawal has been treated with various anti-anxiety or sedative drugs such as benzodiazepines (brand names such as Valium, Librium, Ativan, etc.). However, work in our Center for Drug and Alcohol Programs in animal models of alcohol withdrawal implied that anticonvulsant drugs might be as useful, or better, and they do not have "abuse" potential. This study evaluated a standard benzodiazepine, lorazepam (commonly known as Ativan), compared to the anticonvulsant gabapentin for the treatment of acute alcohol withdrawal over four days. Patients were evaluated during the four days of withdrawal and up to a week after the medication was stopped. The results showed that gabapentin was equal to or better than lorazepam in reducing alcohol withdrawal symptoms (e.g., tremors, anxiety, etc.). Importantly, more patients drank alcohol while taking lorazepam and also experienced an increase in withdrawal-like symptoms when lorazepam was stopped, but not when gabapentin was stopped. These data confirm that an anticonvulsant drug like gabapentin might be quite useful in treating alcohol withdrawal, especially in outpatients, where continued drinking could lead to negative consequences and also where a drug like lorazepam might be abused or diverted to illicit uses. This study then provides new alternatives to support early abstinence in severely dependent alcoholics.

Myrick H, Malcolm R, Randall PK, Boyle E, Anton RF, Becker HC & Randall CL. A double-blind trial of gabapentin versus lorazepam in the treatment of alcohol withdrawal. Alcoholism Clinical & Experimental Research 33(9):1582-1588, 2009.

To read the full publication of this study's findings, visit the journal website.     

Also, see the results of the Flumazenil/Gabapentin research below which had similar findings with the use of gabapentin, but only in alcoholics experiencing significant alcohol withdrawal.

Efficacy of Using a Combination of Flumazenil and Gabapentin to Treat Alcohol Dependence

In a recent study, led by Dr. Raymond Anton at MUSC's Center for Drug and Alcohol Programs, the Prometa Protocol (Hythiam, Inc.) was evaluated. It is believed that this was the first randomized controlled trial evaluating the use of the combination of flumazenil and gabapentin in the treatment of alcohol dependence. The research showed that this combination of medications was effective in the treatment of alcoholics experiencing alcohol withdrawal, with the promotion of abstinence over the few months after withdrawal.

Anton RF, Myrick H, Baros AM, Latham PK, Randall PK, Wright TM, Stewart SH, Waid R & Malcolm R. Efficacy of a combination of flumazenil and gabapentin in the treatment of alcohol dependence: relationship to alcohol withdrawal symptoms. Journal of Clinical Psychopharmacology 29(4):334-342, 2009.

To read more about the research findings of this study, visit the journal website.

The Amygdala's Role in Mediating Drug-Related Memories

Drug addicts often experience memories of prior drug use, and these memories are often evoked by environmental cues such as advertisements for alcohol or nicotine products, returning to the physical location where the drug was frequently taken, or the smell of cigarette smoke or alcohol. These memories can in turn produce strong craving for the drug and potentially lead to relapse. This review focuses on the role of the amygdala, a brain region that is part of the limbic system that normally controls emotions, fear, and anxiety, in memories associated with drug use. Brief overviews are given of the amygdala, its chemical makeup and connections to other regions of the brain, and animal models that are commonly used to examine drug-related memories. The body of literature implicating the amygdala as a key brain structure mediating drug-related memories is then reviewed, followed by a brief survery of experimental methods for disrupting drug-related memories as a potential treatment for drug addiction.

Olive MF. Role of the amygdala in drug-related memories. Cell Science 6(1): 87-103, 2009.

To read the full article, visit the online journal Cell Science.  

If you cannot access the journal's website, please email Dr. Foster Olive for a reprint of the article.  

Research Reveals Some Success in Treating Methamphetamine Addiction

Research led by Dr. Foster Olive reveals that a drug called MTEP helped laboratory rodents overcome their methamphetamine habit, while also decreasing their risk of addiction relapse. By blocking mGluR5 receptors in the brain (a protein found in high concentrations in brain regions affected by methamphetamine use), MTEP lessened the rodents’ motivation to obtain methamphetamine (“meth”). Furthermore, the rodents did not relapse when exposed to cues associated with meth use.

Gass JT, Osborne MPH, Watson NL, Brown JL, Olive MF. mGluR5 antagonism attenuates methamphetamine reinforcement and prevents reinstatement of methamphetamine-seeking behavior in rats. Neuropsychopharmacology 34:820-833, 2009.

To read more about this research and its significance, visit Neuropsychopharmacology for the full article.

If you cannot access the journal's website, please email Dr. Foster Olive for a reprint of the article.

Experimental Drug CDPPB Helpful in Overcoming Memories Associated with Drug Use

Researchers at MUSC’s Center for Drug and Alcohol Programs recently discovered that an experimental drug called CDPPB helped laboratory rodents overcome their drug-associated memories, which likely decreases their craving for a drug when experiencing the environmental situation or place in which they commonly took the drug. 

“We found that after repeatedly giving cocaine injections to rats within a particular environment, the rats developed a strong preference for that environment over another environment where a placebo was given,” explains Dr. M. Foster Olive, Ph.D., co-author and senior investigator.  “Next, we treated the animals with an experimental drug called CDPPB, and found that it decreased the rats’ preference for the cocaine-associated environment during subsequent tests.”

The power of these “contextual memories” greatly contributes to cravings and vulnerability of relapse for those suffering from addiction, even when abstaining from drugs for a long period of time. 

Gass JT, Olive MF. Positive allosteric modulation of mGluR5 receptors facilitates extinction of a cocaine contextual memory. Biological Psychiatry 65:717-720, 2009.

For more information and to read the full article, please visit Biological Psychiatry. 

If you cannot access the journal's website, please email Dr. Foster Olive for a reprint of the article.