N-Acetylcysteine and Contingency Management for Youth Cannabis Use Disorder

N-乙酰半胱氨酸和青少年大麻使用障碍的应急管理

基本信息

批准号：
10087909
负责人：
Kevin M Gray
金额：
$ 51.32万
依托单位：
MEDICAL UNIVERSITY OF SOUTH CAROLINA
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-03-15 至 2024-01-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10087909
关键词：
Abstinence Academic achievement Acetylcysteine Achievement Acute Address Adult Adverse effects Aftercare Antioxidants Attention Behavior Therapy Brain Cannabinoids Cannabis Cognition Cognitive Counseling Development Double-Blind Method Evidence based treatment General Population Impaired cognition Integrative Therapy Life Medication Management Memory Modality Outcome Participant Performance Pharmaceutical Preparations Phase Placebos Positioning Attribute Program Development Randomized Research Personnel Role Task Performances Testing Translating Translations Urine Work Youth active method cannabis cessation clinical practice cognitive control cognitive task comparative efficacy contingency management design efficacy outcomes experience improved learning ability marijuana use marijuana use disorder novel strategies overtreatment processing speed response treatment group trial design

项目摘要

Abstract Cannabis use is particularly prevalent and problematic amount youth. Compared with only one in eleven cannabis-exposed adults, one in six cannabis-exposed youth develops cannabis use disorder. Moreover, youth are more prone than adults to potentially lasting adverse effects of cannabis use, including cognitive impairment, altered brain development, poor educational outcome, and diminished life achievement. Despite this, relatively little work has focused on developing optimally efficacious cannabis use disorder treatments, particularly among youth. Current evidence-based treatments convey generally small to modest effect sizes, and novel approaches are critically needed. Among the most promising approaches are the over-the-counter antioxidant medication N-acetylcysteine (NAC) and the behavioral treatment contingency management (CM). Our team previously demonstrated superior NAC versus placebo (PBO) abstinence outcomes in youth with CUD who concurrently received CM. Further work is now needed to disentangle the effects of NAC and CM. It is possible that they are synergistic, with their combination being critical to maximizing abstinence outcomes. Alternatively, NAC may be efficacious independent of CM, but this has not been formally evaluated. In order to optimally translate NAC and CM findings to real-world clinical practice, their relative contributions to cessation outcomes must be formally evaluated. We propose a 12-week 2 x 2 factorial design trial of NAC and CM for CUD in youth (N=336). Participants will be randomized to double-blind NAC or PBO and to CM or no CM, yielding four equally-allocated treatment groups: NAC + CM, NAC + No CM, PBO + CM, and PBO + No CM. All participants will receive brief weekly cannabis cessation counseling and medication management. The primary efficacy outcome will be the proportion of negative urine cannabinoid tests during the 12-week active treatment, compared between groups. We will also serially assess cognitive task performance, examining changes in performance among participants who achieve abstinence versus those that do not. This proposed trial is the clear “next step” in the assessment of NAC and CM as extremely promising youth CUD treatment modalities, and is positioned to inform researchers, clinicians, and the general public, addressing a critical need for optimization of youth CUD treatments.

抽象的大麻使用尤其普遍，有问题的年轻人。相比之下只有一个暴露于大麻的成年人中，六分之一的大麻暴露于大麻的青年会发展大麻使用障碍。而且，年轻人比成年人更容易发生大麻使用的不利影响，包括认知障碍，大脑发展改变，教育成果不佳以及生活成就减少。尽管这项工作相对较少的工作重点是开发最佳有效的大麻使用障碍治疗，特别是在青年中。当前的基于证据的治疗通常传达了通常很小至适度的效应大小，和新颖的方法至关重要。最有望的方法之一是非处方抗氧化剂药物N-乙酰半胱氨酸（NAC）和行为处理应急管理（CM）。我们的团队以前在年轻人中表现出了优越的NAC与安慰剂（PBO）的禁欲同时收到CM的CUD。现在需要进一步的工作来消除NAC和CM的影响。它们可能是协同作用的，它们的组合对于最大程度地戒酒结果至关重要。或者，NAC可以有效地独立于商业，但尚未正式评估。为了将NAC和CM发现最佳地转化为现实世界的临床实践，它们对戒烟的相对贡献结果必须进行正式评估。我们提出了NAC和CM的12周2 x 2阶乘设计试验青年中的cud（n = 336）。参与者将被随机分为双盲NAC或PBO，以及CM或CM或CM，产生四个同等分配的治疗组：NAC + CM，NAC + NO CM，PBO + CM和PBO + NO CM。所有参与者将获得简短的每周大麻戒烟和药物管理。这一级效率结果将是在12周活动中负尿液大麻素测试的比例治疗，在组之间进行比较。我们还将连续评估认知任务绩效，检查实现禁欲的参与者与那些没有的节制的参与者之间的变化。这提出了试验是对NAC和CM评估的明显“下一步”作为极为有希望的青年待遇模式，并有能力告知研究人员，临床医生和公众，以解决关键需要优化青少年的治疗方法。

项目成果

期刊论文数量（8）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Cannabis Use Disorder in Adolescents.

青少年大麻使用障碍。

DOI：
10.1016/j.chc.2022.06.001
发表时间：
2023
期刊：
Child and adolescent psychiatric clinics of North America
影响因子：
2.4
作者：
Hashemi,Daniel;Gray,Kevin
通讯作者：
Gray,Kevin

Methods to reduce the incidence of false negative trial results in substance use treatment research.

减少物质使用治疗研究中假阴性试验结果发生率的方法。

DOI：
10.1016/j.copsyc.2019.01.009
发表时间：
2019
期刊：
Current opinion in psychology
影响因子：
5.9
作者：
Tomko,RachelL;McClure,ErinA;Squeglia,LindsayM;TreloarPadovano,Hayley;McRae-Clark,AimeeL;Baker,NathanielL;Carpenter,MatthewJ;Gray,KevinM
通讯作者：
Gray,KevinM

Impact of cannabis legalization on treatment and research priorities for cannabis use disorder.