Exercise as a Behavioral Treatment for Cocaine Dependence

运动作为可卡因依赖的行为治疗

• 批准号: 8044571
• 负责人: Richard De La Garza
• 金额: $ 23.48万
• 依托单位: BAYLOR COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-08-01 至 2013-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8044571
• 关键词: Abstinence; Accounting; Adult; Attenuated; Behavior Therapy; Behavioral; Carbon Monoxide; Cardiovascular Physiology; Cigarette; Clinical Trials; Cocaine; Cocaine Dependence; Cognitive Therapy; Cotinine; Data; Diagnostic and Statistical Manual; Exercise; Frustration; Heart Rate; Human; Individual; Inpatients; Intervention; Legal; Measures; Medical; Monitor; Nicotine; Nicotine Dependence; Nurse Practitioners; Participant; Patient Self-Report; Personal Satisfaction; Pharmaceutical Preparations; Physical activity; Physicians; Physiological; Placebo Control; Placebos; Psychostimulant dependence; Public Health; Reading; Reporting; Research; Rest; Rodent; Running; Salivary; Self Administration; Smoking; Study Subject; Testing; Time; Urine; Walking; addiction; base; cigarette smoking; cocaine use; cognitive function; computerized; contingency management; cost; craving; design; effective therapy; enhancing factor; fitness; improved; innovation; interest; meetings; nicotine craving; placebo controlled study; programs; social; standard care

DESCRIPTION (provided by applicant): The problem of cocaine dependence remains a major medical, social, and legal concern, and there is a pressing need for a broadly effective treatment approach. Dozens of medications have been evaluated in clinical trials and, despite these efforts, not one has gained FDA approval as a treatment for cocaine dependence. Behavioral interventions, such as cognitive behavioral therapy, have been moderately effective, indicating that non-pharmacological treatment approaches warrant additional consideration. Recent data suggest that moderate physical exercise attenuates cravings for cigarettes and improves cognitive functioning in humans. These data coincide with several reports in rodents showing that exercise (i.e., wheel running) reduced cocaine self-administration, though the effects of exercise on cocaine use in humans has not been investigated. Of interest, exercise has been shown to be reinforcing in humans, and this may account for its potential efficacy as an addiction treatment. We propose a placebo-controlled, between-subjects design to evaluate the effects of exercise on improved fitness, cocaine use, and craving for cocaine. Given existing data showing beneficial effects of exercise on cigarette smoking, we will also monitor changes in smoking and craving for nicotine as a positive control. The Specific Aims include: 1) To evaluate the effects of exercise (running vs. walking 30 min per session, 3 times per week, over 4 consecutive weeks) versus placebo (sitting for the same period of time and duration) on basic fitness measures; 2) To evaluate the effects of exercise on objective and subjective measures of cocaine and nicotine use and craving. All participants will be adults who meet DSM criteria for current cocaine- and nicotine-dependence, who are seeking treatment for their cocaine addiction. Computerized cognitive behavioral therapy (CBT) will be the standard treatment provided to all participants. A platform of contingency management will also be used to encourage attendance (not abstinence). Exercise sessions will be performed on a NordicTrack Elite 9500 PRO Treadmill, and a physician or nurse practitioner will be present during all physical activity sessions. This application represents an important research effort with considerable public health significance in that it will establish a program for evaluating the effects of exercise on craving and use of cocaine and nicotine in cocaine-dependent individuals. PUBLIC HEALTH RELEVANCE: This application describes a placebo-controlled, between-subjects study to evaluate the effects of exercise on improved fitness, cocaine use, and craving for cocaine in cocaine-dependent individuals.

描述（由申请人提供）：可卡因依赖问题仍然是一个主要的医学、社会和法律问题，迫切需要一种广泛有效的治疗方法。数十种药物已在临床试验中进行了评估，尽管做出了这些努力，但没有一种药物获得 FDA 批准用于治疗可卡因依赖。行为干预，例如认知行为疗法，效果中等，表明非药物治疗方法值得额外考虑。最近的数据表明，适度的体育锻炼可以减弱对香烟的渴望并改善人类的认知功能。这些数据与啮齿类动物的几份报告一致，表明运动（即轮跑）减少了可卡因的自我给药，尽管运动对人类使用可卡因的影响尚未得到研究。有趣的是，运动已被证明对人类有增强作用，这可能解释了它作为成瘾治疗的潜在功效。我们提出了一种安慰剂对照的受试者间设计，以评估运动对改善健康、可卡因使用和对可卡因渴望的影响。鉴于现有数据显示运动对吸烟有有益影响，我们还将监测吸烟和对尼古丁渴望的变化作为阳性对照。具体目标包括： 1) 评估运动（跑步与步行，每次 30 分钟，每周 3 次，连续 4 周以上）与安慰剂（坐相同时间和持续时间）对基本健身指标的影响; 2) 评估运动对可卡因和尼古丁使用和渴望的客观和主观测量的影响。所有参与者都是符合 DSM 当前可卡因和尼古丁依赖标准的成年人，他们正在寻求可卡因成瘾的治疗。计算机认知行为疗法（CBT）将成为向所有参与者提供的标准治疗方法。还将使用应急管理平台来鼓励出勤（而不是禁欲）。锻炼课程将在 NordicTrack Elite 9500 PRO 跑步机上进行，所有身体活动课程中都会有医生或执业护士在场。该应用代表了一项具有重大公共卫生意义的重要研究工作，因为它将建立一个计划，用于评估运动对可卡因依赖者对可卡因和尼古丁的渴望和使用的影响。 公共健康相关性：本申请描述了一项安慰剂对照的受试者间研究，旨在评估运动对改善可卡因依赖个体的健康、可卡因使用和对可卡因的渴望的影响。