Penn Medicine points to new ways to prevent relapse in cocaine-addicted patients

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1-Apr-2014

Contact: Lee-Ann Donegan leeann.donegan@uphs.upenn.edu 215-349-5660 University of Pennsylvania School of Medicine

(PHILADELPHIA) Relapse is the most painful and expensive feature of drug addictioneven after addicted individuals have been drug-free for months or years, the likelihood of sliding back into the habit remains high. The National Institute on Drug Abuse estimates that 40 to 60 percent of addicted individuals will relapse, and in some studies the rates are as high as 80 percent at six months after treatment. Though some relapse triggers can be consciously avoided, such as people, places and things related to drug use, other subconscious triggers related to the brain's reward system may be impossible to avoid they can gain entry to the unconscious brain, setting the stage for relapse.

Researchers at Penn Medicine's Center for Studies of Addiction have now found that the drug baclofen, commonly used to prevent spasms in patients with spinal cord injuries and neurological disorders, can help block the impact of the brain's response to "unconscious" drug triggers well before conscious craving occurs. They suggest that this mechanism has the potential to prevent cocaine relapse. The new findings are reported in the Journal of Neuroscience.

"The study was inspired by patients who had experienced moments of 'volcanic craving', being suddenly overcome by the extreme desire for cocaine, but without a trigger that they could put their finger on," says senior author Anna Rose Childress, PhD, research professor of Psychiatry, director of the Brain-Behavioral Vulnerabilities Division in the Perelman School of Medicine at the University of Pennsylvania. Dr. Childress and colleagues previously found that subliminal drug "reminder cues" (the sights, sounds, smells, and memories of the drug) could activate the brain's reward circuit. "Now, we wanted to understand whether a medication could inhibit these early brain responses," said Childress.

Kimberly Young, PhD, an NIH/NIDA Post-doctoral Fellow at Penn, and first author of the study explained that, "Drug reward and motivation is largely mediated by dopamine transmission in the brain's reward circuiteven drug "reminder cues" can cause dopamine release. Since baclofen and similar medications reduce these effects in laboratory animals, we wanted to examine whether it could prevent drug-cue induced activation in the human brain."

The study tested baclofen, which was approved by the U.S. Food and Drug Administration in 1977 for spasm, on 23 cocaine-dependent men, ages 18 to 55. Each reported using cocaine on at least eight of 30 days before screening. Inclusion in the study required that they stay for up to 10 days in a supervised inpatient drug treatment facility, be drug-free for the duration, not be on any medication affecting dopamine or neurotransmitter response, and have no history of psychosis, seizures, or brain syndromes unrelated to cocaine use.

Upon admission, patients were randomized to receive baclofen (12) or placebo (11). Over the first six days, patients in the baclofen group received the medication in increasing dosage to 60 mg. While on the full 60 mg dose of baclofen, patients were placed in an fMRI and shown a series of images, to measure their neural responses to "ultra-brief" pictures of cocaine or other comparison pictures. Each of the ultra-brief 33 msec "target" pictures was immediately followed by longer picture of non-drug objects or scenes. Under these conditions, the participants are aware of the longer pictures, but the ultra-brief target pictures remain completely outside conscious awarenessthey are "backward-masked".

"We wanted to present the key stimulus: images of drug use and preparation, sexual images, and other aversive images in a way such that the brain could not consciously process them, but so that we could measure their earliest, subconscious effect on the brain," said Childress.

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Penn Medicine points to new ways to prevent relapse in cocaine-addicted patients

MassBiologics viral vector manufacturing grant (press conference highlights) – Video

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The $5 million grant for MassBiologics will be used to build and operate a first-in-Massachusetts cGMP (Current Good Manufacturing Practice) Vector Manufactu...

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Sam Hawgood Takes the Helm at UC San Francisco

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Newswise Renowned pediatrician and medical school dean Sam Hawgood, MBBS, became interim chancellor today of UC San Francisco, the nations leading public university exclusively dedicated to health.

The appointment, which The University of California Board of Regents approved Jan. 23, 2014, places Hawgood at the helm of the $4 billion university during the national search for its 10th chancellor. He assumes the role from Chancellor Susan Desmond-Hellmann, MD, MPH, who will become chief executive officer of the Bill & Melinda Gates Foundation on May 1.

Hawgood has been dean of the UCSF School of Medicine and vice chancellor for medical affairs at UCSF since September 2009, after serving as interim dean since December 2007. The school has excelled under his leadership. It currently is ranked first among all schools nationwide in funding from the National Institutes of Health, indicating the excellence of its research enterprise. It also ranks fourth nationwide in both research and primary care education, according to the recent survey conducted by U.S. News & World Report.

As dean, Hawgood has been a core member of the Chancellors Executive Council, playing an integral role in the universitys leadership and guidance during a time of profound growth.

Sam is a highly respected physician, scientist and leader, with a collaborative and inclusive style that will serve the campus well through this transition, said UC President Janet Napolitano. I have full confidence that his leadership will enable UCSF to maintain its renowned excellence in research, education and clinical care into the foreseeable future.

Napolitano appointed an advisory committee of university faculty, staff, students, alumni and foundation representatives in January to support the national search, which Napolitano will oversee.

As dean of the School of Medicine, Hawgood leads an organization with an operating budget of more than $1.7 billion, nearly 8,000 faculty and staff, and 3,655 medical and graduate students, residents, fellows and postdoctoral scholars.

The school received $439.6 million in NIH funding in 2013, with many of its departments also leading the nation in their fields in these highly competitive grants.

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UTRGV medical school dean will make up to $630,000 a year

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SAN ANTONIO Dr. Francisco Fernandez, recently named the founding dean of the University of Texas Rio Grande Valley's medical school, will be paid $630,000 a year, according to a letter outlining his job offer.

The salary and other aspects of the position were described in a Feb 10 letter by Dr. Francisco Gonzlez-Scarano, dean of UT Health Science Center at San Antonio's medical school, and Dr. Raymond Greenberg, the UT System's Executive Vice Chancellor for Health Affairs, obtained through an open records request.

Fernandez, who will become the dean effective April 28, has been the chairman of the Department of Psychiatry and Neurosciences at the University of South Florida's college of medicine in Tampa.

He will receive an annual base salary of $547,826 and a performance-based incentive of up to 15 percent for total compensation $630,000 a year, according to the letter. He is also entitled to deferred compensation of $150,000 if he remains in the position for three years.

The letter states that the dean's office will be located in a new academic building on what's currently UT Pan American's campus in Edinburg and that Fernandez's highest priority will be obtaining accreditation for the new medical school from the Liaison Committee on Medical Education.

In this capacity, you will work closely with educational deans at the UTHSCSA until such time as you have recruited an Associate Dean for Education, read the letter. Recruitment of key faculty leaders and key staff will also be among the highest priorities in the early stages of your tenure as Dean.

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Chad "Ochocinco" Johnson Calls Monogamy "Impossible", Talks NFL "Box" & Liberty City – Video

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Chad "Ochocinco" Johnson Calls Monogamy "Impossible", Talks NFL "Box" Liberty City
Peter Bailey continues his critically-acclaimed series by sharing a NiteCap inside David #39;s Cafe on South Beach with former NFL star reality TV personality ...

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Lets Play Turning Point – Fall of Liberty (Extrem) (Blind) 1 – Geschichtsstunde mal anders – Video

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