Mindfulness-Oriented Recovery Enhancement (MORE) in Heroin Addiction

  • STATUS
    Recruiting
  • End date
    Jun 25, 2024
  • participants needed
    300
  • sponsor
    Icahn School of Medicine at Mount Sinai
Updated on 25 January 2021

Summary

In this study, neuroimaging of reward processing, drug cue reactivity and inhibitory control is used before and immediately after 8 weeks of two types of group therapy in individuals with opioid addiction; clinical outcomes will be assessed before, immediately and three months after treatment. Results could point to factors that track and predict recovery with treatment, offering clinicians markers that can be used for enhancing precision medicine with the goal of reducing morbidity and mortality associated with opiate addiction.

Description

Over the past 15 years, the US has been affected by increasing prescription and illicit opiate/opioid abuse, addiction, and overdose. Research into the enhancement of treatment options for individuals with opiate/opioid use disorder (iOUD) is clearly a priority. The development of neuroscience-informed behavioral therapies that could be used as adjuncts to improve effectiveness of medication-assisted interventions in iOUD is a national priority, a response to the opiate crisis. This study measures the neural correlates of cognitive function and reward processing as potentially contributing to and predictive of the impact of an 8-week group therapy on addiction outcome in iOUD. Using a pre-post randomized treatment design with a 3-months follow-up, this study will examine the impact of group therapy, as add-on to methadone maintenance, on neural functional and structural plasticity, and clinical outcomes (including daily ecological momentary assessments), in treatment-seeking iOUD (with primary use of heroin). Treatment-seeking iOUD will be randomized to 8-weeks of one of two of group therapies and scanned with magnetic resonance imaging (MRI) immediately before and after treatment. Healthy controls will be scanned at similar time intervals. Clinical outcome will be assessed during, immediately after and 3-months after therapy. Results may help identify individual variability in the brain regions/circuits that support reward processing, including cue reactivity, and inhibitory control and that could change with, and predict, response to treatment, ultimately contributing to precision medicine in OUD.

Details
Condition Opiate Use Disorder
Treatment Behavioral group therapy #1, Behavioral group therapy #2
Clinical Study IdentifierNCT04112186
SponsorIcahn School of Medicine at Mount Sinai
Last Modified on25 January 2021

Eligibility

Yes No Not Sure

Inclusion Criteria

Ability to understand and give informed consent
Males and Females 18-64 years of age
DSM-5 diagnosis of OUD with heroin as the primary drug of choice
Stabilized on methadone or other form of MAT
Inclusion criteria for healthy controls
The same as inclusion criteria 1-2 above; dependence on nicotine or caffeine is non-exclusionary

Exclusion Criteria

DSM-5 diagnosis for schizophrenia or developmental disorder (e.g., autism)
Head trauma with loss of consciousness
History of neurological disease of central origin including seizures
Cardiovascular disease including high blood pressure and/or other medical conditions, including metabolic, endocrinological,oncological or autoimmune diseases, and infectious diseases common in iOUD including Hepatitis B and C or HIV/AIDS
Metal implants or other MR contraindications
Exclusion criteria for healthy control subjects
The same, except history of any drug use disorder is prohibitive
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