Addiction Rehab: D(5) Dopamine Receptor Carboxyl Tail Involved in D(5)-D(2) Heteromer Formation.
D(5) dopamine receptor carboxyl tail involved in D(5)-D(2) heteromer formation.
Filed under: Addiction Rehab
Biochem Biophys Res Commun. 2013 Jan 11;
O’Dowd BF, Nguyen T, Ji X, George SR
We have demonstrated that D(5) and D(2) dopamine receptors exist as heteromers in cells, and determined these receptor interact through amino acids in the cytoplasmic regions of each receptor. Specifically involved in heteromer formation we identified in the carboxyl tail of the D(5) receptor three adjacent glutamic acid residues, and in intracellular loop 3 of the D(2) receptor two adjacent arginine residues. Any pairing of these three D(5) receptor glutamic acids were sufficient for heteromer formation. These identified residues in D(5) and D(2) receptors are oppositely charged and likely interact by electrostatic interactions.
HubMed – addiction
A randomised controlled trial of sublingual buprenorphine-naloxone film versus tablets in the management of opioid dependence.
Filed under: Addiction Rehab
Drug Alcohol Depend. 2013 Jan 11;
Lintzeris N, Leung SY, Dunlop AJ, Larance B, White N, Rivas GR, Holland RM, Degenhardt L, Muhleisen P, Hurley M, Ali R
BACKGROUND: Buprenorphine-naloxone sublingual film was introduced in 2011 in Australia as an alternative to tablets. This study compared the two formulations on subjective dose effects and equivalence, trough plasma levels, adverse events, patient satisfaction, supervised dosing time, and impact upon treatment outcomes (substance use, psychosocial function). METHODS: 92 buprenorphine-naloxone tablet patients were recruited to this outpatient multi-site double-blind double-dummy parallel group trial. Patients were randomised to either tablets or film, without dose changes, over a 31 day period. RESULTS: No significant group differences were observed for subjective dose effects, trough plasma buprenorphine or norbuprenorphine levels, adverse events and treatment outcomes. Buprenorphine-naloxone film took significantly less time to dissolve than tablets (173±71 versus 242±141s, p=0.007, F=7.67). CONCLUSIONS: The study demonstrated dose equivalence and comparable clinical outcomes between the buprenorphine-naloxone film and tablet preparations, whilst showing improved dispensing times and patient ratings of satisfaction with the film.
HubMed – addiction
Improving the capability to provide integrated mental health and substance abuse services in a state system of outpatient care.
Filed under: Addiction Rehab
J Subst Abuse Treat. 2013 Jan 11;
Sacks S, Chaple M, Sirikantraporn J, Sacks JY, Knickman J, Martinez J
The paper reports on the capability of New York State (NYS) outpatient programs to provide integrated services for co-occurring disorders (COD). Assessments of 447 outpatient clinics, using two dual diagnosis capability indices (one used in addiction settings, the other in mental health settings), produced an overall score of 2.70, interpreted to position NYS clinics closer to “capable” (3.0=Dual Diagnosis Capable) than to “basic” (1.0=Alcohol [Mental Health] Only Services). “Assessment” and “Staffing” received the highest scores; i.e., clients with COD were usually identified, and staff (with some additional training and supervision) could treat both disorders effectively. While programs were generally prepared for clients with COD (e.g., welcoming such clients into the program, employing staff with competencies in both disorders, and having established routine screening and assessment to identify COD), results showed that the actual delivery of effective treatment was less satisfactory. The project demonstrated that COD capability can be assessed system-wide, using direct observation.
HubMed – addiction
Which Elements of Improvement Collaboratives Are Most Effective? A Cluster-Randomized Trial.
Filed under: Addiction Rehab
Addiction. 2013 Jan 14;
Gustafson DH, Quanbeck AR, Robinson JM, Ford JH, Pulvermacher A, French MT, McConnell KJ, Batalden PB, Hoffman KA, McCarty D
AIMS: Improvement collaboratives consisting of various components are used throughout healthcare to improve quality, but no study has identified which components work best. This study tested the effectiveness of different components in addiction treatment services, hypothesizing that a combination of all components would be most effective. DESIGN: An unblinded cluster-randomized trial assigned clinics to one of four groups: interest circle calls (group teleconferences), clinic-level coaching, learning sessions (large face-to-face meetings), and a combination of all three. Interest circle calls functioned as a minimal intervention comparison group. SETTING: Outpatient addiction treatment clinics in the U.S. PARTICIPANTS: 201 clinics in 5 states. MEASUREMENTS: Clinic data managers submitted data on three primary outcomes: waiting time (mean days between first contact and first treatment), retention (percent of patients retained from first to fourth treatment session), and annual number of new patients. State and group costs were collected for a cost-effectiveness analysis. FINDINGS: Waiting time declined significantly for 3 groups: coaching (an average of -4.6 days/clinic, P=0.001), learning sessions (-3.5 days/clinic, P=0.012), and the combination (-4.7 days/clinic, P=0.001). The coaching and combination groups significantly increased the number of new patients (19.5%, P=0.028; 8.9%, P=0.029; respectively). Interest circle calls showed no significant effects on outcomes. None of the groups significantly improved retention. The estimated cost/clinic was $ 2,878 for coaching versus $ 7,930 for the combination. Coaching and the combination of collaborative components were about equally effective in achieving study aims, but coaching was substantially more cost effective. CONCLUSIONS: When trying to improve the effectiveness of addiction treatment services, clinic-level coaching appears to help improve waiting time and number of new patients while other components of improvement collaboratives (interest circles calls and learning sessions) do not seem to add further value.
HubMed – addiction
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