MedPath

Suvorexant for Opioid/Stimulant Co-use

Phase 2
Completed
Conditions
Opioid Use Disorder
Stimulant Use Disorder
Interventions
Registration Number
NCT05546515
Lead Sponsor
Johns Hopkins University
Brief Summary

This study will evaluate whether Suvorexant 20mg reduces drug use and craving, and improves sleep and stress among persons with co-occurring opioid use disorder and stimulant use disorder.

Detailed Description

This between-subjects, double-blinded, randomized controlled pilot study will recruit patients who are receiving methadone or buprenorphine treatment for OUD and are using cocaine. Participants will be randomly assigned to receive up to 30-days of Suvorexant (SUVO) or placebo. They will visit the clinic regularly to provide urine drug screens and complete questionnaires and will wear a device that can measure their sleep parameters. We expect that relative to persons who receive placebo, individuals who receive SUVO will 1) be less likely to screen positive for cocaine and/or opioids on urine drug screens, 2) will report lower drug craving, 3) will have longer total sleep time, 4) will report fewer insomnia symptoms, and 5) will report overall lower stress than persons who receive placebo. We also expect that patients will not have side effects from SUVO. These preliminary data will inform whether this FDA-approved medication may help patients stop co-using opioids and stimulants, which can be scaled up to reduce public health consequences related to co-use.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
20
Inclusion Criteria
  1. Ages 18-65,
  2. Meet criteria for stimulant use disorder, based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR)
  3. Currently receiving methadone or buprenorphine treatment for OUD and considered to be stable on current dose for at least 30 days
  4. Willingness to engage with study protocol
  5. Use of birth control (as appropriate)

Exclusion criteria:

  1. Psychiatric or medical conditions that are judged by the investigators to interfere with participation or that are contraindicated for use with SUVO
  2. Pregnant or breastfeeding
  3. Current use of benzodiazepines, tranquilizers, or other schedule IV sleep medications
  4. Moderate or severe substance use disorder other than opioid or stimulant use disorder
  5. SUVO consumption in the last 30 days
  6. Use of medications that are contraindicated with the study
  7. Past 30-day suicidal behavior
  8. Use of continuous positive airway pressure (CPAP) device for sleep apnea
Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
SuvorexantSuvorexant (dual orexin receptor antagonist)20mg Suvorexant
PlaceboPlaceboPlacebo oral capsules
Primary Outcome Measures
NameTimeMethod
Opioid useUp to 30 days post-randomization

Opioid use (measured via uranalysis for qualitative opioid assay) other than prescribed methadone or buprenorphine at scheduled study visits up to 30 days post-randomization (yes vs. no)

Cocaine useUp to 30 days post-randomization

Cocaine use (measured via uranalysis for qualitative cocaine assay) at scheduled study visits up to 30 days post-randomization.

Secondary Outcome Measures
NameTimeMethod
Insomnia Severity Index total scoreUp to 30 days post-randomization

Insomnia severity index total scores at scheduled study visits up to 30 days post-randomization.

Total sleep timeUp to 30 days post-randomization

Minutes of total sleep time at scheduled study visits up to 30 days post-randomization.

Visual Analog Rating (0-100) of Opioid CravingUp to 30 days post-randomization

Opioid craving, as measured via an average score on visual analog scales (VAS), at scheduled study visits up to 30 days post-randomization.

Visual Analog Rating (0-100) of Cocaine CravingUp to 30 days post-randomization

Cocaine craving, as measured via an average score on visual analog scales (VAS), collected at scheduled study visits up to 30 days post-randomization.

Perceived Stress Scale Total ScoreUp to 30 days post-randomization

Perceived stress, measured by the Perceived Stress Scale total score at scheduled study visits up to 30 days post-randomization.

Trial Locations

Locations (1)

Behavioral Pharmacology Research Unit at the Johns Hopkins Bayview Medical Center

🇺🇸

Baltimore, Maryland, United States

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