MedPath

Neurobehavioral Mechanisms of Choice in Opioid Use Disorder

Early Phase 1
Recruiting
Conditions
Opioid Use Disorder
Interventions
Registration Number
NCT03958474
Lead Sponsor
Joshua A. Lile, Ph.D.
Brief Summary

The objective of this protocol is to use probabilistic reinforcement learning choice tasks and magnetic resonance neuroimaging to demonstrate the impact of problematic opioid use and opioid withdrawal on dynamic decision-making and reveal the neurobehavioral and neurobiological processes underlying abnormal task performance. A second objective is to identify an appropriate dose of intravenous remifentanil for subsequent studies in physically dependent individuals with opioid use disorder.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
31
Inclusion Criteria
  • Must meet moderate/severe criteria for moderate/severe opioid use disorder, report recent prescription or illicit opioid use, and be opioid dependent, as evidenced by either a urine sample positive for recent opioid use or being in frank withdrawal during screening.
  • Female subjects must be using an effective form of birth control (e.g., birth control pills, surgical sterilization, IUD, cervical cap with a spermicide, or abstinence).
  • Able to speak and read English
  • Subjects who are interested in completing the remifentanil dose-ranging session must report a history of intravenous opioid use and a baseline O2 saturation of 95% or greater.
Exclusion Criteria
  • History of, or current, clinically significant physical disease (e.g., respiratory disease [asthma, COPD, sleep apnea], impaired cardiovascular functioning, seizure disorder or CNS tumors) or current or past history of psychiatric disorder that would limit compliance in the studies, other than substance use disorder.
  • Meet diagnostic criteria for psychoactive substance use disorder for substances other than opioids (OUD subjects only) or nicotine that would require detoxification (i.e., alcohol, benzodiazepines or barbiturates).
  • Contraindications for MRI scanning (e.g., pacemaker, metal implants, claustrophobia, or any other implanted medical device).
  • Vision or hearing problems that would preclude completion of experimental tasks.
  • At risk for respiratory complications and have predictors of difficult bag mask ventilation (e.g., dentures, very full beard), in case emergency respiratory intervention is needed.
  • Seeking treatment for SUD.
  • Poor venous access (only subjects who will participate in the remifentanil dose-ranging session).

Study & Design

Study Type
INTERVENTIONAL
Study Design
CROSSOVER
Arm && Interventions
GroupInterventionDescription
Active treatment followed by placebo treatmentOxycodoneParticipants complete a gambling task during oxycodone administration and then complete the same gambling task during placebo administration. Participants with a history of IV opioid use can opt to complete a final remifentanil dose-ranging session.
Placebo treatment followed by active treatmentOxycodoneParticipants complete a gambling task during placebo administration and then complete the same gambling task during oxycodone administration. Participants with a history of IV opioid use can opt to complete a final remifentanil dose-ranging session.
Active treatment followed by placebo treatmentRemifentanilParticipants complete a gambling task during oxycodone administration and then complete the same gambling task during placebo administration. Participants with a history of IV opioid use can opt to complete a final remifentanil dose-ranging session.
Placebo treatment followed by active treatmentRemifentanilParticipants complete a gambling task during placebo administration and then complete the same gambling task during oxycodone administration. Participants with a history of IV opioid use can opt to complete a final remifentanil dose-ranging session.
Primary Outcome Measures
NameTimeMethod
Gambling taskChange in monetary rewards earned on a gambling task as a function of the intervention will be assessed by administering this task once per session across two sessions during a 9-day inpatient enrollment in each subject

The number of monetary rewards earned on a gambling task, in which two options signaled by distinct cues are presented on a computer screen and choosing either could result in the delivery of money, but the reinforcement probabilities of the options differ, and change during the task.

Secondary Outcome Measures
NameTimeMethod
Oxygen saturationMeasured continuously during a single 2.5 hour session in which remifentanil is administered.

Blood oxygen concentration measured by capnography device

Respiration rateMeasured continuously during a single 2.5 hour session in which remifentanil is administered.

Breaths per minute measured by capnography device

End tidal carbon dioxideMeasured continuously during a single 2.5 hour session in which remifentanil is administered.

End tidal carbon dioxide measured by capnography device

Trial Locations

Locations (1)

Laboratory of Human Behavioral Pharmacology

🇺🇸

Lexington, Kentucky, United States

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