Highlights of Recently Published NIDA-Supported Studies

Intervention Improves Employment Outlook For Methadone Patients

Assertive outreach and motivational techniques can enhance methadone patients' participation in vocational counseling and increase subsequent employment. In a study of 211 unemployed methadone patients at two facilities in New York City, Dr. Stephen Magura and colleagues at the National Development and Research Institutes found that 47 percent of participants assigned to the Customized Employment Supports (CES) intervention attended five or more vocational counseling sessions within 6 months of beginning the study. In contrast, only 12 percent of those in the clinic's standard vocational programs were as assiduous. CES counselors engaged patients in the program with tactics such as checking their clinic schedules and arranging impromptu visits; spent more time with patients in counseling sessions than counselors in the standard program; responded promptly to requests for help; accompanied patients in their job searches; and helped patients overcome barriers to employment. Among 168 participants interviewed 6 and 12 months after beginning the study, 41 percent in the CES group, compared with 26 percent of those who received standard counseling, reported paid employment at both followup assessments.
Substance Use and Misuse 41(8):1125-1138, 2006; [Abstract]
Substance Use and Misuse 42(5):811-828, 2007. [Abstract]

Morphine Speeds AIDS Onset in Monkeys

Dr. Anil Kumar and colleagues at the Ponce School of Medicine, Puerto Rico, have discovered key ways in which morphine may accelerate the progression of AIDS: The drug increases both viral replication and alterations in a particular part of the virus's coating. Monkeys exposed to long-term morphine administration—20 weeks prior to infection with simian/human immunodeficiency virus (SIV/SHIV) and throughout the 56-week study period—progressed to AIDS faster and showed more signs of compromised immune systems than comparison animals. Of the morphine-exposed animals that developed AIDS, three demonstrated higher viral replication in their blood and cerebrospinal fluid (CSF). When the researchers zeroed in on particular areas of the viral envelope—a lipid-protein covering that helps viruses penetrate cells—they found that morphine-exposed monkeys demonstrated a higher degree of change in the V4 region than control animals. This difference, which may expand the range of cells that HIV can infect, occurred in both CSF and blood. The extent of V4 evolution corresponded with rapid disease progression. Studies such as this aim to open new avenues for intervening against HIV.
Virology 354(1):192-206, 2006; [Abstract]
Virology 358(2):373-383, 2007. [Abstract]

Methamphetamine Restricts Fetal Growth, Increases Lethargy in Newborns

A NIDA-funded study found that newborns whose mothers abused methamphetamine during pregnancy showed higher rates of growth restriction compared with unexposed newborns. Dr. Barry M. Lester and colleagues at Brown Medical School and other institutions analyzed data from 1,618 mother-infant pairs, 84 of whom were meth-exposed. The meth-exposed newborns weighed 3,174 grams (7 pounds), on average, versus 3,381 grams (nearly 7.5 pounds) for unexposed newborns. The meth-exposed newborns also had a lower gestational age at birth (38.7 weeks versus 39.2 weeks). Although most infants were full term, methamphetamine infants were 3.5 times as likely to be small for gestational age—a finding that suggests fetal growth restriction.

In a followup with 166 infants from the study, the researchers assessed the newborns' behavioral capabilities within the first 5 days of life. The 74 meth-exposed newborns showed greater lethargy and were more difficult to awaken than the 92 unexposed newborns. Once aroused, however, meth-exposed newborns also showed a sign of physiological distress—difficulty maintaining normal, regular breathing. The differences held when the researchers took into account factors known to affect fetal growth, including maternal smoking and other drug abuse and socioeconomic status. In addition, higher concentrations of methamphetamine in samples of the babies' stool were related to increased central nervous system stress.
Pediatrics 118(3):1149-1156, 2006; [Full Text]
Neurotoxicology and Teratology 30(1):20-28, 2008. [Full Text]

Volume 21, Number 6 (June 2008)