Research Findings - International Program-Related Research

Publications by Former NIDA Hubert H. Humphrey Fellows

Comparing Topiramate with Naltrexone in the Treatment of Alcohol Dependence
Baltieri, D.A., Daro, F.R., Ribeiro, P.L., and de Andrade, A.G.
Addiction. 2008 October 8; [Epub ahead of print].
HHH Fellow: Arthur Guerra de Andrade, Brazil
The aim of this study was to compare the efficacy of topiramate with naltrexone in the treatment of alcohol dependence. The investigation was a double-blind, placebo-controlled, 12-week study carried out at the University of Sao Paulo, Brazil. The sample comprised a total of 155 patients, 18-60 years of age, with an International Classification of Diseases (ICD-10) diagnosis of alcohol dependence. After a 1-week detoxification period, patients were assigned randomly to receive topiramate (induction to 300 mg/day), naltrexone (50 mg/day) or placebo. Time to first relapse (consumption of >60 g ethyl alcohol), cumulative abstinence duration and weeks of heavy drinking were measured. In intention-to-treat analyses, topiramate was statistically superior to placebo on a number of measures including time to first relapse (7.8 versus 5.0 weeks), cumulative abstinence duration (8.2 versus 5.6 weeks), weeks of heavy drinking (3.4 versus 5.9) and percentage of subjects abstinent at 4 weeks (67.3 versus 42.6) and 8 weeks (61.5 versus 31.5), but not 12 weeks (46.2 versus 27.8). Results remained significant after controlling for Alcoholics Anonymous attendance, which was higher in topiramate than in other groups. There were no significant differences between naltrexone versus placebo or naltrexone versus topiramate groups, but naltrexone showed trends toward inferior outcomes when compared to topiramate. The results of this study support the efficacy of topiramate in the relapse prevention of alcoholism. Suggestive evidence was also obtained for superiority of topiramate versus naltrexone, but this needs to be verified in future research with larger sample sizes.
PMID: 18855810 [PubMed - as supplied by publisher]

Young People's Blood Alcohol Concentration and the Alcohol Consumption City Law, Brazil
De Boni, R., Leukefeld, C., and Pechansky F. Rev. Saude Publica. 2008 Sepember 26; [Epub ahead of print].
HHH Fellow: Flavio Pechansky. Brazil
The paper assesses blood alcohol concentration and risk behaviors for traffic accidents before and after the implementation of a law which prohibits the use of alcoholic beverages at city gas stations. In Porto Alegre, Southern Brazil, young people go out at night and drive to gas station convenience stores to buy alcoholic beverages which are consumed on the premises of parking lots in gas stations. Data were obtained from self-administered questionnaires and breath analyzers in two cross-sectional collections with purposive samples of youngsters in May and July 2006 (n=62, and n=50, respectively). There were no significant differences between the groups before and after the city law was passed. Blood alcohol concentration greater than 0.06% was found in 35.5% of pre-law group and 40% of post-law group (p=0.62). Results point out heavy alcohol use in both groups, which did not change after the law was passed.
PMID: 18833379 [PubMed - in process]

Development of a Questionnaire to Evaluate Sugar Abuse and Dependence
[Article in Portuguese] da Rosa, M.A., de Slavutzky, S.M., Pechansky, F., and Kessler, F.
Cad. Saude Publica. 2008 August;24(8):1869-76. Portuguese.
HHH Fellow: Flavio Pechansky. Brazil
This study describes the development of a questionnaire to evaluate the potential abuse of (and dependence on) non-milk extrinsic sugar (NMES). Recent studies have shown that excessive NMES consumption can cause alterations in the central nervous system due to the influence of these substances in the neurochemical reward system. The questionnaire was originally developed from a summary of reports from four focus groups utilizing the "L" module of the MINI-Plus questionnaire. Addiction specialists subsequently evaluated the draft of the questionnaire and altered the original instrument's content, substituting terms in order to better fit the substance used in this study. However, the original structure of 20 questions on abuse and dependence was maintained. It is hoped that an instrument to evaluate NMES abuse and dependence will help health professionals prevent and treat problems related to over-consumption of sugars. However, the diagnosis of sugar abuse and dependence and the instrument's potential psychometric properties require further study by the scientific community.
PMID: 18709227 [PubMed - in process]

High HIV Prevalence, Suboptimal HIV Testing, and Low Knowledge of HIV-Positive Serostatus Among Injection Drug Users in St. Petersburg, Russia
Niccolai, L.M., Toussova, O.V., Verevochkin, S.V., Barbour, R., Heimer, R., and Kozlov, A.P.
AIDS Behav. 2008 October 9; [Epub ahead of print]
HHH Fellow: Olga Toussova, Russia
The purpose of this analysis was to estimate human immunodeficiency virus (HIV) prevalence and testing patterns among injection drug users (IDUs) in St. Petersburg, Russia. HIV prevalence among 387 IDUs in the sample was 50%. Correlates of HIV-positive serostatus included unemployment, recent unsafe injections, and history/current sexually transmitted infection. Seventy-six percent had been HIV tested, but only 22% of those who did not report HIV-positive serostatus had been tested in the past 12 months and received their test result. Correlates of this measure included recent doctor visit and having been in prison or jail among men. Among the 193 HIV-infected participants, 36% were aware of their HIV-positive serostatus. HIV prevalence is high and continuing to increase in this population. Adequate coverage of HIV testing has not been achieved, resulting in poor knowledge of positive serostatus. Efforts are needed to better understand motivating and deterring factors for HIV testing in this setting.
PMID: 18843531 [PubMed - as supplied by publisher]