A remote wireless sensor network/electrocardiographic approach to discriminating cocaine use

Abstract

s / Drug and Alcohol Dependence 146 (2015) e202–e284 e209 Conclusions: These data indicate that there is an interactive relationship between mPFC 5-HT2AR and 5-HT2CR that may drive impulsive phenotypes. Methylation patterns of these genes maymediate a gene× environment interaction to control inherent impulsivity, such that high impulsivity associates with higher 5HT2CR methylation in a critical brain region linked to impulsivity. Thus, we have uncovered potential neurobiological mechanisms of importance in driving inherent impulsivity. Financial support: DA033374, UL1T71, DA024157, DA020087. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.035 Workforce attitudes regarding the implementation of extended release naltrexone to treat opioid dependence Laura Andrich1, Katherine T. Garvey1, Elias M. Klemperer2,1, Traci R. Rieckmann1 1 Oregon Health & Science University, Portland, OR, United States 2 University of Vermont, Burlington, VT, United States Aims: Prior research indicates that organizational and workforce characteristics influence the implementation of evidencebased treatments. This study examined the workforce’s response to the utilization of extended release naltrexone to treat opioid addiction at time one (n=36) and time two (n=30). It explores staff opinions toward the implementation of a new medicated assisted treatment (MAT) for opioid addiction and documents the integration of an FDA approved treatment in an in-patient addictions facility. Methods: A mixed-methods approach was employed using semi-structured interviews and a quantitative survey with the staff at the addictions facility. Participants were support staff who interacted with patients. The quantitative survey was administered early in the new MAT program implementation (n=36) and again six months later (n=30). Data were analyzed using STATA and included descriptive statistics, correlations t-tests, and analyses of variance. Atlas-ti software was used to analyze codes in the qualitative data regarding attitudes and opinions about MAT. Results: Data from the survey suggest that over time,workforce knowledge about the new MAT increased (33.33–77.78%). There was also a slight increase inworkforce opinion that their coworkers supported the use of the newMAT (11.11–51.85%) as well as opinion that their supervisors supported the newMAT (48.57–70.37%), indicating an increase in perceived social support. The qualitative data indicate the importance of housing and peer support to successful recovery. Conclusions: Our findings indicate that counselors and support staff play a critical role in the adoption of efficacious MATs, with perceived social support at time two ranging from 51.85% for supervisors and 77.78% for coworkers. Greater attention to staff attitudes and perspectives when working to accelerate utilization of medications are recommended for improved patient outcomes. Financial support: This work was supported by the Hooper Detoxification Stabilization Center Vivitrol® Pilot Program State Funded Evaluation Project. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.036 A remote wireless sensor network/electrocardiographic approach to discriminating cocaine use Gustavo A. Angarita1, Annamalai Natarajan2, Edward C. Gaiser1, Abhinav Parate2, Benjamin Marlin2, Ralitza Gueorguieva3, Deepak Ganesan2, Robert T. Malison1 1 Psychiatry, Yale University School of Medicine, New Haven, CT, United States 2 School of Computer Science, University of Massachusetts, Amherst, MA, United States 3 Biostatistics, Yale University School of Medicine, New Haven, CT, United States Aims: To establish the sensitivity/specificity of a RWSN/ECG approach for discriminating cocaine use from other cardiovascular stimulants. Hypothesis: Wearable “on body” sensors will reliably distinguish cocaine-induced ECG changes from those induced by methylphenidate (MPH) and exercise. Methods: Subjects: Five experienced cocaine users (4 male/1 female; 41±8 years; lifetime cocaine use =17±9 years). Procedures: Subjects wore the Zephyr BioHarness 3 chest band (left mid-axillary line) during 180min of self-regulated IV cocaine administration (8, 16, and 32mg/70kg), for 90min after a single 45mg dose of oral MPH, and during 15–30min of aerobic exercise (ping pong or stationary bike) on an inpatient research unit. Statistical Analyses: 1. A computational pipeline was used to preprocess ECG data and identify ECG (P, Q, R, S and T) peaks. We extracted two types of features: one, PQRSTwaves (waveform features); two, all morphological (AM) features (PR, QRS, QT and QTc intervals), following which a binary classification model (logistic regression) was assessed for its ability to distinguish between conditions (cocaine vs. MPH; cocaine vs. exercise). Classifier performance was expressed as Area Under Receiver Operating Characteristics curve (AUROC). Results: Classifiers consistently distinguished cocaine use from exercise (N=5) andMPH(N=4)withmeanAUROCof >0.9 and>0.95 for AM and waveforms, respectively. Conclusions: If sensitivity/specificity of RWSN/ECG approach (>90%) is confirmed in larger outpatient cohorts, suchmethodsmay be of value in medication development efforts (i.e., clinical trials) for cocaine. Financial support: Supported by R01 DA03373301 and CTSA Grant Number UL1 RR024139. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.037 Comparison of synthetic substances: Diffusion of innovation framework Cynthia L. Arfken1, Cheryl Madeja1, Darlene Owens2 1 Wayne State University, Detroit, MI, United States 2 Southeast Michigan Community Alliance, Taylor,