P.285 The substance use intervention team: Preliminary analysis of a population-level strategy addressing the opioid crisis at an academic medical center

Abstract

This study is conducted to investigate the effects differences of escitalopram with or without combined electroacupuncture (EA) among male inpatients with a diagnosis of alcohol dependence and comorbid protracted alcohol withdrawal symptoms (PAWS).A total of 62 participants who met the inclusion criteria were enrolled in a two-arm randomized, placebo controlled, patients-blind trial and allocated to an escitalopram with real-EA group (real-EA group, patients= 31) and an escitalopram with sham-EA group (sham-EA group, patients= 31), respectively. In addition to the oral administration of escitalopram for total four weeks, patients in each group received corresponding EA treatment five days per week and two days off for consecutive four weeks. Both serum homocysteine (Hcy) test and electrophysiological tests, including event-related potentials (ERPs) and exploratory eye movement (EEM) were performed at pre- and post-treatment. Additionally, the global scores of Penn Alcohol Craving Scale (PACS), 17-items Hamilton Depression Rating Scale (HAMD-17), and Hamilton Anxiety Scale (HAMA) were used for assessing the subjective emotion experience of patients, respectively. Meanwhile, adverse effects were monitored and recorded.After four-week treatment, the global scores of PACS and HAMD-17 declined significantly in both groups (both P<0.05). Furthermore, the decline in the real-EA group was superior to that in the sham-EA group (P<0.05). Meanwhile, the total scores of HAMA only decreased in the real-EA group (P<0.05) but not in the sham-EA group (P>0.05). According to the parameters of ERPs, significant declines for N2PL, P3PL, and P3amp were observed in both two groups (all P<0.05), and the decreases for P3PL and P3amp in the real-EA group was much superior to that in the sham-EA group (both P<0.05). According to the parameters of EEM, significant increase for NEF was observed only in the real-EA group (P<0.05). Besides, there was a dramatic decline for serum Hcy level only in the real-EA group (P<0.05). One case in the sham-EA group withdrew from the trial due to self-reported nausea and bitter taste, and outcomes of the remaining 61 patients were adopted for analysis.(1) Escitalopram with EA may be a potential alternative therapy for mitigating PAWS among male inpatients with alcohol dependence. (2) Escitalopram with EA might improve the alcohol-dependence induced cognitive dysfunctions via upregulating the expression of Hcy.