Biomedical subjects

Eric A Jacobs

Publications and source records attributed to Eric A Jacobs.

3 recordsLinked to original sources

PubMed2005

Buprenorphine treatment for opioid dependence: the relative efficacy of daily, twice and thrice weekly dosing.

This randomized clinical trial evaluated the relative efficacy of three buprenorphine dosing schedules. Opioid-dependent adults were randomly assigned to receive buprenorphine seven, 3 or 2 days per week for 24 weeks. Daily maintenance doses were 4, 8, 10, or 12 mg of the sublingual buprenorphine solution. Participants who attended the clinic daily received a maintenance dose of buprenorphine daily. Participants who attended the clinic thrice weekly received double their maintenance dose on Monday and Wednesday, followed by a triple dose on Friday. Participants who attended the clinic twice weekly received quadruple their maintenance dose of buprenorphine on Monday and triple their maintenance dose on Friday. Results demonstrated that all dosing regimens were of comparable efficacy in promoting treatment retention, opioid and cocaine abstinence, and reductions in HIV risk behavior (especially as related to drug use) and severity of life problems. Predictor analyses identified sub-populations of opioid-dependent individuals that may have a more positive treatment outcome under each buprenorphine dosing condition. Less-than-daily dosing schedules may provide the opportunity for treatment programs to serve a greater number of opioid-dependent patients and reduce the risk of medication diversion, which may, in turn, have a positive impact on community support of science-based treatment for opioid-dependence.

Adult↗

PubMed2003

Delay discounting by pathological gamblers.

Discounting of delayed rewards by pathological gamblers was compared to discounting of delayed rewards by matched control nongambling participants. All participants completed a hypothetical choice task in which they made repeated choices between dollars 1,000 available after a delay and an equal or lesser amount of money available immediately. The delay to the large amount of money was varied from 1 week to 10 years across conditions. Indifference points between immediate money and delayed money were identified at each delay condition by varying the amount of immediate money across choice trials. For the majority of participants, indifference points decreased monotonically across delays. Overall, gamblers discounted the delayed rewards more steeply than did control participants.

Adult↗

PubMed2002

Mild opioid deprivation increases the degree that opioid-dependent outpatients discount delayed heroin and money.

RATIONALE: A growing literature suggests that excessive temporal discounting of delayed rewards may be a contributing factor in the etiology of substance abuse problems. Little is known, however, about how drug deprivation may affect temporal discounting of delayed rewards by drug-dependent individuals. OBJECTIVE: To examine the extent to which opioid deprivation affects how opioid-dependent individuals discount small, medium and large quantities of delayed heroin and money. METHODS: Thirteen opioid-dependent individuals maintained on buprenorphine completed a hypothetical choice task in which they choose between a constant delayed reward amount and an immediate reward amount that was adjusted until they expressed indifference between both outcomes. The task was completed for three values of heroin and money rewards during eight sessions under conditions of opioid deprivation (four sessions) and satiation (four sessions). RESULTS: Across conditions, hyperbolic functions provided a good fit for the discounting data. Degree of discounting was significantly higher when subjects were opioid deprived. Consistent with previous findings, degree of discounting was higher for heroin than money and inversely related to the magnitude of the reward. CONCLUSION: Opioid deprivation increased the degree to which dependent individuals discounted delayed heroin and money. Understanding the conditions that affect how drug-dependent individuals discount delayed rewards might help us understand the myopic choices made by such individuals and help improve treatment outcomes.

Adult↗