Fran and Doug Tieman Center for Research

The Efficacy of Suvorexant in the Residential Treatment of Patients with Substance Use Disorder and Insomnia: A Pilot Open Trial

Goal: Research has demonstrated that insomnia is a primary indicator of relapse and is a common problem in patients with substance use disorders. This medication, if effective, may be useful in patients with alcohol use disorders (AUDs) and opioid use disorders (OUDs).

Summary: In collaboration with Penn State/Hershey Medical Center, Caron is participating in an open trial of suvorexant, a drug used to treat insomnia, in patients with substance use disorders (opioid/alcohol) who have sleep disturbances. Suvorexant is an FDA approved medication for insomnia. Suvorexant differs from other sleep medications as it acts on the orexin 1 receptor. It has been reported to reduce cravings and normalize sleep in animal models. This medication may offer the potential to reduce craving as well as improve sleep, both of which would help to minimize the risk of relapse in individuals with substance use disorders.

Use of a Glucagon-like Peptide-1 Agonist to Treat Opioid Use Disorder

Goal: To re-purpose an existing diabetic/obesity medication as a possible medication-assisted treatment option for OUDs.

Summary: Penn State/Hershey Medical Center is partnering with Caron on a pilot study, funded by a grant from the National Institute of Drug Addiction (NIDA). This study will evaluate whether treatment with a GLP-1 agonist can safely and effectively reduce risk of relapse and the associated sequelae in patients with an opioid use disorder. This will be a double-blind, placebo-controlled pilot study examining whether once daily treatment with a GLP-1R agonist can reduce craving and brain responses to drug cues.

Glucagon-like peptide 1 is a hormone that regulates blood glucose and food intake. It’s commonly used to treat diabetes and obesity. It works by producing a feeling of satisfaction. For this study, researchers are examining whether it can do the same for opioid users, thereby preventing relapse.

Analysis of Archival Data of Drug Rehabilitation Clinical Care Outcomes

Goal: To identify electroencephalographic (EEG) correlates of clinical information in a population of individuals with substance use disorders (SUDs).

Summary: Caron is collaborating with ALTO Neuroscience on this study.

Development of Brain Signatures of Drug Rehabilitation using Electroencephalography (EEG)

Goal: To develop electroencephalographic (EEG) predictors of relapse/recovery after rehab for substance dependence.

Summary: Caron is collaborating with ALTO Neuroscience on this study. Previous research has suggested that specific components of brain activity, as measured by resting-state EEG, could yield insight into how people will respond to treatment for depression, for example. In this study, the research team will use EEG to develop markers that indicate likelihood of sustaining recovery or relapsing after SUD treatment.

INFINITI® Neural Response Panel Clinical Study Protocol

Goal: To allow for identifying individuals at risk for OUD prior to medical and dental procedures.

Summary: Caron is collaborating with Prescient Medicine to test its INFINITI® Neural Response Panel. This diagnostic test identifies patients who may be at risk for OUD due to genetic mutations involved in the brain's reward pathways. Physicians, dentists, and other healthcare providers can use the tool to assess risk before prescribing opioids.

Goal: Examine the role of social experiences during residential treatment and links with post-treatment relapse.

Summary: Individual differences in maintaining meaningfulness day by day when faced with negative social experiences may contribute to the risk of relapse in the early months following residential treatment.

Read more about the key findings and specifics of how it is important to recovery.

Goal: Addresses barriers and gaps in scholarly activity by identifying prioritized research training needs of military family medicine physicians at all levels of training and practice.

Summary: Dr. Olapeju Simoyan, Dr. Erin Deneke and Alice Lu of Caron along with colleagues from the Department of Family Medicine of the Penn State College of Medicine co-authored a paper in Military Medicine, Results of a Military Family Medicine Scholarly Activity Training Needs Assessment.

Ketogenic Diet in Alcoholism

Goal: To determine the effects of a ketogenic diet and its ability to improve brain function and reduce alcohol withdrawal symptoms during detoxification.

Summary: Caron is collaborating with the National Institute of Alcohol Abuse and Alcoholism (NIAAA) on this research. AUDs have been shown to create a brain preference for ketones. This study explores whether the use of a ketogenic diet in alcohol detoxification can prevent ketone deprivation following alcohol detoxification.

Ketones are produced when the body burns fat for energy, rather than the glucose it normally burns. A ketogenic diet restricts the amounts of carbohydrates a person eats in favor of fats. Doing so deprives the body of glucose and produces ketones. Ketogenic diets have been used for a number of conditions over the years, including diabetes and epilepsy. It’s also popular as a weight-loss strategy.

Alcohol intoxication leads the brain to use ketones as an energy source and eventually the brain prefers use of ketones. In detox, the brain is deprived of ketones. By providing a ketogenic diet to detox patients, researchers hope to see a reduction in alcohol withdrawal symptoms.

Brain Dopaminergic Signaling in Opioid Use Disorders (OUD)

Goal: To assess the influence of dopamine receptor availability on brain reward and self-control networks and behavior.

Summary: This study explores whether the balance in dopamine receptors is disrupted in individuals with OUDs. Comparisons will be made between individuals receiving medication-assisted treatment and those who are not.

Caron is collaborating with the National Institute on Drug Abuse (NIDA) on this study. Dopamine is a neurotransmitter, or a messenger, produced by the body to carry messages between nerve cells in the brain. In this study, researchers are looking to determine if dopamine signaling is disrupted in people with an OUD and whether decreased dopamine decreases self-control and increases impulsiveness. To do that, researchers are comparing brain scans of opioid users receiving medication-assisted treatment to those who are not.

Goal: To explore whether repetitive transcranial magnetic stimulation (rTMS) is effective in treating chronic pain and reducing cravings.

Summary: Keeping with our understanding of the neurobiology of addiction, Caron endeavors to pursue research opportunities for non-pharmaceutical interventions to reduce cravings, relapse risk and overdose potential. Repetitive Transcranial Magnetic Stimulation (rTMS) is one such opportunity that Caron has explored in partnership with the University of California, Los Angeles (UCLA.)

Additionally, the concept of a pilot has also been discussed with Dr. Nora Volkow, Director of the National Institute on Drug Abuse. Essentially, rTMS induces an electric flow in targeted regions in the brain and can ultimately be utilized to promote or suppress “cellular excitability and resulting behavior.” (Frontiers in Psychology, 2019). The theory is that if the right stimulation site is targeted and the required sequence is identified, Caron may be able to successfully treat and ultimately suppress addictive behaviors.