Evidence map›Paper›PMID 40306006›Full record

Trial reportJournal of psychiatric research2025

A randomized clinical trial of disulfiram at higher doses for the treatment of cocaine use disorder among methadone-stabilized patients.

Alison H Oliveto, Janette McGaugh, Mohit P Chopra, Jeff Thostenson, Michael J Mancino

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Journal of psychiatric research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Alison H OlivetoUniversity of Arkansas for Medical Sciences, Department of Psychiatry, 4301 W. Markham St., Little Rock, AR, 72205, USA. Electronic address: olivetoalison@uams.edu.
Janette McGaughOuachita Behavioral Health and Wellness, 125 Wellness Way, Hot Springs, AR, 71913, USA.
Mohit P ChopraUniversity of Massachusetts Medical School, Psychiatry Dept., 55 N Lake Ave S7-823, Worcester, MA, 01655, USA.
Jeff ThostensonUniversity of Arkansas for Medical Sciences, Biostatistics Dept., Little Rock, AR, 75505, USA.
Michael J MancinoUniversity of Arkansas for Medical Sciences, Department of Psychiatry, 4301 W. Markham St., Little Rock, AR, 72205, USA.

Funding

PHYSIOLOGICAL DISTURBANCES ASSOCIATED WITH NEONATAL INTRAVENTRICULAR HEMORRHAGEP20RR020146 · NCRR · UNIV OF ARKANSAS FOR MED SCIS · PI GARCIA-RILL, EDGAR E. · 2004 to 2011
$17.2M
CTSA INFRASTRUCTURE FOR PEDIATRIC RESEARCHUL1RR029884 · NCRR · UNIV OF ARKANSAS FOR MED SCIS · PI LOWERY, CURTIS L · 2009 to 2011
$11.4M
Translational Training in AddictionT32DA022981 · NIDA · UNIV OF ARKANSAS FOR MED SCIS · PI Melissa Jean Zielinski · 2009 to 2026
$6.1M
Disulfiram for Cocaine Abuse in Methadone- PatientsR01DA013441 · NIDA · YALE UNIVERSITY · PI OLIVETO, ALISON · 2001 to 2010
$4.6M
NCRR NIH HHS P20 RR020146NCRR NIH HHS UL1 RR029884NIDA NIH HHS R01 DA013441NIDA NIH HHS T32 DA022981
6 · The paper itself

Abstract

PURPOSE/

backgroundPreviously, disulfiram less than 250 mg/day increased cocaine use relative to placebo whereas disulfiram at 250 mg/day did not differ from placebo among methadone-stabilized individuals with dual cocaine and opioid dependence, suggesting disulfiram at higher doses needed to be tested. This study determined tolerability and efficacy of disulfiram at higher doses (250-500 mg/day). METHODS/PROCEDURES: In a 14-wk, double blind, placebo-controlled clinical trial, 53 participants with cocaine and opioid dependence were enrolled, inducted onto methadone (weeks 1-2), randomized to receive placebo or disulfiram (250, 375 or 500 mg/day) during weeks 3-14, and provided weekly 1-h individual cognitive behavior therapy throughout. Thrice-weekly urine samples were tested for the presence of cocaine metabolite. Weekly vital signs and monthly mood assessments were obtained. RESULTS/

findingsDisulfiram groups generally did not differ on subject characteristics or retention. Cocaine-positive urine samples showed a significant increase over time in the placebo group (p = 0.04), with the placebo slope being significantly greater than horizontal. Cocaine-positive urine samples decreased over time in the disulfiram 250 mg (p = 0.014) and 375 mg (p = 0.015), but not 500 mg (p = 0.11), groups relative to placebo, although slopes of these medication groups did not differ significantly from horizontal (p > 0.15). No clinically significant differences across groups with respect to vital signs or mood ratings occurred. IMPLICATIONS/

conclusionsAlthough preliminary due to the small sample size, disulfiram at 250-375 mg/day may be ineffective in reducing cocaine use and have limited efficacy to prevent increases in cocaine use among methadone-stabilized patients with dual cocaine and opioid dependence.

Indexed as

Alcohol DeterrentsCocaine-Related DisordersDisulfiramMethadoneOpioid-Related DisordersAdultCocaineDose-Response Relationship, DrugDouble-Blind MethodFemaleHumansMaleMiddle AgedNarcoticsOpiate Substitution TreatmentTreatment OutcomeAlcohol DeterrentsCocaineDisulfiramMethadoneNarcoticsClinical trial methadone randomizedCocaine use disorderControlled trialDisulfiramOpioid use disorder

Identifiers

PMID40306006
PMCPMC12103833

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.