Pickens

Researchers are evaluating how adults who use both e-cigarettes and cannabis respond to a tobacco cessation treatment using the medication varenicline and financial incentives. The study focuses on adults aged 18 to 40 who use e-cigarettes regularly and co-use cannabis, aiming to understand how cannabis use affects quitting e-cigarettes. This is a Phase 4 trial conducted at three sites in South Carolina, investigating cessation outcomes and patterns of co-use during treatment. All participants receive varenicline medication for 12 weeks, following a standard dosing schedule starting with a low dose and increasing to 2.0 mg per day. Alongside medication, participants receive psychosocial counseling and financial incentives weekly for verified e-cigarette abstinence confirmed by urine cotinine tests. The study also monitors cannabis use changes and compares cessation success to previous data on cigarette smokers. Participants attend weekly visits for counseling, medication adherence support, and urine testing to confirm abstinence. Researchers measure 7-day e-cigarette abstinence at the end of treatment (week 12) using biochemical verification. The trial also assesses the impact of cannabis use severity on quitting success and tracks patterns of co-use. The total participation duration is 12 weeks, with ongoing monitoring during this period.

This research aims to evaluate whether switching completely to e-cigarettes (nicotine vapes) helps people who smoke and are receiving treatment for substance use disorders (SUD) to quit smoking, compared with using FDA-approved nicotine replacement therapy (NRT) such as patches and lozenges. Tobacco use remains high among individuals with SUD despite overall declines in the general population, and continued smoking worsens substance treatment outcomes and health. The study addresses the urgent need for effective tobacco cessation strategies in this group and investigates the feasibility and acceptability of these approaches within outpatient SUD treatment programs in South Carolina. Participants will be randomly assigned to one of two groups: one group will receive 12 weeks of e-cigarette products with instructions to switch completely from smoking at a set switch date, while the other group will receive 12 weeks of combination NRT with instructions to quit smoking at a quit date. Both groups will receive brief weekly counseling to support their quit or switch attempts. The treatment period lasts 12 weeks, and the entire participation spans 6 months, including five in-person visits and eleven virtual assessments. During the study, participants will complete daily diaries on their phones for the first 12 weeks and provide breath and urine samples for smoking verification. Researchers will assess smoking abstinence after 7 days at the end of treatment, along with patient, provider, and organizational factors affecting the intervention's success. They will also evaluate the impact of switching to e-cigarettes versus quitting with NRT on substance use treatment outcomes and engagement. Safety and adherence will be monitored throughout the study duration.

Researchers are evaluating the effectiveness of extended-release naltrexone combined with daily extended-release bupropion (XR-NTX/BUP-XL) compared to matching injectable and oral placebos in reducing methamphetamine use. The study focuses on adults aged 18 to 65 with moderate or severe methamphetamine use disorder who want to stop or reduce their use. This is a double-blind, placebo-controlled, randomized clinical trial involving 360 participants. Participants will be randomly assigned to receive either injections of extended-release naltrexone every three weeks plus daily oral extended-release bupropion tablets, or injections of placebo every three weeks plus daily oral placebo tablets. The treatment phase lasts 12 weeks. The main goal is to see if the XR-NTX/BUP-XL group has more participants with at least 75% methamphetamine-negative urine drug tests during the evaluation period in weeks 11 and 12. During the study, participants will provide urine samples multiple times to test for methamphetamine use. Researchers will also assess safety, other substance use, depression, quality of life, functioning, clinic attendance, and how well participants follow medication instructions. Participants will use a smartphone app to record daily medication dosing. The total participation time includes the 12-week treatment phase and related evaluations.