Healthy, Low Back Pain, Recurrent
Conditions
Brief summary
The central scientific premise of the proposed study is that sleep disruption (SD) will influence individuals' subjective response to blinded medication administration. The investigators further believe these responses will vary among patients who have chronic low back pain (CLBP) vs. healthy controls, and that sex will moderate effects. The proposed study evaluates whether CLBP patients' subjective responses to study medication administration are altered by SD. The investigators focus on two outcome domains: abuse liability (i.e., drug liking and valuation) and response to pain testing. The investigators propose a mixed between-within randomized crossover human-laboratory experiment that investigates placebo-controlled effects of study medication on 1) abuse liability metrics (Drug Liking and Monetary Valuation) and 2) response to laboratory-evoked standardized pain measures, after one night of uninterrupted sleep (US) and again after one night of SD. The investigators will recruit both CLBP patients(\*) and healthy controls (N = 60). (\*) We originally aimed to accrue 60 subjects with CLBP. However, we have been granted approval by the National Institute on Drug Abuse (NIDA) to reduce expectations for the target N for the CLBP cohort. We are no longer expected to recruit N=60 CLBP participants; this is a COVID-19 modification, and we are not required to re-do a power analysis.
Interventions
On the day after each sleep condition (Uninterrupted Sleep and Sleep Disruption), participants will undergo multiple injections of study medication or placebo. This is a double-blind within-subject Phase II trial. As such, study medications must remain blinded. Participants may receive a medication from one or more of the following categories: prescription stimulants, prescription benzodiazepines, prescription opioids, prescription cannabinoids, over-the-counter medications, or placebo (saline). This study uses a within-subject design, such that participants serve as participants' own control.
Sponsors
National Institute on Drug Abuse (NIDA)
Johns Hopkins University
Study design
Allocation
NON_RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
BASIC_SCIENCE
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 60 Years
Healthy volunteers
Yes
Inclusion criteria
General Inclusion Criteria: * 18-60 years old * Less than 2 servings/day of caffeinated beverages and willing to discontinue 3 days prior to admission. CLBP-Specific Inclusion Criteria: * Have a physician-confirmed diagnosis of CLBP * Report chronic low back pain.
Exclusion criteria
General
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Drug Liking as assessed by the Visual Analog Scale | up to 420 minute post-medication administration | Visual Analog Scale (0-100), where 0=None and 100 = Extremely , in response to the question, Do you like the drug? |
| Heat Pain Threshold | up to 420 minute post-medication administration | A thermode will gradually increase in temperature until the participant indicates when it first feels painful. The outcome will be the temperature (degrees Celsius) at which the participant indicates they first feel pain. |
| Suprathreshold Tonic Heat Pain | up to 420 minute post-medication administration | A painful temperature above threshold will be held tonically for a period of time, after which pain ratings are obtained on a 0-100 numerical rating scale, where 0 = No Pain and 100 = Worst Pain Imaginable. |
| Monetary Valuation of Drug as assessed by the Drug vs. Money Multiple Choice Questionnaire | up to 420 minute post-medication administration | Participants are presented with an array of choices (in dollar value) which they will compare to the option of receiving study drug. They will decide for each choice whether they would take the money (at that value) or the drug they received in the session. The outcome will be the crossover point, which is the mean of the last price that the participant selected drug and the first price at which the participant selected money. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Good Drug Effects as assessed by the Visual Analog Scale | up to 420 minute post-medication administration | Visual Analog Scale (0-100), where 0=None and 100 = Extremely , in response to the question, Does the drug have any good effects? |
| Clinical Pain | up to 420 minute post-medication administration | This will be rated on a 0-100 Numerical Rating Scale, where 0 = No Pain and 100 = Worst Pain Imaginable. |
| Bad Drug Effects as assessed by the Visual Analog Scale | up to 420 minute post-medication administration | Visual Analog Scale (0-100), where 0=None and 100 = Extremely , in response to the question, Does the drug have any bad effects? |
| Level of Highness as assessed by Visual Analog Scale | up to 420 minute post-medication administration | Visual Analog Scale (0-100), where 0=None and 100 = Extremely , in response to the question, How high are you? |
| Feeling of Sickness as assessed by Visual Analog Scale | up to 420 minute post-medication administration | Visual Analog Scale (0-100), where 0=None and 100 = Extremely , in response to the question, Does this drug make you feel sick? |
Countries
United States
Outcome results
None listed