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Background Guidelines recommend long-term treatment for opioid use disorder including the use of buprenorphine; however, many patients desire to eventually taper off. This study examines the prevalence and patient characteristics of patients that voluntarily taper off buprenorphine. Methods This is a 12-year retrospective cohort study of adults on buprenorphine in a large urban safety-net primary care practice. The primary outcome was completion of a voluntary buprenorphine taper, which was further characterized as a medically supervised or unsupervised taper. The secondary outcome was re-engagement in care after taper. Descriptive statistics and estimated proportions of both taper completion and re-engagement in treatment were calculated using Kaplan-Meier estimates. Results The study sample included 1308 patients with a median follow-up time of 316 days; 48 patients were observed to taper off buprenorphine during the study period, with an estimated proportion of 15% (95%CI: 10%–21%) based on Kaplan Meier analyses. Less than half of the tapers, 45.8% (22/48), were medically supervised. Thirteen of the 48 patients subsequently, re-engaged in buprenorphine treatment (estimated proportion 61%, 95%CI: 27%–96%), based on Kaplan-Meier analyses with median follow-up time of 490 days. Discussion Despite the fact that many patients desire to discontinue buprenorphine, a minority had a documented taper. Among those who tapered, more than half did so unsupervised by the clinic and a majority of those who tapered off returned to buprenorphine treatment within two years. As many patients are unable to successfully taper off buprenorphine, the medical community must work to address any barriers to long-term maintenance.

The prevalence of psychoactive medications (PAMs) use in patients enrolled in Office Based Opioid Treatment (OBOT) and its association with engagement in this care is largely unknown.To describe the use of PAMs, including those medications with emerging evidence of misuse ("emerging PAMs" - gabapentin, clonidine and promethazine) among patients on buprenorphine, and its association with disengagement from OBOT.This is a retrospective cohort study of adults on buprenorphine from January 2002 to February 2014. The association between use of PAMs and 6-month disengagement from OBOT was examined using multivariable logistic regression models. A secondary analysis exploring time-to-disengagement was conducted using Cox regression models.At OBOT entry, 43% of patients (562/1308) were prescribed any PAM; including 17% (223/1308) on an emerging PAM. In separate adjusted analyses, neither the presence of any PAM (adjusted odds ratio [AOR] 1.07, 95% CI [0.78, 1.46]) nor an emerging PAM (AOR 1.28 [0.95, 1.74]) was significantly associated with 6-month disengagement. The results were similar for the Cox model (any PAM (adjusted hazard ratio [AHR] 1.16, 95% CI [1.00, 1.36]), emerging PAM (AHR 1.18 [0.98, 1.41])). Exploratory analyses suggested gabapentin (AHR 1.30 [1.05-1.62]) and clonidine (AHR 1.33 [1.01-1.73]) specifically, may be associated with an overall shorter time to disengagement.Psychoactive medication use is common among patients in buprenorphine treatment. No significant association was found between the presence of any psychoactive medications, including medications with emerging evidence of misuse, and 6-month disengagement from buprenorphine treatment.

Drug and Alcohol Dependence 156 (2015) e183–e245 e197 COCduring conditioning, (3) pre-TAUandTAUduring conditioning, and (4) COC during conditioning. Results: Males and females that were not pre-treated with COC showed a significant preference to the COC-paired chamber. Neither male nor female subjects showed a preference to the TAU-paired chamber. Taurine was effective in inhibiting cocaine preference in both male and female subjects after the preTAU; however, females show a significant preference towards the cocaine-paired chamber when TAU and COC are co-administered. Conclusions:Coc-inducedbehaviors oftenpersist for years after abstinence and the best form of treatment is yet to be determined. This study provides evidence that taurine might deserve study as a treatment for cocaine addiction; however, sex may influence its efficacy. Further studies will be performed to assess possible mechanisms by which taurine inhibits cocaine preference, its relationship to gonadal hormones. Financial support: Supported by NIDA R25DA030310 (KSR); NCRR 5G12RR003060-26, NIMHHD 8G12MD7603-27 (EF, KSR); NIH MARC U*STAR 5T34 GM007639-32 (KU); K05DA015799 (J.C. Anthony, sponsor). http://dx.doi.org/10.1016/j.drugalcdep.2015.07.529 HIV-related stigma and substance use in a Russian cohort of HIV+ risky drinkers Jeffrey Samet1,∗, Karsten Lunze1, Debbie M. Cheng1, Dmitry Lioznov3, Emily Quinn1, Carly Bridden1, Christine Chaisson1, Alexander Y. Walley1, E. Krupitsky3, Anita Raj4, E.J. Edelman2 1 Boston University, Boston, MA, United States 2 Yale, New Haven, CT, United States 3 First St. Petersburg Pavlov State Medical U, St. Petersburg, Russian Federation 4 UCSD, San Diego, CA, United States Aims: To determine whether HIV-related stigma contributes to substance use and dependence among HIV+ Russian individuals with risky alcohol use. Methods: We used data from HERMITAGE, a randomized controlled trial of 700 HIV+ individuals with past 6-month risky sex and risky alcohol use in St. Petersburg, Russia (2007–2011). Demographics, clinical and behavioral characteristics were collected by survey at baseline, 6 and 12 months. We measured HIV-related stigma using the abbreviated Berger HIV-related stigma scale. We assessed past 30 day drug use (modified Risk Behavior Scale), risky alcohol use (Timeline Followback), and substance dependence (CIDI short form). Generalized estimating equations were constructed to examine the association between high HIV-related stigma (score >75th percentile) and substance use over time (any prior 30 days heroin or stimulant or risky alcohol use [per NIAAA criteria]). Secondary outcomes were (1) any prior 30 days heroin or stimulant use; (2) prior 30 days risky alcohol use; and (3) past year alcohol or drug dependence. We adjusted for demographics, education, marital status, intervention group, time since HIV diagnosis, depressive symptoms, antiretroviral therapy use, CD4 count, and social support. Results:At baseline, themean agewas 30 (SD 5) years, with 41% women. Twenty-eight percent reported high HIV-related stigma; 87% reported substanceuse in theprior 30days. In adjustedmodels, high HIV-related stigma (AOR=0.86 [95% CI 0.51, 1.45]) was not significantly associated with substance use. These findings were similar for the secondary outcomes. Conclusions: HIV-related stigma does not appear to be associated with substance use among risky drinkers. Future efforts to identify modifiable factors which contribute to substance use among HIV+ individuals with risky alcohol use are needed. Financial support: R01AA016059; K12DA033312; R25DA013582. http://dx.doi.org/10.1016/j.drugalcdep.2015.07.530 Impact of telehealth in-home-messaging devices on alcohol use in dually diagnosed veterans Elizabeth J. Santa Ana1,∗, Steve Martino2, Mulugeta Gebregziabher1 1 Charleston VAMC and Medical University of South Carolina, Charleston, SC, United States 2 Yale University School of Medicine, West Haven, CT

s / Drug and Alcohol Dependence 146 (2015) e2–e33 e15 Characterization of morphine discriminative stimulus properties in C57BL/6 mice D.M. Walentiny, L.S. Harris Department of Pharmacology & Toxicology, Virginia Commonwealth University, Richmond, VA, United