Paul P. Casadonte, M.D., clinical research interests have focused on heroin and cocaine abuse and HIV infection and prevention in drug abusers. His clinical trials are noted for high recruitment and retention of subjects, and a significant population of women.

Dr. Casadonte participated in a 12-site cooperative study of buprenorphine treatment of heroin addiction (1992-94) sponsored by the Medications Development Division of the National Institute on Drug Abuse. This study evaluated four doses of Buprenorphine and determined that an 8 mg dose was sufficient to prevent heroin craving and abuse. The advantage to this medication is that it will not be subject to the constraints and regulations of methadone and may eventually be available for outpatient medical practice in any treatment program.

The LAAM Labeling Assessment Study (1992-94) had as its major purpose the valuation of the prescribing directions for a medication L-Acetyl Alpha Methados, a synthetic congener of methadone. LAAM has been extensively studied over 20 years, but NIDA believed that the prescribing information had to be updated in a study population that is quite different from the heroin addicts of the 1970's. LAAM, as a result of the findings of the study, was approved for the maintenance treatment of heroin addiction in July 1993. The New York VA is currently the only site in New York State using LAAM.

The Psychological and Behavioral Impact of HIV Testing (1984-95) began when New York City/State began research into HIV Testing. Fifty patients received test results in 1985-86 and did not experience adverse psychological events. At the time of the study, little was know about HIV testing and many feared that receiving test results would precipitate adverse psychological events. It was found that this was not the case, that most patients reported risk reducing activities. HIV testing has now become integrated into treatment planning at many drug abuse treatment sites.

Michael Hwang, M.D., who recently joined the New York VAMC Psychiatry Service, is interested in substance-induced dementias and amnesias as well as impulse control disorders. Dr. Hwang is developing a protocol studying ibogaine in treatment of opiate addiction. Dr. Casadonte is also developing a buprenorphine - naloxone treatment protocol of heroin addiction.