Opioid Drug Interaction Study

Alprazolam (Xanax®) is a short-acting benzodiazepine that is the commonly prescribed in the U.S. (>15 million prescriptions in 2021) and CDC reporting indicates that alprazolam was associated with the greatest increase in number of ED presentations of the benzodiazepines. This study will examine the effects of a widely prescribed and abused mu opioid agonist, oxycodone, and a widely prescribed and abused benzodiazepine, alprazolam, when given alone and in combination to experienced drug using volunteers. Key safety outcomes, including expired CO2, pharmacodynamic measures related to abuse potential, and cognitive/psychomotor performance will be thoroughly examined over a range of doses for both drugs alone and in combination. Pharmacokinetic data will also be collected and analyzed to assess the potential pharmacokinetic interaction as an underlying mechanism of action.

Inclusion criteria

• English-speaking and literate participants, able to understand and sign Informed Consent Document
• ages 18 to 55 years old inclusive
• BMI of greater than/equal to 17 and approximately less than or equal to 30
• self-reported opioid use
• self-reported sedative-like drug use
• women of childbearing potential must not be pregnant or breastfeeding at screening and be using an effective form of contraception throughout study participation
• otherwise healthy as determined by the medical/research team based on medical history, physical examination, vital signs, laboratory chemistries (blood chemistry with liver function tests and hematology, urinalysis and microscopic evaluation, 12-lead electrocardiogram)
• willing and able to comply with all testing requirements defined in the protocol
• adequate venous access (determined by RN) for pharmacokinetic blood draws

Exclusion criteria

• physical dependence on alcohol, opioids, benzodiazepines or sedative/hypnotics requiring medical management/detoxification
• seeking treatment for opioid or any other drug use
• acute medical problem (e.g., infection) or chronic medical problem requiring daily medication or ongoing medical care (e.g., hypertension, cardiovascular disease, diabetes, respiratory disorders [e.g., asthma, COPD])
• clinically significant abnormal ECG (as determined by study physician/cardiologist)
• clinically significant abnormal laboratory findings (e.g., liver function tests greater than 3x the upper limits of normal range)
• current or past history of major psychiatric disorder that would limit ability to participate in the study (e.g., bipolar disorder).
• recent use of CYP2C9, CYP2D6 and CYP3A4 inhibitor or inducer that is long-acting and not amenable to a wash-out period after enrollment
• known hypersensitivity to any of the study drugs
• currently pregnant or breastfeeding
• currently under parole or probation with urine testing requirements