Kenzie L Preston

Kenzie L Preston
National Institutes of Health | NIH · National Institute of Drug Abuse (NIDA)

PhD

About

312
Publications
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13,169
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Publications

Publications (312)
Article
In intensive longitudinal studies using ecological momentary assessment, mood is typically assessed by repeatedly obtaining ratings for a large set of adjectives. Summarizing and analyzing these mood data can be problematic because the reliability and factor structure of such measures have rarely been evaluated in this context, which-unlike cross-s...
Article
Affect and craving are dynamic processes that are clinically relevant in opioid use disorder (OUD) treatment, and can be quantified in terms of intra-individual variability and stability. The purpose of the present analysis was to explore associations between opioid use and variability and stability of affect and craving among individuals receiving...
Article
Full-text available
Background The Covid-19 pandemic and its accompanying public-health orders (PHOs) have led to (potentially countervailing) changes in various risk factors for overdose. To assess whether the net effects of these factors varied geographically, we examined regional variation in the impact of the PHOs on counts of nonfatal overdoses, which have receiv...
Article
Employment problems are common among people with substance use disorders (SUDs), and improving vocational functioning is an important aspect of SUD treatment. More detailed understanding of the psychosocial benefits of employment may help refine vocational interventions for people with SUDs. Here, we used ecological momentary assessment to measure...
Article
Aims To examine evidence for subtypes of opioid craving trajectories during medication for opioid use disorder (MOUD), and to (a) test whether these subtypes differed on MOUD-related outcomes, and (b) determine whether nonresponders could be identified before treatment initiation. Design, Setting, and Participants Outpatients (n = 211) being treat...
Article
Background Employment and improved quality of life (QOL) are, separately, valued outcomes of substance use disorder (SUD) treatment. It is also important to understand QOL changes caused by employment itself; therefore, we assessed QOL during a randomized trial of a contingency-management-based Therapeutic Workplace for people with opioid use disor...
Article
Full-text available
Allostatic load, an operationalization for cumulative strain on physiology from adaptation (allostasis) to stress over a lifetime, can manifest as damage to cardiovascular, neuroendocrine, and metabolic systems. The concept of allostatic load may be particularly useful in research on substance-use disorders (SUDs) because SUD researchers have sough...
Article
Anhedonia is usually defined as partial or total loss of the capacity for pleasure. People with anhedonia in the context of major depressive disorder may have an unexpected capacity for event-related mood brightening, observable when mood is assessed dynamically (with smartphone-based ecological momentary assessment [EMA]) rather than only statical...
Article
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Rationale Given that many patients being treated for opioid-use disorder continue to use drugs, identifying clusters of patients who share similar patterns of use might provide insight into the disorder, the processes that affect it, and ways that treatment can be personalized. Objectives and methods We applied hierarchical clustering to identify...
Article
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As digital technology increasingly informs clinical trials, novel ways to collect study data in the natural field setting have the potential to enhance the richness of research data. Cocaine use in clinical trials is usually collected via self-report and/or urine drug screen results, both of which have limitations. This article examines the feasibi...
Article
Background: We previously showed, in people starting treatment for opioid use disorder (OUD), that stress is neither necessary nor sufficient for lapses to drug use to occur, despite an association between the two. Both theoretical clarity and case-by-case prediction accuracy may require initial differentiation among patients. Aim: To examine: (...
Article
Objective: Evidence suggests that blunted reward responsiveness may account for poor clinical outcomes in both opioid use disorder (OUD) and chronic pain. Understanding how individuals with OUD and comorbid chronic pain (OUD+CP) respond to rewards is, therefore, of clinical interest because it may reveal a potential point of behavioral interventio...
Article
Full-text available
Just-in-time adaptive interventions (JITAIs), typically smartphone apps, learn to deliver therapeutic content when users need it. The challenge is to “push” content at algorithmically chosen moments without making users trigger it with effortful input. We trained a randomForest algorithm to predict heroin craving, cocaine craving, or stress (report...
Article
Aim: To assess the role of momentary pain on opioid craving and illicit opioid use among individuals receiving opioid agonist treatment. Design: Observational study using ecological momentary assessment. Setting: The National Institute of Drug Abuse's Intramural Research Program in the USA. Participants: Fifty-six adults who qualified for op...
Article
Full-text available
Rationale Many people being treated for opioid use disorder continue to use drugs during treatment. This use occurs in patterns that rarely conform to well-defined cycles of abstinence and relapse. Systematic identification and evaluation of these patterns could enhance analysis of clinical trials and provide insight into drug use. Objectives To e...
Article
Adherence monitoring is a vital component of clinical efficacy trials, as the regularity of medication consumption affects both efficacy and adverse effect profiles. Pill‐counts don’t confirm consumption, and invasive plasma assessments can only assist post‐hoc assessments. We previously reported on the pharmacokinetics of a potential adherence mar...
Article
Full-text available
Background: Sleep disturbance is common in patients with opioid use disorder (OUD) receiving medication for addiction treatment. Differences between patients on the two primary agonist medications-methadone and buprenorphine-are not well understood. Methods: In patients receiving either methadone or buprenorphine treatment for OUD, we examined s...
Article
Introduction: The subjective experience of drug craving is a prominent and common clinical phenomenon for many individuals diagnosed with opioid use disorder (OUD), and could be a valuable clinical endpoint in medication development studies. The purpose of this scoping review is to provide an overview and critical analysis of opioid craving assess...
Article
Sleep problems are commonly reported during opioid agonist treatment (OAT) for opioid use disorders. Inpatient studies have found both sleep disturbances and improved sleep during OAT. Illicit opioids can also disrupt sleep, but it is unclear how they affect sleep in outpatients receiving OAT. Therefore, we used electronic diary entries and actigra...
Article
Background: Treatment with methadone is effective in reducing heroin use, HIV risk, and death; however, not all patients respond to treatment. Better outcomes may emerge with personalized treatment based on factors that influence treatment courses. Objectives: To investigate psychosocial variables contributing to treatment response, using a compreh...
Article
Background: Treatment with opioid agonists is effective for opioid use disorder, but early discontinuation of treatment is a major obstacle to success. Intensive longitudinal methods - which take many repeated measurements over time, usually in the field- have provided unique insight into the effects of stress, mood and craving on drug use while p...
Article
Full-text available
Many patients with opioid use disorder do not have successful outcomes during treatment but the underlying reasons are not well understood. An OPRD1 variant (rs678849) was previously associated with methadone and buprenorphine efficacy in African–Americans with opioid use disorder. The objective of this study was to determine if the effect of rs678...
Article
Full-text available
Cocaine use in clinical trials is often measured via self-report, which can be inaccurate, or urine drug screens, which can be intrusive and burdensome. Devices that can automatically detect cocaine use and can be worn conveniently in daily life may provide several benefits. AutoSense is a wearable, physiological-monitoring suite that can detect co...
Article
Background: Individual trajectories of drug use and drug-related problems are highly heterogeneous. There is no standard taxonomy of these trajectories, but one could be developed by defining natural categories based on changes in symptoms of substance-use disorders over time. Methods: Our study was conducted in a community sample in Baltimore,...
Article
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Background: Preclinical and human positron emission tomography studies have produced inconsistent results regarding the effects of opioids on mesolimbic dopamine (DA). Here, we quantify striatal DA release (measured by [11C]raclopride displacement) in response to an intravenous infusion of morphine, and its relationship with morphine-induced subje...
Article
Background Opioid Use Disorder (OUD) is a significant public health issue in the United States and globally. FDA-approved treatment for OUD includes Opioid Substitution Therapy (OST) with medications such as methadone and buprenorphine. While OST has been shown to be effective, a meta-analysis of outcome data from OST studies indicated that a signi...
Article
Full-text available
Background: Preliminary evidence suggested that the PPARγ agonist pioglitazone reduces opioid-withdrawal symptoms, possibly by inhibiting increases in proinflammatory cytokines. Methods: A randomized, placebo-controlled clinical trial was conducted utilizing two different study designs (entirely outpatient, and a combination of inpatient and out...
Article
Background and aims: Stress can be validly assessed "live" or by a summary evaluation of the very recent past. Using smartphone-based ecological momentary assessment (EMA) combined with end-of-day (EOD) entries, we assessed the association between daily hassles, stressful events and use of opioids and cocaine, in opioid- and cocaine-using men and...
Article
Full-text available
RationaleEcological momentary assessment (EMA) of specific events usually focuses more on antecedents and concomitants than on aftermaths. Objectives To examine mental state both before and after discrete episodes of stress and drug use. Methods For up to 16 weeks, outpatients on opioid-agonist treatment carried smartphones on which they initiated...
Article
Full-text available
This study examined how contextual areas defined and operationalized differently may lead to different exposure estimates. Substance users’ exposures to environmental stress (in terms of two variables: community social economic status and crime) were assessed from global positioning systems (GPS) data. Participants were 47 outpatients with substanc...
Article
Location data are becoming easier to obtain and are now bundled with other metadata in a variety of biomedical research applications. At the same time, the level of sophistication required to protect patient privacy is also increasing. In this article, we provide guidance for institutional review boards (IRBs) to make informed decisions about priva...
Article
Background: Responses to stress and drug craving differ between men and women. Differences in the momentary experience of stress in relation to craving are less well-understood. Objectives: Using ecological momentary assessment (EMA), we examined sex differences in real-time in two areas: (1) causes and contexts associated with stress, and (2) t...
Article
Background: In a recent clinical trial (NCT00295308), we demonstrated that clonidine decreased the association between opioid craving and moderate levels of stress and affect in patients receiving buprenorphine-based opioid agonist therapy. Objectives: To examine the relationship between illicit opioid use and craving and affect during the evalu...
Article
In addiction, risk factors for craving and use include stress and drug-related cues. Stress and cues have additive or more-than-additive effects on drug seeking in laboratory animals, but, surprisingly, seem to compete with one another (ie, exert less-than-additive effects) in human laboratory studies of craving. We sought heretofore elusive eviden...
Article
Whereas substance-use researchers have long combined self-report with objective measures of behavior and physiology inside the laboratory, developments in mobile/wearable electronic technology are increasingly allowing for the collection of both subjective and objective information in participants' daily lives. For self-report, ecological momentary...
Article
Objectives: People with substance use problems living in neighborhoods with high levels of disorder are disproportionately likely to experience trauma and develop PTSD symptoms. We sought to evaluate the relationships between objective neighborhood disorder, perceptions of neighborhood, and the use of maladaptive coping behaviors among both non-su...
Article
Full-text available
Rationale: Knowing how stress manifests in the lives of people with substance-use disorders could help inform mobile "just in time" treatment. Objectives: The purpose of this paper is to examine discrete episodes of stress, as distinct from the fluctuations in background stress assessed in most EMA studies. Methods: For up to 16 weeks, outpati...
Chapter
Mobile sensor data collected in the natural environment are subject to numerous sources of data loss and quality deterioration. This may be due to degradation in attachment, change in placement, battery depletion, wireless interference, or movement artifacts. Identifying and fixing the major sources of data loss is critical to ensuring high data yi...
Article
Objective: In a clinical trial examining daily clonidine as an adjunct to buprenorphine treatment for opioid dependence, we found that clonidine increased opioid abstinence and decoupled stress from craving. From a personalized-medicine perspective, the next step is to identify people for whom clonidine would be beneficial. To that end, using data...
Conference Paper
Introduction Sleep disturbances associated with opioid use disorder (OUD) are well recognized. Characterization of sleep abnormalities in individuals on buprenorphine maintenance therapy, a partial mu-opioid agonist used for the treatment of OUD, is limited. Our aim was to characterize and compare subjective and objective sleep measurements in this...
Poster
Full-text available
Background: Cocaine use in clinical trials is typically measured via self-report or urine toxicology screens that are intrusive and require frequent site visits. Both lack the temporal precision and continuous data collection needed to identify antecedents of cocaine use. The AutoSense platform has been validated to detect the timing of cocaine use...
Article
Full-text available
Levamisole, an anthelmintic drug with cholinergic properties, has been implicated in cases of drug-induced vasculitis when added to cocaine for profit purposes. Neutrophil extracellular trap (NET) formation is a cell death mechanism characterized by extrusion of chromatin decorated with granule proteins. Aberrant NET formation and degradation have...
Article
Full-text available
RationaleIn rodents, antagonism of receptors for corticotropin-releasing factor (CRF) blocks stress-induced reinstatement of drug or palatable food seeking. Objective To test anticraving properties of the CRF1 antagonist pexacerfont in humans. Methods We studied stress-induced eating in people scoring high on dietary restraint (food preoccupation a...
Article
We investigated relationships between drinking, other drug use, and drug craving, using ecological momentary assessment (EMA), in a sample of polydrug users who were not heavy drinkers. In a prospective longitudinal cohort study, 114 heroin and cocaine users on methadone-maintenance treatment carried handheld electronic diaries during waking hours...
Article
Aripiprazole blocks psychostimulant seeking in a rat model of relapse. However, in humans, it may increase ongoing use. We tested aripiprazole specifically for relapse prevention. Methadone-maintained outpatients who were abstinent from cocaine in weeks 11-12 were randomized to double-blind aripiprazole (15 mg daily) or placebo in weeks 13-27 after...
Article
Background Levamisole, an anti-helminth drug and known cholinergic agonist, has been implicated in cases of drug-induced autoimmunity in humans exposed to cocaine adulterated with levamisole for profit. Clinical manifestations of levamisole-induced autoimmunity include cutaneous vasculitis and specific autoantibodies (e.g. anti neutrophil cytoplasm...
Conference Paper
Full-text available
Management of daily stress can be greatly improved by delivering sensor-triggered just-in-time interventions (JITIs) on mobile devices. The success of such JITIs critically depends on being able to mine the time series of noisy sensor data to find the most opportune moments. In this paper, we propose a time series pattern mining method to detect si...
Article
Full-text available
Introduction The dopaminergic (DA) system plays important roles in addiction. However, human DA neurons from drug‐dependent subjects were not available for study until recent development in inducible pluripotent stem cells (iPSCs) technology. Methods In this study, we produced DA neurons differentiated using iPSCs derived from opioid‐dependent and...
Conference Paper
ntroduction: Aripiprazole, a partial D2 agonist, has been proposed as a potential treatment for psychostimulant addiction. In the rat reinstatement model of relapse, after psychostimulants are no longer available, it blocks cued or drug-primed psychostimulant seeking, suggesting a benefit. However, in humans who have not yet become abstinent from p...
Conference Paper
ntroduction: Aripiprazole, a partial D2 agonist, has been proposed as a potential treatment for psychostimulant addiction. In the rat reinstatement model of relapse, after psychostimulants are no longer available, it blocks cued or drug-primed psychostimulant seeking, suggesting a benefit. However, in humans who have not yet become abstinent from p...
Conference Paper
Complex systems, such as the brain, involve non-linear neuronal interactions. These in turn translate into self-organization and emergence of distinct pat- terns of activity. And although a loss of integrated neuronal activity or increased entropy during anesthesia has been described in the literature, it has not yet been well characterized. These...
Article
Full-text available
We investigate needs, challenges, and opportunities in visualizing time-series sensor data on stress to inform the design of just-in-time adaptive interventions (JITAIs). We identify seven key challenges: massive volume and variety of data, complexity in identifying stressors, scalability of space, multifaceted relationship between stress and time,...
Article
Objectives: The purpose of this study was to evaluate the effects of homework-task difficulty and electronic-diary reminders on written homework completion during cognitive-behavioural therapy (CBT) for addiction. Completion of homework is an important element in CBT that may affect outcome. Design: All participants received all combinations of...