SUNY on the front lines in the battle with substance abuse and addiction
The current opioid epidemic—regarded by many experts as the worst drug crisis in American history—is particularly acute in New York State. Every year, thousands of New Yorkers are dying from causes directly related to addiction.
SUNY is at the forefront of the current efforts at substance abuse prevention, treatment and recovery, boasting topnotch research facilities and nationally recognized scientists. Across New York State, SUNY researchers are making contributions that could bring about a new day in the way our medical community treats addiction.
SUNY Downstate scientists revolutionized the field of substance abuse research. Dr. Henri Begleiter, a Distinguished Professor of Psychiatry and Neuroscience at SUNY Downstate Medical Center—who died in April 2006—was the first to conceptualize the important role genetics plays in the development of alcoholism and related disorders.
Working with longtime collaborator Bernice Porjesz, PhD, Professor of Psychiatry and Behavioral Sciences, Begleiter discovered that many neurological abnormalities found in the brains of alcoholics are not caused by excessive drinking. Rather, they are inherited, potentially predisposing individuals to alcohol abuse in the first place. The data, published in 1984 in the prestigious journal Science, changed the way many researchers and professionals think about alcoholism and addiction.
The results spurred Drs. Begleiter and Porjesz to focus on the relationship between genetics, brain function and alcoholism. In 1989, Dr. Begleiter founded and led the Collaborative Study on the Genetics of Alcoholism (COGA), with multidisciplinary expertise from 11 sites nationally, and with the overarching aim to identify and understand genes involved in the predisposition to develop alcohol use disorder (AUD).
Sponsored by the National Institute on Alcohol Abuse and Alcoholism, this large-scale family study, which has attracted approximately $200 million in grant funding, is the most comprehensive research project ever to be conducted on the inherited aspects of alcoholism. The project has collected data from 17,762 individuals from 2,255 families of European and African ancestry. The resulting database of observed clinical, behavioral, neurophysiological and neuropsychological characteristics—as well as DNA and cell lines—provides a national and international resource for the field.
COGA accomplishments include identifying genes related to alcohol dependence and finding precursors to alcohol problems and alcohol genetic spectrum conditions, such as substance use disorders, anxiety and mood disorders. COGA is currently participating in two genome-wide association studies involving opiates with the Psychiatric Genomics Consortium-Substance Abuse Disorder Workgroup (which is led by members of COGA) and with the National Institute on Drug Abuse Genetics Consortium.
The COGA project brings together multidisciplinary expertise from molecular to clinical care, closing the circle from gene discovery to translational research. The ultimate goals are: prevention -- identifying novel modifiable pathways, even before disease; and treatment – creating personalized medicines based on genetic profiling.
When the Research Institute on Addictions (RIA) became part of the University at Buffalo in 1999, it was the only research center in New York State with a treatment program designed to have clinicians and researchers work together developing and evaluating new methods for treating addictive behaviors. Today, RIA is a recognized leader, both nationally and internationally, in the study of substance abuse and addiction.
RIA scientists are engaged in dozens of research projects on addiction-related topics, including alcohol and illicit drug use and abuse, prescription drug abuse, smoking, addiction treatment and infant/child development.
Neuroscientists at RIA are studying the brain’s reward pathways, including the dopamine and serotonin systems, to determine how addiction takes hold and under what circumstances it may be provoked, such as prenatal alcohol exposure or anxiety. They also seek ways to reverse the effects of certain drugs on the brain’s neurochemistry.
Other RIA research projects focus on wider family or societal influences on addiction. Rina Das Eiden, PhD, looks at when and under what circumstances children are at risk for problems due to parental substance abuse. Her studies, many of which follow cohorts of children across multiple years, seek to understand the developmental mechanisms, such as infant-parent attachment, self-regulation, individual differences in children’s autonomic and stress reactivity, which explain the association between parental risk factors and children’s developmental outcomes.
Eiden and Jennifer Livingston, PhD, have each recently partnered with UB’s Alberti Center for Prevention of Bullying Abuse to explore different paths to violence and/or victimization among adolescents who come from high-risk environments often exacerbated by substance abuse. These studies, in addition to collaborations with faculty and clinicians throughout UB, including the Jacobs School of Medicine and Biomedical Science, School of Public Health and Health Professions, School of Pharmacy and Pharmaceutical Sciences, School of Social Work and School of Nursing, are made possible due to UB’s strong commitment to promoting interdisciplinary research.
Groundbreaking work on behavioral neuroscience and the psychopharmacology of development is being done at Binghamton University, specifically in the Adolescent Alcohol Research Lab, led by Distinguished Professor of Psychology Dr. Linda Spear. Her research, which details how the adolescent brain responds differently to alcohol than the adult brain, has helped to ground the debate about teen drinking in solid science and provides insights that may improve substance abuse prevention and treatment programs.
As scientific director of the Developmental Exposure Alcohol Research Center, Spear is working with colleagues from Binghamton University, Upstate Medical University and other research-emphasis institutions in upstate New York to examine the consequences of developmental exposure to alcohol, focusing on two specific life stages: prenatally, via maternal use of alcohol, and during adolescence, when kids begin using alcohol themselves. During both of these phases, the developing brain is subject to alteration by alcohol.
Yao-Ying Ma, who joined the Binghamton faculty in 2015, is studying addiction at the cellular level. Science shows that an addictive drug triggers complex physical changes in the brain, and these in turn influence a person’s behavior, making it hard to quit. To study this effect, Ma and the students in her lab employ an animal model—rats prenatally exposed to alcohol, which puts them at high risk of addiction to cocaine or other drugs.
The researchers direct light within specific wavelengths to a synapse, switching certain receptors on or off, and then observe the outcome. Once they learn which patterns of light waves—or other types of stimulation—might counteract the effects of addictive drugs in the brain, the next step in the search for effective therapies will be to learn how to target the correct synapses.
Researchers at Upstate Medical University are doing leading edge work in neurodevelopment and neurodevelopmental disorders, neuropsychiatric disorders and diseases, and their role in the development of addiction.
Dr. Stephen Glatt is director of the Psychiatric Genetic Epidemiology & Neurobiology Laboratory. His current research is focused on finding the “risk” genes for a series of psychiatric disorders, including schizophrenia, bipolar disorder, and post-traumatic stress disorder, that might contribute to addiction. Glatt examines affected individuals and families to reveal how such genes alter brain biology and lead to addiction.
Dr. Brian Johnson, professor of psychiatry and behavioral sciences, aims to understand how opioids exert their effects by treating opioid dependence, fibromyalgia, and autism—three disorders previously considered to be distinct—with varying doses of naltrexone. The theory underlying the research assumes that each involves a dysregulation of the opioid system Johnson is adamant about the problem of liberal prescription of hydrocodone and other highly addictive opioid prescription painkillers. Since the 1990s, Dr. Johnson says, “Opioid prescribing has quadrupled and accidental overdose deaths are more common than motor vehicle deaths.”
The rapid rise in prescriptions for opioid pain relievers is a growing problem, yet treating it is a challenge, as many chronic pain sufferers have a legitimate need for these powerful drugs. The Jacobs School of Medicine and Biomedical Sciences at University at Buffalo is in the vanguard among medical schools throughout the country that are confronting the problem.
“Long before opioid addiction became a front-page issue, faculty in the Jacobs School of Medicine and Biomedical Sciences were leaders in developing formal curricula to teach medical students, residents and fellows how to prevent and treat addiction,” said Michael Cain, MD, vice president for health sciences and dean of the Jacobs School of Medicine and Biomedical Sciences.
This research was led in large part by Richard Blondell, MD, Professor of Family Medicine and Vice Chair for Addiction Medicine. “UB was an early adopter in terms of instructing our students on safe prescribing,” notes Blondell, who has been developing addiction medicine training programs and curricula, and in 2013 was appointed director of the National Center for Physician Training in Addiction Medicine. The addiction medicine fellowship he developed in the UB Department of Family Medicine was among the nation’s first ten postgraduate addiction medicine residencies accredited by the American Board of Addiction Medicine Foundation.
SUNY addiction research efforts have been recognized nationally. A multidisciplinary research team at Stony Brook University has received a five-year $3.8 million grant from the National Institute on Drug Abuse, part of the National Institutes of Health. The research has led to the development of new drugs for pain, inflammation, and potentially drug addiction. One particular compound shows promise for future development. Collaborators at the Research Institute on Addictions tested the drug and found that it does not pose a risk of dependence or motor and cognitive impairment -- a prerequisite before being tested for treatment of opiate addiction.
The opioid epidemic is not going away soon. It is a challenging problem that needs to be addressed on multiple fronts. The SUNY solution involves employing its talented faculty and leading-edge facilities to approach this public health crisis from several angles, from the genetic to the psychological to the educational. Through this multifaceted strategy, SUNY researchers are developing powerful methodologies for prevention, treatment and recovery.
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