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Ultra-Low-Dose Ketamine Can Curb Opioid Withdrawal

Newswise — Drug overdose is the leading cause of injury deaths in young adults in the United States, with fentanyl causing over 70,000 deaths annually.

Many people who use fentanyl become trapped in their addiction out of fear and a low tolerance for the withdrawal symptoms, which include muscle cramps, nausea, chills, sweats and intense cravings. 

They can’t stop using fentanyl, and they also have trouble starting either of the two medications, methadone and buprenorphine, that can dramatically reduce their risk of overdose death.

Research findings published Aug. 29 in Addiction Science & Clinical Practice may offer hope. A pilot study showed that a small amount of ketamine can reduce or eliminate the withdrawal symptoms associated with quitting fentanyl.

“The main takeaway is that we have found an easier way for people trapped in the grip of fentanyl addiction to get started in treatment,” said Dr. Lucinda Grande, a clinical assistant professor of family medicine at the University of Washington School of Medicine. She was the study’s lead author. 

“Methadone can be difficult to access due to strict federal regulations, and starting buprenorphine can cause severe withdrawal symptoms before those who start it become stabilized,” added study co-author Dr. Tom Hutch. He is the medical director of the opioid treatment program at We Care Daily Clinics in Auburn, Wash. “Ketamine, at an imperceptibly low dose, helps bridge that gap.” 

Over 14 months, Grande and colleagues in Auburn and Olympia prescribed ketamine to 37 fentanyl-addicted patients whose fear of withdrawal symptoms had deterred them from trying buprenorphine. Twenty-four patients actually tried the drug, and 16 completed the transition to buprenorphine. 

Most patients reported a reduction or elimination of withdrawal symptoms after each ketamine dose, the effect of which lasted for hours. Of the last 12 who completed the transition, 92% remained in treatment for at least 30 days.

Patients placed a ketamine lozenge or syrup under the tongue. The 16 mg dose is a small fraction of that typically used for anesthesia, the main clinical role of ketamine for 50 years, according to Grande. That dosage also is less than half of the smallest ketamine dose prescribed for depression treatment, an increasingly common use of this medication.

Researchers monitored patients daily or almost daily, and refined the treatment strategy based on patient response and prescriber experience.

Grande developed the concept after she learned that emergency-medicine physician and coauthor Dr. Andrew Herring of Oakland, California, used a higher, sedating dose of ketamine successfully in his emergency department to resolve a patient’s severe case of withdrawal from fentanyl addiction. 

Grande is a primary-care and addiction doctor in practice near Olympia who, in the past dozen years, has used low-dose ketamine to treat more than 600 patients for chronic pain and depression. 

Ketamine has gained prominence in the news since actor Matthew Perry of the sitcom “Friends” overdosed on the drug and drowned. Perry had undergone high-dose ketamine treatment for depression, news reports have suggested.

“Our study underscores the enormous potential of this medication for addressing important health problems such as depression, chronic pain and now fentanyl-use disorder,” said Grande. Ketamine’s positive attributes have been overshadowed by Perry’s death, she said.

Grande hopes this pilot study’s results will be confirmed by larger studies. “I am excited about these results,” she said. “This is a wonderful opportunity to save lives.”

Cannabis and older adults: Poll shows current use patterns, beliefs and risks

Original post: Newswise - Substance Abuse Cannabis and older adults: Poll shows current use patterns, beliefs and risks

Newswise — Whether they’re using it for recreational or medical reasons, a sizable percentage of people in their 50s and older have smoked, eaten, drunk or applied to their skin at least one form of cannabis in the past year, a new poll shows.

In all, 21% of people age 50 and older said they used a form of cannabis that contains the psychoactive compound THC at least once in the past year, according to new findings from the University of Michigan National Poll on Healthy Aging. The poll report focuses on use of cannabis products with psychoactive amounts of THC, not CBD-only products.

More than half of those who used a cannabis product did so frequently: 12% of adults aged 50 and older said they did so at least once a month. Those aged 50 to 64, and those who are in fair or poor physical health, or in lower income households were more likely to report using cannabis at least monthly. 

As for the reasons older adults use cannabis, many cited sleep (68%), help with pain (63%) or mental health (53%), and/or to relax or feel good (81%).

The poll also reveals potential risky behaviors related to cannabis use. 

Among those who use cannabis at least once a year, 20% said they had driven a vehicle within two hours of consumption; many experts recommend waiting two or even three times that long. And the rate of such driving was even higher – 27% – among those who use cannabis at least once a month. 

In addition, nearly half of older adults who use cannabis products at least monthly had not discussed their use with their health care provider. And more than 20% reported at least one sign of potential dependence on cannabis.

The poll is based at the U-M Institute for Healthcare Policy and Innovation, and supported by AARP and Michigan Medicine, U-M’s academic medical center. 

Erin E. Bonar, Ph.D., a U-M addiction psychologist who worked with the poll team on the report, says the findings suggest a need for action at the policy, clinical and community levels to identify those who may need treatment for cannabis addiction and to discourage driving or other risky behaviors after consumption. 

“With some form of cannabis use now legalized in 38 states and on the ballot this November in several others, and the federal rescheduling process under way, cannabis use is likely to grow,” she said. “But as this poll shows, it is not risk-free, and more attention is needed to identify and reduce those risks.”

Bonar is a member of IHPI, the U-M Addiction Center and the U-M Injury Prevention Center as well as a professor in the Medical School Department of Psychiatry. 

In addition to the national poll report, the team compiled data for Michigan adults age 50 and older compared with those in other states; a summary is available at https://michmed.org/JYJer and an interactive data visualization is available at https://michmed.org/4e2KW. 

Cannabis potency and addiction: Views of all older adults

The poll team also asked all older adults – including those who don’t use cannabis – about their views of cannabis. The results suggest a need for more public awareness efforts, Bonar says. 

People in their 50s and beyond may have familiarity with cannabis from decades ago, whether through direct use or indirect knowledge during a time when it was illegal for any use in all states. Because of this, the poll team asked whether they believe cannabis is stronger today than it was 20 to 30 years ago.

The vast majority – 79% — of older adults said they thought this was true. But Bonar notes that this means 21% aren’t currently aware of the major increases in THC levels found in cannabis available today, compared with levels in the 1990s and before. 

Meanwhile, 72% of all older adults said they believe people can become addicted to cannabis. But, Bonar notes, this means more than a quarter of older adults aren’t currently aware that research has shown conclusively that cannabis addiction is real and can affect someone’s life and health just as addiction to other substances can. 

Importance of discussing with health care providers 

For those who use cannabis, especially those who use it often, poll director Jeffrey Kullgren, M.D., M.P.H., M.S. says the poll findings show the importance of communicating with their health care provider about their use. 

In all, 56% of those who use cannabis with THC at least monthly said they had spoken with their regular health care provider about their use. Most of them said they had brought the topic up. 

Talking openly with a provider about use could help identify risky drug interactions, and spot those experiencing signs of cannabis dependence or addiction. 

In all, 22% of those who use cannabis at least monthly said in the past year they had had to use more cannabis to feel the effect they wanted, and 21% said using the same amount of cannabis had less of an effect on them than it had before, while 17% said they had increased the amount or frequency of their cannabis use. Another sign of potential addiction – strong desires or cravings to use cannabis with THC – was reported by 13% of those who use cannabis at least monthly.

“Even if your doctor, nurse practitioner or pharmacist doesn’t ask if you’re using cannabis products, it’s important to offer this information, no matter whether you’re using it to address a physical or mental health concern, or simply for pleasure,” says Kullgren, a primary care physician at the VA Ann Arbor Healthcare System and associate professor of internal medicine at U-M. “Many prescription medications and over-the-counter drugs, as well as alcohol, can interact with cannabis and cause unexpected or unwanted effects. And there are only a few conditions where we have good evidence of a medical benefit from cannabis, though this could change with time.”

The current process at the federal level to change how cannabis is listed on the schedule of controlled substances may free more researchers to do studies of cannabis-derived products in clinical trials involving human volunteers. Right now, such research is very limited because of federal restrictions. 

The poll report is based on findings from a nationally representative survey conducted by NORC at the University of Chicago for IHPI and administered online and via phone in February and March 2024 among 3,379 adults ages 50 and older. The sample was subsequently weighted to reflect the U.S. and Michigan populations. Read past National Poll on Healthy Aging reports and about the poll methodology.

Broadcast quality interview and B-roll footage are available at https://michmed.org/NrGeW 

Virtual learning detrimental to school attendance, especially in districts with higher poverty rates, study finds

BYLINE: Tracy DeStazio

Newswise — Since the COVID-19 pandemic, rates of chronic absenteeism have nearly doubled across the nation for students in kindergarten through grade 12.

This increase was tied to the mode of instruction during the early years of the pandemic. In particular, schools that employed virtual learning as the primary teaching mode during the 2020-21 school year experienced a greater increase in chronic absenteeism in the following year. That increase was significantly greater in school districts with higher levels of poverty, according to new research from the University of Notre Dame.

William Evans, the Keough-Hesburgh Professor of Economics and co-founder of Notre Dame’s Wilson Sheehan Lab for Economic Opportunities, co-authored the study with current undergraduate student Kathryn Muchnick and 2024 graduate Olivia Rosenlund. Their work was recently published in the scientific journal JAMA Network Open.

The study analyzed data for two years from more than 11,000 school districts across the United States and found that chronic absenteeism rates increased from 16 percent in 2018-19 to nearly 30 percent in the 2021-22 school year. Students whose schools had full virtual instruction during the pandemic had chronic absenteeism rates that were nearly 7 percentage points higher than those schools that were fully in person, according to the research.

A student is considered chronically absent if he or she misses at least 10 percent of the instructional days in any given school year. That equates to more than three weeks of absences during a 180-day academic year.

As reported in the study, chronic absenteeism has been shown to lead to lower test scores, reduced social and educational interactions, lower rates of high school graduation and increased substance use. The increase in chronic absenteeism began to occur as public schools in the U.S. were attempting to return to pre-pandemic modes of in-person teaching.

Previous studies have indicated that moving away from in-person instruction during the 2020-21 school year to online teaching methods reduced student achievement and educational development, adversely affected children’s mental well-being and decreased school enrollment.

“We’ve learned a lot from the pandemic,” Evans said, “and a lot of work has gone into researching what effects virtual learning has had on students. It’s really difficult when you disrupt their educational experience by going remote.”

Both of Evans’ co-authors were high school students during the pandemic, giving them a uniquely personal perspective on the study’s results. Rosenlund said that when she entered the end of her senior year with fully virtual classes, she and her classmates “definitely had lower motivation to learn during that time compared to when class was fully in person.”

Muchnick added, “The shift in student motivation after online learning [back to in-person] was palpable.”

The research also indicated that chronic absenteeism rates hit at-risk students and school districts with the highest levels of poverty the hardest. Those school districts saw chronic absenteeism soar more than 10 percentage points higher among students who had participated in fully remote instruction, versus in-person learning.

“There is growing evidence that those in the most precarious situations were the ones that were really hurt the most by virtual instruction,” Evans said. “The districts with higher levels of poverty had higher rates of chronic absenteeism already, and they were much more aggressive at using virtual learning during COVID. So you took a vulnerable population, used this method of delivery for educational instruction, and the outcomes for these children are substantially worse.”

Households with lower incomes or fewer resources were less likely to have reliable or high-speed internet service and had far less access to quality computers or technology, making for a less-than-ideal virtual learning environment. “It was pretty detrimental for those kids who were most at risk in the first place,” Evans added, “and now they’ve been pushed further behind as a result of these policies.”

Although the study did not specifically explore the reasons behind the drop in school attendance, it did offer several possible explanations. First, roughly 10 to 20 percent of students were experiencing post-COVID-19 symptoms and may have elected not to go to school for medical and health reasons. Second, there was a corresponding increase in teacher absences and substitute teacher shortages that made students less compelled to go to school. Third, a greater occurrence of mental health issues, which is often coupled with an increased preoccupation with social media, may have kept students at home. Finally, following the pandemic, parents appear to be more willing to allow their children to miss school for a variety of reasons.

With the worst of the pandemic behind us, many parents, school teachers and administrators believe that virtual instruction is here to stay and will continue as a major component of K-12 education, potentially being used as a substitute for in-person teaching under certain circumstances, such as snow days.

“It’s going to be really difficult to put the genie back in the bottle in this context,” Evans said.

Finding a balance of how to use virtual learning in a way that does not negatively impact the students’ overall educational experience will be crucial, according to the researchers.

Rosenlund added, “It’s disheartening that students are still suffering from the negative effects of online learning. I hope that we can consider its implications more carefully going forward.”

The researchers suggest that educators and policymakers examine the evidence when establishing policies and practices related to online learning, particularly for those communities supporting at-risk students, in order to achieve equitable outcomes for all students.

“I think we need to take a more holistic approach in thinking about how to deal with these pandemics in the future,” Evans said.

Contact: Tracy DeStazio, associate director of media relations, 574-631-9958 or [email protected]

Sleep-deprived, cyberbullied teenagers addicted to smartphones now a common global phenomenon

Newswise — Combine cyberbullying, smartphone use, lack of sleep and poor mental health, and you have the perfect storm for a teenage meltdown.

Australian researchers have polled more than 50,000 primary and secondary school students aged 7-19 years about the link between their sleep and nighttime phone habits, experience of cyberbullying and stress levels.

Researchers from the Behaviour-Brain-Body Research Centre at the University of South Australia found that across all genders and age groups, phone use overnight not only robbed children of sleep, but it also had a negative impact on their mental health, especially among those who had been cyberbullied.

Whether one habit causes or stems from another is not crystal clear, but the study findings should send a clear signal to parents about the need to manage digital device use at home.

Approximately 66% of teenage girls and 58% of teenage boys (aged 12-19 years) reported being cyberbullied at least once in the preceding school term. Among the girls, 17% said they slept less than eight hours a night and the corresponding figure for the teenage boys was 13%.

Stress levels in the moderate-to-severe range were reported by 38% of teenage girls and 23% of teenage boys.

While cyberbullying and lack of sleep were not as common in primary aged children (7-11 years), one in five reported moderate-to-severe stress.

For the purposes of the study, “nighttime” refers to phone use when children are supposed to be sleeping, not prior to bed.

UniSA researcher and co-author Dr Stephanie Centofanti says that girls are particularly vulnerable because their smartphone use at night is higher than other age groups and they start using social media at a younger age.

“We found that frequency of nighttime phone use and getting less than eight hours sleep a night not only peaked in early adolescence but was also more evident in young girls,” Dr Centofanti says.

“Pre-teens are at higher risk for socio-emotional disorders because they are at a developmental stage where they are less prepared cognitively, behaviourally and neurobiologically.”

The researchers say that outside of the digital environment, boys are more likely to be physically bullied, while girls normally resort to psychological or relational bullying, which is more easily enabled online.

Approximately 15% of children in the study reported being cyberbullied, with a higher frequency of boys in primary school and girls in secondary school.

More than one third of primary school children and over 60% of teenagers in the study reported using their phone at night when they were supposed to be sleeping.

Of the children who experienced cyberbullying, almost 75% admitted they checked their phone throughout the night, compared to less than half for those who had never been cyberbullied.

“It is clear that parents need to pay closer attention to managing smartphone use at night, particularly if their children are more vulnerable to cyberbullying, and to ensure their children get enough sleep,” Dr Centofanti says.

The findings are published in the journal Adolescents.

Notes for editors

“Nighttime phone use and past exposure to cyberbullying and their impact on sleep and psychological wellbeing in Australian children aged 7-19 years” is co-authored by researchers from the University of South Australia and Resilient Youth Australia. DOI: 10.3390/adolescents4030025

Physical health has its yardsticks. Mental health is still searching for the right ruler

Original post: Newswise - Substance Abuse Physical health has its yardsticks. Mental health is still searching for the right ruler

Newswise — While doctors can track cancer progression at the cellular level or use a blood test to obtain precise blood cholesterol levels, talk therapy’s impact on mental health is still largely reliant on gut feelings more than hard data. 

A national initiative led by the National Institute of Mental Health is now underway to find figurative “rulers” that can accurately measure and compare the quality of the various mental health treatments available. To lead off this effort, UCLA Health researchers were awarded a four-year, $2.1 million federal grant to study and test whether such a quality measure can be created and applied across all social groups in the United States. 

“We have so many problems with mental health in this country that are only getting worse,” said Dr. Alexander Young, professor at UCLA Health’s Department of Psychiatry and Biobehavioral Sciences. “We really need to be able to provide access to high quality care for all the diverse populations that we serve.” 

Demand for mental health care in America has soared in recent years, with a majority of psychologists reporting having waiting lists for new patients, according to a recent survey by the American Psychological Association. Meanwhile, more treatment options are available including numerous evidence-based psychotherapies, neuromodulation including Transcranial Magnetic Stimulation, new medications and telehealth services among others.  

While some larger health care providers have made efforts to address the issue, the effectiveness and quality of these treatments have generally not been accurately monitored at a national level, resulting in a scarcity of clinical data on patient outcomes, Young said.  

As a result, governmental organizations, provider organizations, insurance companies, patients and families have little information to gauge the quality of the mental health services they are supporting or receiving, Young said. 

As part of a national initiative, UCLA researchers will aim to create accurate quality measurement based on routine, regular patient reports of their symptoms. To develop and test this, Young and his colleagues will utilize a unique database of more than 5 million symptom assessments from 500,000 patients collected during mental health treatment. The data are being analyzed in conjunction with the ACORN Collaboration, an international consortium that includes mental health and substance abuse treatment centers.  

One important aspect of the project will work to ensure that the quality measure supports improvement in socioeconomic disparities in both the access to and quality of mental health treatment. 

“We need to come up with a measurement that’s consistent across social groups and accurate given the diversity of people and situations in the United States,” Young said. 

Other collaborators in the study from UCLA include Li Cai, Nick Jackson, April Thames and Lucinda Leung. 

Three Concepts Key to Recovery from Substance Use Disorders Identified Via Reviewing 30+ Years of Scientific Findings

Newswise — Certain concepts have a demonstrated basis for aiding recovery from dangerous alcohol or substance use, according to an analysis of scientific literature since 1990. Self-efficacy (a belief in one’s ability to achieve a goal), social support, and managing cravings are among the treatment elements best supported by evidence. Effective treatment for alcohol use disorder (AUD) and other substance use disorders (SUDs) depends on understanding how human behaviors change and incorporating that knowledge into clinical practice. An ongoing research effort continues to investigate varying treatment approaches and how they relate to recovery outcomes, but those findings have not been well synthesized into a useful format. For the new review published in Alcohol: Clinical & Experimental Research, researchers from around the USA reviewed published studies, identified the treatment elements best supported by data, and evaluated their potential as key factors in behavior change. The researchers drew on existing study design criteria for validating conclusions about treatment elements.

The researchers explored reviews of studies published between 2008 and 2023 involving AUD and SUD treatments and the effects on substance use and related outcomes in adults. Three constructs involved in treatment were the most well-supported by data from 11 studies: self-efficacy, social support, and craving (coping skills, also well-supported, did not suit the current review process). They then reviewed 48 studies published between 1990 and 2023 that focused on one or more of these three concepts in adults’ recovery, and that met rigorous methodology standards. The 48 studies used varied research designs, participant samples, and contexts.

The analyzed studies provided support for self-efficacy, social support, and craving as factors that likely influence people’s behaviors in treatment or recovery. The researchers called for these three constructs to be incorporated into AUD and SUD treatment and clinical training. Such an approach could improve recovery interventions, inform new treatments and clinical training, help clinicians align patients with approaches likely to work for them, and hone community-based recovery programs.

The researchers called for additional research on how these three concepts drive behavior change and for mining existing science to identify other evidence-based approaches. They recommended several directions for future research. These included expanding the examined outcomes to other manifestations of mental and physical health and experimenting with key elements of treatment to generate direct evidence of associations between those constructs and outcomes. Investigating the roles of context (such as policies, incentives, social norms, and settings) and combinations of influences could improve outcomes across varied real-world situations. Specifying how behavioral change occurs—such as the relevant neurological and biological pathways—is a critical gap that needs to be addressed.

From alcohol and other drug (AOD) treatment mediator to mechanism to implementation: A systematic review and the cases of self-efficacy, social support, and craving. S. Maisto, D. Moskal, M. Firkey, B. Bergman, B. Borsari, K. Hallgren, J. Houck, M. Villarosa-Hurlocker, B. Kiluk, A. Kuerbis, A. Reid, M. Magill.

ACER-24-6054.R1

UC Irvine-led team finds that compound in rosemary extract can reduce cocaine sensitivity

Newswise — Irvine, Calif., Aug. 20, 2024 — A team of researchers led by the University of California, Irvine has discovered that an antioxidant found in rosemary extract can reduce volitional intakes of cocaine by moderating the brain’s reward response, offering a new therapeutic target for treating addiction.

The study, recently published online in the journal Neuron, describes team members’ focus on a region of the brain called the globus pallidus externus, which acts as a gatekeeper that regulates how we react to cocaine. They discovered that within the GPe, parvalbumin-positive neurons are crucial in controlling the response to cocaine by changing the activity neurons releasing the pleasure molecule dopamine.

“There are currently no effective therapeutics for dependence on psychostimulants such as cocaine, which, along with opioids, represent a substantial health burden,” said corresponding author Kevin Beier, UC Irvine associate professor of physiology and biophysics. “Our study deepens our understanding of the basic brain mechanisms that increase vulnerability to substance use disorder-related outcomes and provides a foundation for the development of new interventions.”

Findings in mice revealed that globus pallidus externus parvalbumin-positive cells, which indirectly influence the release of dopamine, become more excitable after being exposed to cocaine. This caused a drop in the expression of certain proteins that encode membrane channels that usually help keep the globus pallidus cell activity in check. Researchers found that carnosic acid, an isolate of rosemary extract, selectively binds to the affected channels, providing an avenue to reduce response to the drug in a relatively specific fashion.

“Only a subset of individuals are vulnerable to developing a substance use disorder, but we cannot yet identify who they are. If globus pallidus cell activity can effectively predict response to cocaine, it could be used to measure likely responses and thus serve as a biomarker for the most vulnerable,” Beier said. “Furthermore, it’s possible that carnosic acid could be given to those at high risk to reduce the response to cocaine.”

The next steps in this research include thoroughly assessing negative side effects of carnosic acid and determining the ideal dosage and timing. The team is also interested in testing its efficacy in reducing the desire for other drugs and in developing more potent and targeted variants.

In addition to UC Irvine researchers, scientists from the University of West Virginia and the University of Colorado participated in the study. See the full list here.

This work was supported by grants from the National Institutes of Health, One Mind, the Alzheimer’s Association, New Vision Research, BrightFocus Foundation, and the Brain & Behavior Research Foundation.

About the University of California, Irvine: Founded in 1965, UC Irvine is a member of the prestigious Association of American Universities and is ranked among the nation’s top 10 public universities by U.S. News & World Report. The campus has produced five Nobel laureates and is known for its academic achievement, premier research, innovation and anteater mascot. Led by Chancellor Howard Gillman, UC Irvine has more than 36,000 students and offers 224 degree programs. It’s located in one of the world’s safest and most economically vibrant communities and is Orange County’s second-largest employer, contributing $7 billion annually to the local economy and $8 billion statewide. For more on UC Irvine, visit www.uci.edu.

Media access: Radio programs/stations may, for a fee, use an on-campus studio with a Comrex IP audio codec to interview UC Irvine faculty and experts, subject to availability and university approval. For more UC Irvine news, visit news.uci.edu. Additional resources for journalists may be found at https://news.uci.edu/media-resources.

NOTE TO EDITORS: PHOTO AVAILABLE AT
https://news.uci.edu/2024/08/20/uc-irvine-led-team-finds-that-compound-in-rosemary-extract-can-reduce-cocaine-sensitivity/

Nationally Recognized Behavioral Scientist Dr. Kelly Dunn Named Director of the Kahlert Institute for Addiction Medicine at the University of Maryland School of Medicine

Newswise — University of Maryland School of Medicine (UMSOM) Dean Mark T. Gladwin, MD, announced today the appointment of Kelly Dunn, PhD, MBA, one of the nation’s leading researchers on opioid use disorder, as the inaugural Director of the School’s Kahlert Institute for Addiction Medicine. She will also serve as a Professor in the Department of Psychiatry with a secondary appointment in the Department of Neurobiology at UMSOM.

Dr. Dunn is currently a Professor of Psychiatry and Behavioral Sciences at Johns Hopkins School of Medicine with a joint appointment in Health Policy and Management at the Johns Hopkins University School of Public Health.

Dr. Dunn has been the Principal Investigator on projects totaling more than $21 million in awards from the National Institutes of Health. She has authored more than 130 peer-reviewed publications in the area of substance use and opioid use disorder. 

The Kahlert Institute for Addiction Medicine, launched in 2023 with a major gift from the Kahlert Foundation, is uniquely positioned to bring together leading addiction experts from across basic science and clinical care to transform the prevention, treatment, education, and research of addiction.

“With addiction, substance use disorder, and overdose deaths reaching epidemic proportions here in Maryland and in the U.S., we are extremely pleased to attract a top academician and leader in this field to move the Institute forward with a long-term impact,” said Dean Gladwin.

Growing up in rural Central New York in the late 1990’s, Dr. Dunn watched several close friends become dependent on opioids, after first being exposed through prescription medications, and eventually go on to develop opioid use disorder (OUD). “This prompted my life-long passion for understanding motivations for opioid use, identifying methods to prevent the onset of OUD, and helping to improve treatments for OUD,” said Dr. Dunn. “I’m honored and thrilled to take the helm of the Kahlert Institute and to work together with all of the stellar faculty who are world-class leaders in addiction research to advance the science of addiction medicine.”

Since 2012, Dr. Dunn has been a faculty member in the Johns Hopkins University Behavioral Pharmacology Research Unit (BPRU) located within the Department of Psychiatry and Behavioral Sciences. Her current work focuses on the conduct of Phase II/III randomized controlled assessments of medications, mainly those targeted for opioid use disorder.

She has also managed trials focused on treatments for cigarette smoking and alcohol use disorder and has conducted several basic science human laboratory examinations of drug effects, which is complemented by a body of work focused on epidemiological and machine-learning analyses of publicly available datasets.

She has held multiple leadership roles in the substance use field, including serving as President for the American Psychological Association’s Society for Psychopharmacology and Substance Use and the College on the Problems of Drug Dependence (CPDD) as well as Co-Editor of the Journal of Addiction Medicine and Editor-in-Chief of the journal Experimental and Clinical Psychopharmacology.

“Dr. Dunn’s current work in the field is impressive,” said Greg Kahlert, President of The Kahlert Foundation. “I am confident with her experience, passion and collaborative spirit, she will help find treatments and cures for those suffering from addiction. I could not be more excited that she is the first director of the Kahlert Institute for Addiction Medicine.” 

Dr. Dunn is currently the principal investigator on a multisite examination of a treatment for co-morbid pain in people with opioid use disorder. She is also an investigator on a Phase II trial examining the use of the drug suvorexant to treat sleep disorders, withdrawal, and craving in people initiating treatment with buprenorphine for opioid use disorder.

Other studies include a combination laboratory/clinical trial examining phenotypes of opioid withdrawal and a pilot trial examination of suvorexant for cocaine use in people being treated for OUD. Dr. Dunn recently completed a series of human laboratory trials examining genetic contributions to opioid sensitivity and opioid-cannabinoid interactions for pain treatment in healthy and clinical populations.

In addition to her numerous peer-reviewed original and review publications, Dr. Dunn edited the Oxford Handbook on Opioids and Opioid Use Disorder. She received her PhD Degree from the University of Vermont in 2009 and earned an MBA Degree from Johns Hopkins University Carey School of Business in 2019.

National Academy of Medicine Selects FAU for Substance Use, Opioid Crises Collaborative

Original post: Newswise - Substance Abuse National Academy of Medicine Selects FAU for Substance Use, Opioid Crises Collaborative

Newswise — As of 2024, approximately 2.7 million Americans aged 12 and older were estimated to have misused prescription opioids in the past year. Moreover, alcohol, cannabis, cocaine, methamphetamines, among other substances, reflect a complex landscape that requires ongoing efforts aimed at prevention, treatment and policy changes to address the various issues associated with each substance.

Florida Atlantic University was recently selected to participate in the National Academy of Medicine’s (NAM) Action Collaborative on Combatting Substance Use Opioid Crises Core Competency Implementation Pilot Project. To improve coordination and accelerate the pace of change, NAM partnered with more than 80 organizations to form the collaborative. This initiative brings together key stakeholders from the public, private and nonprofit sectors to collaboratively address critical issues posed by addiction.

Armiel Suriaga, Ph.D., an assistant professor in FAU’s Christine E. Lynn College of Nursing, will serve as the project lead. FAU joins other implementation sites across the United States in working toward advancing substance use care, workforce competency, and interprofessional education and practice by implementing the Action Collaborative’s 3Cs Framework for Pain and Unhealthy Substance Use, released in 2022.

The 3Cs Framework aims to set a standard for the minimum level of competence in pain management and substance use care expected from all health professionals to address professional practice gaps while strengthening the delivery of coordinated, interprofessional, high-quality and person-centered care.

The NAM Action Collaborative has selected 16 pilot sites from across the nation to participate in the Implementation Pilot Project. FAU was selected as one of the implementation pilot sites. The project focuses on implementing the selected 3 Cs framework, such as core knowledge domains with competencies of foundational and applied knowledge on pain and unhealthy substance use, such as  opioids, with nursing students and medical students, in collaboration with the FAU Office of Interprofessional Education and Practice (IPE&P) within the Office of the Provost.  

“Being selected to address substance use by the National Academy of Medicine is more than just an honor, it’s a pivotal chance to drive transformative change,” said Patricia Liehr, Ph.D., interim dean, FAU Christine E. Lynn College of Nursing. “The Action Collaborative is committed to proactively advancing structural solutions through comprehensive, multi-sector strategies aimed at reducing substance misuse and enhancing outcomes for those impacted by addiction. This crisis cannot be solved by any single entity alone – no organization, government agency, or sector has all the answers. It is through our collective effort that we can tackle this complex public health issue and forge a healthier, safer future for individuals, families and communities.”

The NAM Action Collaborative’s Implementation Pilot Project seeks to gain insights into the varied applications of the 3Cs Framework and the respective implementation processes. The learnings from this project will offer insight into the feasibility and utility of implementing the 3Cs Framework to improve health professional competency across the learning continuum and a diversity of interprofessional education and practice settings.

Through participation in the implementation pilot, FAU will help inform and shape the future of health professions education policy and practice. As part of the implementation pilot, the project team will engage in a dynamic learning community where they will share insights and best practices while fostering relationships and connections with other sites and Action Collaborative members. The team also will travel to Washington, D.C. to participate in a final knowledge sharing convening that will bring together representatives from the pilot sites and leaders across health professions education and training, health care delivery and policy.

Other members of the FAU project team include Ophelia Empleo-Frazier, GNP-BC, CDP, Yale School of Nursing; Ruth M. Tappen, Ed.D., Christine E. Lynn Eminent Scholar and Professor, FAU Christine E. Lynn College of Nursing; Terry Eggenberger, Ph.D., a professor and executive director of the FAU IPE&P; George R. Luck, M.D., interim associate program director, hospice and palliative medicine and associate professor of anesthesia, FAU Schmidt College of Medicine, Reynel Lavandera, Ph.D., associate professor and associate director of IPE&P for nursing, and Aloha Balza Montes, assistant IPE&P director, and FAU Ph.D. candidate.

“Addressing substance use in the context of pain and health care requires a unified effort because no single perspective can encompass the complexity of these issues,” said Suriaga. “Collaboration among researchers, clinicians, students and others will enable us to develop comprehensive solutions that address both the physiological and psychological dimensions of substance use, ultimately leading to more effective and compassionate care for our patients.”

– FAU –

About the Christine E. Lynn College of Nursing

FAU’s Christine E. Lynn College of Nursing is nationally and internationally known for its excellence and philosophy of caring science. In 2024, the College was ranked No. 4 for the Family Nurse Practitioner Master’s concentration nationwide by U.S. News and World Report, No. 17 for “Best Online Master’s in Nursing Administration and Financial Leadership Programs” and No. 32 for the “Best Online Master’s in Nursing Programs.” In 2023, FAU graduates on the Boca Raton campus earned an 81% pass rate on the National Council Licensure Examination for Registered Nurses (NCLEX-RN®) and a 100% AGNP Certification Pass Rate. The baccalaureate, master’s and DNP programs at Florida Atlantic University’s Christine E. Lynn College of Nursing are accredited by the Commission on Collegiate Nursing Education. The College is the only one in the U.S. to have all degree programs endorsed by the American Holistic Nursing Credentialing Corporation.

 

About Florida Atlantic University: Florida Atlantic University, established in 1961, officially opened its doors in 1964 as the fifth public university in Florida. Today, the University serves more than 30,000 undergraduate and graduate students across six campuses located along the southeast Florida coast. In recent years, the University has doubled its research expenditures and outpaced its peers in student achievement rates. Through the coexistence of access and excellence, FAU embodies an innovative model where traditional achievement gaps vanish. FAU is designated a Hispanic-serving institution, ranked as a top public university by U.S. News & World Report and a High Research Activity institution by the Carnegie Foundation for the Advancement of Teaching. For more information, visit www.fau.edu.

Unveiling the Brain’s Reward Circuitry

Newswise — PHILADELPHIA (August 14, 2024) – A research team – co-led by Penn Nursing – has made a significant breakthrough in understanding the complex neural circuitry underlying reward and addiction by identifying 34 distinct subtypes of medium spiny neurons (MSNs) in the nucleus accumbens (NAc), a key brain region involved in pleasure and motivation. The findings, published in the journal Scientific Reports by Nature, offer insights into the diversity of these neurons and their potential roles in substance use disorders.

MSNs are the primary type of neuron in the NAc and have long been classified based on their expression of dopamine receptors. However, this new research reveals a far more intricate picture of MSN diversity. By analyzing a massive dataset of single-nucleus RNA sequencing data from rat brains, the researchers identified 34 distinct MSN subtypes, each with its own unique genetic profile.

“Our study challenges the traditional view of MSNs as a homogenous population,” said co-lead author Heath D. Schmidt, PhD, Professor in Penn Nursing’s Department of Biobehavioral Health Sciences. “By uncovering this level of diversity, we can begin to understand how specific MSN subtypes contribute to different aspects of reward processing and addiction.”

The researchers also found that these MSN subtypes are conserved across species, suggesting that the findings may have broad implications for human brain function and behavior. Additionally, by analyzing genetic data linked to substance use disorders, the team identified potential differences in the roles of specific MSN subtypes in these conditions.

This groundbreaking research provides a foundation for future studies aimed at developing targeted therapies for addiction and other brain disorders. By understanding the specific functions of different MSN subtypes, scientists can develop treatments that precisely target these cells, potentially leading to more effective and less harmful interventions.

This work was supported in part by a State of Pennsylvania Department of Health Nonformula Tobacco Settlement Act Grant, Pharmacogenetics of Opioid Use Disorder; National Institutes of Health grants R01 DA037897, R21 DA045792, R21 DA 057458, R21 DA 055846, NIH/NIDA DP1DA054394, K01 AA028292, and R01 AA030056; Tobacco-Related Disease Research Program (TRDRP) Grant Number T32IR5226; and Department of Veterans Affairs grant I01 BX004820. The researchers have no conflicts of interest to report.

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About the University of Pennsylvania School of Nursing

The University of Pennsylvania School of Nursing is one of the world’s leading schools of nursing. For the ninth year in a row, it is ranked the #1 nursing school in the world by QS University. For the third year in a row, our Bachelor of Science in Nursing (BSN) program is ranked # 1 in the 2023 U.S. News & World Report’s Best Colleges rankings. Penn Nursing is also consistently ranked highly in the U.S. News & World Report annual list of best graduate schools and is ranked as one of the top schools of nursing in funding from the National Institutes of Health. Penn Nursing prepares nurse scientists and nurse leaders to meet the health needs of a global society through innovation in research, education, and practice. Follow Penn Nursing on: Facebook, Twitter, LinkedIn, & Instagram.