As the country reels from a substance abuse crisis that shatters daily life, scientists and clinicians at the University of Colorado Anschutz Medical Campus work hard in labs and clinics in hopes of preventing the tragedy of addiction. I’m here.

While the deaths of fentanyl and heroin are making headlines and grabbing the attention of research campuses, another long-time killer is claiming more and more lives. Alcohol use disorder (AUD) kills more than 95,000 people each year. of Americans, and the death toll has increased by 25% from 2019 to 2020. The biggest increase in deaths was between the ages of 25 and 44.

Dr. Joseph Schacht is an associate professor in the Department of Addiction Science, Prevention and Treatment at CU Psychiatry, whose primary focus is avoiding the harm of alcohol addiction.

“When you talk to people clinically, they know it’s bad and it’s hurting them, but they still can’t stop it,” CU Anschutz. “I found that really compelling. It made me want to make a difference clinically by helping people like that.”

Schacht’s target group is large, as statistics suggest that at least one member in half of all American families suffers from AUD. “Everyone is under the influence of alcohol or knows they are under the influence.”

For Schacht and his colleagues, science holds many answers at the academic medical research campus, home to California’s top recovery center, CeDAR (UCHealth’s Center for Dependency, Addiction and Rehabilitation).

Using science in recovery

A clinical neuroscientist, Schacht combines psychology and neuroscience to find new drugs aimed at reducing alcohol use. “Unfortunately, there hasn’t been much progress on that front,” Schacht said, noting that the last Food and Drug Administration approval of such a drug was in 2006, with three drugs available that work for everyone. “We need better treatments and more treatments.”

Scientists today have a sophisticated biological understanding of AUD, a term adopted in the medical field to emphasize that alcoholism is a disease and not a character defect. With better tools and richer data readily available, researchers are turning to recovery techniques with a more personalized, technology-driven approach.

For example, in Schacht’s lab, NIH-funded researchers will compare before and after brain scans of trial participants, looking for evidence that an experimental drug works based on what they know about AUD brains. I’m here.

When AUD develops from excessive drinking, the brain becomes more sensitive to alcohol’s mood-altering “rewards” and to anything associated with drinking (bars, parties, frothy beer mugs, etc.). Schacht’s team monitors this “alcohol cue reactivity” by showing alcohol-related pictures while scanning the brains of study participants.

Brain changes trigger AUD behavior

“Our findings are consistent with many other animal model studies that show that the part of the brain that processes rewards is hyperactive in the AUD brain. ready to respond to.”

AUD’s brain also gets smaller year by year, losing important functions especially in the prefrontal cortex, referring to the part of the brain that is heavily involved in behavioral control.

“So it’s like, ‘That looks good. Go get it.’ There’s this weakened control system that can’t say, ‘Please,'” Schacht said. “So it’s like the gas got too strong and the brakes stopped working.”

Personalize your recovery approach

In his lab at the new Anschutz Health Sciences Building, Schacht’s team is tailoring experimental drugs to these neurological differences. The two drugs being tested are aimed at making alcohol less rewarding.

With one of these drugs, scientists are taking a “pharmacogenetic approach,” individualizing treatment by identifying specific genetic subgroups for which the drug should be most effective. I’m here.

A third drug, aimed at improving control, has also been tested in participants with ADHD (attention deficit hyperactivity disorder) to help scientists learn more about the bi-directional relationship between AUD and other mental health disorders. I am working on

“Having AUD increases the risk of many other psychiatric disorders, including depression, anxiety, and ADHD,” Schacht said. Conversely, having these mental health disorders increases the risk of AUD and other substance use disorders, he said, with people with ADHD having a two to four times higher risk.

Importance of science-based care

Schacht’s research is an example of recovery-related science and innovation taking place on the CU Anschutz campus. This science is being applied in classrooms and clinics to transform the course of drug recovery.

“We are an academic medical center,” said Patrick Fehling, Associate Clinical Professor of Psychiatry and CeDAR psychiatrist with nationally recognized inpatient and outpatient treatment programs for all substance use disorders. says MD.

As the largest such center in the region, CU Anschutz will provide patients with strategic, science-based care in an environment that meets all medical needs “right across the street,” Fehling said. .

CeDAR’s full-time, on-site staff of physicians, nurses, healthcare professionals, and students utilize these resources to provide progressive care that is aligned with current research and trends.

“We are now building a really state-of-the-art protocol for liver transplant recipients,” said Fehling. Alcohol use has surpassed hepatitis and is today the number one cause of liver transplantation. Many of those patients were in his 20s and his 30s, especially last year.

“After being stabilized here, they will have a transplant and then come back and live in our program for several months for alcohol recovery treatment,” Fering said.

Today’s research covers all stages of recovery and has the potential to ease the lifelong journey and reduce the effects of alcohol on people’s health. “That’s the goal,” Schacht said. . “We want to catch people before they get to that point and intervene.”

Other promising research areas for recovery include:

neuromodulation: Research into noninvasive neuromodulation, including transcranial magnetic stimulation (TMS), is common in treatment research for substance use disorders, and TMS is already FDA-cleared as a smoking cessation treatment. Invasive neuromodulation, or deep brain stimulation, used in Parkinson’s disease and able to target structures deep in the brain, has shown early promise. Joseph Sakai, M.D., Ph.D., a clinician at the TMS Clinic in New York, recently received a grant to study deep brain stimulation for methamphetamine addiction.

cannabis: Dr. Kent Hutchison, a professor of psychiatry, is the principal investigator of a study with Schacht testing whether raising cannabidiol levels in people already using cannabis can help reduce alcohol use. Preclinical studies suggest that cannabidiol, a non-psychoactive component of cannabis, can help reduce cravings. Researchers are also preparing studies to test cannabidiol as an aid to help people who want to reduce cannabis use.

smart device technology: Computing tools, wearable devices, and mobile technology are generating much research in healthcare, including long-term substance use recovery. For example, at the Peters Mile Advanced Institute for On-Campus Emotional Health and Addiction Recovery, researchers are investigating how to help people maintain emotional health and prevent physical triggers of relapse. In addition, we are researching devices that provide guided breathing exercises. For example, techniques are being researched to identify spikes in blood pressure or sweating, which can help predict when high-risk relapses can occur, leading to more rapid intervention.

To participate in the TrAIL Alcohol Study, call (303) 724-2424 or email alcoholstudy@ucdenver.edu. Please Confirm CU Anschutz research page for more testing.