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  • UT Health San Antonio launches Be Well Institute for substance use research and treatment

    UT Health San Antonio launches Be Well Institute for substance use research and treatment

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    The University of Texas Health Science Center at San Antonio (UT Health San Antonio) is establishing the Be Well Institute on Substance Use and Related Disorders, a pioneering initiative dedicated to advancing research, education and evidence-based treatments.

    The new institute includes the current Be Well Texas initiative of UT Health San Antonio as part of a new overall comprehensive center of excellence with national scope for research, clinical and public health programs, as well as education and community engagement to advance the field addressing addiction and related conditions.

    The goal of the Be Well Institute is to be a nationally premiere substance use and addiction institute for clinical care and research to advance the understanding of substance use.

    The institute will support grants and contracts, partner with organizational entities at UT Health San Antonio whose activities are relevant to these priorities and provide person-centered, interprofessional and comprehensive care. It also will launch clinical and translational research programs to significantly advance the understanding of substance use to scientific discovery and into daily practice more quickly to improve health and reduce sickness and death.

    This institute will lead transformational change in addressing substance use and substance use disorders throughout Texas and the nation.”


    Robert A. Hromas, MD, FACP, acting president of UT Health San Antonio

    “We support the discovery, development and implementation of new treatments, or more effective use of current treatments, and this important effort will facilitate the recruitment of outstanding scientists and clinicians to UT Health San Antonio,” he said, “accelerating collaboration among scientists, educators and clinicians to discover, validate and implement new treatments, and serve as a vehicle for partnerships among stakeholders in the community to include scientists, providers and policymakers.”

    UT Health San Antonio is the largest academic research institution in South Texas with an annual research portfolio of $413 million. Spearheaded by Be Well Texas founding director Jennifer Sharpe Potter, PhD, MPH, vice president for research at UT Health San Antonio, the new institute marks a significant milestone in UT Health San Antonio’s commitment to addressing the complex challenges posed by substance use.

    It will provide compassionate and transformational care of people who use substances and those with substance use disorder (SUD) – or co-occurring mental health disorders – through innovative research, local networks and engagement, thereby removing stigma and supporting recovery for patients, their families and communities.

    A highly integrated, collaborative center

    With more than $50 million in National Institutes of Health, state and other federal funding annually, the Be Well Institute will work as a highly integrated and collaborative center across the university and represent a comprehensive framework and programming for advancing the understanding and treatment of substance use disorders.

    Through a diverse array of statewide initiatives, including the Be Well Provider Network, the Be Well Clinic, the Center for Substance Use Training and Telementoring, and the Texas Substance Use Symposium, the institute seeks to expand access to services and support for Texans and beyond.

    With support from the National Institute on Drug Abuse Clinical Trials Network and other federal funding, the institute includes research, medical interventions and evidence-based treatments, psychological therapies, social and peer support, counseling on lifestyle changes, follow-up care, provider training and education, and many community outreach and educational initiatives.

    Substance use is a significant public health problem that includes several challenges, from the illicit use of substances that have been available for centuries, such as opioids, to drugs that have appeared more recently, like synthetic cannabinoids. Substance use and other mental health disorders worsened significantly during the COVID-19 pandemic. Substance use among many mentally ill patients also increased during that time as many sought to self-medicate.

    Although opioids are most prominent in news headlines, the most problematic drugs of abuse in some regions of the United States, including South Texas, are not opioids, but alcohol, marijuana and stimulants like methamphetamine. Alcohol use is a major contributor to morbidity, including cancer, and mortality. The rate of alcohol-related deaths in the U.S. doubled from 1999 to 2017.

    There currently are no FDA-approved medications for treating substance use disorder outside of opioids and alcohol. Thus, the exploding use of stimulants and marijuana represents a vast unmet medical need.

    The worsening overdose epidemic exemplifies the desperate need to improve prevention and treatment of SUD through research and programmatic efforts. An unprecedented 107,000 Americans died in 2022 from drug overdose, the highest rate ever recorded.

    Often lost in the national discussion of this medical crisis is the fact that this dramatic increase in opioid use and overdose occurred despite the availability of FDA-approved medications that are effective in many patients: methadone, buprenorphine and naltrexone for opioid use disorder (OUD) and naloxone for opioid overdose. Discovering and advancing new and innovative approaches for treating opioid overdose and OUD is a critically important endeavor.

    Investigators at UT Health San Antonio are conducting state-of-the-art research exploring novel approaches for understanding SUD that will uncover new targets and new methods for treatment.

    Similarly, UT Health San Antonio faculty are at the forefront of addressing SUD statewide, including establishing statewide treatment networks, workforce development initiatives and distribution of life-saving naloxone to traditional and non-traditional first responders. Collectively, what is available at UT Health San Antonio is unique in Texas and ready to be expanded nationally.

    About Jennifer Sharpe Potter

    As a nationally recognized public health scientist and practitioner, Potter leads the state in groundbreaking research and treatment aimed at mitigating addiction, substance use disorders and related disorders. Her expertise spans the development, dissemination and implementation of evidence-based practices to support individuals grappling with substance use disorders.

    In her role as vice president for research at UT Health San Antonio, Potter provides strategic oversight over the institution’s research initiatives, ensuring the university’s continued pursuit of excellence in scientific inquiry and innovation. Her leadership also extends to pivotal roles as principal investigator of UT Health San Antonio’s Institute for Integration of Medicine and Science (IIMS) and the National Institute on Drug Abuse (NIDA) Clinical Trials Network (CTN), underscoring her commitment to advancing the frontiers of substance use research.

    Prior to joining UT Health San Antonio, Potter was with Harvard Medical School and McLean Hospital in Belmont, Mass. She earned her doctorate in clinical psychology from the University of Georgia and her Master of Public Health from the Rollins School of Public Health at Emory University.

    “The launch of the Be Well Institute heralds a new era of collaboration and innovation in the field of substance use research and care,” Potter said, “and stakeholders from across the academic, health care and public sectors are encouraged to join us in this vital endeavor as we strive to improve the lives of individuals and communities affected by substance use disorders.”

    Source:

    University of Texas Health Science Center at San Antonio

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  • Restoring brain pathways to fight opioid addiction

    Restoring brain pathways to fight opioid addiction

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    Medical University of South Carolina scientists report in Neuron that they have uncovered a way to restore an opioid-weakened brain pathway in a preclinical model.

    With funding from the National Institute on Drug Abuse, part of the National Institutes of Health, the MUSC research team, led by neuroscientist James Otis, Ph.D., used advanced neuroscience tools to return a pathway between the thalamus and basal ganglia to healthy functioning in mice. As a result, this restoration prevented mice that were opioid-dependent from seeking or self-administering heroin. Results also suggested that sustained opioid use was the cause of this weakened pathway, rather than being caused by it.

    Our study is the first showing that this pathway, associated with the capability of stopping behavior, can be ‘rescued’ after being weakened by opioid use.”


    James Otis, Ph.D., Neuroscientist 

    Otis was surprised that not only could this brain pathway be returned to healthy functioning, but that its recovery prevented relapse.

    “When we brought this brain circuit back to what we think of as a healthy state, we were excited to see that it could inhibit behaviors such as relapse,” said Otis.

    This pathway of neurons identified by Otis’ team is critical for controlling or stopping behavior – also referred to as behavioral control. Difficulty stopping is a hallmark feature of many neuropsychiatric disorders, including substance use disorders. The capacity to stop is a critical skill in recovering from drug dependence and avoiding relapse.

    Studies have shown that people with substance use disorders find it more difficult to stop behavior, he explained. In previous studies, they took longer to pause behavioral tasks than those without a history of substance use.

    Difficulty stopping is a key reason why people with substance use disorders may continue to use substances despite negative consequences or despite their desire to stop. Restoring behavioral control could improve their ability to stop such behaviors and remain drug abstinent.

    Researchers have identified pathways in the brain that influence our capacity to stop different behaviors. For example, our brains can stop motor movement when two regions of the brain – the prefrontal cortex and basal ganglia – talk to one another. The prefrontal cortex makes the decision to stop and sends this message to the basal ganglia. The basal ganglia then prevents the movement. The communication between these areas of the brain has been shown to be disrupted in people with substance use disorders, helping to explain the challenges they face with this skill.

    Expanding on this research, Otis and his team identified a new pathway of neurons in mice involved with stopping behavior. In a previous study, his team found that this series of neurons, beginning in the thalamus, similarly communicated with the basal ganglia to control movement.

    This study reported in Neuron helps to resolve a long-standing chicken-or-egg debate about the relationship between difficulty stopping behavior and substance use disorder. Does an impaired capacity to stop increase the likelihood that someone will later develop a substance use disorder? Or does repeated drug use weaken the parts of the brain involved with this ability?

    “We wanted to know more about how opioid use influences these neurons, or if instead these neurons are already impaired in those who are vulnerable to future opioid addiction,” Otis explained.

    Findings from this research strongly suggest that the weakening of this pathway happens because of opioid use, rather than being a cause of opioid use. After two weeks of opioid use by the mice, Otis and his team observed that this pathway became half as strong as it was prior to drug use. 

    The next step is to see if these results can be repeated with substances such as alcohol, methamphetamine, amphetamine and cocaine.

    The experimental techniques used to restore this brain circuit in a preclinical model are not suitable for human studies. However, Otis can envision that future drug treatments could rehabilitate brain functioning associated with drug use.

    “The goal of addiction treatment should be to recover healthy brain circuitry, rather than just prevent relapse or prevent the symptoms of addiction,” said Otis.

    Source:

    Medical University of South Carolina

    Journal reference:

    Paniccia, J. E., et al. (2023). Restoration of a paraventricular thalamo-accumbal behavioral suppression circuit prevents reinstatement of heroin seeking. Neuron. doi.org/10.1016/j.neuron.2023.11.024.

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