Division of Alcohol & Drug Abuse: Treatment and Research
DIVISION OF ALCOHOL & DRUG ABUSE TREATMENT & RESEARCH
OVERVIEW
The addictive disorders of alcohol and drug abuse are among the leading
major health problems in the nation and around the world. According to
the World Health Organization (WHO) status report in 2004, a causal
relationship exists between alcohol consumption and more than 60 various
types of diseases and injuries. Moreover, these conditions are associated
with enormous suffering to affected individuals and their families and with
a staggering economic cost. The National Institute on Drug Abuse (NIDA)
states that substance abuse costs the U.S. more than $484 billion per year,
even more so than costs associated with other diseases such as diabetes
($131.7 billion annually) and cancer ($171.6 billion annually).
The Division of Alcohol & Drug Abuse: Treatment and Research is
dedicated to improving the treatment for persons suffering from addictive
disorders through commitment to education and research, and a highly
personalized approach to care, recovery, prevention and health promotion.
Our multidisciplinary faculty is an integrated team of highly experienced,
nationally renowned clinicians, clinical scientists and basic neuroscientists.
They lead the development of clinical, educational, and research programs
for the division.
CLINICAL SERVICES
Health & Recovery Center, Mental Health Hospital Center
The Health & Recovery Center at the Mental Health Hospital Center
(MHHC) in the UM/Jackson Memorial Medical Center offers highly
structured, individualized treatment plans for patients via educational
classes, group therapy sessions and therapeutic groups. Additionally,
12-step support groups are introduced such as Alcoholics Anonymous
and Narcotics Anonymous.
Furthermore, counselors assist each patient by helping them build a
support network at home and in their community to encourage the
maintenance of sobriety upon the conclusion of treatment.
Programs
All programs place a strong emphasis on relapse prevention:
Chemical Dependency/ Detoxification Program
The Chemical Dependency/Detoxification Program provides
personalized treatment in a medically supervised setting for a
patient’s safe withdrawal from alcohol or drug addiction.
The highly structured, multi-disciplinary treatment plan safely
combines neurological, psychiatric and internal medicine to help
mitigate patients’ discomfort from withdrawal symptoms and help
them in continuing their recovery journey.
Health care professionals are specially trained in addictions and create
recovery regimens that include 24-hour nursing care and therapeutic
interventions (individual and/or group counseling, support groups,
and 12-step addiction support models and education regarding
detoxification and rehabilitation).
Patients are assured the strictest confidentiality and may seek help for
addiction to alcohol, cocaine, opiates (heroin), benzodiazepines
(Xanax), barbiturates or a mixture of substances.
Maternal Addiction Program
The Maternal Addiction Program addresses the specialized needs of
pregnant and postpartum women with chemical addictions.
Dual Diagnosis Services
Dual Diagnosis Services are available for adults who have an acute
psychiatric illness as well as a substance abuse disorder. The
recovery service assists patients while also addressing medical and/or
emotional influences that may contribute to the addiction.
Individualized treatments are provided in a medically supervised
setting and are designed to help patients overcome depression,
psychosis, anxiety, anger, and poor self-esteem. Family education
and counseling is also available and encouraged.
Admission criteria are as follows:
• Presence of a psychiatric disorder
• Impairment of regular, day-to-day activities
• A pattern of pathological drug or alcohol use
• Alcohol or drug use that undermines social or occupational interactions
• Weak response to outpatient consultation and treatment
Location
Mental Health Hospital Center (MHHC)
UM/Jackson Memorial Medical Center
1695 NW 9th Avenue
Miami, FL 33136
FOR FREE, CONFIDENTIAL ASSESSMENT & REFERRAL, PLEASE CALL THE 24-HOUR HELP LINE:
(305) 324-HELP (4357) or toll-free (888) 463-HOPE (4673)
Addiction Psychiatry Fellowship & Psychiatry Residency Training
• Two (2) psychiatrist positions are available for the Addiction Psychiatry
Fellowship each year.
• Fellowship duration is one (1) year
Clinical Experiences and rotations:
• Broad experience—“cradle to grave” exposure
• Maternal addiction (adolescent to adult)
• Detoxifications
• Rehabilitation
• Consultant service to medical, surgical, OB/GYN and
trauma units
• Rotations: Inpatient adult/adolescent addiction treatment,
psychiatric ER, organ transplant service, methadone clinic
and outpatient
Research experience:
• Available but not mandatory—Research opportunity to
work with established researchers in broad based areas
including basic science, and clinical translational research.
Teaching activities:
• Participation in didactics for PGY 1-4 lectures, medical
students and hospital staff teaching
Administrative work:
• Light, primarily with program development.
Principal goal of fellowship training program:
• To provide addiction fellow(s) with skills and knowledge to
provide expert treatment to the addicted population.
Contact Information
Michelle Bauer, M.D.
Assistant Professor of Clinical Psychiatry
Department of Psychiatry and Behavioral Sciences
(305) 355-9028
mbauer@med.miami.edu
The primary focus of this research has been to pioneer the development of innovative
treatment approaches for patients with “dual diagnosis” or psychiatric and addiction
disorders, as treatment needs for this population have been largely unmet. Our effort
included completing the first clinical trial ever conducted among patients with bipolar
disorder and alcoholism, demonstrating the usefulness of the anticonvulsant, valproate,
in decreasing alcohol use in persons suffering from bipolar disorder (See
Anticonvulsant Drug Cuts Drinking in Bipolar Alcoholics to read more about this). It
also included conducting clinical trials for people suffering from co-occurring
depression and alcoholism, and developing psychosocial interventions for persons
suffering from bipolar disorders and alcoholism. This research program also
conducted multiple studies on novel pharmacotherapy for alcoholism and for cocaine
addiction without comorbid psychopathology.
CURRENT ACTIVE STUDIES
Valproate Efficacy in Cocaine-Bipolar Comorbidity
Source of funding: National Institute on Drug Abuse
PI: Ihsan M. Salloum, M.D., MPH; Co- Investigators: Ma-Li Wong, M.D., Lauren
Williams, M.D.; Michael Thase, M.D. (University of Pennsylvania)
The aim of this randomized, double-blind, placebo-controlled 12-week trial is to test
the efficacy of divalproex sodium (valproate) compared to placebo in decreasing
cocaine use among patients with comorbid cocaine dependence and bipolar disorder.
Optimizing Pharmacotherapy for Bipolar Alcoholics
Source of funding: National Institute on Alcohol Abuse and Alcoholism
PI: Ihsan M. Salloum, M.D., M.P.H.; Co- Investigators: Ma-Li Wong, M.D.,
Lauren Williams, M.D., Michael Thase, M.D. (University of Pennsylvania)
The aim of this randomized, double-blind, placebo-controlled 12-week trial is to test
the efficacy of naltrexone hydrochloride compared to placebo in decreasing alcohol
use among patients with comorbid alcoholism and bipolar disorder.
COMPLETED STUDIES UNDER ANALYSIS
Recovery Adherence Therapy for Bipolar Alcoholics
Source of funding: National Institute on Alcohol Abuse and Alcoholism
The aim of this study was to develop and pilot test a specialized behavioral
intervention for the engagement, retention, and adherence of patients with comorbid
bipolar disorder and alcoholism and other drugs of abuse. The intervention was based
on treatment models that emphasize integrating psychosocial and pharmacotherapeutic
interventions in an empathic and motivationally informed paradigm.
Combined Pharmacotherapy in Depressed Alcoholics
Source of funding: National Institute on Alcohol Abuse and Alcoholism
The aim of this study was to test the efficacy of the combination of naltrexone and
fluoxetine versus fluoxetine alone in the treatment of patients with alcoholism and
comorbid major depression in a double-blind, placebo-controlled, randomized,
parallel group trial. The major hypothesis is that combined fluoxetine and naltrexone
treatment will offer enhanced treatment for alcoholics with comorbid major
depression.
Phase 2, Double-Blind, Placebo-Controlled Trial of Modafinil for the
Treatment of Cocaine Abuse
Source of Funding: National Institute on Drug Abuse
Site PI: Ihsan M. Salloum, M.D., M.P.H.
This multi-center study for the National Institute on Drug Abuse is a double-blind,
placebo-controlled, parallel group trial was designed to evaluate the safety and
efficacy of modafinil relative to placebo in reducing cocaine use in subjects with
cocaine dependence.
Research Training Opportunities
Additionally, this program offers individual mentoring in clinical research for addiction
psychiatry fellows, PGY 3-4 psychiatry residents, medical students, and senior
psychology students.
Contact information
Remonia Green, M.A.
Administrator to Ihsan M. Salloum, M.D., M.P.H.
Clinical Research Building
1120 NW 14th Street, Suite 854 (D-28)
Miami, FL 33136
(305) 243-1301
rgreen@med.miami.edu
Investigators at the Laboratory of Experimental Drug Addiction have been
investigating how “popular” drugs of abuse such as cocaine, crystal meth and ecstasy
cause changes in different neurons in the brain, how these changes contribute to
cognitive and behavioral abnormalities, and if specific genes are responsible for the
enhanced sensitivity to drugs of abuse. The goals of these studies are to understand
what makes the brain vulnerable to drug addiction and what medications can combat
the development of addiction. The following studies are currently active:
CURRENT ACTIVE STUDIES
Role of the nNOS Gene in Cocaine Effects
Sources of funding: National Institute on Drug Abuse, NIH
PI: Yossef Itzhak, Ph.D.
Research is conducted on animal models of addiction involving studies in mice with
targeted mutation of the nNOS gene in the brain. Behavioral, neurochemical and
neuroanatomical outcomes of exposure to several psychostimulant drugs of abuse as
well as alcohol, are investigated with an emphasis on the role of the nNOS gene in
vulnerability to drugs of abuse. The long-term goal is to develop pharmacotherapies
for the treatment of addiction.
Research Training Opportunities
Several graduate students from the neuroscience program at the University of Miami
Miller School of Medicine are trained in the laboratory for a period of about three
years to achieve a doctoral degree (Ph.D.) in neuroscience.
Psychiatric residency fellows who wish to be involved in basic research related to
drug addiction are also welcome.
Contact Information
Yossef Itzhak, Ph.D.
Professor
Department of Psychiatry and Behavioral Sciences
(305) 243-4635
yitzhak@med.miami.edu
Laboratory for Neuropharmacology of Drug Abuse
Investigators in the laboratory study the effects of drugs of abuse on the brain and on
behavior. Currently there are five projects receiving ongoing funding.
CURRENT ACTIVE STUDIES
Neurochemical Consequences of Drug Exposure in Adolescent Rats
Source of funding: National Institute on Drug Abuse
PI : Sari Izenwasser, Ph.D.
The focus of this grant is to study the effects of abused substances including cocaine,
MDMA (ecstasy), methylphenidate (Ritalin), and THC in adolescent rats and to
examine the subsequent effects once these rats become adults.
An understanding of the differential effects of drugs during the adolescent period and
on how this use impacts drug-taking in adults may lead to different treatments for
different age groups, as well as a better understanding of how drug use in adolescence
may lead to psychostimulant abuse in adulthood.
Cocaine behavior: Regulation by
-opioids and Serotonin
Source of funding: National Institute on Drug Abuse
PI : Sari Izenwasser, Ph.D.
The focus of this grant is on the effects of
-opioid agonist and antagonist treatments
on serotonin systems and on the effects of cocaine. The proposed studies are both
neurochemical and behavioral in nature (e.g. receptor binding and autoradiography,
functional studies of dopamine uptake and release, and second messenger studies
including adenylyl cyclase activity and GTPgS binding correlated with behavioral
studies to determine whether any of the observed biochemical changes are
physiologically relevant).
Synthesis of Potential Cocaine Abuse Therapeutics
Source of funding: National Institute on Drug Abuse
PI : Mark Trudell, Ph.D. (University of New Orleans) Co- Investigator: Sari Izenwasser, Ph.D.
This project is a collaborative effort with Dr. Mark Trudell in the chemistry
department at the University of New Orleans. It involves the measurement of
dopamine transporter binding and dopamine uptake of two series of compounds
synthesized as potential treatments for stimulant abuse.
Specifically, the project focuses on differential regulation of the dopamine transporter
by different uptake inhibitors, especially as compared to cocaine. These compounds
have potential usefulness as treatments for disorders related to dopaminergic
dysfunction.
Sex and Gender Influences on Addiction and Health: A Developmental Perspective
Sources of funding: National Institute on Drug Abuse; Office of Research on Women’s Health, NIH
PI: Emmalee Bandstra, M.D., Department of Pediatrics; Co- Investigator: Sari Izenwasser, Ph.D.
Project 2: Sex differences in Drug Effects: The Adolescent Trajectory
PI: Sari Izenwasser, Ph.D.; Co- Investigator: Ma-Li Wong, M.D.
This project is part of the Center on Addiction and Health in Women, Children and
Adolescents at the University of Miami Miller School of Medicine. The project
involves studies of the effects of nicotine, marijuana, and cocaine in adolescents.
Development of Cannabinoid Receptor Based Medications for Drug Addiction
Source of funding: National Institute on Drug Abuse
PI : Mark Trudell, Ph.D. (University of New Orleans); Co- Investigator: Sari Izenwasser, Ph.D.
It has been suggested that the cannabinoid receptor system can indirectly modulate
dopaminergic transmission and thus mediate the effects of psychostimulants on brain
circuitry. The aim of this project is to develop a clinically useful cannabinoid antagonist
that could have application for the treatment of cannabinoid and/or psychostimulant
addiction.
Research Training Opportunities
Currently there is an open postdoctoral position and technical specialist position in the
laboratory.
Contact Information
Sari Izenwasser, Ph.D.
Professor
Department of Psychiatry and Behavioral Sciences
(305) 243-2032
sizenwasser@med.miami.edu
EDUCATION
Addiction Psychiatry Fellowship & Psychiatry Residency Training
CORE FACULTY
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Ihsan M. Salloum, M.D., M.P.H.
Professor, Department of Psychiatry and Behavioral Sciences
Chief, Division of Alcohol and Drug Abuse: Treatment and Research
Director, Addiction Psychiatry and Psychiatric Comorbidity Program
Chair, Section on Classification, Diagnostic Assessment and Nomenclature
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Yossef Itzhak, Ph.D.
Professor, Department of Psychiatry and Behavioral Sciences
Professor, Cellular and Molecular Pharmacology
Director, Laboratory of Experimental Drug Addiction
Departments of Psychiatry and Neuroscience Graduate Faculty
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Sari Izenwasser, Ph.D.
Professor, Department of Psychiatry and Behavioral Sciences and Neuroscience Program
Director, Laboratory for Neuropharmacology of Drug Abuse
Co-Director, Center on Addiction and Health in Women, Children and Adolescents
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Michelle Bauer, M.D.
Assistant Professor of Clinical Psychiatry, Department of Psychiatry & Behavioral Sciences
Medical Director, Division of Alcohol and Drug Abuse: Treatment and Research
Director, Health Recovery Center, Mental Health Hospital Center at Jackson Memorial Hospital
Director, Addiction Psychiatry Fellowship
To apply for staff positions in the Department of Psychiatry and Behavioral Sciences, please visit the
University of Miami Miller School of Medicine Careers website and select 'Psychiatry & Behavioral Sciences' from the department/hospital drop-down menu. For further inquiry you may also contact the Miller School of Medicine's human resources office at
careers@med.miami.edu.
IN THE NEWS
Interview: UM doctor discusses culture of drinking on college campuses
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IMPORTANT LINKS
Relevant national institutes:
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
National Institute on Drug Abuse (NIDA)
National Institute of Mental Health (NIMH)
Relevant professional associations:
American College of Neuropsychopharmacology (ACNP)
American Academy of Addiction Psychiatry (AAP)
American Psychiatric Association (APA)
American Society of Clinical Psychopharmacology (ASCP)
The College on Problems of Drug Dependence (CPDD)
New Clinical Drug Evaluation Unit (NCDEU)
Research Society on Alocoholism (RSOA)
Substance Abuse and Mental Health Services Administration (SAMHSA)
World Health Organization (WHO)
World Psychiatric Association (WPA)