SAMHSA Welcomes Child and Adolescent Psychiatrist Dr. Justine Larson, Senior Medical Advisor for the Center for Mental Health Services

Over the past 25 years, CMHS has worked to develop and implement behavioral health treatment, prevention, and recovery support programs for Americans with mental disorders and addictions.  Our work will soon get a bigger boost with the appointment of child and adolescent psychiatrist, Justine Larson, M.D., M.P.H., M.H.S. as our new Senior Medical Advisor.

Dr. Larson’s expertise and leadership will be invaluable in applying a clinical lens across a broad spectrum of mental health programs. She will provide her medical and clinical expertise particularly in programs to support services for people with serious mental illness and serious emotional disturbance. She will help formulate public health policy initiatives and provide clinical expertise to senior leaders and program staff.  Dr. Larson will work closely with SAMHSA’s Chief Medical Officer, Dr. Anita Everett, and across federal departments and agencies, to ensure federal coordination in the provision of effective treatment and services for people with serious mental illnesses.

Dr. Larson brings a wealth of academic, research, and practice-based expertise to her new role – especially in the areas of child and adolescent mental health, evidence-based treatment, and integrated care.  She is board certified in adult psychiatry, child and adolescent psychiatry, and neurology and obtained her undergraduate degree from Columbia College with a major in Women and Gender Studies.  Dr. Larson received her medical degree from Harvard Medical School, a master’s degree in public health from the Harvard School of Public Health, and a master’s degree in health sciences from the Bloomberg School of Public Health at Johns Hopkins University.  She trained in adult psychiatry at the Harvard Longwood residency program, and completed her training in child and adolescent psychiatry at Johns Hopkins University School of Medicine.

Dr. Larson remained at Johns Hopkins as a full-time faculty member, where she conducted research in the area of access to care for under-served and minority populations.  Her publications have covered topics including barriers to behavioral healthcare for children and adolescents, parents’ perceptions of pediatricians providing behavioral healthcare, and the importance of involvement of youth and family voice in service development and provision.

After leaving Johns Hopkins, Dr. Larson became Medical Director for the Arlington County Community Services Board in Virginia.  As Medical Director for a county behavioral health system, she led initiatives in integrated primary care, evidence-based medication management, medication-assisted treatment for substance use disorders, and organizational management in behavioral health settings.  Most recently, Dr. Larson has served as a consulting psychiatrist for an integrated behavioral health program at a Federally Qualified Health Center in the state of Maryland.  In that role, she provided education to primary care providers, curbside consultations, and direct clinical care.  She has been an active member with the American Academy of Child and Adolescent Psychiatry and served as co-chair of the Committee on Systems of Care for youth with serious emotional disturbances.

Please join me in welcoming Dr. Larson who will be joining CMHS this September.

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Contact:
NIDA Press Office
301-443-6245
media@nida.nih.gov

About the National Institute on Drug Abuse (NIDA): The National Institute on Drug Abuse (NIDA) is a component of the National Institutes of Health, U.S. Department of Health and Human Services. NIDA supports most of the world’s research on the health aspects of drug use and addiction. The Institute carries out a large variety of programs to inform policy, improve practice, and advance addiction science. Fact sheets on the health effects of drugs and information on NIDA research and other activities can be found at www.drugabuse.gov, which is now compatible with your smartphone, iPad or tablet. To order publications in English or Spanish, call NIDA’s DrugPubs research dissemination center at 1-877-NIDA-NIH or 240-645-0228 (TDD) or email requests to drugpubs@nida.nih.gov. Online ordering is available at drugpubs.drugabuse.gov. NIDA’s media guide can be found at www.drugabuse.gov/publications/media-guide/dear-journalist, and its easy-to-read website can be found at www.easyread.drugabuse.gov. You can follow NIDA on Twitter and Facebook.

About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

NIH. . .Turning Discovery Into Health®

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Epigenetics takes center stage with this year’s Addiction Science Awards 

A project applying the science of epigenetics to demonstrate the health dangers of hookah smoke won a first-place Addiction Science Award at the 2017 Intel International Science and Engineering Fair (ISEF)—the world’s largest science competition for high school students. The awards are coordinated by the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health, and Friends of NIDA, a coalition that supports NIDA’s mission. The Intel ISEF Addiction Science Awards were presented at a ceremony Thursday night at the downtown Convention Center in Los Angeles.

First place winner of the 2017 Addiction Science Award (L to R): Judges Drs. Eric Hayden and Chris Evans, 1st place winner Anusha Zaman, and Judge Dr. Mitchell WongFirst place winner of the 2017 Addiction Science Award (L-R): Judges Drs. Eric Hayden and Chris Evans, 1st place winner Anusha Zaman, and Judge Dr. Mitchell Wong

The first and second place awards went to students using epigenetics—how the environment can change gene expression. First place went to 16-year-old Anusha Zaman from the Baton Rouge Magnet High School in Louisiana, for her project, Epigenetic and Biotransformation Effects of Hookah Smoke Extract on Human Oral Keratinocytes. The high school sophomore analyzed the effect of wet and dry hookah smoke extracts on epithelial cells taken from inside human mouths. She discovered that hookah smoke induces potentially detrimental cellular responses relevant to inflammation and cancer. Her findings suggest that hookah smoke produces adverse health effects similar to those produced by cigarette smoke.  

The second place award went to Nkima Stephenson from Conyers, Georgia, for her project, Data Analysis of the Epigenetics of Drug and Alcohol Dependence. The 18-year-old senior from the Rockdale Magnet School for Science and Technology used the GeneWeaver database, which allows a functional analysis across multiple species through homology mapping. Using both human and rodent data, she compared data sets containing genes directly related to alcohol exposure, to sets containing genes modified by environmental influences, but also related to alcohol exposure. In doing so, she identified genetic and environmental factors that could signify a predisposition to addiction. Thanks to her work, the database now contains a more extensive collection of information that could be useful to other researchers studying substance use disorders. 

"We are delighted that these students are discovering the potential of epigenetic research to study the effects of drugs on our brain and our body, including those that result in addiction," said NIDA Director Nora D. Volkow, M.D.

Third place went to Kashfia Rahman from Brookings High School in Brookings, South Dakota for her project The Dynamics of Habituation: A Neural Study of the Effects of Repeated Exposures to Risky Behaviors on Cognitive Control and Emotional Responses in the Adolescent Brain. The 17-year-old junior used a comprehensive series of measures to test the process of habituation, where the perception of risk decreases incrementally each time the teen is exposed to a decision about a dangerous behavior. She tested many components of risky behaviors and in some subjects even used a portable EEG technology to measure emotional responses. She concluded that repeated risky exposures can desensitize associated negative responses, explaining why teens take risks when they know a behavior is dangerous. 

The Friends of NIDA provides funding for the awards as part of its ongoing support of research into the causes, consequences, prevention, and treatment of drug abuse and addiction.

"It is impressive to see so many high-quality projects related to addiction science this year," said William Dewey, Ph.D., president and chair of the Executive Committee, Friends of NIDA, as well as the Louis S. and Ruth S. Harris Professor and chair, Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond. "In fact, to recognize as many of these young scientists as possible, we took the unusual step of awarding three Honorable Mentions this year."

Honorable Mentions were awarded to 18-year-old Anuj Gupta from Roslyn High School in Roslyn Heights, New York for Do Parents Really Know Best? Investigating the Relationship between Perceived Parental Goals and Academic Factors; Dilge Kocabas (age 17) and Dilara Alev Ortel (age 19) from the Takev Fen Lisesi School in Izmir Narlidere, Turkey for Illegal Substance Biodetectives: Apta-Liposomes; and 15-year-old Caleb Martonfi from Tuscumbia High School in Tuscumbia, Missouri for And the Winner Is…Developing a Computer Program to Investigate Neural Competition with Multimodal Stimuli.

In referring to all of the awardees, Dr. Volkow commented, "It’s very gratifying to see the creative contributions that these young researchers are already making to the science of drugs and substance use disorders, including the factors that might underlie vulnerability for drug-taking."

Judges for this year’s Addiction Science Awards included three NIDA grantees from the University of California at Los Angeles (UCLA): Drs. Chris Evans, Vivek Shetty, and Mitchell Wong, as well as UCLA neuroscientist Dr. Eric Hayden.

This year, about 1,800 students from more than 75 countries, regions and territories participated in the Intel ISEF competition, coordinated by the Society for Science and the Public. The nonprofit organization partners with Intel—along with dozens of other corporate, academic, government and science-focused sponsors—to provide support and awards each year. Addiction Science winners receive cash awards provided by individual scientists in the field through Friends of NIDA, with a $2,500 scholarship for the first-place honoree, $1,500 for second place and $1,000 for the third-place distinction. NIDA has developed a special section on its website, which includes other resources on addiction science, to highlight the winning projects and to help science fair entrants understand the criteria for the awards:  The NIDA Science Fair Award for Addiction Science.

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The Promising Impact of Prescription Drug Monitoring Programs

By: Ryan Mutter, PhD, Lead, Health Economics and Financing Team; Mir M. Ali, PhD, Health Economist, Center for Behavioral Health Statistics and Quality (CBHSQ); Lisa Patton, PhD, Director, Division of Evaluation, Analysis and Quality, CBHSQ

In the United States, non-medical prescription opioid use is a major public health concern. The Centers for Disease Control and Prevention (CDC) reported that opioids, including prescription medications and heroin, killed more than 30,000 Americans in 2015. Almost half of those deaths involved prescription medication. To address this crisis, states have exercised a number of strategies to prevent prescription drug overdose. Prescription drug monitoring programs have evolved as an effective tool to safeguard public health and safety while supporting the appropriate use of controlled substances, including opioids. A recent studyExternal Web Site Policy by SAMHSA found that prescription drug monitoring programs (PDMPs) are effective in preventing patients from seeking multiple doctors to prescribe them opioids.

PDMPs are state-run electronic databases used to track the prescribing and dispensing of controlled prescription drugs, such as opioids and benzodiazepines, to patients. In our study of PDMPs as a tool to combat the opioid crisis, we found that the programs reduced doctor shopping, or going to multiple doctors to try to get prescriptions for pain relievers. PDMPs also reduced the non-medical use of prescription drugs by an average of 10 days a year per user. In places where participation in the programs was mandatory, the reduction in non-medical use was even greater.

As of April 2017, 49 states now have a PDMP. There has been some concern that, because the monitoring programs make it harder for people to get prescription pain relievers for non-medical use, those people will turn to heroin instead. We found that prescription drug monitoring programs did not lead to an increase in people starting to use heroin.

Overall, our research encourages us that PDMPs can help curb the opioid crisis by providing health care providers access to patients’ prescription histories and helping to identify individuals at risk of opioid misuse. The monitoring programs will be one strategy in an effort to engage all sectors of the health service system to addresses various aspects of the crisis.

For more information on PDMPs and how they serve as a decision-making tool for providers, please see SAMHSA’s In Brief: Prescription Drug Monitoring Programs: A Guide for Healthcare Providers.

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Lives in the Balance: Addressing “Deaths of Despair” among People with Serious Mental Illness

The United States had seen decades of continually declining mortality rates, as advances in health care and safety have allowed us to live longer. This century, however, mortality rates among certain demographic and socioeconomic groups have increased. A recent studyExternal Web Site Policy attributes this uptick to what the authors call “deaths of despair,” which are drug and alcohol overdoses, liver disease associated with chronic alcohol use, and suicide. To save lives, we must replace the consequences of despair with the promises of hope – health, knowledge, prevention, and effective treatment.

The authors of the study on deaths of despair point to several factors—particularly lack of education and economic insecurity—that help explain this alarming trend. However, we cannot lose sight of the strong relationship between serious mental illness and these causes of death, most of which are preventable and treatable.

For example, the National Survey on Drug Use and Health  revealed that about 2 in 5 people with serious mental illness use illicit drugs, and nearly 1 in 4 have a substance use disorder (alcohol or illicit drugs). As many as 1 in 25 people with mental illness dies by suicide, and numerous studies link serious mental illness to early mortality from other chronic diseases such as higher rates of cardiovascular disease, diabetes, and respiratory disease.

We can decrease mortality across all demographic and socioeconomic groups by promoting prevention, treatment, and recovery supports. SAMHSA is working to promote health and reduce early mortality so that people with behavioral health conditions lead longer, healthier, and more productive lives. Our suicide prevention activities include efforts across the lifespan, and recent initiatives such as Zero Suicide focus on working-age adults, whose mortality rates are increasing. Further, first episode psychosis interventions are addressing an important cause of early mortality.

However, prevention and treatment are only part of the solution. To reduce deaths of despair, we must promote hope, resilience and recovery. SAMHSA’s Recovery Support Strategic Initiative includes efforts to:

  • increase access to treatment and medications
  • prevent and end homelessness
  • link people to permanent supportive housing
  • promote work through evidence-based supported employment
  • foster peer support, and
  • build connections with faith communities.

As a recent blog post by the Department of Health and Human Services (HHS) points out, we all can make a difference! There are lives in the balance. The HHS and SAMHSA have made it a priority to reduce suicide and opioid abuse, and SAMHSA plays a leading role in these efforts. If we work together, we can reverse the trend of early mortality for Americans with behavioral health conditions by ensuring access to evidence-based prevention and treatment programs.

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