The Icahn School of Medicine at Mount Sinai recently opened a new Addiction Institute that will address one of the nation’s greatest health concerns by exploring effective treatments for patients with substance abuse problems.
“Bringing science to bear on the development of new therapies has reached the top of the national agenda, and that is where Mount Sinai excels,” says Yasmin Hurd, PhD, the Ward-Coleman Chair in Translational Neuroscience and Director of the Addiction Institute at Mount Sinai.
The Institute will manage therapies for all types of substance abuse. By removing the traditional silos that separate research and clinical care, and unifying all areas of addiction under one umbrella, Dr. Hurd says the Institute is “well positioned to meet the challenges of New York City and the nation.” The Institute will leverage Mount Sinai’s considerable body of research and clinical expertise in neuroscience and behavioral health in order to move the field forward.
According to the 2016 U.S. Surgeon General’s Report on Alcohol, Drugs, and Health, more than 20 million Americans have substance abuse disorders and 12.5 million reported misusing prescription painkillers. Despite decades of expense and effort focused on a criminal justice-based model for addressing substance-related problems, the report acknowledged that addiction remains a public health crisis with economic consequences in crime, health, and lost productivity totaling more than $400 billion annually. Dr. Hurd says the Institute’s collaboration with Mount Sinai’s other specialties such as precision medicine, population health, infectious disease, epidemiology, and genomics will help advance treatments and novel discoveries.
“The Institute’s modernized structure across a large, integrated health system will enable us to approach addiction in a cohesive way,” says Dr. Hurd. “In addition to prioritizing our research based on clinical needs, we want to understand the populations at risk and their patterns of behavior. Addiction is complex and one group cannot do it alone.”
Yasmin Hurd, PhD
An important aspect of the Institute’s work will be dispelling the stigma associated with addiction through greater understanding of the biological and behavioral complexities of substance use disorders. Another goal will be encouraging young clinicians to enter residencies and fellowships in the fields of addiction psychiatry and addiction medicine.
“We want to train the best and the brightest through enhanced clinical and research rigor to elevate the field,” says Dr. Hurd. “Clinical treatments for some addictions have not advanced in 50 years. This and other stigmas can deter young physicians from going into this field. Unless we improve the clinical toolkit available for clinicians we will not be able to change the trajectory of care.”
Decades of scientific studies have established that chronic substance misuse leads to profound disruptions of brain circuits involved in pleasure, reward, habit formation, stress, and decision-making. Repeated drug use alters the expression of genes to ultimately increase or decrease their production of proteins, leading to long-term changes in cellular function and even reshaping of the physical structure of neurons.
“Drugs can change the morphology of cells and induce a cascade of adverse events in the brain,” says Dr. Hurd. The Institute plans to move forward with multiple clinical trials that seek to reverse those disruptions. “Most addicts do not want to be addicted,” she adds. “Addiction can be treated. We need medical therapies that partner with behavioral therapies, and we need to be diverse in our treatment portfolio.”