Updated on Jun 30, 2022 | Featured, Psychiatry, Research, Your Health
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.”
Updated on Jun 30, 2022 | Featured, Inside, Psychiatry, Research
René S. Kahn, MD, PhD
Two world-renowned researchers in brain disease have assumed key leadership roles at the Icahn School of Medicine at Mount Sinai: René S. Kahn, MD, PhD, as Chair of the Department of Psychiatry, and Paul Kenny, PhD, as Chair of the Department of Neuroscience. Both men have made significant academic and scientific achievements in their respective fields. Dr. Kahn, the newly appointed Esther and Joseph Klingenstein Professor of Psychiatry, has dedicated his career to studying psychotic disorders, particularly the origins and treatment of schizophrenia. Dr. Kenny, Ward-Coleman Chair in Pharmacology and Experimental Therapeutics, has focused on understanding the neurobiological mechanisms of drug addiction, obesity, and schizophrenia, and developing novel therapeutics that address each.
Dr. Kahn returns to the Mount Sinai Health System after more than 20 years. Most recently, he served as Professor of Psychiatry and Director of the Brain Center Rudolf Magnus at the University Medical Center Utrecht in the Netherlands. The author of 800 research papers and book chapters, he has made major findings that have helped inform clinical work in the field. One of his seminal discoveries was that schizophrenia starts in the early teenage years, earlier than previously thought, and that the first cognitive symptoms usually precede the first psychosis and visit to the psychiatrist by 10 years. “This is very important because we now know if we want to understand the illness and identify people at risk, we have to look much earlier in the process,” says Dr. Kahn.
Using neuroimaging, Dr. Kahn has uncovered progressive changes in the brain over the course of schizophrenia that are linked to its severity. In his new role as Chair, he plans to establish a high risk clinic to identify and treat individuals at an early age who are likely candidates for a range of psychiatric illnesses, as well as drug abuse. “A specialized clinic of this type will have a major impact scientifically, as well as on the overall health care system, and New York’s population, in particular,” he says.
A member of the Royal Netherlands Academy of Science and a former Fulbright Scholar, Dr. Kahn completed a four-year psychiatry residency at The Mount Sinai Hospital and was appointed to the Icahn School of Medicine at Mount Sinai faculty in 1992. He conducted schizophrenia research and served as Research Unit Chief at the James J. Peters VA Medical Center in the Bronx, before returning to the Netherlands. For two decades, Dr. Kahn has maintained an adjunct appointment at Mount Sinai to continue his collaborations with faculty members.
“I am delighted that Dr. Kahn is joining us,” says Kenneth L. Davis, MD, President and Chief Executive Officer of the Mount Sinai Health System. “His medical acumen is evidenced by the honors and accolades awarded to him through his noteworthy career.”
Paul Kenny, PhD
When Dr. Kahn received an endowed professorship at Mount Sinai’s Convocation Ceremony in September, he told the audience that his mentors were Dr. Davis and Dennis S. Charney, MD, Anne and Joel Ehrenkranz Dean, Icahn School of Medicine at Mount Sinai, and President for Academic Affairs, Mount Sinai Health System, both of whom have made significant discoveries in neuroscience.
“My two mentors are together,” he said, “having built one of the best medical schools in the United States and probably the world, and I am extremely honored to be part of that.”
Dr. Kenny is a world authority on the neurobiology of addiction and obesity and has advanced the scientific community’s understanding of the mechanisms of both disorders. His recent work in tobacco addiction has centered on a group of proteins known as nicotinic acetylcholine receptors (nAChRs) that consist of five subunits, each encoded by its own unique gene. (Previous research by a Mount Sinai scientist identified a mutation in one of those genes, CHRNA5, which appears to influence whether someone becomes a smoker, and the severity of his or her habit.)
“My lab played an important role in understanding how the CHRNA5 gene works, and that has opened a new window on nicotinic-receptor signaling in the brain and how it influences behavior,” says Dr. Kenny. People who carry CHRNA5 variants are more likely to smoke, not because they enjoy nicotine more than others, but because they are resistant to adverse effects of the drug, according to his team’s findings.
The Kenny Laboratory is currently investigating the molecular and cellular mechanisms of CHRNA5 in nicotine addiction and also developing novel smoking-cessation therapeutics based on a better understanding of how this gene variant works.
His interests also include the role for novel regulatory RNA elements in brain cells called microRNAs in drug addiction and schizophrenia. Dr. Kenny says, “We were among the first to show that microRNAs in the brain can influence behavior and may play a role in various aspects of neuropsychiatric disorders.” Under Dr. Kenny’s direction, Mount Sinai’s Experimental Therapeutics Institute is actively exploring the novel therapeutic potential of microRNAs.
“Dr. Kenny is an international authority on applying the tools of molecular biology to neuropharmacology and using the new insights obtained to develop novel treatments for neuropsychiatric disorders. He has served as an inspiring leader of Mount Sinai’s Experimental
Therapeutics Institute, and the Department of Neuroscience will be fortunate to benefit from his innovative leadership,” says Eric J. Nestler, MD, PhD, Nash Family Professor of Neuroscience, Director of The Friedman Brain Institute, and Dean for Academic and Scientific Affairs at the Icahn School of Medicine at Mount Sinai.
Prior to joining Mount Sinai in 2013, Dr. Kenny served as Associate Professor of Molecular Therapeutics, and Director of the Medications Development Program in Substance-Related Disorders at The Scripps Research Institute’s Jupiter, Florida, campus. He completed his doctorate in Neuroscience at King’s College London, and pursued his postdoctoral training at The Scripps Research Institute in La Jolla, California.
Yasmin Hurd, PhD, a professor of psychiatry, neuroscience, and pharmacology and systems therapeutics at the Icahn School of Medicine at Mount Sinai, discusses her new report on marijuana, and its potential to curb opioid addiction.