Addiction Institute to Explore Effective Therapies

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.”

Music Therapy Found to Aid Spine Surgery Patients

Researchers at the Louis Armstrong Center for Music and Medicine and the Department of Orthopaedic Surgery at Mount Sinai Beth Israel found in a recent study that music therapy—an integrative treatment that addresses mind, body, and spirit—decreased the perceived pain of patients recovering from spine surgery.

“Our aim was to substantiate years of evidence-based reporting on the benefits of music therapy,” says John Mondanaro, MA, LCAT, MT-BC, Clinical Director, Louis and Lucille Armstrong Music Therapy Program, Mount Sinai Beth Israel, and the senior author of the study, which was published in the January/February 2017 issue of The American Journal of Orthopedics. The principal investigator was Joanne V. Loewy, DA, LCAT, MT-BC, Director of the Louis Armstrong Center, which has been at the forefront of integrative medicine for the past 24 years, conducting numerous clinical trials with doctors and nurses as co-investigators.

The study, which was conducted from 2009 to 2014, involved 60 patients who had just undergone spinal fusion surgery, for which recovery is often extremely painful, Mr. Mondanaro says. The patients, who ranged from ages 40 to 55, were randomly divided into two groups: One group received a half-hour music therapy session plus standard care (medical and nursing care, with pain medication). And a control group received standard care only. Measurements for both groups were completed within 72 hours after each surgery, then about 30 minutes after the intervention.

Joanne V. Loewy, DA, and John Mondanaro, MA, co-investigators

The music therapy session provided the patient with guided breathing exercises accompanied by live music played by members of the team and selected to fit the patient’s preferences, such as jazz, pop, or classical.

“Patients had opportunities to release tension through clinical improvisation, where they played musical instruments and focused on themes related to their lives and their recovery,” Dr. Loewy says. The sessions ended with a relaxation exercise in which patients envisioned a place that brings them peace—“a beach, a park, their bed at home,” Mr. Mondanaro says. The control group and the music therapy group showed significant differences in pain as measured by the visual analog scale (VAS), in which zero is “no pain” and 10 is “worst pain imaginable.” Pain levels rose slightly in the control group, to 5.87 from 5.20, but fell by more than 1 point in the music group, to 5.09 from 6.20.

Although the results for the control and music therapy groups did not differ in hospital anxiety and kinesiophobia (a fear of movement that can impede recovery), the decrease in VAS pain levels was significant. Overall, the study concluded, “Conventional pain-alleviating medical interventions can be enhanced with integrative therapies that empower patients to marshal their inner resources during recovery. Music therapy may be particularly suited to this effort, as it is adaptable to the patient’s individual and culturally specific needs.”

Treating Depression with Software: Technology from Mount Sinai Steps into the Digital Healthcare Universe

A treatment for depression using Emotional Faces Memory Task (EFMT), a technology originally developed by two Mount Sinai researchers, resulted in a significantly greater reduction of major depressive disorder (MDD) symptoms compared to a control group, according to initial clinical results presented at the Society of Biological Psychiatry Annual Scientific Convention.This treatment was developed at the Icahn School of Medicine at Mount Sinai by Brian Iacoviello, PhD, an Assistant Professor of Psychiatry who is Director of Scientific Affairs for Click Therapeutics, and Dennis S. Charney, MD, Anne and Joel Ehrenkranz Dean and Professor of Psychiatry, Neuroscience, and Pharmacological Sciences.

Read the press release

New York Daily News: How to Stay Healthy on Your Summer Getaways

A summer trip can be bliss — but not if you spend those days sick and cooped up in your hotel room.Taking common-sense precautions can make all the difference, whether you’re traveling someplace far-flung or close to home, according to Daniel Caplivski, MD, Medical Director, Mount Sinai Travel Medicine Program, and Associate Professor of Medicine (Infectious Diseases), Icahn School of Medicine at Mount Sinai.

Read the article in The Daily News

 

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