Research is the cornerstone for every sector of healthcare. Every year, billions of dollars in private and public funding is dedicated to furthering detection and treatment options for the diseases that affect us most – all except for substance use disorder (addiction). Even though addiction affects almost one in three American families and claims tens of thousands of lives annually, research on addiction medicine and substance use disorder is severely underfunded. And for the research that exists, there’s often a gap between it and actual practice.
Caron serves a unique purpose in closing this gap. Our facilities and staff have the capabilities to serve patients and develop research. Each year, we’re participating in innovative new projects that are advancing the medical community’s understanding of addiction and its treatment. This shift toward a more academic climate has brought many important areas of study to the forefront. We’re currently working on the following initiatives:
Furthering Success in Early Recovery
Most people in early recovery relapse within the first 90 days of leaving treatment. One of our top goals is to lower the number of those who relapse and help those who do relapse reengage in their treatment plan again quickly. Caron’s My First Year of Recovery program monitors newly sober patients and offers them a variety of aftercare services during the pivotal one-year time period after leaving treatment.
Each patient in the program allows what they report – their struggles, successes, cravings, what type of aftercare they’re participating in, and more – to be analyzed. Using this information, we’ve determined the main components to a successful transition: Continuation of therapy, rapid re-engagement in a program after relapse (of patients who relapse and then reengage, more than half are able to get sober again), family involvement, chronic pain management, and quality sleep.
This data informs our care and how we treat the disease for current and future patients. It also helps to move the treatment field forward. We have these programs and services for other mental health issues, but it’s never been present for addiction. With its high relapse rate, substance abuse disorder is in desperate need for more data on maintaining recovery. The information collected in My First Year is a valuable part of the recovery process.
Restoring the Brain After Long-Term Alcohol Abuse
Long-term alcohol abuse can cause cognitive decline in memory, movement, speech, and judgment. Caron is assisting the National Institutes of Health (NIH) in examining the Ketogenic Diet and its potential to mitigate the effects of alcohol on the brain.
The Ketogenic Diet is a low-carb, high-fat diet that puts the body in a state of ketosis, where fuel is processed more efficiently. Ketosis decreases inflammation and neuronal damage, improves brain cell growth and function, and regulates neurotransmitters. The Ketogenic Diet has been proven to help with mood and sleep disorders. It could have the same effect on a brain damaged by alcohol.
The NIH is recruiting patients with alcohol use disorder to be studied over a three-week period, and Caron is actively referring patients to this study. When a potential participant crosses our radar, we evaluate and then put them in touch with the NIH. Eligible patients receive three weeks of free addiction treatment, where they will be a part of one group in the study on the Ketogenic Diet, or a second group that is not on the diet and receiving standard treatment. At the end of three weeks, the study will determine if those on the diet have improved brain function. If this diet can be shown to be an effective tool in restoring brain function and mitigating withdrawal symptoms such as sleep and other mood disturbances, everyone will have access to an additional and free supplement to treatment that can be used for a lifetime.
Finding Cost-Effective Tools for Neurofeedback
Neurofeedback is the real-time display of brain activity, and it is a valuable but expensive tool used in the treatment of many mental health conditions. Caron and Penn State Hershey Medical Center are conducting research here on campus evaluating the efficacy of Functional Near-Infrared Spectroscopy (fNIRS) as a neurofeedback device.
The fNIRS machine consists of a band that goes across the forehead and uses an infrared laser to penetrate millimeters into the prefrontal cortex of the brain to measure its activity in response to triggers. This collaborative study with Penn State Hershey Medical Center will use fNIRS on 30 patients: half with alcohol abuse disorder and half with opioid use disorder. The participants will be subjected to a maze that presents them with an item blocking their way –a beer or pill bottle, for example – that triggers a craving. The patients must then practice mindfulness to shrink the item until it disappears before they can move forward in the maze. The endpoint of the study is to determine if this combined method can reduce actual cravings over time.
This is an important piece of research. While other machines needed for neurofeedback can cost millions of dollars, an fNIRS machine costs only thousands and could be widely implemented across treatment centers.
Solving the Problem of Insomnia During Recovery
Those in recovery can almost certainly expect to battle insomnia, andlack of sleep is a big risk factor for relapse. The problem is that most sleep aids are addictive. Belsomra is a new sleep aid that could be the answer. It works differently than most sleep aids do; instead of slowing down brain activity, it turns off the neurotransmitter that promotes wakefulness. Caron and Penn State Hershey Medical Center are working together to evaluate whether Belsomra’s approach to treating insomnia makes it a safe medication for those in recovery. The ability to avoid insomnia would make a big difference in how recovery is managed and how successful patients can be.
This new research-driven agenda at Caron is incredibly exciting. It gives us the chance to work with revered institutions on groundbreaking techniques and tools that serve our current patients and prepare us to help new future generations live long and happy lives in recovery.
By Joseph Garbely, D.O., DFASAM