Mentored Patient-Oriented Research on Adolescent Alcohol Misuse and Treatment

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PROJECT SUMMARY/ABSTRACT This K24 midcareer research and mentoring program aims to provide the candidate with protected time from direct patient care to conduct patient-oriented research (POR) on adolescent alcohol misuse and to mentor junior clinical investigators in translational research in addiction science. Understanding how behavioral, physiological, and neurocognitive assays measured in controlled laboratory settings can be leveraged to advance knowledge of how medications impact alcohol use in the real world requires expertise in clinical and behavioral neuroscience, psychophysiology, and clinical trials methods. For nearly two decades, the candidate has built a productive and continuously funded POR program that translates theory-driven hypotheses from preclinical and human laboratory research to real world applications. The proposed integrated plan will facilitate the candidate’s ability to mentor junior clinical investigators in POR and augment his capabilities as an independent clinician scientist. The research plan, which focuses on improving treatment options for adolescent alcohol misuse by optimizing ways to combine medications with behavioral interventions, dovetails the mentoring goals by providing a vehicle for mentoring junior scientists in: i) mechanisms of alcohol use disorder (AUD) pathogenesis and treatment effects, ii) clinical trial methods, iii) ecological momentary assessment (EMA) and psychophysiological research approaches, and iv) training in the responsible conduct of research. The candidate’s goal is to further develop and refine an experimental therapeutics approach (R01 AA007850) that yields high quality information to inform decisions about whether further development of novel treatments is warranted. This work centers on developing innovative human laboratory paradigms and related methods that reliably predict the efficacy of novel pharmacological and behavioral interventions in the real world and inform models of AUD etiology. This K24 will support the collection of pilot data for an integrative neurobehavioral therapy that combines a promising novel medication, shown to reduce alcohol use and craving in adults, with a gold standard psychosocial intervention for treating AUD among adolescents. Adolescence is a critical period for the pathogenesis of alcohol use disorder (AUD). Alcohol use typically begins during adolescence and prevalence rates for AUD peak before age 21. Yet, despite clinical demand, AUD treatments for youth rely on psychosocial interventions that yield only modest benefits. One potential way to improve adolescent alcohol treatment is to augment the best available psychosocial interventions with pharmacotherapy. Although the FDA approved four medications to help treat AUD in adults, no medication is indicated for adolescent use and controlled clinical trials with teenagers are almost nonexistent. Optimizing treatment options for youth will require closing this important gap in medication development research.