Synopsis of ISAP Research and Related Activities
The UCLA Integrated Substance Abuse Programs (ISAP) conducts research, provides research training and clinical training, and arranges treatment for substance abuse disorders in coordination with the UCLA Department of Psychiatry and Biobehavioral Sciences and in affiliation with community-based treatment providers. ISAP efforts span the spectrum of scientific and clinical activities pertinent to the investigation and amelioration of substance abuse and its related consequences. ISAP work ranges from epidemiological and policy studies to basic science and human laboratory programs to clinical trials of treatments involving innovative behavioral and pharmacological approaches. ISAP activities are briefly summarized below. Descriptions of ISAP research projects, training and dissemination efforts, and treatment services appear later in this report.
Basic Science/Neurophysiology/Imaging
An extensive program of brain imaging research is coordinated with a program of cognitive and neuropsychological assessment, using innovative imaging approaches (e.g., PET and fMRI) to study brain changes and physiologic responses to nicotine, methamphetamine, cocaine, and other substances. The UCLA Human Infusion Laboratory is one of the leading national resources for the study of interactions of potential treatment medications and illicit drugs.
Clinical and Behavioral Trials
ISAP directs the Pacific Region Node of the National Institute on Drug Abuse (NIDA) Clinical Trials Network (CTN), which includes a geographically and clinically diverse group of community treatment programs throughout California and Hawaii. In concert with other CTN nodes across the country, the Pacific Region Node conducts research on medication and behavioral treatments for drug abuse and dependence. ISAP also operates the world’s leading Phase I and II program for identifying potential medications and examining their safety and efficacy for treatment of stimulant dependence.
Criminal Justice Populations
ISAP researchers have conducted comprehensive reviews of drug treatment in the criminal justice system and have examined treatment programs focused on women offenders and ethnic minorities under criminal justice supervision. Other work has investigated the differential effects of incarceration, parole, and methadone maintenance on drug use and criminal behavior, and has documented the effects of civil commitment and other forms of compulsory treatment. ISAP investigators have consistently explored the relationship between drug use and crime, including outcomes of treatment for drug-abusing offenders and the role of drug use in perpetuating the cycle of crime among offenders. ISAP is a participant in the NIDA Criminal Justice Drug Abuse Treatment Research Studies, a nationwide effort to optimize treatment for drug-abusing individuals under criminal justice supervision.
HIV/AIDS
Since the early 1980s, ISAP researchers have investigated HIV/AIDS among drug abusers and have participated in community-based interventions to combat HIV, including tracking long-term trends in risk behaviors among drug-abusing arrestees. A series of studies testing psychosocial predictors of HIV risk reduction led to the development of a culturally congruent HIV education program serving drug users in Los Angeles. Several NIDA-funded projects have evaluated the effectiveness of a variety of interventions, both pharmacologic and behavioral, designed to reduce risk of HIV infection among drug users.
International Activities
ISAP investigators conduct ongoing collaborative research efforts in the Middle East, Southeast Asia, Mexico, Europe, Latin America, South Africa, and Australia. ISAP personnel conduct extensive training throughout the world, disseminating research methods and proven clinical practices through their direct efforts and by hosting conferences around the world. ISAP directors have contributed to United Nations/World Health Organization policymaking efforts to address global drug problems. ISAP is coordinating the worldwide “Treatnet” capacity-building effort by the United Nations Office on Drugs and Crime to train drug abuse professionals in best practices regarding assessment and treatment of drug abuse and related consequences.
Medication Development
Consistent with NIDA’s increased emphasis on developing effective medications for substance abuse disorders, ISAP investigators are pioneers in the field, having been instrumental in the development and implementation of several medications for opiate dependence, most recently advancing the approval of buprenorphine for use by physicians in office-based treatment of opiate dependence. ISAP’s innovative development of pharmacotherapies (delivered in the context of a behavioral treatment platform) addresses the growing problem of stimulant dependence, especially regarding methamphetamine. Notably, the NIDA-funded P50 Center, the UCLA Medication Development Unit for Stimulant Abuse, is leading the way in identifying, testing, refining, and implementing medication-based and psychosocial therapies for stimulant abuse.
Natural History, Treatment Process and Outcomes, and Health Services
ISAP is the lead organization or a participating member in most significant treatment outcome evaluations at the national level, in California, and in the Los Angeles area. Specific research projects focus on treatment effectiveness for dually diagnosed patient populations and development of enhanced strategies for engaging difficult-to-treat and special populations. These research efforts involve ISAP researchers who are expert in the design and application of advanced analysis techniques such as structural equation models, hierarchical linear models, latent curve models, and latent transition models. Incorporation of these techniques into ISAP investigations ensures rigorous research and carefully derived findings. Several publications produced by ISAP researchers have been used as guides for the application of statistical methods to social science research. Based on ISAP’s standing as the leading repository of expertise in longitudinal research on drug abuse, ISAP hosts the NIDA-funded Center for Advancing Longitudinal Drug Research.
Research-to-Practice Efforts and Practice Improvement
A major focus of ISAP efforts is increasing dissemination of research-proven treatment techniques into application, often termed “research to practice.” Several ISAP projects have formed and supported networks of community-based treatment providers and researchers committed to improving the quality of interaction among service providers, policymakers, researchers, and members of the community. These efforts continue to provide educational activities, assist community programs with the use of evidence-based screening and treatment practices, and foster new collaborative projects in the community.
Special Populations and Topics
ISAP researchers have examined patterns of substance abuse and related behaviors as they vary according to differences in individual/demographic characteristics, with recent work examining genetic-based variations. Research has shown that treatment must be designed to accommodate the unique needs of special populations, such as substance abusers who are dually diagnosed (with substance abuse and mental health disorders), women, adolescents, the homeless, welfare recipients, the disabled, men who have sex with men, and transgender populations. In addition, the engagement and retention of such persons in treatment require targeted efforts informed by research.
Substance Abuse Policy
Serving in an advisory capacity, senior members of ISAP have supported efforts of the U.S. Attorney General’s office, the White House Office of National Drug Control Policy, four directors of NIDA, the director of the Center for Substance Abuse Treatment (CSAT), and agencies and organizations in many states and counties. Senior ISAP scientists have testified as experts before Congress, state legislatures, the Food and Drug Administration, and the United Nations.
Training and Dissemination
Many ISAP professionals contribute to the UCLA education mission by providing coursework and lectures within the University. ISAP personnel also provide training in substance abuse treatment protocols and research processes, delivering hundreds of workshops and presentations in the United States and abroad. ISAP’s NIH/NIDA-funded Drug Abuse Research Training Center supports annual fellowships for predoctoral and postdoctoral fellows. In addition, ISAP is the organizational host of the Pacific Southwest Addiction Technology Transfer Center (PSATTC), one of 14 regional centers supported by the Center for Substance Abuse Treatment. The PSATTC provides training, information, and collaborative promotion of empirically proven substance abuse treatment practices through activities such as the Western Conference on Addictions and the California Addiction Training and Education Series. Like the CTN, the PSATTC increases knowledge about and improves the delivery of effective treatments for substance abuse disorders. ISAP researchers annually produce approximately 100 publications in peer-reviewed journals and present research findings at scientific meetings throughout the world.
Treatment Services
The UCLA Addiction Clinic, based at the Resnick Neuropsychiatric Hospital, provides comprehensive, evidence-based assessment and treatment in a caring and confidential environment. The program is directed by ISAP’s Thomas Newton, M.D., and offers partial hospitalization and inpatient/detoxification services. The program coordinates outpatient treatment with aftercare, which occurs at the ISAP-affiliated network of community-based outpatient clinics: Matrix Institute clinics, Van Ness Recovery House, Friends Research Institute sites, and others. This clinical system supports patient care, teaching, research training, clinical training, and research activities.
Last Updated: 04/07/2008