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 related consequences. ISAP work ranges from epidemiological and policy studies to basic science and human laboratory programs to clinical trials of innovative behavioral therapies and pharmacotherapies. ISAP activities are briefly summarized below.
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.
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.
Natural History, Treatment Process and Outcomes, and Health Services
ISAP is the lead organization or a participating member in major 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 Research on Drug Abuse.
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’s Pacific Coast Research Center is a component of the NIDA Criminal Justice Drug Abuse Treatment Services Research System, 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 medication based and behavioral, designed to reduce risk of HIV infection among drug users. In addition, ISAP’s Health Risk Reduction Projects (HRRP) conducts HIV/AIDS behavioral research on children, adolescents, adults, and families. HRRP has examined the impact of maternal HIV/AIDS on children in what will be a 15-year longitudinal study.
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. ISAP continues to offer training as part of the NIDA INVEST program for addiction medicine researchers and clinicians. Two physicians from China recently spent a year of mentored clinical research training at ISAP, and eight physicians and researchers attended a week-long training session at ISAP.
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 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.Program Evaluation
ISAP’s Program Evaluation Services offers a full array of evaluation and consultant services including needs assessment, culturally competent evaluation planning and design, methods for improving grant priority scores, performance and outcomes monitoring, and evaluation data collection and analysis (including GPRA). ISAP assists in program evaluation at any stage, including helping programs secure grant funding and improve their programs during the planning and grant proposal stage. ISAP has evaluated numerous projects conducted locally by Los Angeles agencies, as well as around the nation, including a number of projects funded by state and federal grants. The number of sample participants in these projects range from 40 to 10,000. The evaluations vary in scope from outcome reports involving a small number of variables, such as retention and engagement in treatment, to complex analyses of multiple measures of performance and outcomes collected longitudinally.
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), adolescents, the homeless, welfare recipients, the disabled, or gay, bisexual, and/or 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. 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 Alcoholism and Addiction Medicine Service, based at the Resnick Neuropsychiatric Hospital at UCLA, provides comprehensive, evidence-based assessment and treatment in a caring and confidential environment. The program is directed by ISAP’s Karen Miotto, M.D., and offers partial hospitalization and inpatient/detoxification services, as well as an outpatient clinic directed by Tim Fong, M.D. The program coordinates outpatient treatment with aftercare, which occurs at the ISAP-affiliated network of community-based outpatient clinics: Matrix Institute clinics, Tarzana Treatment Clinic, Friends Research Institute sites, and others. This clinical system supports patient care, teaching, research training, clinical training, and research activities.
Women's Substance Abuse Issues
ISAP researchers are making significant contributions to the growing body of research on the particular needs of women substance abusers. These include studies of women in gender-specific substance abuse treatment programs (e.g., the organizational characteristics of these programs, the evidence basis for treatment models, and treatment outcomes); outcomes of women and their children who come into contact with child welfare services; evaluations of programs developed for women offenders, both in correctional programs and community settings that involve innovative arrangements between corrections and treatment; and longitudinal examinations of gender differences in drug use, treatment, other service system interactions, and recovery over the life course. ISAP researchers also participate in numerous advisory boards for state and national policymakers on applying research findings to improve the delivery and outcomes of treatment for women with substance abuse problems.Last Updated: 02/10/2010