This competing renewal reflects my long-term research and career objectives to study addiction treatment, generate information that improves outcome and reduces the burden of addiction on others, expand international addiction research, and mentor young investigators for addiction research careers. To this end, I have been PI or a Co-l on studies on antidepressant pharmacotherapy, propoxyphene maintenance, methadone maintenance and its impact on HIV risk and infection, LAAM, buprenorphine, psychotherapy, a HIV vaccine, a rapid HIV test, HIV and drug use in Brazil and Russia, naltrexone for treating heroin addiction and reducing HIV risk in Russia and the U.S., methadone patients who do not stop opioid use, motivational incentives, motivational enhancement, and others as P.I. of the Delaware Valley Node of the Clinical Trials Network (CTN). I have been a member of NIDA study sections, the FDA Drug Abuse Advisory Committee, the DSM-IV Substance Abuse Work Group, CPDD Board of Directors, and the Board of Addiction Psychiatry for the American Psychiatric Association. I mentor young investigators, review papers for many journals, am associate editor of two, supervise residents, participate in medical student teaching, and co-directed the addictions component of the Philadelphia VA Center of Excellence until retiring from the VA in 2004. Research activities for the next 5 years include publishing results of the buprenorphine study of adolescent/young adult opioid dependent individuals that was a focus of the prior K award, finishing CTN studies in which our group is currently participating, developing CTN studies on the impact of integrating substance abuse interventions in primary care, completing a naltrexone implant study in St. Petersburg Russia and a methadone study Kiev, submitting a R01 to study the impact of naltrexone implant vs. oral naltrexone on adherence to antiretroviral medication in HIV+ heroin addicts in St. Petersburg, developing a study of thrice weekly Suboxone for Subutex addiction in the Republic of Georgia, and a study of Concerta for reducing HIV risk in adolescents with ADHD and marijuana abuse or dependence in Brazil, helping develop guidelines for integrating addiction and HIV treatment in Russia, consulting on a study of methadone maintenance in primary care and a study of implant buprenorphine, and developing a study to assess the impact of offering treatment to opioid dependent persons being released from prison. Current mentees are two VA/NIDA fellows, an INVEST fellow from Malaysia, and a mentee from Tbilisi. Educational activities include supervising a Penn resident, leading case conferences at Penn and the VA, participating in an addiction course for medical students, and working with international collaborators on research topics including study design, implementation, procedures for quality assurance, human subjects protection, writing papers, and facilitating Good Clinical Practice.
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