Heroin use and abuse are increasing, leading to the reemergence of opioid dependence as a significant clinical and public health problem. This application for a mentored clinical scientist development award aims to enhance the developing research skills of Eric D. Collins, M.D., by focusing on several approaches to testing treatment strategies for opioid dependence. Dr. Collins, a Board Certified psychiatrist, is a research fellow the Division on Substance Abuse at Columbia University/New York State Psychiatric Institute (NYSPI). As a fellow, Dr. Collins has begun studying heroin self-administration by humans. In the next several years, he plans to utilize laboratory models for heroin self-administration in combination with clinical treatment trial to find answers to treatment questions that arise out of research and clinical experience. In this way, Dr. Collins will be well prepared to achieve his long-term career goal of becoming a clinical research scientist able to move between the laboratory and the clinic. Under the sponsorship and guidance of Dr. Herbert Kleber, together with the resources available at Columbia University, Dr Collins will be able to achieve these goals. His training plan not only includes formal course work but draws on the experience of several preceptors, both at Columbia and elsewhere. Training is planned specifically in several areas: methodology of clinical treatment trials; laboratory modelling of drug self-administration; specific psychosocial treatments for substance abuse disorder pharmacology and pharmacokinetic analyses; and biostatistics and epidemiology. The Division's center grant, """"""""Novel Medication Approaches for Substance Abuse,"""""""" will provide much of the necessary funding to enable Dr. Collins to carry out his research plan. That research plan specifically includes the following: a laboratory study of the effects of naltrexone on heroin self-administration; double-blind clinical treatment trials comparing naltrexone precipitated detoxification with buprenorphine as intermediary detoxification agent for transition to naltrexone maintenance; and an open trial combining naltrexone maintenance with relapse prevention/coping skills training. Taken together, the proposed plans provide Dr. Collins with the broad and unique expertise he requires to build a clinical research career aimed at developing new treatments for opioid dependence specifically as well as substance abuse disorders generally.
