This is a proposal for a Mentored Clinical Scientist Development Award to provide supervised experience in clinical research, didactic education, and some clinical activities. This will provide a foundation for a career in academic medicine with opportunities for research, teaching, and some clinical practice. This award will allow the candidate to begin research in substance abuse treatment and Health Services Research (HSR) in a supervised setting. The effects of symptom-triggered therapy versus scheduled dosing for acute withdrawal from alcohol will be studied in a general medical population. The first two years of the award period will be spent taking graduate courses in biostatistics, pharmacology, research design and methodology, attending seminars on HSR topics, and refining the final study protocol by doing a pilot study. Practical clinical experience will be gained in outpatient clinics including rotation through community programs such as a local methadone maintenance clinic, a residential center for pregnant and newly delivered women and their young children, and inpatient substance abuse services in a large urban teaching hospital. Symptom-triggered therapy with benzodiazepines is the treatment of choice for alcohol withdrawal. It has not been studied in a general medical population. Patients admitted to two general medical wards will be assigned as randomly as possible to symptom-triggered or scheduled therapy for acute alcohol withdrawal. They will be regularly assessed by a clinical assessment tool to evaluate its applicability in this population. Data will be collected on concurrent medical problems, total dose of medication for withdrawal, duration of treatment, complications, length of stay, and recidivism. The medication protocols will be evaluated in terms of acceptance by nurses and physicians, especially housestaff. The data will be evaluated from a HSR standpoint to help determine the most cost-effective regimen for acute drug withdrawal in a general medical population.
| Weaver, Michael F; Hoffman, Heather J; Johnson, Robert E et al. (2006) Alcohol withdrawal pharmacotherapy for inpatients with medical comorbidity. J Addict Dis 25:17-24 |
