This is a proposal to designate the Behavioral Pharmacology Research Unit of the Department of Psychiatry and Behavioral Sciences of The Johns Hopkins University School of Medicine as a drug abuse Treatment Research Center. This Center will serve as an institutional, regional, and national resource concerning drug abuse treatment and concerning drug abuse treatment research, and will serve as a major site of scientific research on drug abuse and drug abuse treatment. The Center program will consist of three major elements: (1) clinical research directly supported by Center funds; (2) research and training activities supported through other funding sources, but affiliated with the Center; and (3) core support resources provided by the Center and used to facilitate and enhance both of the preceding elements. The individual research projects in the Center represent a coordinated program of clinical research involving the active participation and collaboration of all of the major substance abuse treatment programs at this institution. Within the Department's methadone maintenance program we will study the prevalence of psychiatric and substance abuse diagnoses and family histories, compare the detection rates of different diagnostic instruments, evaluate the relation of these patient characteristics to treatment response, and test the efficacy of specific pharmacological (antidepressant medication) and behavioral (contingency management) treatments for those patients diagnosed with depression or antisocial personality, respectively. Within the Department's alcoholism treatment programs we will study the prevalence of polydrug abuse and the diagnostic characterization of polydrug abusers, we will test the feasibility of family therapy with these individuals, and we will assess the efficacy of cognitive behavioral treatment of depression and its impact upon polydrug abuse. We will establish a specialty cocaine abuse outpatient treatment research clinic and, in collaboration with the Department of Medicine's inpatient detoxification Center for Chemical Dependency, will characterize the effects of cocaine abstinence/withdrawal and will conduct controlled clinical trials of pharmacological agents of potential utility in cocaine abuse treatment.
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