Alcoholism is a multifaceted disease with many different etiologies. This probably explains why no single approach to treatment has been universally successful. Clearly, more research is needed. The Medical University of South Carolina (MUSC) is uniquely qualified to fulfill this need, but it requires the resources provided by an Alcohol Research Center (ARC) in order to realize its potential. A Center mechanism permits an institution to embark on a thematic research program by providing an infrastructure which encourages a blending of scientific talents. While clinical research is the most common treatment research approach, advances are more likely to be achieved when clinical research is complemented by animal research. This application for an ARC at MUSC has afforded the opportunity to bring the disciplines of psychiatry and experimental psychology together along the treatment research theme. A total of five research components are proposed, along with four core components that support the research infrastructure, the ARC's education/training mission, or provide support for three pilot projects from young psychiatric researchers. The thread that ties all the research components together is pharmacotherapy. Psychiatric comorbidity represents a secondary area of expertise as well as research interest of some of the faculty. The thematic approach of the proposed ARC is a multidisciplinary one. The projects are interdigitated. Research components #2 and #4 involve medical management of alcohol withdrawal in humans and animals, respectively. Research components 1, #3, and #5 involve evaluation of pharmacologic agents that affect the serotonin and/or opiate systems in humans, or animals, respectively. The approaches and models being employed are applicable to studies of other agents, as well. Thus, the MUSC ARC would be well positioned to evaluate compounds first in animal models, and then in clinical trials. Such an integrated and concerted """"""""bench-to- clinic"""""""" strategy is certainly needed toward achieving the ultimate goal of developing and successfully implementing effective treatment. Further, it is likely that the best therapy will be derived from multidisciplinary and interdisciplinary approaches, and not just from medications alone. Given that matching patients to treatments based on individual psychological or psychiatric characteristics may have more promise than standard homogeneous approaches to improve treatment outcome, it seems like a Center with focused basic and clinical research in this area is sorely needed. MUSC has the dedicated research talent, administrative support, and physical space to be such a Center.
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