Alcohol use disorder remains a major public health concern, with persistent disparities in treatment outcomes. Traditional interventions often fail to account for the heterogeneity of drinking triggers, limiting their effectiveness. This study aims to develop and evaluate an idiographic, mobile-based clinical tool to identify personalized triggers for alcohol use. Idiographic methods allow for individualized assessments of momentary risk factors, providing tailored insights into when a person is most vulnerable to drinking.
The study will allow for customization of a given participant’s data collection process, such that individuals can track what is clinically meaningful to them (e.g. one individual may track feelings of loneliness following divorce, while another may track experiences of racial microaggressions) through diverse data collection techniques including ecological momentary assessment (EMA), audio diaries, and GPS. We will evaluate the feasibility and acceptability of this approach by pilot testing the data collection process, analyzing each participant’s data, and providing personalized feedback on the momentary conditions that influence one’s drinking.
This approach leverages current advances in mobile monitoring and precision idiographic machine learning analysis to pilot a novel clinical tool. If successful, this tool could enhance treatment equity and effectiveness by empowering individuals to recognize their unique drinking triggers.
Targeted Condition: Substance use disorders/misuse
How fentanyl changes the brain: assessing mood, cognition, and withdrawal using animal models of addiction and brain-wide neural activity markers
Fentanyl overdose is responsible for nearly 75,000 deaths each year in the U.S. and causes severe psychological, physical, financial, and social harm. Despite existing treatments, fentanyl addiction remains difficult to overcome due to the chronic and complex nature of fentanyl addiction which contributes to patterns of chronic use and high relapse rates. This is partly due to fentanyl’s ability to rewire the brain’s reward and executive cognitive system to cause lasting changes in mood and cognition while also triggering intense withdrawal symptoms that drive continued use. To better understand the widespread impact of fentanyl on the brain, this project uses mouse models of addiction to explore the effects of fentanyl on various brain regions and neural populations involved in reward, motivation, mood, and cognition. Using artificial intelligence-guided behavioral and cellular analyses, we then correlate these neural signatures to mouse behaviors during withdrawal and a cognitive working memory task. We will then test whether two promising emerging treatments, semaglutide and ketamine, can improve cognition, withdrawal symptoms, or mood in mice exposed to fentanyl. Through this, we will contribute to our understanding of how fentanyl exerts its negative effects which can inform the development of more effective therapies for its devastating impact.
Substance Use Disorder assessment tools in jails & prisons: a systematic review
Over 65% of people who are incarcerated have a substance use disorder (SUD). Many jails and prisons provide substance use treatment, including behavioral and pharmacotherapy, and SUD identification is the first step. Prisons and jails are a distinct setting for SUD assessment, and tools used for SUD screening in community settings may not perform the same way in carceral settings. This systematic review will identify psychometric evaluation studies in carceral settings of screening and diagnostic tools for SUDs, generally, or specific SUDs (excluding alcohol and nicotine). Additionally, will use and adapt an existing clinical usability scale and develop new metrics to assess acceptability of screening tool use in carceral settings for a person-centered evaluation. This will be guided by further analysis of interviews with prison staff and people with lived experience of incarceration. The additional assessments will capture potential barriers and facilitators to SUD assessment in jails and prisons as they represent resource-limited settings with unique challenges compared to other health systems. The goals for the study are: 1) to help carceral facilities make informed decisions about SUD assessment, 2) to reveal key gaps in the literature, and 3) to inform the development and testing of future tools.
Brain, Environment, and Alcohol Research (BEAR) Study
This project examines how brain responses to alcohol cues interact with everyday social contexts to shape drinking in young adult heavy drinkers. We pair multimodal neuroimaging (fMRI, EEG) with a 2-week ecological momentary assessment including transdermal alcohol monitoring and photo-based context capture. We test whether neural incentive salience predicts real-life intoxication, how social features (group size, familiarity, gender mix) influence drinking, and how perceived norms mediate these effects. We further assess whether incentive salience moderates context and norm influences. Findings will refine models of alcohol use disorder etiology and inform prevention and intervention strategies by linking precise brain markers with ecologically valid, context-rich assessments.
Improving treatment strategies and clinical outcomes in patients with first-episode psychosis and substance use disorders
Our project will seek to identify factors associated with gaps in transitions of care for psychiatric inpatients who presented with substance-induced psychosis (SIP) for the first time. We will analyze historical electronic health record data of patients who were treated for psychosis at Harborview Medical Center. We will test the hypotheses that (1) treatment with long-acting injectable antipsychotics (LAI) and referrals to outpatient behavioral health are lower for patients diagnosed with first-episode SIP compared to those diagnosed with first-episode psychosis and that (2) patients diagnosed with first-episode SIP will have worse post-discharge outcomes (rehospitalization, ED utilization), in part due to lower use of LAI.
Optimizing telemental health with live artificial intelligence clinical scaffolding and feedback
This project aims to develop a clinical scaffolding system to enhance telemental health care by providing real-time coaching and actionable suggestions during video-based sessions. Modeled after live supervision methodologies, it supports clinicians by identifying intervention targets and offering text-based coaching prompts to guide care. Unlike automated chatbots, this approach enables clinicians to adapt suggestions to patient needs, balancing automation with oversight for safer AI-supported mental healthcare. The proposed in-session support will facilitate efficient implementation of strategies and clinician skill development. This project seeks to enhance data privacy by processing all data on-device and avoiding external data transfers.
GATHER: Growing a Tribal Healing Effort through Research
The GATHER initiative aims to: 1) Coordinate a national research network to support tribally led research on etiology and prevention of overdose, substance use, mental health, and pain management. 2) Provide administrative support and shared resources to facilitate the successful completion of N CREW research projects. 3) Provide an administrative infrastructure, intellectual environment, and access to resources and initial support for investigators. 4) Provide research training and access to subject matter experts for investigators, staff, and students in the areas of cognitive, motivational, and behavior therapies, Indigenous approaches to research and healing, and multimodal holistic approaches to prevention and treatment. 5) Serve as a local, national, and international resource for dissemination of information and training to reduce risk in diverse tribal and urban Indian populations.
Once-weekly GLP-1R agonist dulaglutide for treatment of fentanyl use disorder and modulation of lateral habenula activity in male and female rats
Current pharmacological treatments for fentanyl use disorder, primarily opioid replacements, have proven insufficient to stem the tide of fentanyl related suffering and deaths. Novel pharmacotherapies are desperately needed, ideally ones that are non-opioid, highly convenient, and produce minimal side effects. One promising class of drugs that meets these criteria are glucagon-like peptide 1 (GLP-1) receptor (GLP-1R) agonists. Endogenous GLP-1 is released in response to food intake, but GLP-1Rs are present in many tissues throughout the body, including brain regions involved in addiction. Early studies have shown GLP-1R agonists may reduce drug seeking. Here, we aim to determine if the long acting GLP-1R agonist dulaglutide, given once weekly, can reduce fentanyl SA for a substantial period of time (3 weeks), even after SA has been established.
Determining if activity in specific lateral habenula output pathways motivates avoidance of synthetic opioid withdrawal or cue induced reinstatement
Fentanyl abuse has reached epidemic proportions in the United States and is responsible for more than 70,000 overdose deaths each year. Avoidance of significant physical and emotional turmoil during withdrawal and exposure to drug-associated cues are two key deterrents to voluntary abstinence in those suffering from substance abuse disorder. By investigating the localized neuronal projections responsible for motivating avoidance of withdrawal, and processing reward cues, we may be able to produce targeted pharmacotherapies or genetic therapies to improve the rate of voluntary abstinence.
Default mode network impairments in comorbid anxiety and cannabis use disorders
Social anxiety disorder (SAD) is characterized by maladaptive self-focused attention (SFA), which itself is correlated with large scale brain network connectivity impairments. Cannabis use disorder (CUD) is commonly conceptualized as impaired reward processing within the ventral dopaminergic network, however, it is also implicated in connectivity disturbances in other critical cortical circuits. In the current study we will characterize the large scale brain network impairment in comorbid SAD and CUD given commonly overlapping symptoms and population prevalence
