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

Willow Study

The goal of this study is to understand the impact of stigma on mental health and recovery from trauma in different parts of the country.

NIDA Clinical Trials Network: Pacific Northwest Node

The NIDA Clinical Trials Network (CTN) is a means by which medical and specialty treatment providers, treatment researchers, participating patients, and the National Institute on Drug Abuse cooperatively develop, validate, refine, and deliver new treatment options to patients. The Network consists of 16 regional Nodes, including the Pacific Northwest Node located at the UW Addictions, Drug & Alcohol Institute.

Project RELATE

The present study seeks to significantly expand our understanding of alcohol and cannabis co-use behaviors in the context of young adult romantic relationships through collecting daily dyadic quantitative data and qualitative interviews, and using this information to develop and pilot an integrated brief intervention to decrease alcohol and cannabis misuse and increase healthy relationships skills among this understudied, high-risk group.

Partnering with the Quinault Indian Nation to develop a community-based contingency management intervention

Indigenous knowledge remains strong in American Indian/Alaska Native (AI/AN) communities despite colonization, postcolonial efforts to assimilate and eradicate AI/AN people, present-day inequities and structural racism. Despite strength and resilience, AI/AN populations have high rates of unintentional overdose and death by suicide. There is an urgent need for evidence-based, culturally responsive approaches to increase protective factors against substance use and mental illness in AI/AN communities.

This study is a partnership between University of Washington researchers and the Quinault Indian Nation’s behavioral health providers and community. We will design a culturally adapted community-based contingency management intervention to increase positive reinforcement for adolescents and young adults at risk for substance use and mental illness. This intervention will focus on community identified target behaviors rather than abstinence. By prioritizing the needs of the community we will develop an intervention that is effective, usable and sustainable.