TEAMING UP ON SUBSTANCE ABUSE
are highly comorbid—that is, medical conditions that have a high likelihood of existing simultaneously.
PTSD AMONG VETERANS Among the general population, current rates of PTSD are estimated to be between 3.5 and 8 percent. In comparison, a large- scale investigation of 88,000 veterans serving in the Iraq war found that 12 percent had symptoms of PTSD soon after deployment and 17 percent had symptoms of PTSD at six months post-deployment, which is more than twice the civilian rate.
Along with the current effects of PTSD, approximately 25-30 percent of veterans who served in the Iraq and Afghanistan conflicts may have suffered a mild trau- matic brain injury. Evidence indicates that the prevalence of alcohol and other substance abuse disorders from these recent conflicts in veterans with TBI is
approximately twice that of veterans who did not suffer TBI.
Te “warrior ethos” of the military, which may make some service members reluc- tant to admit to either mental health or substance abuse problems, can make military personnel less likely to seek help when it’s needed, Santullo said. This challenge has to be taken into account in order to reach the military population that needs help.
Te ASADRP is conducting its research at U.S. Department of Veterans Affairs medical centers, as well as military substance abuse treatment centers at Fort Gordon, Georgia, and Naval Medi- cal Center San Diego. By conducting research at these military-specific loca- tions, the program is able to access the appropriate populations and ensure rele- vant, impactful research.
A BIG-PICTURE APPROACH
“Te current services offered to veterans do not adequately address co-occurring substance abuse disorders and PTSD, and there is an immediate need for the development of novel, evidence-based treatments,” Santullo said. “Our goal here is to explore new opportunities address- ing alcohol and substance abuse disorders, especially related to TBI and PTSD.”
BRINGING SOLUTIONS TO THE TABLE
Peer and programmatic review panels include scientists, clinicians, consumers from advocacy communities and members of the military. Consumers serve as full voting members and play a major role in ensur- ing that a program continues to focus on research with the potential to make a signifi- cant impact. (Image courtesy of the author)
To achieve this goal, the ASADRP has invested in multidisciplinary teams of leading expert scientists and clinicians, in the form of consortia partnerships. One such partnership is the Pharmacotherapies for Alcohol and Substance Abuse (PASA) Consortium, a collaborative effort with 10 research institutions aimed at bring- ing new medications to market to treat alcohol and substance use disorders, with a special emphasis on TBI and PTSD in service members and veterans.
This team-based research approach aims to identify promising compounds for use as pharmacotherapies; conduct proof-of-principle research to determine which compounds are most appropriate for human trials; and conduct human proof-of-concept trials with the prom- ising compounds, in order to ultimately provide functional medication to patients.
“Te PASA consortium has released three rounds of funding opportunities and five studies are funded: two preclinical discov- ery studies and three proof-of-concept trials,” said Dr. Rick Williams, PASA principal investigator with RTI Inter- national.
Four medications are in preclinical tests for alcohol use disorder and PTSD: doxazo- sin, developed to treat high blood pressure; zonisamide, an anti-seizure medication; ASP 8062, developed to treat fibromyal- gia; and CERC 501, developed to treat depression and substance abuse disorders. Tree other compounds are undergoing clinical review: PT 150, developed to treat alcohol abuse; naltrexone, used to treat substance abuse disorders; and buprenor- phine, developed to treat opioid addiction.
“We have actively cultivated pharmaceuti- cal company partners who have excellent compounds for alcohol and substance use disorders or PTSD available but need the complement of experts, which the PASA consortium provides, in order to complete human studies to the U.S. Food and Drug Administration’s (FDA) standards,” Williams said.
“Our initial partnerships started with small companies, but our successes in just the last two years have progressed to larger- scale partnerships with companies that can afford to conduct FDA Phase III stud- ies and prepare new drug applications, if our Phase II studies show efficacy,” he said.
56 Army AL&T Magazine January-March 2019
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