The University of Maryland School of Medicine on Wednesday announced the opening of the Kahlert Institute for Addiction Medicine, which will bring together neuroscientists, clinical researchers and substance use specialists to research the causes and treatment of addiction.
“Substance use touches everyone,” Maryland Lt. Gov. Aruna Miller said in a news conference announcing the institute, and should be treated as a chronic condition that can be managed instead of a personal failure. She said people struggling with substance use often must “suffer in silence” without getting the help they need — only 10% of people nationwide who could benefit from treatment access it, she noted — but the work of the Kahlert Institute and others like it could help to change that.
Dr. Yngvild Olsen, director of the Center for Substance Abuse Treatment at the federal Substance Abuse and Mental Health Services Administration, said the evolution of the opioid epidemic over the last several years — shifting from heroin to prescription drugs, and now to fentanyl and xylazine — has “complicated everything,” requiring new solutions led by the medicine and public health fields.
University of Maryland medical school faculty at the institute will include neuroscientists, studying the brain mechanisms underlying substance use and its lifelong consequences; clinical researchers investigating potential treatment interventions; and substance use disorder specialists who understand the daily realities of caring for patients with complex disorders often involving psychiatric illness, trauma and socioeconomic stressors, according to a news release.
Although the institute has already begun its work, a dedicated space will not open until 2026. It will be housed on a currently vacant floor of the Health Sciences Research Facility Ill on the medical school’s campus in Baltimore, and will include research labs along with space for clinical care and education. In the meantime, work will be carried out in other facilities on campus.
The institute will be jointly funded with $30 million from the Maryland-based Kahlert Foundation, the University of Maryland at Baltimore, and the university’s School of Medicine.
The institute will be co-led by a multidisciplinary team with experience in psychiatry, addiction research and treatment, infectious disease and neurobiology. One of the three associate directors is Dr. Eric Weintraub, a professor of psychiatry at the University of Maryland School of Medicine, who specializes in treating people with opioid use disorder and co-occurring mental health diagnoses.
Weintraub said “our best teachers are our patients,” and that the center plans to integrate its research activities with the substance use treatment services provided at University of Maryland clinics.
He said the struggles of people who “misuse drugs on a daily basis” tend to follow certain themes, such as estrangement from family, unstable living conditions, difficulty working and trouble with the legal system. They often feel “isolated, alone, and full of shame,” he said. Substance use can be complicated by a host of factors that must also be addressed in treatment, Weintraub said, such as psychological trauma and mental health disorders.
Despite the bleak picture, “recovery is possible,” he said.
Dr. Sarah Kattakuzhy, another associate director of the institute, is an associate professor of medicine and psychiatry at the school of medicine who specializes in infectious diseases contracted through intravenous drug use — such as HIV and hepatitis C. She said even some providers don’t realize “people can get better.”
The institute aims to help integrate substance use training into medical school curriculums, specifically with regard to prescribing buprenorphine — a drug used, like methadone, in medication-assisted treatment of opioid users. A recent change to federal law loosens requirements to prescribe the drug and allows any provider registered with the Drug Enforcement Administration to do it.
The University of Maryland Medical Center has six substance use treatment centers in Baltimore, including the Addiction Treatment Center downtown that provides medication-assisted treatment to over 700 patients at any given time, using buprenorphine, methadone or the injectable naltrexone.
After skyrocketing nationwide in 2020, overdose deaths from any drug saw more modest increases in 2021, the last year for which data is available. Total overdose deaths increased by about 3% in Maryland — from 2,076 to 2,129 people — in the last three quarters of 2021 compared to the same time period in 2020. Opioid deaths comprise the majority of total overdose deaths, and rose from 1,865 to 1,904 — an increase of 2% — over the same time period.
Over the long term, drug overdose deaths in Maryland more than doubled between 2015 and 2020, from from 21 deaths to 44 deaths per 100,000 people, according to the Kahlert Institute’s news release. In Baltimore City, 964 deaths were attributed to opioid overdose in 2020, nearly triple the number of deaths from homicide, the release said.
The institute will research all forms of addiction, not just to opioids, said Kattakuzhy, as the disease is “neurobiologically consistent” across its many manifestations. Weintraub said they may study the epidemiology of gambling addiction in the future.
The impending legalization of cannabis in Maryland, combined with the dearth of research on its effects, presents an opportunity for the Kahlert Institute to contribute its expertise, Kattakuzhy said. A major area of focus should be studying the impact of cannabis on youth, though more data is needed overall, she said, even on simple measures such as prevalence of cannabis use, the proportion of medical use versus recreational, and the age distribution of users.
Ultimately, the Kahlert Institute’s goal is to expand the scientific and clinical evidence base on addiction so that evidence can be used to guide government policy decisions, Kattakuzhy said, to ensure they will be effective in helping people struggling with addiction and their families. Policy should always be evidence-based, she said.