‘Think Science: Let’s take about addiction’ held Monday at UT Health San Antonio

Substance-use disorders, recovery and impact of the Be Well Institute among topics discussed

An enthusiastic audience of colleagues, volunteers, students and members of the public turned out Monday night for the Texas Public Radio's "Think Science: Let's talk about addiction" live question-and-answer event held in partnership with The University of Texas Health Science Center at San Antonio at the Joe R. and Teresa Lozano Long School of Medicine campus Pestana Lecture Hall.

TPR moderator Nathan Cone started off the event by sharing some startling statistics about the tragic impact of substance-use disorder on the state of Texas:

• From 2017 to 2021, drug-poisoning deaths doubled in the state.
• San Antonio's Bexar County was in the top three counties in the state for drug-poisoning deaths in 2022, mostly due to methamphetamine, heroin and fentanyl.
• Five people die each day in the state from fentanyl poisoning.

"It's clear we are in the midst of a crisis involving both illegal and prescription drugs," Cone said.

UT Health San Antonio has launched a program to address the crisis with high-quality, evidence-based approaches grounded in compassion, built on science and improved by technology.

Expert panelists for the discussion were Jennifer Sharpe Potter, PhD, MPH, vice president for research and founding director of the Be Well Institute on Substance Use and Related Disorders; Van L. King, MD, medical director of Be Well, Texas, and professor in the Department of Psychiatry and Behavioral Sciences; and Brett Ginsburg, PhD, director of the Biochemical Pharmacology Analytical Laboratory (BPAL) and professor in the Department of Psychiatry and Behavioral Sciences.

Ginsburg has conducted basic research on substance-use and alcohol-use disorders for more than 30 years. He gave an overview of some of the forward-thinking research his lab is undergoing around substance-use and alcohol-use disorders.

One of his current projects is researching a biomarker that can determine if a person has been drinking alcohol over the past several weeks. While there are breath and blood tests to determine very recent alcohol use, the alcohol leaves the body within a few hours and can no longer be detected. The identified chemical biomarker is present after someone drinks and remains detectable weeks later. This chemical biomarker is helpful for research projects related to alcohol-use disorders as well as clinical and medicolegal uses because the biomarker will gradually decrease over time as drinking decreases.

A second project pays individuals for drinking less. This surprising technique, called contingency management, is highly effective, Ginsburg said.

"We can reward them for drinking less and hopefully over time they learn new habits, new behaviors, new outlets and that can be sustained over time," he said.

Another project that Ginsburg was recently granted funding for through the Wellcome Leap program uses transcranial magnetic stimulation to reduce alcohol intake. The non-invasive treatment places a high-powered magnet near a person's head to stimulate specific parts of the brain thought to be involved in the desire to drink alcohol.

This study is also examining brain imaging as a noninvasive biomarker of substance-use cravings and potential for return to drug use. This research could determine which individuals are more vulnerable to a recurrence of drug use and may benefit from additional support.

"The common theme here is that we like to work with other groups, other experts, because only by bringing in many areas of expertise are we going be successful in tackling this complicated problem," Ginsburg said.

King said it was his great fortune to become a part of the Be Well Institute for Substance Use and Related Disorders when Potter began forming it about four years ago.

"It has generated this incredible range of services that is statewide and that we are continuing to develop," King said.

The Be Well Institute aims to treat all types of drug and alcohol problems in an outpatient setting with low-barrier, evidence-based approaches. Low barrier refers to providing services with the fewest difficulties, he explained. This could mean financial assistance for treatment or medications, transportation assistance to appointments, along with maintaining relationships with agencies like the San Antonio Fire Department and area hospitals for rapid referral to treatment after interactions with people with a substance-use disorder. The evidence-based approach means everything they do is backed by research, providing the highest likelihood of success for people with substance-use disorders.

King said the services they offer continue to expand based on needs in the area and the state. They recently hired an adolescent substance-use expert who will begin in the fall and allow the Institute to offer adolescent and young adult services for the first time for this underserved population.

Potter said she enjoys working in mental health and substance-use disorders because she gets to see people who have struggled and then recovered from these conditions. Universities like UT Health San Antonio have three missions she said - research, education and service. Part of that service, Potter said, is public health service.

Five years ago, she was discouraged that solutions to address substance-use disorders based on decades of robust science were not being implemented. Soon after this, Potter said the Texas Department of Health and Human Services (HHS) contacted her to help them bring evidence-based solutions to Texas. The Be Well Institute, she said, provides a platform to continue to invest in and elevate science, education, clinical and public health service to help people.

What is substance-use disorder?

King said the simplest definition of substance-use disorder is when a person is using drugs or alcohol, and it creates a problem in their life. He said at Be Well, they consciously do not use the term "addiction" because of the stigma surrounding this word.

"We make an intentional choice to be stigma-free in the way that we operate because stigma is one of the major barriers and reasons why people do not talk about substance-use disorder, and why people do not come forward for help," he said.

San Antonio and substance-use disorder

Potter said substance and alcohol use in San Antonio appears to be similar to national trends. Fentanyl is a rising concern and Texas does not currently allow drug-supply testing. Anyone using illicit drugs is at risk of taking fentanyl unknowingly because it is being added to counterfeit medications and other drugs. Methamphetamine is also a significant issue in the city. Alcohol and marijuana use continue to be of concern as well.

Works well with others

The Be Well Institute works with HHS and other agencies across the state to distribute federal funding for resources wherever they are needed.

"Our job is to shepherd those dollars and responsibly navigate them to community resources," Potter said.

She lauded the great work of their peer-recovery network that allows them to be a 24-hour program with someone available to answer the phone at any time.

There is no wrong door to enter recovery, Potter said, and they work with each individual to create the treatment plan that works best for them.

While many services are offered at the Be Well Clinic, other times they work with agencies to bring the services where they are needed. Corazon Ministries, a nonprofit organization, provides meals, hygiene kits, healthcare services and more to the city's unhoused population. Be Well recently received funding to begin a mobile medical team that will focus on helping unhoused people in central San Antonio.

Question: Where does technology fit in?

Cone invited audience members to ask the panel questions. The first question was about the use of technology, especially artificial intelligence, in this field.

Ginsburg said there is research into telephone technology for pinging or geofencing (with a person's permission) to alert a person about locations that could trigger urges to use drugs or alcohol. Technology is also assisting research through the ability to compile a massive data bank from the Wellcome LEAP project his team is working on, as part of an international consortium. Researchers from all over the world are working on related topics and projects in the areas of substance-use and alcohol disorders. This information can be leveraged to improve the way health providers diagnose and treat these conditions.

King noted mobile apps that Potter and the Be Well Institute are currently researching. One is for people in early opioid recovery, where individuals can input symptoms and the app software will learn about the individual and provide targeted feedback. Another application uses chatbot technology to assist people in determining whether they might be experiencing problems with substance use and provides constructive feedback.

Potter added that the goal, when using this technology, is figuring out how to use tools on the AI (artificial intelligence) continuum to promote an engaging and informative experience.

Cone wrapped up the evening by asking each of the panelists to discuss what they are looking forward to in the future for their research or programs.

Ginsburg said he aims to continue research into the physical and behavioral aspects of how some people successfully recover from substance- or alcohol-use disorders.

"What we are learning is that recovery changes the way the person responds to those things that used to be triggers, so those things that might have promoted a drug-seeking response or return to drug use no longer do," he said.

He added that even if there were a drug that eliminated the craving for these substances, the person would still have to find a way to lead a substance-free life.

"Learning how to optimally use these medications to help reduce some of the physiologic hallmarks of substance-use disorders, and how to strengthen their behavioral repertoire so that they can learn to live without the substances. That's my hope for the future is that we get better at understanding how to improve recovery for people," Ginsburg said.

King said he hopes to continue developing and expanding the Be Well Clinic to increase capacity and expertise to help more people both in San Antonio and across Texas.

Potter said there is still a great deal of work to do because many people are not ready for the help available to them.

"When people are not ready, when they are not at that moment, when they are not ready to connect, is when we lose them," she said.

Potter said the goal is to have a resilient system in place so that when a person is ready - whether it be the first, second or sixth time - they are there to help.

The Think Science: Let's talk about addiction event is available for listening at https://www.tpr.org/tags/think-science.

For more information about the UT Health San Antonio Be Well Institute visit https://bewelltexasclinic.org/ or call 888-85-BeWell (3935). The Institute is located at 5109 Medical Drive, fourth floor.

Public link

Please use the above public link if you want to share this noodl on another website.