Kahlert Institute’s 2nd Annual Research Symposium: Focus on New Addiction Treatments, Help for Cravings

The University of Maryland School of Medicine (UMSOM) Kahlert Institute for Addiction Medicine hosted its second annual Research Symposium on May 28, bringing together dozens of researchers and clinicians to share the latest research into the underlying biology and treatment of substance use disorders. 

This year’s symposium — held nearly two years to the day from the establishment of the Kahlert Institute in May 2023 — featured opening remarks by the institute’s new Director, Kelly Dunn, PhD, MBA, and UMSOM Dean Mark T. Gladwin, MD. Gary Aston-Jones, PhD, Director of the Rutgers University Brain Health Institute, and Anna Konova, PhD, Co-Director of the Rutgers-Princeton Center for Computational Cognitive Neuro-Psychiatry, each gave a keynote address.

Sara Whaley, Baltimore City’s first Executive Director of Overdose Response, also presented on the status of Baltimore City's litigation against manufacturers of opioid pain medications and overdose prevention efforts.  

In her opening remarks, Dr. Dunn highlighted the Kahlert Institute’s many accomplishments in two short years — from launching the symposium, to submitting 19 research grants for more than $18 million, to collaborating with the Baltimore City Mayor’s Office on a new overdose prevention program, among others — all of which were made possible through a generous initial $10 million donation from the philanthropic non-profit Kahlert Family Foundation.

The Kahlert Institute’s initial successes serve as an important foundation from which it will pursue its multifactorial mission, which includes discovering and employing innovative new tools to combat an ongoing opioid and drug addiction epidemic, according to Dr. Dunn. 

 “We have a significant gap between the number of people who receive access to treatment and those who need it and achieve recovery through it,” she said in her remarks. “I would argue that this gap exists because innovation is slow in the areas of substance use disorder, especially compared with the treatment of other neuropsychiatric conditions, such as depression.” 

Dean Gladwin also emphasized the importance of driving more innovation in addiction treatments in his remarks, citing the Kahlert Institute’s unique position as a bridge between preclinical and clinical research as providing a new path toward discovery. 

“With 80,000 Americans losing their lives every year to overdoses, we desperately need new therapies that can help bend that curve. The advances in neuroscience and clinical trials at the Kahlert Institute present an enormous opportunity to develop those therapies,” said Dean Gladwin, who is also Vice President for Medical Affairs, University of Maryland, Baltimore, and the John Z. and Akiko K. Bowers Distinguished Professor. “Addiction has been one of the great challenges of mankind. The work you all are doing is one of the most important things that anybody can do in the fields of science and medicine.”

Update on Research Advances in Addiction Medicine

Both keynote addresses explored research that could yield entirely new approaches and therapies for clinicians in the addiction field.

Dr. Aston-Jones shared the work he and his colleagues have conducted on the orexin-hypocretin system, a neurotransmitter system based in neurons in the brain’s hypothalamus. Dr. Aston-Jones presented findings from a range of preclinical studies, adding to the evidence that increased activity in these nerve cells in response to exposure to drugs, or even food, could drive sensations of craving and addictive behaviors. 

He presented evidence suggesting that drugs that block activity at orexin-hypocretin receptors could help treat addiction, or even prevent people from developing addiction if given alongside potentially addictive medications, such as opioid analgesics, when needed for extreme pain after surgery or an acute injury. One such drug, suvorexant (Belsomra), is already approved by the FDA for treating insomnia, and could be repurposed to use in patients in treatment for opioid use disorder, he said. Dr. Dunn has conducted clinical trials with the drug and patients in treatment for opioid use disorder, he added.

“I think in a short period, we're going to see these medications used as the first non-opioid drugs to treat opioid addiction,” Dr. Aston-Jones said. 

Dr. Konova, meanwhile, presented her work with her Rutgers colleagues using fMRI imaging and computational modeling to study states of craving in people with substance use disorders, and how craving interacts with decision making in the brain.

"We need to better understand what happens when a person enters a vulnerable state of craving,” she said, “and hopefully translate this knowledge to generating better intervention targets. 

Dr. Konova showed how her team’s model of states of craving could predict actual drug use by people in treatment for addiction and hopes to organize a future study to test whether the model is useful in the clinic. 

Need to Develop Clinical Assessment of Craving

An important element of evaluating potential new treatments for addiction and symptoms of drug craving is developing a standard assessment, accepted by the medical community, to measure craving, according to Cecilia Bergeria, PhD, an Associate Professor of Psychiatry and Behavioral Sciences at Johns Hopkins University School of Medicine. She shared her work on creating a clinical outcome assessment for craving (The Faceted Opioid Research Craving Assessment for Substance use Treatment, ‘FORCAST’), which has the potential to be the first-ever FDA-qualified patient reported outcome assessment in the field of addiction. The FDA accepted her letter of intent, and Dr. Bergeria has been working on a qualification plan for the assessment involving intensive interviews with people in recovery for opioid use disorder. Conducting the interviews revealed just how difficult it can be to clearly define what different people mean by “craving” a drug, she said. 

“We found that even though some people were reporting no craving, they also reported greater stress symptoms when exposed to images of opioids,” she said. “They’re having some sort of internal cue response, but they are not calling it craving. It may be clinically relevant, and we want to name and measure it.” 

Dr. Bergeria plans to join Dr. Dunn and colleagues at the Kahlert Institute in September as the Matthew Osborne Lead Addiction Researcher. 

Other speakers at the symposium included Jimmy Olusakin, PhD, and Sophia Weber, PhD, both Matthew Osborne Fellows at the Kahlert Institute, as well as David Epstein, PhD, Unit Chief for Real-World Assessment, Prediction and Treatment in the Translational Addiction Medicine Branch of the National Institute for Drug Abuse.