Impact on Society
Substance use disorders produce enormous suffering and are caused by both environmental and genetic factors. The effects are felt worldwide, in all societies. Economic losses due to substance use disorders are greater than those caused by cancer, AIDS, or heart disease. Lost productivity, the burden on the health care system, and other factors caused by alcohol, tobacco and illicit drugs are estimated to cost the U.S. $600 billion annually. The emotional stress on family members and friends of the afflicted is incalculable. Alcohol and other drugs have been implicated as factors in this country's most serious and expensive problems, including family violence and HIV/AIDS.
In 2017, there were an estimated 18.7 million people in the U.S. who suffered from a substance use disorder 1. Among these, alcohol use disorder was the most common, afflicting 15.1 million people. Despite this high prevalence, federal support for research on alcohol use disorder is the lowest for any major public health problem. Research in this field has the potential to impact not only the lives of those afflicted, but also their family members - an estimated 126 million Americans.
Establishment of the Center
Dramatic scientific advances over the past two decades have revolutionized our understanding of substance use disorders. Foremost among these developments is the clear understanding that these disorders are treatable diseases of the brain. This realization has energized greater efforts to understand the biological causes of substance use disorders and discover new treatments. The Waggoner Center for Alcohol and Addiction Research was created to research these neurobehavioral disorders. Established in 1999 as an organized research unit of the College of Natural Sciences at The University of Texas at Austin, the Center was made possible by a generous gift from M. June and J. Virgil Waggoner and matching university funds.
Experienced investigators from the College of Natural Sciences, College of Liberal Arts, Cockrell School of Engineering, Dell Medical School, Hicks School of Social Work, and the College of Pharmacy explore alcohol and drug actions at the molecular, electrophysiological and behavioral levels. Collaborations with engineers and scientists who are not currently alcohol researchers allow the development of new tools and research approaches not possible in any one laboratory. Clinical researchers explore the relationship of substance use disorders to comorbid conditions like depression and bipolar disorder.
New gene sequencing technology (NexGen RNA-Seq) allows us to measure changes in the activity or expression of thousands of genes. Waggoner Center labs are using this rapidly evolving technology to determine gene expression changes in humans with alcohol use disorder and in animal models of addiction. This information is being used in conjunction with online databases to identify approved drugs that could be repurposed for treating substance use disorders. This work has identified neuroinflammatory pathways as being especially important in alcohol dependence. This finding has led to testing of approved anti-inflammatory agents, such as phosphodiesterase inhibitors as potential treatments.
To prevent or reverse the process of addiction, investigators research the molecular targets responsible for drug actions on brain cells. Center researchers examine potential targets in test tube assays as well as in experimental animals with genetic changes in key molecules. This information will be useful in designing novel therapeutic approaches to addiction.
The Food and Drug Administration (FDA) has approved disulfiram, naltrexone and acamprosate for the treatment of alcohol dependence, but none of these medications has shown strong, consistent effects in clinical trials. For opioid use disorder, the FDA has approved methadone, buprenorphine, and naltrexone, which all have significant drawbacks. Methadone must be administered in special licensed facilities and carefully tapered to avoid severe opioid withdrawal. Since buprenorphine is a partial agonist and naltrexone is an antagonist, they can induce withdrawal symptoms. For smoking cessation, the FDA has approved nicotine replacement, bupropion and varenicline. Varenicline is the most effective of these, but its use is limited by side effects such as insomnia, irritability and gastrointestinal symptoms. No medications have yet been approved for psychostimulant or cannabis use disorders. Therefore, there is a need to develop new medications. Given this need for more effective treatments, the Center uses emerging research in addiction neurobiology to identify new candidates for medication development.
Training Future Scientists
Progress in addiction research requires education and focused training of future scientists in state-of-the art approaches to the problem. Members are committed to this endeavor, developing new courses in the neurobiology of substance use disorders for undergraduate and graduate students. Additionally, the University has designated substantial endowment funds to train graduate students in this research field. In the long run, this may have the greatest impact of all of our programs.
1 Substance Abuse and Mental Health Services Admin., 2017 National Survey on Drug Use and Health. https://www.samhsa.gov/data/nsduh/reports-detailed-tables-2017-NSDUH