The focus of my scholarly work has been within the field of substance use and addiction, and the neurobiological and behavioral correlates that predispose individuals to use, and to recovery. Of those 12 and over in the US, nearly 49 million individuals meet the criteria for a substance use disorder (SUD), 30 million of which are specific to alcohol, and 6 million for opioids. Certainly, these numbers are considerable yet represent a fraction of the cumulative number of individuals that have tried illicit substances (139 million), drank alcohol (219 million), or filled a prescription for an opioid (13 million). My question has always been: why do some individuals go on to develop substance or alcohol use disorder, when so many individuals can maintain casual or moderate use? In short: why do some brains become addicted, while others do not?

Answering the questions that help us understand how substance use can progress from experimental to compulsive encompasses a multitude of environmental, social, pharmacological, and neurobiological factors for consideration. For example, we know the various environmental factors are associated with a greater likelihood of developing a substance use disorder: having a first order relative with a history of substance abuse, easy access to substances, and initiating use at a young age. Even when controlling for the aforementioned, we still observe differences in individual response to substances and their future use. Understanding how the neurobiology of individuals contributes to their experience with substances and subsequent behavior is of utmost importance in the development of interventions and treatment.

As a behavioral pharmacologist, I have focused on investigating brain areas and receptor types associated with the response to drugs and the behaviors associated with reward and compulsion. Behaviorally, individuals who abuse substances often exhibit impulsive behaviors, and have difficulty perceiving cues to stop use (both acutely and chronically). These behaviors can be decreased or exaggerated when certain prefrontal areas of the brain are affected, and when specific receptor subtypes are blocked or stimulated. However, what remains unclear is whether the impulsivity itself contributes to the initiation of substance use or arises as a result of use. Using pharmacologic and molecular techniques, we can investigate the role of brain areas and receptor subtypes associated with impulsivity in both humans and animals to answer this question. I am particularly interested in the function of the dopaminergic system in reward, the overlay between the GLP receptor system and reward pathways, and the use of pharmacologic management to treat substance use and other addictive behaviors.

In addition to understanding the neuropharmacological aspects of impulsivity and reward, I also am interested in applying that information to the field of recovery science to understand how some individuals with SUD can stop using, when others try and fail repeatedly. To do so, I investigate the tenets of behavior, personality, attachment, empowerment, community, and trauma on initiation of treatment/recovery and the accumulation of recovery capital. I seek to identify factors that predict successful recovery, whether or not that involves abstinence from the substance of choice. I seek to understand the application of medication-assisted treatment (MAT) to recovery, and how MAT can interface with typical abstinence-based recovery programs. I believe everyone truly operationalize recovery as restorative justice, we need to bridge the gap between traditional recovery structures and MAT, increase access to harm reduction tools and education, and eliminate stigma in SUD treatment.