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TRANSLATIONS : Not “One Size Fits All”

News from the Johns Hopkins Department of Psychiatry and Behavioral Sciences

Dr. Eric Strain
Dr. Eric Strain

The fact that Hendree Jones sorts out the effects of buprenorphine for heroin-dependent pregnant women and their newborns is typical of Hopkins’ response to the miseries of addictive drugs, says psychiatrist Eric Strain.  (See 'Rock Bottom' article)

Strain, a specialist in addictions and pharmacology research, has conducted key studies with buprenorphine as well as other medications for treating substance abuse. His current work on a prescription pain drug, for example, not only checks its potential for abuse; it also explores possibilities that the weak opioid might, by its mildness, become a replacement therapy for people with low-level addiction. Both scientists’ research reflects Hopkins’ commitment to greater variety in treating drug dependencies—one that has encouraged studies ranging from the usefulness of voucher-based rewards to clinicians’ attitudes during counseling. “It’s not a one-size-fits-all world,” says Strain.

Nationwide, variety is slow to catch on. Yet though methadone has been a part of opioid dependence treatment at Hopkins from the early days—this year marks the 40th anniversary of its appearance as therapy—the search for alternatives here is entrenched. “With NIDA support, for example, work to develop buprenorphine took place in Baltimore,” Strain says. Studies on dosing, optimal circumstances for its use, safety, efficacy and pharmacology all happened here.

Today, researchers like Jones are still teasing out methadone’s fine niches of use compared with buprenorphine’s. New versions of the latter, such as the depot-forms (they’re longer-lasting and injectable) may soon undergo testing.

“The years have made us strong on infrastructure, on expertise,” Strain adds. That plus the Hopkins/Baltimore access to special populations—the unemployed drug-dependent patients Ken Silverman studies or those ill with other psychiatric disorders—makes helping everyone more likely.

Find other Hopkins Newsletter articles from past issues.