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Addiction Researchers Receive Institute of Medicine's 2010 Sarnat Prize in Mental Health
Oct. 11, 2010 -- The Institute of Medicine today awarded the 2010 Rhoda and Bernard Sarnat International Prize in Mental Health to two scientists -- Eric J. Nestler, the Nash Family Professor of Neuroscience, chair of the department of neuroscience, and director of the Friedman Brain Institute at Mount Sinai School of Medicine; and Charles P. O'Brien, the Kenneth Appel Professor of Psychiatry and vice chair of psychiatry at the University of Pennsylvania School of Medicine -- for their complementary achievements in addiction science. The Sarnat Prize, consisting of a medal and $20,000, recognizes the researchers' leading roles in elucidating the biological mechanics of addiction, improving the quality of care offered by treatment programs, and ultimately reducing the stigma associated with the condition. The prize was presented to O'Brien and Nestler at IOM's annual meeting in Washington, D.C.
"The work of Eric Nestler and Charles O'Brien has shaped our understanding of addiction as a disease rather than a weakness of character," said Institute of Medicine President Harvey V. Fineberg. "It is highly appropriate to recognize both these accomplished scientists, whose respective work on the biological mechanisms of addiction and the clinical and policy sides of substance abuse complement each other so well. Their research has led to new ways to understand and treat addiction and to prevent relapses of disorders that affect millions of people and their loved ones."
Addiction was not viewed as a medical disorder when O'Brien began his career in the 1970s. His discoveries have been fundamental in proving that drugs affect how the brain works and in developing pharmaceutical and behavioral therapies for addiction. His laboratory provided the first evidence that symptoms of addiction result from reflexive memories that persist even after a person stops using a drug. His research showed that drug use over time conditions automatic responses and that re-exposure to drug-associated cues activates drug urges; this discovery has led to behavioral therapies that aim to prevent relapses by diminishing conditioned reactions. The pharmaceutical therapy naltrexone also is now used to treat many people with alcoholism because of O'Brien's persistence in testing it for this purpose despite skepticism from many in the research community that alcoholism could be treated pharmaceutically. He led the team that first demonstrated the effectiveness of outpatient detoxification for alcoholics and paved the way for outpatient treatment to become the norm rather than confining patients in hospitals or clinics. O'Brien and colleague Tom McLellan developed the Addiction Severity Index, used worldwide to determine the extent of patients' problems and tailor appropriate treatment approaches.
O'Brien earned his M.D. and Ph.D. at Tulane University. He was elected to the Institute of Medicine in 1991. He has received numerous national research awards as well as an honorary doctorate from the University of Bordeaux.
Nestler's research has been instrumental in revealing how drugs affect the brain at the molecular level, and his work recently pointed to similar molecular mechanisms behind stress disorders. His laboratory has discovered many proteins and genes involved in drugs' effects on the brain's "reward" regions, which stimulate good feelings and cravings, and demonstrated how drugs rewire the brain's normal reward responses. This work has provided a fuller picture of how addiction occurs, starting at the molecular level and proceeding to the cellular and behavioral levels. Nestler also discovered a molecular basis for relapse among drug abusers. His lab found that a protein accumulates and persists in the brain as a result of chronic drug administration and continues to stimulate cravings long after drug use has stopped. Nestler introduced the concept that the brain's reward pathways also play an important role in stress-related disorders such as depression. His advances in stress research include development of a novel mouse model for depression, which has shown that long-lasting behavioral abnormalities caused by stress can be reversed by treatment with antidepressants.
Nestler helped transform the department of psychiatry of the University of Texas Southwestern Medical Center into one of the top 10 National Institutes of Health-funded psychiatry departments in the nation when he served as department chair. Nestler earned his medical and doctorate degrees from Yale University and is the recipient of numerous awards and honors. He was elected to the Institute of Medicine in 1998 and to the American Academy of Arts and Sciences in 2005.
Since 1992 the Institute of Medicine has presented the Sarnat Prize to individuals, groups, or organizations that have demonstrated outstanding achievement in improving mental health. The prize recognizes -- without regard for professional discipline or nationality -- achievements in basic science, clinical application, and public policy that lead to progress in the understanding, etiology, prevention, treatment, or cure of mental disorders, or to the promotion of mental health. As defined by the nominating criteria, the field of mental health encompasses neuroscience, psychology, social work, nursing, psychiatry, and advocacy.
The award is supported by an endowment created by Rhoda and Bernard Sarnat of Los Angeles. Rhoda Sarnat is a licensed clinical social worker, and Bernard Sarnat is a plastic and reconstructive surgeon and researcher. The Sarnats' concern about the destructive effects of mental illness inspired them to establish the award. Nominations for potential recipients are solicited every year from IOM members, deans of medical schools, and mental health professionals. This year's selection committee was chaired by Kenneth B. Wells, professor of psychiatry and biobehavioral sciences, David Geffen School of Medicine, and director, Health Services Research Center, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles. Additional information on the Sarnat Prize can be found at www.iom.edu/sarnat.
Established in 1970 under the charter of the National Academy of Sciences, the Institute of Medicine provides independent, objective, evidence-based advice to policymakers, health professionals, the private sector, and the public. The National Academy of Sciences, National Academy of Engineering, Institute of Medicine, and National Research Council make up the National Academies. (contacts listed below)
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