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Michael E. DeBakey VA Medical Center - Houston, Texas

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Award-Winning Substance Abuse Specialist Joins Staff at Houston VA

July 7, 2006

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Thomas R. Kosten, M.D., (pictured speaking at a Department of Veterans Affairs event) recently joined the Michael E. DeBakey VA Medical Center as the Senior Advisor on Substance Abuse Disorders.
Photo provided by Thomas R. Kosten, M.D.


HOUSTON - Thomas R. Kosten, M.D. has joined the staff of the Michael E. DeBakey VA Medical Center (MEDVAMC) as the Senior Advisor on Substance Abuse Disorders based in the Mental Health Care Line.

In 2002 and 2003 according to the National Survey on Drug Use and Health, an estimated eight percent (approximately two million) of male veterans aged 18 or older were dependent on or abusing alcohol or illicit drugs. The study showed younger male veterans were more likely to have co-occurring serious mental illness and a substance use disorder than older male veterans.

The Substance Dependence Rehabilitation Section (SDRS) at the MEDVAMC is a critical element in the facility’s comprehensive mental health treatment services. The SDRS is an outpatient treatment program serving veterans struggling with alcohol and other drug dependence; the more intensive portion of the program typically lasts six months. Inpatient detoxification is available when medically necessary.

Most veterans present with addiction to alcohol, crack cocaine, and/or marijuana; however, the MEDVAMC also offers a methadone program for patients with opiate dependence. Many veterans in this program are homeless and unemployed, and have other psychiatric diagnoses in addition to substance use disorders. The SDRS works closely with the VA Healthcare for Homeless Veterans Program and the Vocational Rehabilitation Section.

“Thomas Kosten’s expertise and cutting-edge research in the areas of clinical neurobiology, medications development, and treatment of substance use disorders is recognized world-wide. His unique knowledge and insight will allow our medical center to provide advanced mental health care to our older veterans, as well as the veterans of the current conflicts in Iraq and Afghanistan. The effects of deployment, post-traumatic stress disorder, as well as other stressors of military life can lead to unhealthy coping behaviors or addiction to alcohol and drugs in veterans returning to civilian life,” said Thomas B. Horvath, M.D., F.R.A.C.P., MEDVAMC chief of staff.

In June 2006, Kosten was proposed as professor of Psychiatry at Baylor College of Medicine by Stuart C. Yudofsky, M.D., the D.C. and Irene Ellwood professor and chairman of the Menninger Department of Psychiatry and Behavioral Sciences of Baylor College of Medicine. Formerly, Kosten served as professor in the Departments of Psychiatry and Medicine at Yale University School of Medicine.  In addition, he served in many key leadership positions at the Yale-affiliated VA medical system in Connecticut. Kosten is the founder of the Division of Substance Abuse at Yale and directs their National Institutes of Health (NIH) Medications Development Center for substance abuse. He has been supported by a Research Scientist Award from the NIH since 1987 and has served on national and international review groups for medications development in substance abuse.

In addition to serving as a visiting professor in Germany, Spain, Greece, China, and Canada, Kosten has been a Congressional Fellow in the U.S. House of Representatives. He is the founding vice chair for Added Qualifications in Addiction Psychiatry of the American Board of Psychiatry and Neurology.  He is a distinguished fellow in the American Psychiatric Association and fellow of the American College of Neuropsycho-pharmacology, past president of the American Academy of Addiction Psychiatry, and president-elect of the College on Problems of Drug Dependence.

Kosten has several major awards for clinical research, is editor of two major Journals in substance abuse, and has served on the American Journal of Psychiatry Editorial Board. Recently, he served on the National Academy of Sciences, Institute of Medicine Committee on vaccines for substance abuse.

“By all measurable standards of scientific originality, productivity, and impact, Dr. Kosten is a leading research scientist in the realm of addictive disorders,” said Yudofsky. “His discoveries in the development and testing of innovative, effective ways to utilize the opiate antagonist naltrexone in treating people with heroin dependence and his continuous and comprehensive study of pharmacological therapeutic treatments of cocaine abuse, and his developing and testing agonist strategies for the treatment of opiod dependence, particularly the newly-approved use of buprenorphine have transformed the practice of addiction psychiatry.”

From his studies on substance dependence, post traumatic stress disorder, and neuroimaging, Kosten has published over 300 papers in peer-reviewed scientific journals in addition to numerous book chapters and reviews. His neuroimaging research includes detecting and treating cocaine induced cerebral perfusion defects, and using functional magnetic resonance imaging to predict pharmacotherapy outcome. His medication contributions include a cocaine vaccine, immunotherapy for hallucinogens, buprenorphine for opioid dependence, disulfiram for cocaine dependence, vasodilators for cocaine-induced cerebral perfusion defects, and combining medications with contingency management for opioid and cocaine dependence.

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