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Michael E. DeBakey VA Medical Center - Houston, Texas

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Houston VA Psychiatrist Named to IOM's Armed Forces Substance Use Disorder Committee

March 25, 2011

Thomas R. Kosten, M.D. 

“Tom’s expertise and cutting-edge research in the areas of clinical neurobiology, medications development, and treatment of substance use disorders is recognized world-wide,” said J. Kalavar, M.D., Michael E. DeBakey VA Medical Center chief of staff. “His unique knowledge and insight will definitely lead to improvements in mental health care for our older Veterans, as well as the Veterans of the current conflicts in Iraq and Afghanistan.”

Thomas R. Kosten, M.D., senior advisor on Substance Abuse based in the Mental Health Care Line at the Michael E. DeBakey VA Medical Center (MEDVAMC), was recently selected to serve on the Institute of Medicine’s Committee on Prevention, Diagnosis, Treatment, and Management of Substance Use Disorders in the U.S. Armed Forces.

In response to a mandate contained in The National Defense Authorization Act for Fiscal Year 2010 (Public Law 111-84), the IOM will conduct an independent study on substance use disorders in the military. The study will assess the adequacy and appropriateness of protocols used by the Military Health System; the adequacy of the availability of and access to care for substance use disorders in military medical treatment facilities and under the TRICARE Program; and the adequacy and appropriateness of current credentials and other requirements for physician and non-physician health care professionals treating members of the Armed Forces with substance use disorders.

“Tom’s expertise and cutting-edge research in the areas of clinical neurobiology, medications development, and treatment of substance use disorders is recognized world-wide,” said J. Kalavar, M.D., Michael E. DeBakey VA Medical Center chief of staff. “His unique knowledge and insight will definitely lead to improvements in mental health care for our older Veterans, as well as the Veterans of the current conflicts in Iraq and Afghanistan.”

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 Treatment Program (SDTP) at the MEDVAMC is a critical element in the facility’s comprehensive mental health treatment services. The SDTP is a six month, outpatient treatment program serving veterans struggling with alcohol and other drug dependence. Inpatient detox 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, unemployed, and have psychiatric diagnoses in addition to substance use disorders.  The SDTP works closely with the VA Healthcare for Homeless Veterans and the Vocational Rehabilitation Services programs. 

Kosten is also the Jay H. Waggoner professor of psychiatry and behavioral sciences in the Menninger Department of Psychiatry at Baylor College of Medicine and research director of the Veteran Affairs National Substance Use Disorders Quality Enhancement Research Initiative. He has won several major awards for clinical research, is the editor of two major Journals in substance abuse, and has been 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.

With more than 30 years of work in the field of addiction, Kosten has created a series of ground-breaking vaccines and technologies. He has developed a cocaine vaccine to treat addiction and buprenorphine for opiate dependence, which has now overtaken marijuana as the most common drug abused by adolescents. Using neuroimaging technology, Kosten has shown that 60 to 70 percent of cocaine abusers suffer from minor strokes, and that plavix, aspirin, and ameloride, a diuretic, could treat these strokes.
 
Established in 1970, the Institute of Medicine, the health arm of the National Academy of Sciences, is an independent, nonprofit organization that works outside of government to provide unbiased and authoritative advice to decision makers and the public. 
 


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Awarded re-designation for Magnet Recognition for Excellence in Nursing Services in 2008, the Michael E. DeBakey VA Medical Center serves as the primary health care provider for more than 120,000 veterans in southeast Texas. Veterans from around the country are referred to the MEDVAMC for specialized diagnostic care, radiation therapy, surgery, and medical treatment including cardiovascular surgery, gastrointestinal endoscopy, nuclear medicine, ophthalmology, and treatment of spinal cord injury and diseases. The MEDVAMC is home to a Post Traumatic Stress Disorder Clinic; Network Polytrauma Center; an award-winning Cardiac and General Surgery Program; Liver Transplant Center; VA Epilepsy and Cancer Centers of Excellence; VA Substance Abuse Disorder Quality Enhancement Research Initiative; Health Services Research & Development Center of Excellence; VA Rehabilitation Research of Excellence focusing on mild to moderate traumatic brain injury; Mental Illness Research, Education and Clinical Center; and one of the VA’s six Parkinson’s Disease Research, Education, and Clinical Centers. Including the outpatient clinics in Beaumont, Conroe, Galveston, Houston, Lufkin, and Richmond, MEDVAMC outpatient clinics logged more than one million outpatient visits in fiscal year 2010. For the latest news releases and information about the MEDVAMC, visit www.houston.va.gov