Julius Axelrod, who won the Nobel Prize for his work in neuroscience, spent much of his career as a lab tech. Born in 1912 on the Lower East Side of Manhattan, he got most of his education at the tuition-free City College of New York, which he described as a “proletarian Harvard.”

There are now four medications that are approved by the FDA for the treatment of alcohol dependence, so it is high time we take a fresh look at what our options are.

Motivational interviewing (MI) has taken the world of addiction therapy by storm. The essence of MI is that the therapist maintains an empathic, supportive stance with patients while gently prodding them to focus on discrepancies between how they would like their life to be and how it actually is.

Suboxone (buprenorphine/naloxone) was approved by the FDA on October 8, 2002 for the treatment of opioid addiction. Until the approval of Suboxone, we had two options for treating opioid addiction— naltrexone and methadone.

I have found Suboxone to be a tremendous breakthrough in the treatment of individuals addicted to opiates.

Dr. Chappel, you’ve been involved in addiction medicine for many years. What are some of the major advances that you’ve seen over that time?

After reading these articles, you should be able to…

When National Public Radio’s Science Friday devotes most of a program to a psychiatric study, it must be newsworthy. The STAR*D study got this special treatment recently, with Ira Flato interviewing John Rush about the ins and outs of the NIMH-funded project.

Because the first results from STAR*D make antidepressants look less powerful than we might have hoped, researchers have emphasized another aspect of the study – namely, that it represents a system that allows us to bring research techniques into our practices. A review of the STAR*D treatment manual is a useful exercise.

Dr. Rush, thanks for agreeing to help us understand the STAR*D trial. You were the overall principal investigator of what I believe was the largest study in history comparing different antidepressants. Looking at the first set of results, are you encouraged by the findings?