New CASA partnership will prioritize adolescent services, process addictions

A newly announced collaboration between the National Center on Addiction and Substance Abuse at Columbia University (CASA) and two schools within Yale University will lead to some new priority initiatives at CASA, including a broader focus on process addictions and aspects of adolescent treatment.

In an interview with Addiction Professional last week, CASA president and CEO Samuel A. Ball, PhD, explained that the initiative, which officially launched June 1, coincides with the CASA board's desire to expand its traditional focus on alcohol and drugs to incorporate an analysis of gambling, sex, food and other subjects. This should not be interpreted, however, as an indication that CASA sees all areas where repetitive behaviors occur as an indication of an addictive process at work, Ball says.

“The case is probably clearest for gambling,” says Ball, a Yale School of Medicine psychiatry professor who is leading the new initiative. “The other three are areas for ongoing research. For example, there may be a subtype of eating that is best thought of as a food addiction, but the reason people become obese is more complicated than that.”

He adds. “To say that brain processes are in play in the same way for any repetitive behavior defines addiction too broadly.”

The collaboration with Yale's School of Medicine and School of Public Health will bring in efforts of key Yale researchers such as Marc Potenza, MD, PhD, who will examine behaviors involving gambling, sex and the Internet, and Carlos Grilo, PhD, who will explore binge eating disorder, food addiction and obesity. Columbia University's role in CASA remains the same, says Ball.

Access to adolescent care

Ball doesn't mince words when discussing the importance of CASA's involvement in adolescent treatment research and evaluation in the years to come. “The adolescent treatment system is not in good shape,” he says.

It is not a situation of lacking treatment approaches with documented effectiveness, but rather that these interventions are in short supply in most communities, Ball says. Family-focused approaches, contingency management, and medication-assisted treatment are not accessible to most youths, and unless someone is in the criminal justice system, chances of receiving treatment within one's home state remain slim, he says.

Adolescent treatment evaluation at CASA will occur in collaboration with the Yale Child Study Center and the APT Foundation.

Public policy development

Ball says that while CASA will remain focused on a core policy message of restricting youths' access to substances, the center will broaden its public policy approach somewhat.

“The discussion will shift more to the reality that despite everyone's efforts, there will be kids who will still misuse, and what do we do when that happens?” says Ball. “What kinds of policies do we need to ensure that there is access to treatment of sufficient duration to reverse this before it turns into its chronic disease form?”

CASA chairman Jeffrey B. Lane characterized the new developments at the center by saying in a June 16 statement, “Combining the resources and talent of Yale, a leading source of research findings in almost every aspect of addiction, with CASAColumbia, an institution on the cutting edge of translating scientific findings and disseminating information, is a momentous achievement in the fight against the disease of addiction.”