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Research in Focus: Addiction and Opioids

The opioid crisis continues to touch far too many lives. At Saint Louis University, an interdisciplinary group of researchers is working toward compassionate and innovative solutions. 

Four of these researchers discuss their work and its connection to the University’s Catholic, Jesuit Mission.

The opioid crisis is one of the most devastating public health crises of the 21st century, with the number of opioid-related deaths quadrupling in the last 20 years. Researchers at SLU are mobilizing to provide relief in the midst of this. 

“This issue of addiction has touched everyone. Everyone has had a friend, a loved one, whose life has deteriorated because of addiction,” said Fred Rottnek, M.D., professor of family and community medicine at SLU. “We’re in a unique position at Saint Louis University as a research institution and as a Catholic Jesuit institution to look very broadly at… all the things that have come together to create a perfect storm with the opioid epidemic and with the problems associated with that.”

Novel Ideas

A number of the researchers working on this issue today have been studying it for some time now. Their work continues to provide novel insights into addiction, criminal justice, pain management, and a number of other related areas.

Jeffrey Scherrer, Ph.D., is one of these researchers. Scherrer, who is a professor of family and community medicine at SLU, has conducted a number of insightful studies at the University, including a first-of-its-kind study into prescription opioid use and depression. The study discovered a dangerous, self-perpetuating cycle of abuse.

“The longer you use, the greater your risk of developing new onset depression,” Scherrer said. “And what it’s going to do is make it more difficult to manage pain, creating a cycle of increasing exposure to opioids, higher doses, and this cycle that kind of feeds on itself.”

Scherrer’s research highlights the critical importance of addressing upstream risk factors like mental health as part of pain management.

Daniela Salvemini, Ph.D., is another researcher whose work is breaking new ground. Salvemini is a professor of pharmacology and physiology at SLU.  She studies neuropathic pain, one of the most common pain states and one of the most difficult to manage.

Salvemini’s recent work has focused on two research projects: the development of novel, non-opiate medication and the development of adjuncts so that opioids can be used at very low doses, thus greatly mitigating adverse side effects. A number of these are going into clinical trials very soon.

It’s all about helping people,” said Salvemini. “Helping come up with something that will alleviate human suffering. We’re getting there slowly, but surely we’re getting there.”

National Recognition

These researchers have been the recipients of both prestigious accolades and significant federal funding, establishing SLU as a national leader in the fight against addiction. 

In April 2019, Scherrer was awarded over $3 million from the National Institute on Drug Abuse of the National Institutes of Health (NIH) to study the pathways from chronic opioid use to new onset mood disorder. 

In October 2018, Salvemini was awarded $4.5 million from the NIH to help find solutions to, among other things, opioid addiction, and in August 2019, she was awarded $2.1 million from the NIH to investigate a pain signaling pathway that could open up a new avenue for pain medication research. She is also a Fellow of the Saint Louis Academy of Science. 

Liz Chiarello, Ph.D., associate professor of sociology at SLU, studies strategies to address the opioid crisis and was recently selected for an elite fellowship at the Radcliffe Institute for Advanced Study at Harvard University for this work.

Chiarello’s current project is determining how the health care and criminal justice systems are managing the crisis. Specifically, Chiarello is interested in what resources can be provided to health care providers and law enforcement officials to curb the effects of the crisis. She believes that a prescription drug monitoring program is one resource that could help; Missouri is the only state without one. 

“We have to figure out how to make more meaningful entry points into the health care system instead of meaningful entry points into the criminal justice system,” said Chiarello.

The Center for Substance Use Disorder and Pain Management

Rottnek, Scherrer, Salvemini, and Chiarello are all among the researchers working in the Center for Substance Use Disorders and Pain Management at SLU. The Center supports and advances excellence in research and clinical care pertaining to substance use disorder and pain management.

“We have so many tools in our tool belt here at SLU to create this very broad, ambitious initiative which not only reflects the values of our university, but allows us to engage more fully as a regional leader in this work,” said Rottnek. "I have not seen any other institution be this bold in terms of an idea."

The Center has catalyzed existing research ambitions and strengthened connections with researchers across the university.

“The energy and commitment and investment in research at SLU in the past two years has probably been the greatest since I’ve been involved at SLU, and that goes back 25 years,” Scherrer said.

The work of the Center is informed by SLU's Catholic, Jesuit Mission and the institution's commitment to the local community in St. Louis. Much of this research informs the primary care that is being given to the local community.

“SLU has really positioned itself as a community ally. So many people across campus are doing work that has a meaningful impact,” Chiarello said. 

“So much of what we do well here at SLU is grounded in the community in St. Louis,” Rottnek said. “These issues touch all of our lives. We can learn together, and we can find ways to support each other.”

In May 2019, the Center joined the National Academy of Medicine and more than 100 other organizations across the nation in declaring a commitment to countering the opioid epidemic.

About the Faculty

Learn more about the four faculty members featured in this article and video:

Liz Chiarello, Ph.D.

Associate Professor, Sociology

In May 2019, Chiarello joined 50 scholars, scientists, and artists from 10 countries in receiving a prestigious fellowship from the Radcliffe Institute for Advanced Study at Harvard University. The fellowship has an acceptance rate of 3.7% and will allow Chiarello to write a book that examines the impact of the U.S. opioid crisis on how health care providers and law enforcement officials do their job. Chiarello is also in the second year of a five-year NSF Faculty Early Career Development grant. These grants are given to early-career faculty who demonstrate potential to serve as leaders within their institutions and as academic role models in research and education. 

Fred Rottnek, M.D., MAHCM

Professor, Family and Community Medicine 

Rottnek is the Director of Community Medicine in the department of Family and Community Medicine and the medical director of the Physician Assistant program at SLU. Rottnek was among the first individuals in the region to be Board-Certified in Addiction Medicine and founded the Addiction Medicine Fellowship program at SLU, for which he currently serves as program director.

Daniela Salvemini, Ph.D.

Professor, Pharmacology and Physiology

Salvemini is a national leader in the study of neuropathic pain. In October 2018, she was awarded $4.5 million from the NIH to study “chemo brain” and opioid addiction, and in August 2019, she was awarded $2.1 million from the NIH to investigate a pain signaling pathway that could open up a new avenue for pain medication research. She is also the director of the Henry and Amelia Nasrallah Center for Neuroscience and a fellow of the Saint Louis Academy of Science. She is also chief scientific advisor and chair of the research advisory board of BioIntervene Inc., a SLU based start-up which she founded in 2014.

Jeffrey Scherrer, Ph.D.

Professor, Family and Community Medicine

Scherrer is the research division director in the department of Family and Community Medicine at SLU. He has been awarded a number of grants to study a variety of complex issues; in September 2016, he was awarded $2.3 million from the NIH to study PTSD and, in April 2019, he was awarded $3 million from the National Institute on Drug Abuse of the NIH to study the pathways from chronic opioid use to new onset mood disorder. He is also a research leader on campus; in January 2019, he became one of the first 15 faculty members to receive a total of $1.8 million in research growth funding from the SLU Research Institute.