Q & A: Roger Weiss, MD, Chief of the Division of Alcohol, Drugs, and Addiction

The misuse of alcohol, prescription medications, and illegal drugs is one of the most serious health problems in the United States. Substance use disorders have devastating effects on families and communities and their cost to society is immeasurable.

McLean’s Division of Alcohol, Drugs, and Addiction fosters integrated, evidence-based approaches to prevention, early detection, and treatment. It offers a continuum of care, including brief hospitalization for detoxification and stabilization, four residential programs, a partial hospital program, outpatient treatment, a consultation service, and the Co-Occurring Disorders Institute. The division also has a strong research and training focus. Horizons recently checked in with the division’s Chief, Dr. Roger Weiss, for updates.

Horizons: What have been the division’s greatest accomplishments in the last few years?
Dr. Weiss: On the clinical side, we have been responsive to patient needs by developing new programs to fill gaps in care. The LEADER (Law Enforcement, Active Duty, Emergency Responder) program and Borden Cottage are two recent examples.

We developed the LEADER program following a request by the Boston police department for treatment focused on the specific needs of their personnel following the Boston Marathon bombing. During the first 20 months of the program, McLean provided nearly 200 inpatient admissions and many dozens of residential stays, day treatment, and outpatient services to men and women in uniform.

Similarly, Borden Cottage, our new residential program in a gorgeous facility on the Maine coast and our first program outside of Massachusetts, responds to an unmet demand for residential care in a private setting for people struggling with substance use disorder and another psychiatric illness.

We have also expanded our opioid dependence services in response to the growing number of patients—many of them young people—struggling with addiction to prescription opioids and heroin.

Horizons: What sets McLean apart from other organizations that treat addictions?
Dr. Weiss: This integrated approach—treating substance abuse and mental illness in tandem and by the same team of clinicians—is extremely effective and standard practice in all of our division’s treatment programs. Our recently launched Co-Occurring Disorders Institute is now training McLean staff from other clinical specialties in this approach.

We also have a very strong research component to our work with dozens of investigators conducting basic, translational, and preclinical research as well as clinical trials on a broad array of issues in the field.

Finally, we offer dedicated training for psychiatrists and other clinicians who wish to specialize in addictions.

Horizons: Are there other notable trends in addiction that are evident in the work the division is doing?
Dr. Weiss: The most common addiction we see at McLean has always been alcohol and that hasn’t changed. The number of patients we treat who are dependent on marijuana has risen, which is not surprising given that medical marijuana is now legal in many states, and efforts to legalize recreational marijuana are gaining traction across the country. Two people in our division, Kevin Hill, MD, MHS, and Staci Gruber, PhD, are doing fascinating marijuana research. Dr. Hill’s work focuses on medications and behavioral interventions to improve available treatments for people wanting to stop using marijuana. Dr. Gruber studies the effects of marijuana on cognitive function.

Horizons: What role has philanthropy played in the division?
Dr. Weiss:Philanthropy has played a huge role in all three arms of our division—clinical, research, and training. Generous donors have launched new clinical initiatives, such as Fernside, our residential program in Princeton, Massachusetts. Donor gifts also have supported the research endeavors of our scientists in the early stages of their careers—providing that critical bridge to eventual federal funding. For example, this year we launched the Sarles Young Investigator Award, which will provide two years of support for research on women and addiction. It is also thanks to our donors that we are able to train our staff in the latest, evidence-based treatments and support families through group programs. Finally, our new Co-Occurring Disorders Institute, a dream of ours for years, became a reality because of the generosity of several donors.

Horizons: What important goals are on the horizon as you lead the division forward?
Dr. Weiss: One major goal is to help promising young investigators in their search for answers to the many questions we have about the causes and best treatments for substance use disorders. I would love to expand the Co-Occurring Disorders Institute to help develop research into the complexities of the intersection between substance use disorders and other psychiatric illnesses. Whether we are talking about clinical work, research, or training, our primary objective is to find increasingly effective prevention and treatment strategies so that we can improve the lives of our patients and their families.