My Career in Translational Addiction Research:  1972-Present

Mark S. Gold, M.D.

Introduction

Mark S. Gold is a translational researcher, author, and inventor best known for his work on the brain systems underlying the effects of opiate drugs, cocaine and food. He an author and inventor who has published over 1000 peer reviewed scientific articles, texts, and practice guidelines. His work is widely cited by his peers. It includes citation classics in cocaine neurobiology, opioid addiction neurobiology and treatment, food and process addictions. He has been called a groundbreaking researcher, father of medication assisted recovery, the first to translate rat experiments into theory and treatments for human addicts, mentor of the next generation of addiction researchers and clinicians.

After working on state dependency of memory, amphetamines and sleep neurobiology Gold proposed a novel model for opiate action, dependence, and withdrawal changing the way opiate action was understood. This locus coeruleus theory of opiate and drug withdrawal is a mainstay of 2016 theory and practice, even though he proposed it in 1978. Gold is the senior author on the discovery paper and was awarded a patent for the discovery of new uses for clonidine which remains widely used for opiate withdrawal and pain management. Drs. Gold and Herbert Kleber were the first to suggest use of clonidine and naloxone in rapid detoxification and sequential use of clonidine and Naltrexone. Gold demonstrated successful treatment of Physician and Business Executive addicts using detoxification, monitored therapy, and Naltrexone in the early 1980s which was pivotal to Naltrexone’s approval by the FDA after the failed NIDA trial .

During 1980s Gold and Dackis developed a new theory for cocaine action, dependence, and withdrawal based on his understanding of the neuroscience of dopamine-rich areas of the brain. While most at the time did not consider cocaine addictive because of the lack of a classic withdrawal syndrome, Gold proposed a dopamine theory of pathological attachment, loss of control and addiction. This work not only helped to reclassify cocaine as addicting but reduced the importance of withdrawal to the nosology of addiction. Gold had many of the first reports related to cocaine and crack, including cocaine and panic disorders, cocaine and cardiovascular accidents and symptoms, cocaine and body temperature and was the first to describe crack smoking. His work increased interest in dopamine in pleasure and addictions. Gold completed a 5 year State Department study on opium smoking, second and third hand exposure in the Children of Afghanistan. His work reduced stigma, served as the basis for many educational and prevention campaigns and changed the lives of addicts with basic and applied science leading to new evidence-based treatment. Dr. Gold is a multiple patent holder and translational researcher who has been a mentor of many of the leaders in addiction medicine and psychiatry.

Gold also has worked for over 30 years trying to understand overeating as related to drug of abuse or addiction models. He described Food Addiction in several classic papers and texts. With Bart Hoebel and Nicole Avena he advanced this food addiction work showing glucose and fructose corn syrup self-administration, dependence and withdrawal. Gold and his Yale colleague, Kelly Brownell organized what is now called the Yale Historic Conference on Food, Obesity and Addiction. Bringing to Yale national research experts in Bariatric Surgery, Obesity Medicine, Psychology, Psychiatry, Neuroscience, and NIH Directors like Nora Volkow this 3 meeting was widely covered in the Press and began the process of identifying what was known, debated and yet to be studied in Obesity. This work with Hoebel at Princeton and Brownell at Yale has stimulated the field and is summarized in Kelly Brownell & Gold’s Oxford University text Food Addiction.

Gold was a Professor, Eminent Scholar, Distinguished Professor, Distinguished Alumni Professor, Emeritus Eminent Scholar during his 25 years at the University of Florida. He was, along with William Luttge and Al Rhoton, a Founder of the McKnight Brain Institute and then, one of the Directors. Gold helped build the Brain Institute, Neurology-Neurosurgery-Psychiatry Departments, and translate research into new treatments. Both Axogen and Viewray are examples of this in the nerve repair and transplants as well as in MR guided cancer radiation oncology. He has been recognized for innovative translational research and technology transfer by UF President Bernie Machen, Florida U.S. Senator Bill Nelson and Governor Jeb Bush.

He is a Distinguished Alumnus of Washington University, Florida and Yale University. He has served as a Consultant to ONDCP, NIDA, the State Department and other Governmental Agencies, Professional Sports, and CASA-Columbia University. He has worked with all Administrations since President Ford and continued with Drug Czar Botticelli. President Obama’s Drug Czar asked Dr. Gold to be a member of his kitchen cabinet and they have traveled to Cartegena, spoken at various meetings such as CADCA and worked to improve research, reduce stigma, and increase access to treatment.

Gold is an inventor who has had a number of inventions and use patents that have been sold. For example, his discovery of Clonidine as an opiate-like drug for acute opiate withdrawal led to a use patent and also use in pain was sold to Boerhinger Ingelheim. He has also sold patents to Sandoz-Novartis and licensed others through UF. Since his retirement as a full-time academic in 2014, Gold lectures at Medical Schools, Grand Rounds around the USA and at international and national scientific meetings on his career, bench-to-bedside science in eating disorders, obesity, and addictions.

He is currently as an (Adjunct) Professor of Psychiatry at Washington University in St Louis and the Chairman of the Scientific Advisory Boards for RiverMend Health- a national provider of addiction, eating disorders, and obesity evaluation and treatment. Gold has been awarded a number of national awards for his research including the Foundations Fund Prize (APA), the McGovern Award for Lifetime Achievement (ASAM-ABAM 2015), National Leadership Award (NAATP), Silver Anvil, PRIDE and DARE awards for his career in research and prevention (2015) and the PATH Foundation’s Lifetime Achievement Award (2016) presented by the White House Drug Czar, Yale Chairman of Psychiatry John Krystal, MD and Dr. Dave Baron USC Professor and Acting Chair.

Learning Objectives

1. Summarize the early work on drugs, memory and state dependency of memory and how these realte to slips, relapse, cravings and depression.
2. Describe the link between locus coeruleus to opiate withdrawal and nucleus.
3. Examine how smoking is injection without a needle and smoking cigarettes or marijuana is like and unlike nicotine or THC.

 
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Industry Acknowledgment (if applicable): None.

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As a Jointly Accredited Provider by ACCME, ACPE, and ANCC, Mayo Clinic College of Medicine and Science must ensure balance, independence, objectivity and scientific rigor in its educational activities. Course Director(s), Planning Committee Members, Faculty, and all others who are in a position to control the content of this educational activity are required to disclose all relevant financial relationships with any commercial interest related to the subject matter of the educational activity.  Safeguards against commercial bias have been put in place.  Faculty also will disclose any off label and/or investigational use of pharmaceuticals or instruments discussed in their presentation.  Disclosure of these relevant financial relationships will be published in activity materials so those participants in the activity may formulate their own judgments regarding the presentation.

Listed below are individuals with control of the content of this program who have disclosed…

Relevant financial relationship(s) with industry:

Mark Frye, M.D., Mayo Clinic           

Grant Support:  AssureRx, Janssen R&D, Myriad, PfizerConsultant:  Janssen R&D, Mitsubishi Tanabe Pharma Corp., Myriad Genetics, Sunovion, Supernus Pharmaceuticals, Teva Pharmaceuticals, Neuralstem, Inc.

CME/Travel:  American Physician Institute, CME Outfitters

No relevant financial relationship(s) with industry:
Mark Frye, M.D., Kriti Gandhi, M.D., Allison Holgerson, Ph.D., Matej Markota, M.D., Charlene Nelson, Reem Shafi, M.B.B.S., Larua Suarez, M.D.

Speaker:  Mark S. Gold, M.D.

References to off-label usage(s) of pharmaceuticals or instruments in their presentation:  NONE