Advancing the Science of Addiction and Trauma Recovery

What is the relationship between early-life trauma and addiction? What treatments are most effective for people, particularly poor women and families who are struggling with these often-linked challenges? How can these treatments be implemented in community clinics?

These are questions that Denise Hien, Ph.D., a professor at the Gordon F. Derner Institute of Advanced Psychological Studies, has been seeking to answer throughout her career. A researcher, clinician and teacher, her overarching aim is to “understand how early-childhood abuse evolves over the course of life and intersects with substance use and other kinds of problems.”

Dr. Hien has noted that “as many as 80 percent of women seeking treatment for drug abuse report lifetime histories of sexual and/or physical assault.” Through her clinical work with women and families in New York City’s Harlem, Morningside Heights and Washington Heights neighborhoods, as well as her national research, Dr. Hien works to improve treatment outcomes for patients who struggle with trauma and substance abuse.

Since 2002, Dr. Hien has been a co-principal investigator with the National Institute on Drug Abuse (NIDA) Clinical Trials Network Greater New York Node. The network is a federal initiative to link researchers and community-based treatment centers to collaborate on studies of drug treatments. In a recent NIDA-sponsored study, for example, Dr. Hien and her team examined what happened when an antidepressant medication was added to a cognitive behavioral therapy treatment for PTSD and alcohol use disorders. The researchers found that the drug combined with the therapy, known as Seeking Safety, was significantly more effective at treating PTSD and alcohol abuse than therapy alone.

“You might think, ‘Well isn’t that obvious? That’s what people do—they give [patients] medication and they give them therapy,” Dr. Hien said. “But nobody really knows if it works. So here’s a trial that showed that it really works.”

In another NIDA-sponsored project, Dr. Hien and her colleagues worked with drug counselors across the country to see if they could safely and effectively conduct trauma treatment groups with their clients. “The answer was yes, they could, so it provided support for being able to translate treatment into the real world,” Dr. Hien said.

Having conducted numerous clinical trials, Dr. Hien is intimately familiar with their advantages as well as their shortcomings. “It’s hard to show big effects with relatively small sample sizes,” she pointed out, adding, “And then there’s the problem of ending up testing what amount to short-term treatments for long-term problems.”

How can these challenges be overcome? For Dr. Hien, the short answer is big data. She is now applying for a grant to create a large data set from more than 20 clinical trials that tested the efficacy of medication and psychotherapy in treating PTSD and substance use disorders. Dr. Hien explained that with information on thousands of patients, “you can ask questions that are more nuanced when it comes to trying to advance the science of treatment.”

Dr. Hien teaches master’s- and doctoral-level psychology courses at Adelphi and says that her work in the field amplifies what she can offer students in the classroom.

“My clinical work and my research inform my teaching because they’re what I’m passionate about, and usually I’m teaching things that link up to these topics,” she said.