The MRC Addiction Research Clinical Training programme: MARC
Lead Research Organisation:
Imperial College London
Department Name: Brain Sciences
Abstract
Addiction to alcohol, tobacco and drugs have a considerable economic and social impact on society in the UK and internationally. In addition concerns are growing about gambling, now classified as a behavioural addiction. Despite awareness of the magnitude of associated harms, the amount of evidence to address them can be limited compared to other physical and mental health disorders. Academic psychiatry has been at the forefront of the development of addiction research in the last 30 years and the UK has made key contributions to the international evidence base as well as contributing to NHS service development and national policy on addictions. Currently however in the UK there are only 7 professors in addictions with a background in clinical psychiatry or clinical psychology and all will have retired or be near retirement within the next decade. The majority of psychiatrists and psychologists do not get any experience working in an addiction service during their training or if they do, it is towards the end. Therefore opportunities of a career in clinical academic addiction are rarely presented with the result that there are very few existing potential candidates to become the future UK clinical research leaders in addiction. Consequently, there is a need to kick start clinical addiction research in order both to sustain capacity in this vital area of clinical neuroscience.
To meet such a need, the MRC Addiction Research Clinical Training (MARC) programme has been developed by bringing together the clinical addiction research expertise in three leading Universities, Imperial College London (IC), King's College London (KCL) and University of Bristol (UoB)). These three internationally renowned mental health and addiction researchers and their Universities can provide expertise in a broad range of techniques including neurosciences, genetics, epidemiology and clinical research as well excellent post-graduate education and training. MARC's initiatives will attract and mentor outstanding clinical trainees to addiction early in their career, support outstanding individuals to undertake research training for a PhD and support individuals with a PhD to establish their career with independent funding in order to build and sustain capacity in this vital area of clinical neuroscience, addiction. Research from the MARC programme will undoubtedly improve understanding of the nature of addiction, its impacts on public health, and methods to reduce the harm through development of more effective prevention, treatment and public policy approaches in addiction.
To meet such a need, the MRC Addiction Research Clinical Training (MARC) programme has been developed by bringing together the clinical addiction research expertise in three leading Universities, Imperial College London (IC), King's College London (KCL) and University of Bristol (UoB)). These three internationally renowned mental health and addiction researchers and their Universities can provide expertise in a broad range of techniques including neurosciences, genetics, epidemiology and clinical research as well excellent post-graduate education and training. MARC's initiatives will attract and mentor outstanding clinical trainees to addiction early in their career, support outstanding individuals to undertake research training for a PhD and support individuals with a PhD to establish their career with independent funding in order to build and sustain capacity in this vital area of clinical neuroscience, addiction. Research from the MARC programme will undoubtedly improve understanding of the nature of addiction, its impacts on public health, and methods to reduce the harm through development of more effective prevention, treatment and public policy approaches in addiction.
Technical Summary
MARC will develop and support the future UK clinical research leaders in addiction by
1. Increasing exposure to addiction earlier in clinical training by increasing addiction psychiatry in foundation year posts, specialist interest sessions and
2. Supporting attendance at Summer schools, training and conferences. We will continue to run courses and scientific meetings within our institutions and national organisations eg Royal College of Psychiatrists, Society for Study of Addiction, British Association of Psychopharmacology.
3. Establising PhD posts. Each institution will establish at least 2 PhD posts (two from MARC and others through additional matched funding) that are modelled on '3+1' studentships where the first year involves research method training and completion of mini-projects plus formal training, followed by a 3 year PhD project. We offer a range of expertise - Imperial College: neuroimaging, neuropharmacology; King's College London: addiction psychiatry, imaging, genetics, clinical trials; Univeristy of Bristol: epidemiology, genetics, neuroscience. Their research project will add value to existing MRC projects and grants already established in the host institutions.
4. Supporting MARC fellows to make them competitive for existing schemes: MRC, Wellcome, NIHR clinical training research fellowships and career development/intermediate fellowships. This will be also offered to those outstanding individuals who are unable to take up a MARC posts.
5. Providing academic mentorship for those in the UK interested in a clinical academic career in addictions complementary to those run by Academy of Medical Sciences and utilizing institutional training and support.
6. Each Institution committing to sustaining MARC through strategic development of their strong track record in clinical addiction research and through associating posts with MARC to support additional training and PhD opportunities.
1. Increasing exposure to addiction earlier in clinical training by increasing addiction psychiatry in foundation year posts, specialist interest sessions and
2. Supporting attendance at Summer schools, training and conferences. We will continue to run courses and scientific meetings within our institutions and national organisations eg Royal College of Psychiatrists, Society for Study of Addiction, British Association of Psychopharmacology.
3. Establising PhD posts. Each institution will establish at least 2 PhD posts (two from MARC and others through additional matched funding) that are modelled on '3+1' studentships where the first year involves research method training and completion of mini-projects plus formal training, followed by a 3 year PhD project. We offer a range of expertise - Imperial College: neuroimaging, neuropharmacology; King's College London: addiction psychiatry, imaging, genetics, clinical trials; Univeristy of Bristol: epidemiology, genetics, neuroscience. Their research project will add value to existing MRC projects and grants already established in the host institutions.
4. Supporting MARC fellows to make them competitive for existing schemes: MRC, Wellcome, NIHR clinical training research fellowships and career development/intermediate fellowships. This will be also offered to those outstanding individuals who are unable to take up a MARC posts.
5. Providing academic mentorship for those in the UK interested in a clinical academic career in addictions complementary to those run by Academy of Medical Sciences and utilizing institutional training and support.
6. Each Institution committing to sustaining MARC through strategic development of their strong track record in clinical addiction research and through associating posts with MARC to support additional training and PhD opportunities.
Planned Impact
In order to deliver research of maximum impact on public health and to maintain the international competitiveness of UK addiction research, MARC will recruit, train and prepare a new cadre of clinical academic researchers in addictions to a high level of expertise. The research will be in a broad range of disciplines including imaging, genetics, epidemiology and clinical trials. The research outputs from MARC will undoubtedly improve our understanding of the nature of addiction, its impacts on public health, and methods to ameliorate the harm through development of more effective prevention, treatment and public policy approaches.
Currently addiction treatment is increasingly delivered not solely through the NHS but in services working with third sector organisations such as Turning Point, Addaction, CRI. The main beneficiaries of work from MARC will be people receiving treatment from such services who require more effective treatment interventions than we currently have. In addition, physical and/or mental ill health is generally also present and evidence to support their treatment is even more limited and requires development of novel approaches to enhance and sustain recovery. Indeed the lack of addiction clinical training and research contributes to the perpetuation of stigma and adverse outcomes. Improving treatment outcomes will indirectly benefit their families and local communities, and the wider public who bear the burden and costs of collateral damage from the addicted individual. New, more effective treatments of addictions are also urgently needed to reduce the considerable economic impact of addictions in the UK and internationally.
The MARC cohort of clinical academics in addiction will be well placed to develop, package and deliver the high quality evidence needed for the benefit of public health in the UK. At the heart of MARC is engagement with translational research. The increased presence of clinical academic trainees and academic clinicians in addiction services will also contribute to changes in the culture and attitudes of staff in clinical services by increasing knowledge about how research translates to their clinical practice. MARC events will be multidisciplinary and bring together the scientific and clinical communities with other stakeholders and policy makers.
The MARC programme will also build on existing extensive engagement with the pharmaceutical industry in the UK and internationally both in terms of encouraging investment in pharmacological approaches to addictions as well as providing the crucial clinical research expertise and facilities to conduct high quality pharmacological research with NHS patients. Securing industry interest and support in the development of new pharmacological approaches to addiction treatment will be crucial and MARC offers an ideal training platform to attract clinical academics of the future who are able to foster these collaborations with industry.
Currently addiction treatment is increasingly delivered not solely through the NHS but in services working with third sector organisations such as Turning Point, Addaction, CRI. The main beneficiaries of work from MARC will be people receiving treatment from such services who require more effective treatment interventions than we currently have. In addition, physical and/or mental ill health is generally also present and evidence to support their treatment is even more limited and requires development of novel approaches to enhance and sustain recovery. Indeed the lack of addiction clinical training and research contributes to the perpetuation of stigma and adverse outcomes. Improving treatment outcomes will indirectly benefit their families and local communities, and the wider public who bear the burden and costs of collateral damage from the addicted individual. New, more effective treatments of addictions are also urgently needed to reduce the considerable economic impact of addictions in the UK and internationally.
The MARC cohort of clinical academics in addiction will be well placed to develop, package and deliver the high quality evidence needed for the benefit of public health in the UK. At the heart of MARC is engagement with translational research. The increased presence of clinical academic trainees and academic clinicians in addiction services will also contribute to changes in the culture and attitudes of staff in clinical services by increasing knowledge about how research translates to their clinical practice. MARC events will be multidisciplinary and bring together the scientific and clinical communities with other stakeholders and policy makers.
The MARC programme will also build on existing extensive engagement with the pharmaceutical industry in the UK and internationally both in terms of encouraging investment in pharmacological approaches to addictions as well as providing the crucial clinical research expertise and facilities to conduct high quality pharmacological research with NHS patients. Securing industry interest and support in the development of new pharmacological approaches to addiction treatment will be crucial and MARC offers an ideal training platform to attract clinical academics of the future who are able to foster these collaborations with industry.
Organisations
Publications
López-Pelayo H
(2020)
"The post-COVID era": challenges in the treatment of substance use disorder (SUD) after the pandemic.
in BMC medicine
Puddephatt JA
(2019)
A Qualitative Evaluation of the Acceptability of a Tailored Smartphone Alcohol Intervention for a Military Population: Information About Drinking for Ex-Serving Personnel (InDEx) App.
in JMIR mHealth and uHealth
Anderson NC
(2022)
Acceptability of, and barriers and facilitators to, a pilot physical health service for people who inject drugs: A qualitative study with service users and providers.
in The International journal on drug policy
Ashok A
(2021)
Acute acetate administration increases endogenous opioid levels in the human brain: A [ 11 C]carfentanil molecular imaging study
in Journal of Psychopharmacology
Drummond C
(2019)
Addiction Treatment: Who Needs It?
in Journal of studies on alcohol and drugs. Supplement
Herlinger K
(2021)
Addressing unmet needs in opiate dependence: supporting detoxification and advances in relapse prevention
in BJPsych Advances
Description | ALH appointed Chair of Addiction Mission, OLS. |
Geographic Reach | National |
Policy Influence Type | Influenced training of practitioners or researchers |
Description | Samaritans' Media Guidelines for Reporting Suicide 6th Edition. |
Geographic Reach | National |
Policy Influence Type | Contribution to new or Improved professional practice |
Description | Suicide prevention in England: fifth progress report |
Geographic Reach | National |
Policy Influence Type | Citation in other policy documents |
Description | Building multi professional UK partnerships and networks to improve access to palliative care for people experiencing homelessness |
Amount | £96,885 (GBP) |
Funding ID | NIHR135250 |
Organisation | National Institute for Health Research |
Sector | Public |
Country | United Kingdom |
Start | 02/2022 |
End | 08/2023 |
Description | Suicide prevention for Emergency Department attenders presenting with self-harm and a history of substance misuse |
Amount | £141,945 (GBP) |
Funding ID | ABL-2019-20-05 |
Organisation | Bristol Hospital |
Sector | Hospitals |
Country | United Kingdom |
Start | 01/2020 |
End | 12/2021 |
Title | Healthcare use by people who use illicit opioids (HUPIO): development of a cohort based on electronic primary care records in England (extended data) |
Description | This dataset includes:
1. Search terms used to identify codes that may represent a history of illicit opioid use 2. Codelist for identifying people with a history of illicit opioid use 3. Age- and sex-distribution of patients by product and clinical codes 4. Detailed table of mortality rates and ratios 5. Number of patients currently in the cohort 6. Age of patients at cohort entry |
Type Of Material | Database/Collection of data |
Year Produced | 2020 |
Provided To Others? | Yes |
URL | https://rdr.ucl.ac.uk/articles/dataset/Healthcare_use_by_people_who_use_illicit_opioids_HUPIO_develo... |
Description | - Ministry of Justice - Better Outcomes Through Linked Data (BOLD) Project |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Policymakers/politicians |
Results and Impact | Dr Emmert Roberts was a Subject Matter Expert, Government advisory role on benefits of data linkage |
Year(s) Of Engagement Activity | 2013,2021 |
Description | 26th British Isles Research Workshop on Suicide and Self Harm. Oxford. Talk by Dr Prianka Padmanathan |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Professional Practitioners |
Results and Impact | Talk: Development and testing of a brief suicide prevention intervention for ED attenders presenting with self-harm and a substance-use disorder. |
Year(s) Of Engagement Activity | 2019 |
Description | Alcohol Clinical Guidelines, Public Health England |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Professional Practitioners |
Results and Impact | Dr Emmert Roberts is the Lead on Homelessness, Prof Lingford-Hughes is contributing to pharmacological aspects; Prof Colin Drummond on service delivery. |
Year(s) Of Engagement Activity | 2020,2021,2022 |
Description | BNA Christmas symposium |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Other audiences |
Results and Impact | Speaker at BNA Christmas symposium. To increase awarenss about MARC scheme |
Year(s) Of Engagement Activity | 2016 |
Description | Disseminating information about the MARC scheme |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Professional Practitioners |
Results and Impact | Presented MARC scheme, its aims and opportunities. Presented at RCPsych Addictions Faculty Meeting 2016 as well as other regional meetings alongside presentation of research outputs from other grants |
Year(s) Of Engagement Activity | 2015,2016 |
URL | http://www.imperial.ac.uk/medicine/mrc-addiction-research-clinical-training/ |
Description | Greater London Authority (GLA) London Asylum Healthcare Task and Finish Group |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | Regional |
Primary Audience | Professional Practitioners |
Results and Impact | Dr Emmert Roberts was a member of this group: 6000 people housed in Asylum Hotels; London; Increased healthcare provision to this group of people with substance misuse support provided |
Year(s) Of Engagement Activity | 2020,2021 |
Description | Imperial Lates |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Public/other audiences |
Results and Impact | We curated an interactive booth called "Visualising Addiction in the Brain" at the Imperial Lates: Drug Experiments. Imperial Lates draw hundreds of attendees consisting of academics, students, and the general public. Our work communicated different mechanisms of addiction and how brain imaging can characterise the neural substrates of substance use disorder, as well as how we investigate interventions to attenuate the mechanisms and symptoms of substance use disorders. Our booth employed presentations, live demos of the tasks our participants play, and art created by our team members, which generated an engaging display for the large crowd of attendees |
Year(s) Of Engagement Activity | 2023 |
Description | Interview for MRC Spring Newsletter |
Form Of Engagement Activity | A magazine, newsletter or online publication |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | Interview with Dr Emmert Roberts, a MARC PhD fellow about his career and the MARC scheme. |
Year(s) Of Engagement Activity | 2017 |
URL | http://www.insight.mrc.ac.uk/2017/07/07/working-life-clinical-fellow-emmert-roberts/ |
Description | Invited speaker at the Royal College of Psychiatrists (RCPsych) London Division Conference by Dr Emmert Roberts |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | Regional |
Primary Audience | Professional Practitioners |
Results and Impact | Alcohol, Tobacco and GBL Prescribing for the Jobbing Psychiatrist.To inform and educate colleagues about addiction. |
Year(s) Of Engagement Activity | 2019 |
Description | Joint meeting with CLAHRC, SLAM and IOPPN |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Professional Practitioners |
Results and Impact | Presentation about MARC scheme by Prof Anne Lingford-Hughes, presentation from 2 MARC PhD fellows (Turton & Roberts), presentation about 'How to survive a PhD from a supervisor's perspective' |
Year(s) Of Engagement Activity | 2017 |
Description | MRC Summer school, Cardiff Neuroscience |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Postgraduate students |
Results and Impact | Speaker at MRC Centre for Neuropsychiatric Genetics and Genomics Summer School in Brain Disorder Research: https://www.cardiff.ac.uk/medicine/news/remedy/27/mrc-cngg-summer-school Cover neurobiology of addiction and its treatment. Promote MARC scheme to delegates. |
Year(s) Of Engagement Activity | 2015,2017,2018 |
Description | Media Coverage of paper by Dr Emmert Roberts |
Form Of Engagement Activity | A press release, press conference or response to a media enquiry/interview |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Media (as a channel to the public) |
Results and Impact | Media Coverage: Multiple newspaper articles, radio and news mentions following the publication of 'The prevalence of wholly attributable alcohol conditions in the United Kingdom hospital system: a systematic review, meta-analysis and meta-regression' Including: The Guardian front page, Sky News live television interview |
Year(s) Of Engagement Activity | 2019 |
Description | Presentation at a Carer-led charity |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Patients, carers and/or patient groups |
Results and Impact | Dr Katie Herlinger (MARC PhD student) gave a talk called "Developing new treatments for alcohol dependence: a neuroimaging approach" at a conference organised by 'Share'. This is a charity set up to support people and families with addiction in Shrewsbury. Katie presented work from her PhD. |
Year(s) Of Engagement Activity | 2022 |
Description | Presentation for Speakers for Schools at Dorcan School |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Schools |
Results and Impact | I gave a presentation about my career and about how drugs and alcohol impact on the brain using examples from my research. |
Year(s) Of Engagement Activity | 2022 |
Description | Presentation of poster at Faculty of Addictions Annual Conference, |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Professional Practitioners |
Results and Impact | Poster presentation: Prevention of suicide and reduction of self-harm among people with substance use disorder: A systematic review and meta-analysis.. Presentation of research data to colleagues to transmit results and hear their feedback. |
Year(s) Of Engagement Activity | 2019 |
Description | Presentation of study to Service User Group, CNWL NHS Foundation Trust |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Study participants or study members |
Results and Impact | Purpose was to describe our research study to User group to facilitate recruitment. |
Year(s) Of Engagement Activity | 2020 |
Description | Presentation to academic psychiatric trainees/students |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Professional Practitioners |
Results and Impact | Presentations at a meeting about supporting academic training in psychiatry, held at RCPsych. |
Year(s) Of Engagement Activity | 2015,2016 |
Description | RCPsych Neuropsychiatry meeting |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | Talk about neurobiology of addiction and used this to raise awareness of MARC scheme. |
Year(s) Of Engagement Activity | 2016 |
Description | Spring residential school |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Professional Practitioners |
Results and Impact | To bring MARC fellows together, learn skills around publication in print and media and to raise awareness of opportunities of MARC programme. |
Year(s) Of Engagement Activity | 2019 |
Description | Symposium about Addiction at British Association for Psychopharmacology's annual meeting: The neurobiology of addiction and its relevance to treating addiction |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | I organised this symposium with 2 clinical and 2 non-clinical speakers. To provide a framework for this plenary session, this lecture will first cover diagnostic criteria for substance use and addiction, highlighting how DSM-5 and ICD-11 now differ and the implications of this. The neurobiology of substance use and addiction will be described drawing on a range of different models and evidence from human neuroimaging studies. In particular brain regions involved in mediating reward and motivation, inhibitory control and emotional processing will be described. Evidence about how any dysregulation. |
Year(s) Of Engagement Activity | 2022 |
Description | Talks at MRC Cardiff summer school |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Professional Practitioners |
Results and Impact | To increase visibility about opportunities in addiction research and knowledge about neuroscience of addiction |
Year(s) Of Engagement Activity | 2019 |