DALYs attributable to the most important risk factors by region and sex in 2004 (5 24-year-olds. DALY=disability-adjusted life-year.

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3 DALYs attributable to the most important risk factors by region and sex in 2004 (5 24-year-olds. DALY=disability-adjusted life-year. Physical injuries refer to unintentional injuries resulting from occupational risks

4 Comorbidity.

6 A consortium of 3 universities bringing together internationally renowned mental health and addiction researchers Imperial College London Prof Anne Lingford-Hughes University of Bristol Prof Matt Hickman MRC King s College London Prof Colin Drummond

7 MARC: Vision Our vision is that the MARC programme will develop the future UK clinical research leaders in addiction to build and sustain capacity in this vital area of clinical neuroscience and address the gap in clinical research capacity in the addictions field in the UK. Most likely to be psychiatrists or psychologists but is open to all clinicians aiming for a leading role in clinical academic addiction in UK. Have you thought about a career in addiction neuroscience?

8 What is needed? Training for clinical academics in neuroscientific, psychological and psychopharmacological approaches using small, well characterized populations with neuroimaging, experimental medicine techniques small proof-of-concept leading to larger clinical trials larger populations to understand how the brain and behaviour are modified by genes and environment using complementary epidemiological approaches

9 MARC: How? MARC will develop a cohort skilled in effectively translating basic and epidemiological evidence into the clinical environment using early (T1, T2) experimental medicine studies in patients for the benefit of clinical populations and their treatment as well being skilled clinicians treating patients.

10 What will MARC do to achieve this vision? 1. Increasing exposure to addiction earlier in clinical training by increasing addiction psychiatry in foundation year posts, specialist interest sessions 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.

11 What will MARC do to achieve this vision? 3. Establishing PhD posts: at least 2 PhD posts/institution 1+3' studentships: 1 st year involves research method training and completion of mini-projects plus formal training, then a 3 year PhD project. 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 post.

12 What will MARC do to achieve this vision? 5. Provide academic mentorship for those in the UK interested in a clinical academic career in addictions complementary to those already running 6. Each Institution is committed to sustaining MARC through strategic development in clinical addiction research and through associating posts with MARC to support additional training and PhD opportunities.

13 MARC: so far Started October 2015 Will run for 6 years. Advisory panel has met Website: marc@imperial.ac.uk Celeste Miles: Administrative support Appointed Dr Sam Turton to matched Imperial College PhD GABA and opioid function in alcoholism

MARC @ Imperial College Who: Led by Prof Anne Lingford-Hughes @ Centre for Neuropsychopharmacology A multidisciplinary team clinicians, neuroscientists, modellers, students (BSc, MSc/MRes, MD, PhD)

15 Imperial College Who: Led by Prof Anne Centre for Neuropsychopharmacology A multidisciplinary team clinicians, neuroscientists, modellers, students (BSc, MSc/MRes, MD, PhD) Prof David Nutt Dr Tony Goldstone (Endocrinologist) Dr Jim Myers (PET methodology) Dr Henrietta Bowden-Jones: (National Problem Gambling Computational, Cognitive and Clinical Neuroimaging Laboratory (C3NL) Prof David Sharp (Neurologist, Traumatic Brain Injury)

16 Imaging brain chemistry and function MRI scanner PET scanner Benzodiazepine Opioid Dopamine Patterns of activation

18 Cortex Multimodal Imaging of Functional Brain Networks Jim Myers Multi-ligand integration: examine two systems at once GABA GABA A 5 -opioid Both GABA A 5 -opioid Co-distribution Opioid Cerebellum Networking Thalamus Multi-modal integration: PET-MR BOLD Functional Connectivity Arrival of PET-MR scanner in 2016

19 Overview of PhD opportunities at University of Bristol Matt Hickman

Supervisors Prof Matt Hickman: Public health and addiction epidemiology

Psychiatric Epidemiology Dr Tim Williams: Addiction psychiatry Prof

Psychopharmacology Prof Caroline Relton: Genetic & Epigenetic

Primary care and addiction epidemiology Avon Longitudinal Study of

School of Public Health Research School of Primary Care Research Health

20 Supervisors Prof Matt Hickman: Public health and addiction epidemiology Prof Marcus Munafo: Experimental Psychology Prof Stan Zammit: Psychiatric Epidemiology Dr Tim Williams: Addiction psychiatry Prof Graeme Henderson: Psychopharmacology Dr Emma Robinson: Psychopharmacology Prof Caroline Relton: Genetic & Epigenetic Epidemiology Prof Kate Tilling: Medical Statistics Prof John Macleod: Primary care and addiction epidemiology Avon Longitudinal Study of Parents and Children Elizabeth Blackwell Institute for Health Research School of Public Health Research School of Primary Care Research Health Protection Research Unit in Evaluation CLAHRC West Collaboration for Leadership in Applied Health Research and Care West

ALSPAC 14,000 index participants enrolled 1991-1992 10,000 of their parents Increasing numbers of their children Deep longitudinal phenotyping

21 ALSPAC 14,000 index participants enrolled ,000 of their parents Increasing numbers of their children Deep longitudinal phenotyping plus genotyping Linkage to Health records (HES, Mental Health Minimum Dataset and primary care) Education records Criminal records Economic records

22 Causal Inference: MR Mendelian randomization Randomized controlled trial Random segregation of alleles Randomization method Exposed: one allele Control: other allele Exposed: intervention Control: no intervention Confounders equal between groups Confounders equal between groups Outcomes compared between groups Outcomes compared between groups

23 Addiction Research at KCL Professor Colin Drummond National Addiction Centre Institute of Psychiatry, Psychology and Neuroscience King s College London

24 Why Addictions? 40 years of research excellence in addictions Most highly cited addiction research in UK (RAND Europe) 7M research income last 3 years, 28 grants 33 PhD students Integrated clinical and academic activity - KHP Policy advisors: CMO, DH, PHE, HO, SG, DWP, EC, WHO, UN Leading professional organisations: RCPsych, SSA, MCA, EUFAS

25 Addictions Senior Staff Prof John Strang, Head of department, Drugs Prof Colin Drummond, Deputy HOD, Alcohol Prof Ann McNeil, Deputy HOD, Tobacco Prof Michael Lynskey, Adolescents, epidemiology Prof John Marsden, Psychology, drugs Prof Hilary Little, Psychopharmacology Prof Gunter Schumann, SGDP, genetics, addiction biology Dr Joanne Neale, qualitative research, Service User Research Group Dr Paolo Deluca, Alcohol, Novel Psychoactive Substances Dr Ed Day, Drugs Dr Gail Gilchrist, BBV, intimate partner violence Plus: 4 Lecturers, 3 senior research fellows, 13 post docs, 21 research assistants, 9 admin staff

26 Major research programmes Alcohol Brief interventions: SIPS, SIPS Jr, SIPS Jr High, CLAHRC Assertive outreach programme: ACTAD, CLAHRC Medication adherence, NIHR HTA Alcohol treatment capacity project Drugs Contingency management Naloxone programme, N-Alive Novel Psychoactive Substances Nicotine UKCTAS E-cigarettes Tobacco policy Smoke free policies Adolescent brain development, genetics and neuroimaging IMAGEN (SGDP) Externalising disorders (SGDP)

Addiction and substance misuse

Addiction and substance misuse Research Strategy Addiction and substance misuse Research Strategy Contents Introduction 1 Overview 2 Rationale 2 Achievements 3 Timeline 4 Research supported through the