Medical school alumna has brought ‘humane understanding’ to addiction research for three decades

January 15, 2020
MUSC College of Medicine Professor Kathleen Brady has been a leader in addiction research since earning her Ph.D. at Virginia Commonwealth University School of Medicine. Photo by Anne Thompson

This story originally appeared on VCU News at Virginia Commonwealth University. It is used here with permission.

While some children grow up in families steeped in sports or immersed in the arts, Kathleen Brady’s childhood was framed by science.

Her father, a behavioral pharmacologist at Johns Hopkins University, helped train the primates that preceded NASA astronauts in spaceflight. Friends and colleagues were frequent guests in the Brady home, and young Kathleen would sit in on their conversations. She conducted her own small behavioral experiments and turned to her father for advice on science fair projects. 

“His help and our discussions over the years were a huge influence,” said Brady, who earned her first author credit in the fourth grade with a paper in the Journal of the Experimental Analysis of Behavior. The Virginia Commonwealth University School of Medicine pharmacology and toxicology graduate has had many author credits since.

Brady, M.D., Ph.D., is vice president for research, a distinguished university professor in psychiatry and director of the South Carolina Clinical & Translational Research Institute at the Medical University of South Carolina, where she divides her time between administrative and research roles. She is the current president of the International Society of Addiction Medicine and has served in extensive advisory and leadership positions in her field.

A widely respected clinical researcher, a committed mentor and a tireless advocate, Brady has dedicated her career to helping redefine the understanding of addiction and to promoting evidence-based approaches to treatment.

An early interest in addiction science 

In 1976, having earned degrees in psychology and biology from Fordham University, Brady arrived on the MCV Campus in pursuit of a Ph.D., studying the impact of drugs and chemicals on behavior. It was her father whom she had asked for advice on the best programs in the country. VCU’s Department of Pharmacology and Toxicology was among those he recommended, particularly the work of Robert Balster, Ph.D. 

“I really hit it off well with Bob Balster from the very beginning,” Brady said. “One of the things I knew early — and if anything, has become truer the more experience I get — is that it is really important to have good mentors, people whose science you not only admire but also how they live their lives.”

In Balster, she found a mentor she describes as a “brilliant scientist and very productive.” She also admired his positive outlook and ability to maintain a healthy work-life balance.

One of the foundational things Brady said she learned from Balster was “good, solid experimental design.” In his lab — thanks to a National Institutes of Health grant — they focused on what was then gaining ground as a new class of abusable “club drugs” including phencyclidine, or PCP (dubbed “angel dust”), and ketamine.

“Kathleen had a strong interest in the addiction field even before she came to VCU,” said Balster, now the Luther A. Butler Professor of Pharmacology and Toxicology. Her research “was on the forefront of the first real knowledge about that class of drugs,” he said. 

A summer spent doing laboratory-based addiction research at McLean Hospital, a psychiatric facility affiliated with Harvard Medical School, “sealed the deal,” said Brady, leading her to pursue an M.D. at the Medical University of South Carolina.

Following medical school and a psychiatry residency, Brady completed a fellowship in addiction psychiatry before joining the Medical University of South Carolina faculty as an assistant professor. She had continued her research throughout her medical training — “I don’t think there was a year when I didn’t publish something,” she said — and came to her new faculty position with a grant in hand, establishing a precedent that has continued throughout her career. 

Brady has been instrumental in bringing in more than $120 million in research funding during her years at the Medical University of South Carolina.

An evidence-based approach to addiction 

Not that long ago, addiction and substance use disorders were widely regarded as a personal weakness or failure of individual will. Brady has contributed to a major shift in that view by establishing the neurobiological basis of addiction during her three decades at the Medical University of South Carolina.

“The view of addiction as fundamentally a brain disease — the result of alterations that drugs produce in the brain — has happened during her career,” Balster said. Brady’s work has been at the forefront of combining neuroscience and clinical psychiatry research to understand that, he said.

As Brady explains it, her work has focused on exploring gender differences in addiction and elucidating the roles that early childhood trauma, stress and stress-reactivity play in addiction development and relapse. 

“We have discovered that the flight-or-fight stress system in drug-addicted women is actually more dysregulated than it is in men — and that dysregulation (difficulty managing emotions) is highly correlated with relapse,” Brady said. “A lot of people with addictions, particularly women, have long histories of early childhood trauma that contribute to stress-system dysregulation and make them more vulnerable to develop addictive disorders.”

“Stress and trauma have very significant effects on the biology of the brain,” Balster added. “You can trace a lot of the interest in the importance of trauma to Kathleen’s work. It’s one thing to say there is an actual correlation; she has been interested in the actual mechanisms.” 

Brady also has contributed to a growing body of research identifying how mental health disorders, such as anxiety, depression or post-traumatic stress disorder, occurring together can play a role in addiction.

Addiction is “really a biopsychosocial disorder,” she said, “and every individual presents with and has different facets to their addiction. Thirty years ago, when I started in this field, there was not much communication between the psychiatric field and the addiction field. There was little recognition of the important role of psychiatric illness, stress and early childhood stress, both in the development of addictions and in driving continued drug use.”

If helping establish the how and why of addiction has been central to Brady’s work, perhaps even more important has been building on that research to promote evidence-based treatments, including medications that Brady said “really target correcting some of the underlying neurobiologic abnormalities.”

She cited, for example, replacement therapies that have been developed for opioid dependence. By making it easier for people to stop using and remain off drugs, she said, “These medications can actually save lives and give people the breathing room and opportunity to get their lives back together.”

To that end, Brady considers one of her most important contributions to have been leading the effort to establish the Medical University of South Carolina as a central “node” in the Clinical Trials Network of the NIH’s National Institute on Drug Abuse. NIDA created the network to enhance the delivery of scientifically based treatments to drug abuse patients.

“We run clinical trials in front-line addiction treatment programs throughout the Southeast to promote evidence-based treatment,” Brady said. Initiatives include investigating the efficacy of telehealth services in addiction treatment and engaging overdose victims in treatment while in the emergency room.

“Her seminal work has been a major driver of the modern push to develop and deploy combined treatments that recognize the myriad facets of complex psychiatric phenomena like chronic stress, PTSD, anxiety and substance use disorder,” said Ruben Baler, Ph.D., health science administrator at the National Institute on Drug Abuse. And while Brady’s standing as a scientific leader is unquestionable, he said, “A truer measure of her contributions can be found in the lasting public health impact of her work, which includes a more humane understanding of substance use disorders." 

An advocate for team science

Brady serves as co-principal investigator for the Medical University of South Carolina’s Clinical Trials Network node, adding to an already lengthy list of roles, responsibilities and accomplishments which, it should be noted, includes having raised three daughters with her husband, now-retired psychiatrist R.B. Lydiard, M.D., Ph.D. Brady gave birth to their first child while in medical school, her second while in residency and her third as a new assistant professor.

It’s no wonder friends and colleagues call Brady “a rock star” or “Renaissance woman” and marvel at her productivity. 

“I can’t even begin to fathom how she accomplishes all these significant leadership jobs and continues to be an amazingly productive scientist,” Balster said. 

Brady acknowledges having been “blessed with a high energy level and good organizational skills. I am good at prioritizing,” she said. She is quick to note that her work is deeply collaborative, and she credits mentors, colleagues and those she has mentored as essential to her success. 

“I believe strongly in team science,” she said. “My productivity is often a reflection of a lot of strong people around me who are also being productive, and we are all helping each other in our scientific discovery.”

It’s an approach she can trace back to her years on VCU’s MCV Campus, which she describes as a vibrant and supportive learning environment for which she still holds some of her fondest memories.

“This department has graduated a lot of people who have done very well, and Kathleen is certainly one of the leaders,” said William Dewey, Ph.D., the Louis S. and Ruth S. Harris Professor and chair of the VCU Department of Pharmacology and Toxicology.

“She is recognized in the field, without question, as one of the most eminent, excellent scientists in drug abuse research. We should be extremely proud of her.”

This story originally appeared on VCU News at Virginia Commonwealth University. It is used here with permission.

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