Dr. Julio Meza lost two family members to addiction-related illnesses when he was a child.

Now, as a UCLA Health physician, he leads a program providing doctors with addiction-specific training.

Meza, and dozens of other researchers and clinicians, are working across the UCLA Health system to destigmatize and treat addiction.

Addiction impacts tens of millions of people in the United States annually, according to the National Institute on Drugs and Addiction. UCLA ranks as one of the top institutes in the U.S. for federal research funding in addiction medicine, which is a medical subspecialty designed to prevent, diagnose and treat addiction.

Nicolas Massaly, a co-director for the UCLA Integrative Center for Addictive Disorders, said UCLA Health is an international standout in addiction medicine because of its strong researchers. UCLA Health has a history of achievements in addiction medicine, he added, such as the creation of the nicotine patch.

Massaly said he is working on developing new medications for pain that have less addiction potential. He added that he also researches how pain can remodel the brain, as well as conditions like depression and anxiety, which can increase a person’s risk for addiction.

Genetic and lifestyle factors, as well as social determinants of health, can influence someone’s predisposition to addiction, he said. Massaly added that he tries to reduce addiction-related stigma by spreading awareness about the neuroscience and root causes of addiction.

“When we talk about destigmatizing addiction, we mean that it’s now considered a mental health disorder, rather than 30 years ago, it was considered a weakness for people to not be able to stop taking drugs,” Massaly said. “This is a massive misconception, and people have to stop thinking that way. It’s a mental health disorder.”

UCLA Health offers a collaborative approach to treating addiction by combining science, clinicians and public outreach, said Dr. Catherine Cahill, a fellow director of the BRI Neuroscience Integrative Center on Addictions.

As an opioid neuropharmacologist, Cahill studies opioids’ pain-relieving effects and addiction potential, she said. Her work examines the intersection between these two ideas and explores the question of why pain is a risk factor for developing an opioid use disorder, she added.

Opioids work well as pain medications because they target both the affective and sensory components of pain, Cahill said.

“Pain is a silent epidemic in our society,” she added. “We talk about the opioid epidemic because it is killing people, but 20%-25% of all Americans at all age groups and all socioeconomic classes suffer from chronic pain, and we don’t have any good pain medications for these patients.”

The stigma surrounding addiction often hinders progress in finding treatments, Cahil said. Some people believe addiction is a choice, which can make it harder to secure funding to study it, she added.

Dr. Isabella Morton, an addiction psychiatrist and the newly appointed program director of the UCLA/VA Greater Los Angeles Addiction Psychiatry Fellowship Program – which provides a year of additional speciality training in addiction medicine following psychiatry residency – said addiction treatment is an important part of mental health care.

Morton said she decided to pursue addiction medicine training during her first year of residency in Baltimore, where the rate of death by overdose is about five times higher than the national average, according to data collected by the city. She added that her favorite part of addiction medicine is creating a space where people do not feel judged, and she takes a harm reduction-centered approach to addiction medicine.

“Harm reduction is about meeting people where they’re at and working with them towards whatever their goals are,” Morton said. “The first thing we want to make sure of is that they’re staying alive. Even if someone is not ready to stop using, even if they’re never going to be ready to stop using in their whole life, we still don’t want them to die.”

Dr. Jesse Clark, the medical director of Vine Street Clinic – a UCLA-run outpatient clinic in Hollywood that focuses on the intersection between HIV and substance use – said the clinic works on both the research and clinical aspects of addiction medicine.

Clark said the most rewarding part of his work is getting to form meaningful, long-term relationships with patients. However, the clinic has limited access to funding, he added.

“Our patients are stigmatized – our work is stigmatized,” Clark said. “But, we think what we do is important. We get respect from the people who we consider important.”

UCLA Health also has an Addiction Medicine Fellowship Program within the Department of Family Medicine. Meza, the program’s director program said as a family medicine physician, he takes a holistic and preventative approach to treating addiction.

The goal of the fellowship program is to train fellows in different population settings, from UCLA hospitals and clinics to various residential treatment facilities to correctional health facilities, Meza said.

Meza said the most challenging part of his job is finding locations for his patients to receive treatment.

The most exciting and difficult part of working in addiction medicine is the unknown, Massaly said. Researchers and clinicians have made significant progress in understanding and destigmatizing addiction in the last 15 years, but there are still questions that need to be answered about the condition, Massaly added.

“I really hope that we can move this forward, put the stigma away and really focus on patient health and improving outcomes for people suffering,” Massaly said.