Silvi Goldstein, a graduate student from the School of Psychology, received a grant to analyze the effectiveness of naltrexone and harm reduction counseling methods in regards to marginalized populations. PHOTO CREDIT: Contributed by uri.edu
In September, third-year clinical psychology graduate student Silvi Goldstein received a National Institutes of Health (NIH) two-year National Research Service Award grant worth $80,000 with the National Institute on Alcohol Abuse and Alcoholism (NIAAA).
Goldstein’s grant will be used to perform efficacy and acceptability analysis on the study “Harm Reduction with Pharmacotherapy” by Susan Collins, a professor of psychology at Washington State University. Here, Goldstein will look into and compare the effectiveness of naltrexone, a drug that helps prevent relapse in drug or alcohol abuse, and harm reduction counseling methods in regards to marginalized populations.
Collins’ study looked to test the efficacy of extended-release naltrexone and other harm-reduction counseling to help decrease the harms of alcohol dependency among homeless populations with alcohol use disorder in Seattle, Washington from 2013 to 2018, according to Goldstein.
During her time working at the Harm Reduction Research and Treatment (HaRRT) Center at the University of Washington during her senior year of undergraduate, Goldstein became interested in this study topic, before participating in Collins’ study in 2016.
“Through the HaRRT center, I worked with people experiencing homelessness,” Goldstein said. “That became a passion point for me was to make sure our treatments were working; substance use treatment was working equitably across different groups, especially those who needed it most.”
Goldstein’s secondary research analysis with Collins focuses on whether the impact of the study’s alcohol use harm reduction treatment can vary among marginalized populations. She was surprised by how those within Collins’ study were in and out of treatment 15 times on average during their time seeking treatment.
“I think what surprised me about it was how underserved some of our most marginalized groups are,” Goldstein said. “So, in this case, people experiencing chronic homelessness, some of them have been in and out of normal treatment.”
Since receiving the grant, Goldstein has also been working on a grant with Nicole Weiss, an assistant professor of clinical psychology, and Dr. Nichea Spillane on a three-year NIH treatment development grant to help develop trauma-informed and culturally grounded alcohol intervention with a first nation community since July 5, 2021.
“At this point, Dr. Spillane and I have conducted focus groups with the community to better understand the link between historical trauma and alcohol use within the community as well as traditional methods of healing historical trauma,” Weiss said. “Silvi will be leading a group of graduate students in qualitative analysis of that data.”
After working on her grant for one and a half years in Weiss’s grant writing seminar, Goldstein has started pre-production on her qualitative and quantitative research that will show the efficacy of extended-release naltrexone and other alcohol use treatments, including community-based supportive treatment, in various marginalized and underserved communities.
“What it means is I’ll be able to report on these kinds of innovative treatments to say yes or no, it does or does not work the same across different groups that might have different meanings,” Goldstein said.
As one of three sponsors on Goldstein’s project, Weiss said Goldstein is working to accomplish five goals within a training plan that centers around developing knowledge about alcohol intervention and treatment development for marginalized populations.
“There is not much information out there on how acceptable or efficacious our treatments are for individuals from underserved racial, ethnic and sex populations,” Weiss said. “That’s a really critical and important next step.”
Beyond analyzing Collins’ study, Goldstein is working on publicizing a paper on “Harm Reduction Acceptability and Feasibility on a Rural North American Indigenous Reserve” that started two years ago. She said that she will be trying to get the paper published soon.
Goldstein predicted that her research analysis could be the next step for further studies from her mentors.
“It also will be used as pilot data for some of my mentors,” Goldstein said. “They’ll probably use the results to support grant applications for themselves or use as support for different papers.”