Reader in Addiction Science
Biomarkers of substance misuse
I am currently a Reader in Addiction Science and Postgraduate Education at King’s College London. I completed a PhD in ‘Methadone Pharmacokinetics’ from the University of Leeds in 1990 and was awarded funding from the Medical Research Council (Postdoctoral Research Fellow) continuing to investigate the kinetics of methadone in drug addicts before taking up a lectureship at the Institute of Psychiatry in 1997. Whilst based at the National Addiction Centre, I led the MSc Clinical & Public Health Aspects of Addiction and then developed a distance learning MSc (International Programme of Addiction Studies) in a joint venture with Prof. Jason White (University of Adelaide) and Prof. Bob Balster (Virginia Commonwealth University, USA).
My main research interest is concerned with biomarkers of substance misuse. A particular interest is in the effects of methadone in pregnancy and I am currently involved in a study to explore ventilator responsiveness, chemoreceptor sensitivity and arousals in infants exposed to methadone in utero in collaboration with colleagues in the School of Medicine. My research portfolio also includes investigation of the physiological effects of 3, 4-methylenedioxymethamphetamine (MDMA) use in a clubbing environment, in particular ecstasy-induced changes in water homeostatic measures. Individual differences in the metabolism of MDMA (CYP2D6 metaboliser status) and COMT rs4680 genotype have been shown to have an influence on various physiological phenotypes.
My research has led to advancement in the area of biomarkers of alcohol misuse. For instance, carbohydrate deficient transferrin (CDT) has been shown to be a useful marker of long-term chronic alcohol misuse indicating excess consumption over a sustained period (7-14 days). I led the research group that has demonstrated the clinical efficacy of this biomarker for the identification of continuous alcohol use (problematic drinking) in high-risk drink-drivers. My research has shown that CDT concentrations in blood are superior for assessing high-risk drink drivers compared to other biomarkers. The findings have resulted in a change of national policy for the Driver Vehicle Licensing Agency (DVLA), which has made CDT the sole biomarker for use by medical practitioners to aid decision making with regard to relicensing high risk drink drivers. Research is continuing with a pilot study collecting samples from suspended drivers to examine different CDT thresholds for use in re-licensing decisions and will be presented to the Secretary of State for Transport’s Honorary Medical Advisory Panel on Alcohol, Drugs and Substance Misuse & Driving in October 2013.
I have chaired an expert Panel on drug-driving for the Department for Transport (2012) to make recommendations about which drugs should be included in regulations for the purposes of a new offence of drug-driving. I was responsible for the expert panel’s report and made a significant contribution to the content which recommended thresholds for 14 drugs to be set in regulations to improve road safety, including cannabis, cocaine and MDMA. Wolff, K, Brimblecombe R, Forfar JC, Forrest AR, Gilvarry E, Morgan J, Johnston A, Osselton MD, Read L, Taylor D. Driving Under the Influence of Drugs https://www.gov.uk/government/ publications/driving-under-the-influence-of-drugs–2