5 Questions With…
Nancy Diazgranados, M.D. Deputy Clinical Director, National Institute on Alcohol Abuse and Alcoholism (NIAAA)
You are the deputy clinical director for NIAAA’s intramural research program at the National Institutes of Health (NIH) Clinical Center. What factored into your decision to conduct research at the NIH Clinical Center?
Initially, I trained in the National Institute of Mental Health (NIMH) intramural program, where I learned to love the unique character of the NIH Clinical Center. I believe that the care that patients receive at NIH is among the best in the world. Also, the resources available to NIH physicians are really outstanding, and there are great resources to help our patients. Some of the best doctors and scientists I have met work at the NIH Clinical Center and the NIH intramural program. I really consider it an honor to work among them. Our team at NIAAA has exceptional and dedicated staff, clinicians, and investigators. I am deeply gratified that our work can make a difference in helping our patients directly at the hospital and indirectly with our study results. I truly feel that I have a dream team at NIAAA.
How did you choose to work in the field of research on alcohol and other substance use disorders?
I always felt intrigued by the brain and how it determines who we are, what we feel, and what we do. I went into medicine to study the brain, planning to be a neurologist. However, in medical school I realized that it was psychiatry that had the complexity to study how our brain can make us happy, lose contact with reality, or use a substance compulsively to our own detriment. I worked with mood disorders for years, but I learned to admire the intricacy of alcohol use disorder, or AUD, and how much we need to learn about it. This brought me to NIAAA, where I am looking forward to continuing to study the many sides of AUD. I am sure that by investigating the brain and specifically AUD, we discover many answers, which are always followed by more questions to solve.
Much of your research has addressed AUD along with co-occurring conditions. Why have you found it important to focus on both?
Co-occurring conditions, or comorbidities, are what we find among many real-world patients. Usually, patients in our clinic face AUD along with other issues—whether it’s depression, anxiety, or other substance use disorders. In addition, because alcohol misuse can cause damage to many organs, AUD often devastates overall well-being and health. So, I view comorbidities as an extension of the patient’s illness, not as a separate construct that must be isolated or avoided. I believe it is part of our work to understand the full complexity of AUD and address how alcohol-related problems can impact every aspect of a person’s health.
Looking ahead, what do you consider to be some of the major challenges in the field of clinical research on AUD?
Some of the challenges stem from AUD’s all-encompassing nature, as I mentioned earlier. Our patients often present with mood and anxiety symptoms, severe insomnia, liver disease, and heart damage, among other problems. They usually smoke or use other substances. Also, many people with AUD can be stigmatized and feel isolated. Our patients often report having strained relationships or that they’ve lost all social support due to conflicts at work, school, or home. Many face unemployment or homelessness as a consequence of AUD-related problems. They are among the most complex patients I have treated. At NIAAA we take a team approach in working with participants in our clinical studies; we aim to untangle the complexity of their illness. The team approach is very beneficial to effective treatment.
Clearly your work keeps you busy! But when you’re not seeing patients in the clinic, or working in the laboratory, or writing scientific papers, what do you do for fun?
I love reading, and I read compulsively! I also love painting. I painted in watercolors and oils for years, although I am not painting as much as I did in the past. Now, most of my free time is spent with my dog and foster dogs. I adopted a greyhound and fell in love with the breed. This led me to foster greyhounds who “retired” from the racetrack. I help get them ready for life as pets. My most recent foster greyhound was just adopted, and there is a great satisfaction in finding the right family for a dog. It is very sweet to hear “pupdates” from my foster dogs being loved and loving their families.