Q&A With Alicia Allen: Leading the Fight Against Opioid Addiction Through Research and Community Impact at NCOR

Alicia Allen, Ph.D., M.P.H., director of the National Center for Opioid Research and Clinical Effectiveness (NCOR) in Little Rock, grew up in a small town of fewer than 1,000 people outside Duluth, Minn. This rural upbringing influenced her desire to work at Arkansas Children’s.  

When she was a sophomore at the University of Minnesota, Allen said she was looking for "any job," and found one as a research assistant on a study examining how menstrual cycles can influence smoking cessation outcomes. It launched her research career into substance use disorders, staying with the university's tobacco research group through her doctoral studies.  

In an effort to expand her research into other substance misuse, Allen served at the University of Arizona. She was the university's founder and director of the Recovery through Engaging and Empowering Women (RENEW) Research Team, integrating epidemiological and clinical trial methods to understand and address addiction in women of reproductive age. In 2020, she was honored with the National Institutes of Health Director's New Innovator Award (DP2), a significant grant that allowed her to shift her focus to opioid use disorder.  

"The goal of this grant was to look at how postpartum hormones and infant caregiving activities contribute to the risk of return to opioid misuse in women who have opioid use disorder. So that was a big pivotal point," Allen said.  

Last year, Allen said she reflected on her childhood in a small town, similar to the rural towns that populate Arkansas. She wanted to make a difference that would directly impact the community and chose NCOR to fulfill this mission.  

In July, Arkansas Children's broke ground on NCOR, a center focused on maternal and child health, with a primary emphasis on research, developing prevention and recovery support programs, and community outreach and engagement. The proposed 65,000-square-foot research building, scheduled for completion in early 2027, includes three floors on the southeast end of the Arkansas Children's Hospital (ACH) campus. NCOR and the Arkansas Children's Nutrition Center, one of six National Human Nutrition Centers funded through the USDA-ARS, are collaborative programs within Arkansas Children's Research Institute (ACRI). Arkansas Attorney General Tim Griffin awarded the $75-million center $55 million of opioid and vaping settlement funds.  

"I started to really connect the dots in that where I grew up, my community was really impacted by addiction. I didn't realize that, as I was going into my academic career, that's one of the reasons why I was drawn to addiction," Allen said. "And when I made that discovery, I realized I really wanted to do more to be involved with the community and directly, positively impact the community. So, as I was mulling that over, I learned about this position. That's what really brought me here - I can do the academic research and make new discoveries but also have a direct and quick impact on the community."  

Allen shared her upcoming work with NCOR in the following Q&A. Click the video to watch her entire interview.   

What makes NCOR’s approach to addressing the opioid crisis unique? 

NCOR's approach to addressing the opioid crisis is unique in two ways. One, is that we received $20 million in opioid settlement funds from the Attorney General, which I think really signifies Arkansas's dedication to solving this issue. So, I think that is unique in and of itself. The other unique aspect is the focus on children and families. There is a lot of opportunity for us in terms of helping infants and children who've been exposed to opioids in utero go on to live their best lives. And there are also a lot of opportunities for us to support families who've been impacted by someone who has a substance use disorder. And that is really unique to NCOR.  

Is there anything that surprised you during your studies to learn more about opioid use disorder? 

One thing that has surprised me in research of opioid use disorder and addiction more broadly is the limited work that's been done with females. Up until the mid-1990s, females were not included in the research. It was thought that their hormones basically created too messy of a scenario to actually effectively research how substances impact animal models and also in humans. But luckily, in the mid-1990s that changed, and now both men and women have to be included in studies. Even to this day, the impacts are felt. A lot of the treatments that have been developed were shown to be effective in a male biological system, and oftentimes that does not prove to be true in women. I'm surprised that there are not more treatment approaches that are designed for the biological needs of women.  

What is the biggest misconception people have about opioid use disorder?

I actually love this question, because I'm excited to hopefully dispel some myths. So, I think one thing that people have a misconception about opioid use disorder is that it's the result of bad choices or a moral failing, when, in fact, it's really strongly proven to be a chronic brain disorder. The way it can be thought of is essentially, when someone uses a substance, it dysregulates the neurobiological reward response, and then the brain. Our choices are really driven by that neurological reward response. For example, when we get out of bed and we are hungry for breakfast, that is our reward response, telling us to go and get breakfast. When you take a substance, your reward response really responds kind of off the charts for that than it would for anything else. And so basically, the brain then starts to really focus on needing that substance to get the reward that it's desiring. Something that might seem like a bad choice to maybe you or me, is going to seem like a good choice to the person who's impacted by opioid use disorder, because their brain has now been programmed or reprogrammed to go after that substance. So that's the thing I really mostly want to dispel, is that opioid use disorder and other addictions are not the result of a bad choice. It's the result of a hijacked neurological report system. 

What is the primary purpose of NCOR, and how will it impact the people of Arkansas and nationwide?  

The goal of the National Center for Opioid Research and Clinical Effectiveness, also known as NCOR, is to support children and families who've been impacted by opioid misuse and other addictions. The way that we will do that is first conduct research so we can advance the ways that we prevent substance misuse in adolescents and young adults, as well as a treat addiction or substance use disorder in adults.  

What would you say to a woman or family that is considering being a part of NCOR research? 

There certainly can be a lot of hesitation because of potential stigma with opioids or addiction in general. For children, families and parents who are considering becoming involved with NCOR's research, I would say, just reach out to us. There are a lot of different ways to get involved. You could potentially join a study as a study participant; that is certainly one way that you could get involved. But say you're not ready, or you're not at that point, reach out to us, and we could talk about what is actually involved in being in a research study. Maybe you just want to learn in general what happens and what to expect. The other thing I always say to people, and this goes beyond opioid and addiction research - everything in research is voluntary. I say this to every single study participant. That means everything from not wanting to answer one question on one survey, all the way up to discontinuing your participation at any time. Even if you decide afterwards that you don't want us to have your data, you can pull it out. You are really the one with the power. I think  getting to know what your rights are within research and knowing that it's really you who chooses what happens with your data gives people a lot of empowerment. 

*This article was written by the Arkansas Children’s content team and medically reviewed by Alicia Allen, Ph.D.