United States Department of Veterans Affairs
 Health Care
VA Psychiatrist Named One of America’s Top Doctors for Fifth Time
Doctor in lab coat
Dr. Thomas R. Kosten of the Michael E. DeBakey VA Medical Center, Houston.

For the fifth year in a row a physician at the Houston VA Medical Center has been named one of ‘America’s Top Doctors’ by a leading health care company that rates physicians nationally. For his work in treating drug addiction, Dr. Thomas R. Kosten, senior advisor on substance abuse at the Michael E. DeBakey VA Medical Center in Houston, was recently named one of ‘America’s Top Doctors’ for the fifth time by Castle Connolly Medical Ltd.

“Only a small percentage of physicians have earned the prestigious recognition of America’s Top Doctor at all,” said Dr. J. Kalavar, chief of staff at the medical center. “Fewer still have earned it five years in a row.”

Castle Connolly’s ‘Top Doctors’ selection process is a rigorous one. Each year, the company surveys thousands of physicians and other health care professionals and asks them to identify excellent doctors in every specialty in their region and throughout the nation.

Kalavar added, “Dr. Kosten’s work in the field of addiction has resulted in a series of ground-breaking vaccines and technologies. This bodes well for those Veterans returning from the Iraq and Afghanistan theaters with drug dependency issues.”

“I’ve been working with drug-addicted Veterans since the Vietnam era in the late ’70s,” Kosten explained. “At that time, many of the Veterans had heroine addiction and post traumatic stress disorder. Some of these Veterans had smoked morphine while in theater to cover up the horrors of Vietnam. Others had gotten dependent on morphine after being treated for combat injuries. After coming home they continued using morphine, then switched to heroine because it was cheaper.

My passion is to develop a new morphine vaccine that can help our Veterans get free of this addiction.
—Dr. Thomas R. Kosten,
Department of Veterans Affairs

“This sad state of affairs is being relived with many of the young Veterans from Iraq and Afghanistan,” he continued. “Many of them are coming to the VA seeking help after years of abusing pain killers such as morphine, heroine and vicodin. They started the pain medication in theater for injuries like head trauma, severe back pain and PTSD. We’re using new medications like buprenorphine and old ones like methadone to treat them, but my passion is to develop a new morphine vaccine that can help our Veterans get free of this addiction and prevent them from relapsing.

“We’re making progress,” Kosten said. “The vaccine we’ve developed works in animals. It prevents morphine addiction by blocking the rush that these opiate drugs produce. I certainly hope our research will soon result in a vaccine that can help relieve the suffering of the Veterans I see every day at our VA in Houston.”

In addition to his responsibilities at the Michael E. DeBakey VA Medical Center, Kosten is also a professor of psychiatry and behavioral science in the Menninger Department of Psychiatry at Baylor College of Medicine. He has earned several major awards for his clinical research, is editor of two major journals on substance abuse, and has served as a member of the American Journal of Psychiatry Editorial Board.

Recently, he served on the National Academy of Sciences, Institute of Medicine Committee on vaccines for substance abuse.

By Tom Cramer, VA Staff Writer