Two UK College of Medicine researchers have received a grant award from the Kentucky Opioid Abatement Advisory Commission, part of more than $30 million the commission distributed this year to over 100 organizations statewide. The funds flow directly from landmark settlements with opioid manufacturers and distributors, which have directed more than $1 billion to Kentucky to date.
Gopalkumar Rakesh, M.D., associate professor of psychiatry, and Elizabeth Arnold, PhD, professor and director of research in the Department of Psychiatry, received approximately $733,000 over two years for their project, “Helping Kentuckians Overcome Opioid Addiction and Depression with Brain Stimulation,” to study an innovative treatment approach for individuals living with both opioid use disorder (OUD) and depression.
The multi-disciplinary study team also includes Danielle Anderson, M.D., assistant professor of psychiatry, and Hongbin Zhang, Ph.D., assistant professor of biostatistics in the UK College of Public Health. The project includes a double-blind clinical trial evaluating accelerated transcranial magnetic stimulation (TMS) combined with buprenorphine treatment for patients with both OUD and active depression.
The project addresses a significant challenge in addiction treatment. Although buprenorphine is an evidence-based first-line therapy for OUD, co-occurring depression is common and has been associated with poorer treatment engagement and increased risk of return to opioid use. Epidemiologic studies suggest that approximately half of individuals with OUD also experience major depressive disorder.
In Kentucky, drug overdose mortality remains high. According to the Kentucky Injury Prevention and Research Center (KIPRC), more than 1,400 residents died from drug overdoses in 2024, including over 980 deaths involving opioids.
“Treating co-occurring depression and OUD together is essential,” said Rakesh. “Left unaddressed, each worsens the other and undermines recovery for Kentuckians. By pairing accelerated TMS with buprenorphine, we are trying to treat both conditions at once to facilitate recovery, which our current standard of care doesn't do well.”
TMS is already FDA-approved for depression, which uses magnetic pulses to stimulate targeted areas of the brain. There is growing evidence that it may also decrease opioid cravings. What is new here is the accelerated schedule, delivering a full course in days rather than weeks, and testing whether it can realistically fold into the everyday treatment Kentuckians are already receiving.
The research team will recruit participants through two UK-affiliated clinics. Patients enrolled in the study will continue receiving buprenorphine while researchers evaluate the feasibility, tolerability, and preliminary effectiveness of the combined treatment approach.
“We appreciate the commission’s support for this important project that will give access to this innovative treatment model for Kentuckians facing challenges with both opioids and depression,” said Arnold. “Given the significant impact of the opioid epidemic on Kentucky, it is important that people have access to the treatments that they need to address commonly co-occurring conditions, such as depression, using evidence-based interventions.”
The award was selected through a highly competitive statewide process that received nearly 400 applications. The project reflects the department’s commitment to advancing innovative research that addresses substance use disorders and improves the health of Kentuckians across the Commonwealth.