RAMS Alumni Spotlight: Dr. Tae Woo (Ted) Park

For our July 2023 RAMS Alumni Spotlight, we interviewed Dr. Tae Woo (Ted) Park, MD, from the 1st RAMS Cohort (2012-2014) about his background and work since completing the RAMS Program.

Ted is an Assistant Professor of Psychiatry in the University of Pittsburgh Department of Psychiatry. He specializes in addiction psychiatry and is certified by the American Board of Psychiatry and Neurology. He completed his medical degree at Case Western Reserve University, psychiatry residency at the University of Pittsburgh , and addiction clinical and research fellowships at the University of Pittsburgh and the Boston VA. He is a member of the American Academy of Addiction Psychiatry and the Association for Multidisciplinary Education and Research in Substance Use and Addiction.

Read on to learn more about Ted!

Tell us about your clinical and research background. What led you to study substance use?

I am an addiction psychiatrist by training. I trained at the University of Pittsburgh. A number of things got me interested in addiction, but a lot of it is about mentorship and the people I met here in Pittsburgh who inspired me to get interested in the topic. And, of course, it was about the patients that I was seeing. During my residency, I did a number of different rotations in different settings, and in each setting, I just felt like the patients with substance use disorders kind of got short shrift. Physicians seemed to be tired of taking care of these patients, oftentimes because they were repeat offenders in a sense; they just kept coming back with the same problems. It is so highly stigmatized, and it is not always viewed from the perspective of a medical disorder. I empathized with that a lot and felt like there was a lack of fairness for those patients. The thing that really turned me around was working in an outpatient setting. When I was working in inpatient settings, I felt like it was hard to see people getting better. When I started working with patients with substance use disorders in the outpatient setting, I was actually able to see patients get better, and I found it powerful. The field also appealed to me as a psychiatrist. Instead of becoming highly specialized in one disorder, I was able to deal with a variety of disorders along with addiction – there was a very wide range of depression, anxiety, psychosis, etc. Of course, after I got into it I could see that it was just such a growing public health problem with the opioid epidemic and it felt like “all hands on deck,” which was really inspiring and engaging.

How did you become involved with RAMS? In what ways did your involvement with the RAMS Program assist you with your research career?

Once I chose the field of medicine, I did not really fully understand what all the different options were. Once you get to be an MD, there are so many things you can do administratively, clinically, and research-wise, so I took a sort of circuitous route. Many people get into research right away because it is built into a lot of programs, but in psychiatry I think people in general are not driven to be researchers, and not many people go into medical school knowing they want to do research. I didn’t really think I wanted to do research, but I took a detour and went to Japan for a year because my wife took a job there, and I ended up working in a volunteer research position there. That experience was eye-opening. I helped write a lot of papers, mostly because I’m a native English speaker, but I hadn’t had that much experience writing papers before and found that I really enjoyed it. However, I didn’t really learn the nuts and bolts about clinical or public health research until I came back to the US and reached out to someone I happened to meet at an addiction conference while I was living in Japan, who was working in Boston, where my wife had taken a fellowship.

So I reached out to this person who was at BU, Richard Saitz, and he was very gracious and invited me to meet. We ended up working together, with him as my research mentor while I was doing a fellowship with the Boston VA. I also had a clinical mentor at the VA, John Renner, who was also quite influential in my career. So when the opportunity to join RAMS came along, I was already able to appreciate the value of mentorship. But I think that participating in RAMS really hammered that home because they do a great job of picking people who are interested in mentoring early-career addiction researchers. I got to know a number of people through RAMS, including Ned Nunes at Columbia, Patrick O’Connor at Yale, and Jeffrey Samet at BMC. RAMS is like a fellowship in the real sense that you get to meet people who are also interested in the same thing you are from around the country, although I will say that the person in my cohort that I probably connected with the most was Sarah Bagley, who was also at BU. I got to be involved in her program that she developed, the CATALYST Program, as a psychiatric consultant, and we also did a couple of studies together on stigma in young adults with opioid use disorder. RAMS really was great in terms of opening those doors and introducing me to a lot of people.

My RAMS project also allowed me to get to know some of the faculty that I did the project with. I got to work with Karen Lasser at BMC, who is a very successful researcher in the Department of General Internal Medicine, and with Jane Liebschutz, who eventually became the Chief of the Department of General Internal Medicine here at Pittsburgh. That was a great experience. Overall, RAMS was a nice supplement to my research education.

Did you move institutions post-fellowship? If so, what was the most challenging about this transition?

After my time in Boston and my fellowship with the VA, I got a job at Brown University in their General Internal Medicine department. I started to write a K award application, but my primary mentor at Brown ended up leaving so I decided to come back to Boston. I ended up at BU in the Department of Psychiatry. I would say that that was an exciting time until the pandemic hit. I got my K award, and that was moving along, but I ended up leaving Boston and coming back to Pittsburgh. It was a big transition, but the nice thing was that Jane was here, and I had already worked with her previously. Moving institutions also had strong effects on recruitment for my K because I was really depending on recruiting a group of people who were using benzodiazepines while they were on opioids. I saw a lot more prescribing of benzodiazepines in Boston, but physicians at Pittsburgh were much more hesitant with prescribing. I should have known that because I trained here! The lesson there was that recruitment is one of the most important things to consider in planning a clinical trial. You have to know how feasible it is, and if it is not going to be feasible at the sites that you are looking at, you have to go elsewhere. I think had we considered the community, we would have done a better job recruiting. So that transition made recruitment difficult, but it was also difficult for other reasons. If you stay at an institution for a while, you kind of build up credibility, you become known for your research and clinical focus. People know who you are, especially when the department isn’t that big. When you move to a new institution, you’re essentially starting over again in that sense, unless you have this national reputation or you’re maybe leading a section or leading a department, which I was not. So, it took a while after the move to build up that reputation again, and I’m still kind of working on who I’m supposed to know and who to turn to for help. However, I have been lucky in that I’ve met a lot of people and have been offered a lot of opportunities here in terms of pursuing research.

What are some of your research interests?

My K was about decreasing benzodiazepine use in people receiving methadone or buprenorphine. Benzodiazepines were used in this population to help with tapering. We developed an intervention that was psychotherapy based. The psychological target of the intervention was the improvement of distress tolerance, to help people withstand higher levels of distress, which can be a big problem for people with emotional disorders like depression and anxiety and for people with substance use disorder. There’s a whole line of psychological research surrounding exposure, exposing yourself to things that are uncomfortable so that you can better tolerate them. The idea is that, for example, if you’re an anxious person and you expose yourself to things that might stimulate your anxiety over and over again, you start to acclimate and experience less anxiety from those stimuli. That was the idea behind the intervention.

Since coming to Pittsburgh, as I mentioned I’ve had a lot of research opportunities. I’m on a number of grants and I’ve had a lot of opportunities to help write, edit, and submit grants as a co-investigator. I’m on two projects right now that I think are really interesting. One is a clinical trial, the mPROVEN trial, which is led by Walid Gellad. The trial is focused on using machine learning models and algorithms to predict which patients are at highest risk of overdose, and creating clinical alerts for providers to hopefully influence prescribing behavior. The other project I’m working on is with Jane. She’s running a trial through the Appalachian Node of NIDA Clinical Trials Network focused on treating polysubstance use. It’s called the Co-CARE study and the aim is to design and implement this interesting intervention to treat polysubstance use patients, utilizing a nurse care manager model along with something called telephone health coaching. It’s a really fascinating study and I’m really excited that I got to contribute by helping to develop the protocol and the intervention. It’s been a really good experience and it’s a wonderful team.

What are some directions you see your career going in, as far as research and clinical work?

In terms of my own research, I just submitted an R01 application. It’s interesting because I was involved in some of the work that helped inform the FDA black box warnings about people being prescribed opioids and benzodiazepines together. That may have influenced patients being taken off of these medications, so I’m curious about what’s been the impact of that. Have there been downsides to de-prescribing benzodiazepines as a means to keep patients who use opioids? So that’s the focus of my R01, which is currently under review.

As far as clinical work, I would call that my primary identity. As an addiction psychiatrist, I have a lot of thoughts in terms of the psychiatrist’s role within the field, which I think is important. There are a lot of co-occurring mental disorders in patients who have substance use disorders and I think addiction psychiatrists are better equipped to dealing with that and leading the programs that deal with those aspects. That association isn’t completely coincidental, either. For patients who develop an addiction, even without a pre-existing mental health disorder, there’s a strong, strong chance that those patients will develop those disorders alongside or as a result of their substance use. And vice versa, people with mental health problems oftentimes will take substances to cope with those problems. So there’s plenty of work for addiction psychiatrists as consultants for mental health problems, but also for the issue of substance use itself. I think to effectively address substance use disorders, you need to involve both addiction-informed internists and addiction-informed psychiatrists. That’s the role I filled in addiction clinics in Internal Medicine in Boston, and I have and will continue to do that here in Pittsburgh while also working in our addiction clinic in the Department of Psychiatry.

Tell us one thing about yourself that readers might find interesting.

I’ve always liked to cook and always been semi-obsessed with food. But during the pandemic, like a lot of people did, I started cooking and baking even more. I got really into pizza making, and we would make pizza several times a week during the height of the pandemic – my wife even got me a pizza oven. Maybe not so great on my waistline but it’s a lot of fun.

Interview conducted by Lydia Carlson, MPH