Return to the Faculty List

Theodore Cicero, PhD

Current Position
John P. Feighner Professor of Psychiatry

Education and Training
Undergraduate: 1964; B.Sc. (Hons), Psychology, Villanova University

Graduate: 1966; M.S., Physiological Psychology, Purdue University

Postgraduate: 1969; Ph.D., Neuropharmacology, Purdue University

1968-1970; Postdoctoral Fellow in Neurochemistry,
Washington University School of Medicine,
Department of Psychiatry

Major Awards
2010 Nathan B. Eddy Award

Areas of Research Interests
Theodore J. Cicero was the innovator of the first post-marketing drug abuse surveillance program imposed by the FDA as a condition for the approval of tramadol in 1992. He served as the chairman of the advisory board which was charged with developing a comprehensive surveillance project that would detect abuse of tramadol in a timely fashion with a geographic precision down to the 5 digit postal zip code. This program evolved over time and has now emerged as one element of a much larger risk-management program: RADARS (Researched Abuse, Diversion and Addiction-Related Surveillance). This program, the Survey of Key Informants’ Patients (SKIP) is fully funded by a grant from the non-profit Denver Health and Hospital Authority. The purpose of this program is to provide a nationwide network of patients entering drug abuse treatment programs across the country who meet criteria for abuse and dependence on prescription opioids. Our goals are to determine where there are disproportionately high areas of abuse for specific drugs and then characterize the abusers to the extent possible to develop treatment, prevention and intervention strategies. To supplement and add context to the structured SKIP survey, we have also recruited over 600 patients who had previously completed the SKIP survey and indicated by a mail-in postcard provided with the survey that they were willing to give up their anonymity to participate in a follow-up study, dubbed Researchers and Participants Interacting Directly (RAPID). The purpose of this program is two-fold: 1) to be able to contact participants with questions that can be answered in a relatively short amount of time to establish real-time data; and 2) to quickly ask follow-up questions based on SKIP and RAPID analyses. Based on SKIP and RAPID data analyses, we are achieving a much better understanding of the motivations underlying the epidemic of prescription opioids in this country which should better inform prevention and treatment strategies.

In a totally different arena, in 1985-1988, Dr. Cicero also documented that paternal administration of opioids and/or alcohol influenced the development and maturation of their offspring. The only explanation for this phenomenon was that the function of sperm had in some way been affected. The most obvious possibility was that the expression of genes was affected in some way, and this was postulated by his group in 1988. However, this flew in the face of conventional wisdom which posited that such “Lamarckian” charges in DNA expression did not occur. As a result, his results were viewed with considerable skepticism and it was difficult to get papers published or get any support from the NIH to follow these studies to their logical conclusion. Interestingly, 15 years later, it has been shown in several landmark studies that environmental toxins and drugs influence the methylation of DNA, a process which influences gene expression. This launched the new field of “epigenetics” and Dr. Cicero’s research in the late 1980s is uniformly cited as the original observations documenting epigenetic processes. He is presently actively re-engaging in this research and exploring the molecular genetics of this phenomenon.

Key Publications
Cicero TJ, Ellis MS, Surratt HL, Kurtz SP (2014 May 28). The Changing Face of Heroin Use in the United States: A Retrospective Analysis of the Past 50 Years. JAMA Psychiatry 71(7):821-6;  Full Article ->

Dart Richard C,Surratt Hilary L,Cicero Theodore J,Parrino Mark W,Severtson S Geoff,Bucher-Bartelson Becki,Green Jody L,;Trends in opioid analgesic abuse and mortality in the United States.; N Engl J Med 372:241-8;  Full Article ->

Cicero Theodore J,Ellis Matthew S,Surratt Hilary L,;Effect of abuse-deterrent formulation of OxyContin.; N Engl J Med 367:187-9;  Full Article ->

Cicero Theodore J,Ellis Matthew S,;Abuse-Deterrent Formulations and the Prescription Opioid Abuse Epidemic in the United States: Lessons Learned From OxyContin.; JAMA Psychiatry 72:424-30;  Full Article ->

Cicero Theodore J,Ellis Matthew S,Harney Jessie,;Shifting Patterns of Prescription Opioid and Heroin Abuse in the United States.; N Engl J Med 373:1789-90;  Full Article ->

Chorbov Vesselin M,Todorov Alexandre A,Lynskey Michael T,Cicero Theodore J,;Elevated levels of DNA methylation at the OPRM1 promoter in blood and sperm from male opioid addicts.;7:258-64;  Full Article ->

Funded Research Projects
NIDA(PI):Biomedical Research Training in Drug Abuse
NIDA(Key Personnel):Prescription Drug Misuse, Abuse and Dependence
NIDA(Key Personnel):Understanding the Scope and Magnitude of Prescription Drug Diversion
Barnes-Jewish Hospital Foundation(PI):Characteristics of Prescription Drug Abusers
Unrestricted grant from Denver Health and Hospital Authority