Department of
Anesthesiology and Perioperative Medicine

Howard B. Gutstein, MD

  • Professor

Howard B. Gutstein, MD holds joint appointments in the departments of Pediatrics, Neurobiology, Cell Biology, and Pharmacology and Chemical Biology.

Dr. Gutstein began his academic career as an Assistant Professor in the Section of Pediatric Anesthesiology at the University of Michigan, and he held a concurrent position as a Research Investigator in the Mental Health Research Institute. During this time, he also had a year-long appointment as a Visiting Scientist at the Ontario Cancer Institute, University of Toronto. In 1998, Dr. Gutstein moved to the University of Texas-MD Anderson Cancer Center as an Associate Professor of Anesthesiology. In 2008, he was promoted to full professor in the Department of Anesthesiology with a secondary appointment in the Department of Biochemistry and Molecular Biology. In 2013-14, he was a Visiting Professor at the Weizmann Institute of Science, Israel.

The primary focus of Dr. Gutstein’s research has been the molecular mechanism underlying the development of opioid tolerance and dependence and the interactions between pain and analgesic signaling. Opioids such as morphine are the most effective pain treatments currently available.  However, these drugs are ineffective against many types of cancer pain, and with chronic use, the efficacy of opioids decreases as tolerance develops. Dr. Gutstein has utilized proteomics, Drosophila genetics, as well as behavioral neuropharmacology in an effort to determine a priori which signaling adaptations can cause maladaptive changes in response to pain or narcotics. Recently, Dr. Gutstein has identified a mechanism responsible for opioid tolerance and was the first to demonstrate that mechanisms underlying tolerance can be completely dissociated from the pain-relieving effects of opioids. He has also identified ways to eliminate or reverse tolerance in vivo. Dr. Gutstein has also determined the reason why opioids are ineffective in cases of neuropathic pain. 

Education & Training

  • Undergraduate, Washington University, St. Louis, MO
  • MD, Johns Hopkins University School of Medicine
  • Anesthesiology Residency, University of California, San Francisco
  • Pediatric Anesthesiology Fellowship, University of California, San Francisco
  • Postdoctoral Fellowship, Neuroscience Mental Health Research Institute, University of Michigan
  • Graduate Certificate in Healthcare Management, Jones School of Business, Rice University

Representative Publications

Dr. Gutstein's publications can be reviewed through PubMed.

Research, clinical, and/or academic interests

  • pain
  • narcotic tolerance and addiction