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									 Director’s Report to the
National Advisory Council
     on Drug Abuse
       February 12, 2004
       Recent NIDA Staff
     Appointments/Changes


Richard A. Millstein, J.D.
Acting Deputy Director
NIH John E. Fogarty International Center
for Advanced Study in the Health Sciences
         Recent NIDA Staff
       Appointments/Changes

Timothy P. Condon, Ph.D.
Deputy Director, NIDA
        and
  Director, OSPC
        Director’s Report to the
National Advisory Council on Drug Abuse

        What’s New at NIH?
        Budget Update
        Recent NIDA Activities
        Science Highlights
        FY 2004 and Beyond
What’s New at NIH?
        NIH Central Steering Committee

Rotating Members (three year terms):
•   Francis Collins   Genome Research Institute
•   Richard Hodes     Aging
•   Stephen Katz      Arthritis Musculoskeletal & Skin Diseases
•   Donald Lindberg   National Library of Medicine
•   Stephen Straus    Complementary & Alternative Medicine
•   Larry Tabak       Dental & Craniofacial Research
•   Nora Volkow       NIDA
Permanent Members (three largest institutes):
• Andrew von Eschenbach – National Cancer Institute
• Barbara Albin – National Heart, Lung and Blood Institute
• Anthony Fauci – National Institute of Allergy and Infectious Diseases
Report by National Research Council and IoM


 Enhancing the Vitality of the
2. Create a public process for considering proposed changes in the number
   of NIH institutes or centers.
 National Institutes of Health:
4. Enhance and increase trans-NIH strategic planning and funding.
     Organizational Change to
           Meet New Challenges
7. Create a Director’s Special Projects Program to support high risk, high
   potential payoff research.
8. Promote innovation and risk-taking in intramural research.
        THE NIH ROADMAP
        An Agency-Wide Effort To Identify the
       Critical Roadblocks and Knowledge Gaps
            That Constrain Rapid Advances
            in Biomedical Research Progress

• Molecular Libraries and Imaging
• Research Teams of the Future
• High-Risk Research
• Private-Public Partnerships
• Re-engineering the Clinical Research Enterprise
    What Has NIDA Done to Ensure Participation
          of Substance Abuse Researchers
               on the NIH Roadmap?

•    Dr. Condon named NIDA’s representative for
     the Roadmap
•    Program officers have contacted potential grantees to
     encourage them to submit grants for Roadmap RFAs
•    Created a page on NIDA website that highlights
     opportunities from the roadmap relevant to NIH
     grantees
•    Periodic staff meetings with NIDA Director to review
     progress and plan strategies
              Ethics Issues at NIH
Concern by congress that there may be conflict between the role
of NIH directors and of NIH scientists and private partnerships

       New Initiatives to Strenthen the NIH Ethics Program:
   •   Raynard S. Kington, M.D., Ph.D., NIH Deputy Director, appointed
       as Deputy Ethics Counselor (DEC) for the NIH and the Office of the
       Director, NIH

   •   Blue Ribbon Panel established to review current NIH Ethics policies


   •   NIH Ethics Advisory Committee (NEAC) established
       (composed of members of the NIH community)
   NIH Consolidation and Centralization Activities
              (occurring through several approaches)
Outsourcing studies:
NIH “competes” against outside contractors
Extramural Support was studied last year
656 FTEs now in ICs (22 in NIDA) will be centralized into a new NIH Office the
“MEO” – Most Efficient Organization -- Implementation Date: April 1, 2004.

NIH Administrative Restructuring Plan – ARAC
(Administrative Restructuring and Advisory Committee)
Consolidation of functions in several areas including:
Personnel, Grants Management, Budget, Acquisitions, Information Technology,
Facilities, Financial Maagement and EEO

Harmonization of and accountability for achieving both corporate NIH objectives
and IC-specific objectives – Looking at “Dual Reporting” for senior IC staff

FTE Ceiling imposed to limit the number of NIH employees at each institute;
NIDA’s is 373 in FY04
Budget Update
                NIDA BUDGET
                           (Thousands)

                 2003               2004      2005
                Actual            Estimate    P.B.
NonAIDS         $659,431          $677,808   $703,328

AIDS            $301,514          $312,979   $315,732

TOTAL           $960,945          $990,787   $1,019,060
Increase Over
 Prior Year     +8.2%              +3.0%      +2.9%
Recent NIDA Activities
New NIDA PAs and RFAs
   Prevention Research (Children and Adolescents)
       Novel Approaches to Phenotyping Drug Abuse (RFA)
       Behavioral and Cognitive Processes in Adolescent Drug Abuse (RFA)
       Animal Models of Adolescent Drug Abuse (RFA)
       Prevention Research for the Transition to Adulthood (RFA)
       Consequences of Marijuana Use on the Developing Brain (RFA)


   Treatment Interventions
       Medications Development for Cannabis-Related Disorders (RFA)
New NIDA PAs and RFAs
   HIV/HCV
       Drug Abuse Aspects of HIV/AIDS and Other Infections (PA)
       HIV/AIDS and Other Infections Among Drug Users in the Criminal
            Justice System (RFA)
       Targeted Integrative Research in Drug Abuse and HIV/AIDS in
            Pregnancy (RFA)


   Training
       Research Education Grants in Drug Abuse and Addiction (PA)
PAs and RFA With Other NIH Components


            8 New PAs and
     4 New RFAs (Totaling $9.8 Million)
        Focus predominantly on:
            CO-MORBIDITY
             Mental illness
              Alcoholism
                 HIV
                NIDA/SAMHSA
Addiction Technology Transfer Center (ATTC)
             Blending Initiative
              BLENDING TEAMS
         Members of CSAT’s ATTC Network
                       +
                NIDA Researchers


                             Training materials and
Buprenorphine awareness      products to help program
training and materials for   managers, administrators
non-physicians in the drug   and policy makers use
abuse and addiction field    Addiction Severity Index (ASI)
                             results for management and
                             program planning decisions
Highlights of Recent
Meetings and Events
Society for Neuroscience Annual Meeting
                Opening Plenary Lecture
        THE ADDICTED HUMAN BRAIN
           Nora D. Volkow, M.D., Director, NIDA




       NIDA-Sponsored Mini-Convention



  Growth in Drug Abuse-Related Presentations
               2002 ~ 471 of 13, 393
               2003 ~ 576 of 16,155
We Recently Released Our New
     Website for Teens!
NIDA’s                             .. .
                                      .


Primary Healthcare
Outreach Initiative
Educational Seminar for Primary Health Care Providers
Co-sponsored by NIDA and the Sheppard Pratt Health System
Sheppard Pratt Conference Center
Baltimore MD
December 17, 2003


Tent at New Year’s Eve Spectacular
(widely attended alcohol- drug- and smoke-free community event)
Co-sponsored by NIDA in collaboration with the Maryland Chapter
of the American Academy of Pediatrics, coalition partners and
corporate sponsors
Baltimore MD
December 31, 2003
Science Highlights
       Percent of Students Reporting Past
         Month Use of Any Illicit Drug
                      GREAT NEWS!!

         20
                        19.4

         19
                                    18.2
         18
                                           17.3
         17

         16
                     2001          2002    2003
                                                  11% Decline
Monitoring the Future Study 2003                  2001 to 2003
    Percent of Students Reporting Abuse of
    Pain Killers in Past 12 Months in 2003
                 WORRISOME NEWS

          12.0
                                               10.5
          10.0
Percent




           8.0                           7.2
                                                              8th Grade
           6.0                                                10th Grade
                             4.5
                       3.6                                    12th Grade
           4.0                     2.8
                 1.7
           2.0

           0.0
                 Oxycontin           Vicodin
                                    Source: Monitoring the Future Study, 2003.
 Numbers of New Abusers of
Prescription Drugs: 1965-2001




       Source: SAMHSA, 2002 NSDUH
  Use of Prescription Drugs for Non-Medical Purposes
     2002 National Survey on Drug Use and Health
                                                    4.4 million
              4.5
                4
Americans
Millions of




              3.5
                3                     2.2 million
              2.5
                2      1.2 million
              1.5
                1
              0.5
                0
                    Stimulants       Sedatives      Pain Relievers

               Millions of Americans Abuse Prescription Drugs
 Why Has the Abuse of Prescription
        Drugs Increased?
 Increasing numbers of prescriptions
    (greater availability)
 Attention by the media and advertising
    (television and newspaper)
 Easier access
    (e.g. internet availability)
 Improper knowledge and monitoring
    (adverse effects go unrecognized)
                                      As Prescriptions Increase Emergency Room
                                            Visits For Non-Medical Abuse
                                                 Have Also Increased
Number of Prescriptions (in 1000s)




                                                                                                         24000
                                     80000                                                                       Hydrocodone
                                     70000
                                                                                                         18000     prescriptions
                                     60000
                                                                                                                    emergency
                                     50000
                                     40000                                                               12000
                                     30000
                                                                                                                 Oxycodone
                                     20000                                                               6000       prescriptions
                                     10000                                                                          emergency
                                          0                                                              0
                                                                             1998
                                                            1996




                                                                                           2000
                                                                      1997




                                                                                    1999
                                              1994


                                                     1995




                                                                   Source: SAMHSA, DAWN, 2002     2001
Increased Media Attention
   Availability on the Internet
Delivered in the Privacy of your Home
                              “Some reasons why
                              you should consider
                                   using this
                                  pharmacy”

                              No
                              prescription
                              required!
           Other Reasons for Concern
 These drugs can have serious medical consequences i.e
    lethal overdose with pain killers, psychosis with
    stimulant medications
 Misuse in elderly populations who are particularly
    sensitive to adverse medical reactions
 Increase use by adolescents of drugs that may have long
    term effects in brain development
How Does NIDA’s Science Help
Fight Prescription Drug Abuse?
Continue Research on Prescription Drugs and
       on Treatment and Prevention


When analgesics are injected
they are much more addictive
than when taken orally; hence
formulations that can interfere
with the drug effects if injected
would decrease its diversion and
abuse
What could have accounted for this reduction?
                   Example for Marihuana:
           As Perceived Risk Increases Use Decreases
      60

      50

      40

      30

      20

      10

       0
           '75 '77 '79 '81 '83 '85 '87 '89 '91 '93 '95 '97 '99 '01 '03
                               Year
 Education of patients, physicians, pharmacists and the public
Development of Alternative Medications with no
            Drug Abuse Potential
FY 2005 and Beyond
 NIDA FY 2005 Initiatives

• Prevention Research (Children and Adolescents)
  • Gene/Environment Interactions
  • Drug Exposure and the Developing Prenatal Brain
  • The Effects of Drugs of Abuse Across the Lifespan
  • Impact of Drugs, Risky Behavior and HIV on Adolescent Brain
  • Drug Abuse Prevention and Treatment in Primary Care System
  • Neurobiological Processes Underlying Co-morbidity
• Treatment Interventions
  •    Pharmacogenetics and Medications Development

• Training
   •   Using Science to Improve Providers’ Knowledge and Skills
Systems and Translational Research
     Approaches in Addiction
• Infrastructure Development and the Creation of Translational Research Centers

     DRUGS OF ABUSE

                                    social
                                 behavior
                            neuronal circuits
                           protein expression
                                   genome
Brain, Behavior & Health Roadmap
   Brain, Behavior & Health Initiative
                Mission
To develop the knowledge and the technology
necessary for understanding how the human brain
   • works and molds human behavior,
   • how genes and environmental factors mold its
       development and function
   • how it changes throughout the lifespan

 This knowledge will help to better understand
 brain diseases including ADDICTION, and to
 develop strategies to promote optimal health
FIRST MILESTONE
Create a matrix that will
 Catalog ongoing projects that pertain
 to a brain/behavior/health initiative

 Identify scientific questions

 Identify research areas of redundancy and areas that
 need to be developed

 Identify technology or infrastructure that needs to be
 developed

 Optimize chances for integrating efforts across research
 centers, institutes and agencies.
                 Matrix is based on a
Social Network   systems approach
                 including
                 data from all levels of
                 biology: genes, proteins
                 and their complexes,
                 cell, circuits, behavior
                 individual and social.

                 The matrix includes
                 projects in laboratory
                 animals and implicitly
                 addresses development
                 and gender.
BRAIN BEHAVIOR & HEALTH ROAD MAP
            1. Scientific   2. Infrastructure   3. Need for
             Question           & Projects      Technology
SOCIAL
NETWORKS

BEHAVIOR

CIRCUITS/
PATHWAYS

CELL


PROTEIN


GENE
 PAs and RFA With Other NIH Components
PAs
 National Cooperative Drug Discovery Groups for the Treatment of
 Mood Disorders or Nicotine Addiction (NCDDG-MD/NA)
 Mechanisms of Alcoholic Pancreatitis
 Neurotechnology Research, Development and Enhancement
 Bioengineering Research Partnerships
 HIV/AIDS, Severe Mental Illness and Homelessness (with NIAAA and NIMH)
 Ruth L. Kirschstein National Research Service Awards for Individual
 Predoctoral Fellows (F31)
 ELSI Regular Research Program (R01)
 ELSI Small Grant Research Program (R03)
RFAs
 Transdisciplinary Tobacco Use Research Centers (with NCI and NIAAA)
 Group Therapy for Individuals in Drug Abuse or Alcoholism Treatment
 Screening and Intervention for Youth in Primary Care Settings
 HIV/AIDS, Drug Use and Highly Vulnerable Youth: Targeting Research Ga
 (with NIMH)
   Monitoring the Future Study 2003
Percent of Students Reporting Any Illicit Drug Use
              in Past Year, by Grade

   60
   50
   40                                                  12th Grade
   30                                                  10th Grade
   20
                                                       8th Grade
   10
    0
        75 77 79 81 83 85 87 89 91 93 95 97 99 01 03
  Recent NIDA Staff Appointments/Changes
Office of the Director
   Cheryl Kassed, M.S.P.H., Ph.D., Special Assistant to the Director
   Helen Cesari, M.S., Special Assistant to the Deputy Director
Office of Science Policy and Communication
   Susan Weiss, Ph.D. – Chief, Science Policy Branch
   Robin Mackar, M.P.H. – Deputy Chief, Science Policy Branch
   Gayathri Jeyarasasingam – Science Policy Branch
Office of Extramural Affairs
   Mark Green, Ph.D. – Deputy Director
Division of Epidemiology, Services and Prevention Research
   Arnold Mills -- Acting Chief, Epidemiology Research Branch
   Kevin Conway, Ph.D. – Deputy Chief, Epidemiology Research Branch
   Yonette Thomas, Ph.D. -- Deputy Chief, Epidemiology Research Branch
   Jessica Campbell, Ph.D. – Epidemiology Research Branch
   Elizabeth Genexi, Ph.D. – Prevention Research Branch
Division of Treatment Research & Development
   Steve Oversby, Psy.D. – Medications Research Grants Branch
   Jennifer Wong, Ph.D. – Regulatory Affairs Branch
Center on AIDS and Other Medical Consequences of Drug Abuse
   Jag H. Khalsa, Ph.D. – Acting Head, Medical Consequences Unit
   Denise Burns
Center for the Clinical Trials Network
   Theresa Montini, Ph.D.
   Arnaldo R. Quinones, M.D.
                  NIH
 NCI    NIBIB   NIDDK   NIDA    NCRR    NCMHD


NIAAA   NIAID   NIEHS   NIGMS   NCCAM   NICHD


 NIA    NIDCD    NEI    NIMH    NINDS   NHGRI


NIAMS   NIDCR   NHLBI   NINR    NLM      FIC


         CIT     CSR     CC
        NIDA-Sponsored Mini-Convention
Endocannabinoids in the Brain: From Micro to Macro
  Drs. Yu Lin and Nancy Pilotte, DNBR, co-chairs
Mechanisms of Receptor & Transporter Trafficking
  Dr. Christine Colvis, DNBR, chair
Embryogenesis of Reward-Based Behavior
  Dr. Robert Riddle, DNBR, chair
Young Investigators: Research & Funding Opportunities at NIDA
  Drs. Susan Volman and Pushpa Thadani, DNBR, co-chairs
Signal Transduction Mechanism in Drug Abuse & Addiction
  Dr. David Shurtleff, DNBR, chair
Neurobiological Mechanisms of Drug & Natural Reward
  Dr. Paul Schnur, DNBR, chair
Cognition &Behavior:Functional Changes in Synaptic Transmission & Drug Abuse
  Dr. Susan Volman, DNBR, chair
Synaptic Transmission and Excitability: Genetically Encoded Biosensors for
Defining Neuronal Circuits and Synaptic Change
  Dr. Jonathan Pollock, DNBR, chair

								
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