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Director’s Report to the National Advisory Council on Drug Abuse

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

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Director’s Report to the National Advisory Council on Drug Abuse

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  1. Director’s Report to the National Advisory Council on Drug Abuse February 12, 2004

  2. 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

  3. Recent NIDA Staff Appointments/Changes NIDA and Director, OSPC Timothy P. Condon, Ph.D. Deputy Director, NIDA

  4. Director’s Report to the National Advisory Council on Drug Abuse Science Highlights What’s New at NIH? Budget Update Recent NIDA Activities FY 2004 and Beyond

  5. What’s New at NIH?

  6. 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

  7. Report by National Research Council and IoM Enhancing the Vitality of the National Institutes of Health: Organizational Change to Meet New Challenges Create a public process for considering proposed changes in the number of NIH institutes or centers. 2. 4. Enhance and increase trans-NIH strategic planning and funding. Create a Director’s Special Projects Program to support high risk, high potential payoff research. 7. 8. Promote innovation and risk-taking in intramural research.

  8. 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

  9. 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

  10. 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)

  11. 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

  12. Budget Update

  13. 2005P.B. 2004Estimate 2003Actual $703,328 $659,431 $677,808 $315,732 $301,514 $312,979 $1,019,060 $960,945 $990,787 +2.9% +3.0% +8.2% NIDA BUDGET (Thousands) NonAIDS AIDS TOTAL Increase Over Prior Year

  14. Recent NIDA Activities

  15. 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)

  16. 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)

  17. 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

  18. NIDA/SAMHSA Addiction Technology Transfer Center (ATTC) Blending Initiative BLENDING TEAMS Members of CSAT’s ATTC Network + NIDA Researchers Training materials and products to help program managers, administrators and policy makers use Addiction Severity Index (ASI) results for management and program planning decisions Buprenorphine awareness training and materials for non-physicians in the drug abuse and addiction field

  19. Highlights of Recent Meetings and Events

  20. 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

  21. We Recently Released Our New Website for Teens!

  22. . . . . . . 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

  23. Science Highlights

  24. 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 2001 to 2003 Monitoring the Future Study 2003

  25. Percent of Students Reporting Abuse of Pain Killers in Past 12 Months in 2003 WORRISOME NEWS 12.0 10.5 10.0 7.2 8.0 Percent 8th Grade 6.0 10th Grade 4.5 12th Grade 3.6 4.0 2.8 1.7 2.0 0.0 Oxycontin Vicodin Source: Monitoring the Future Study, 2003.

  26. Numbers of New Abusers of Prescription Drugs: 1965-2001 Source: SAMHSA, 2002 NSDUH

  27. Use of Prescription Drugs for Non-Medical Purposes 2002 National Survey on Drug Use and Health Millions of Americans Abuse Prescription Drugs 4.4 million 4.5 4 Millions of Americans 3.5 3 2.2 million 2.5 2 1.2 million 1.5 1 0.5 0 Stimulants Sedatives Pain Relievers

  28. 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)

  29. 24000 80000 70000 18000 60000 50000 12000 40000 30000 ED Mentions 6000 20000 10000 0 0 1998 1996 2000 1994 1995 1997 1999 2001 As Prescriptions Increase Emergency Room Visits For Non-Medical Abuse Have Also Increased Hydrocodone prescriptions Number of Prescriptions (in 1000s) emergency Oxycodone prescriptions emergency Source: SAMHSA, DAWN, 2002

  30. Increased Media Attention

  31. Availability on the Internet Delivered in the Privacy of your Home “Some reasons why you should consider using this pharmacy” No prescription required!

  32. 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

  33. How Does NIDA’s Science Help Fight Prescription Drug Abuse?

  34. 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

  35. What could have accounted for this reduction? Example for Marihuana: As Perceived Risk Increases Use Decreases 60 50 % Reporting Use % Reporting Harmfulness 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

  36. Development of Alternative Medications with no Drug Abuse Potential

  37. FY 2005 and Beyond

  38. 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

  39. 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

  40. Brain, Behavior & Health Roadmap

  41. 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 topromote optimal health

  42. 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.

  43. Matrix is based on a 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. Social Network

  44. BRAIN BEHAVIOR & HEALTH ROAD MAP 1. Scientific Question 2. Infrastructure & Projects 3. Need for Technology SOCIAL NETWORKS BEHAVIOR CIRCUITS/ PATHWAYS CELL PROTEIN GENE

  45. 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) 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 Gaps (with NIMH) RFAs

  46. Monitoring the Future Study 2003 Percent of Students Reporting Any Illicit Drug Use in Past Year, by Grade 60 50 12th Grade 40 10th Grade 30 20 8th Grade 10 0 75 77 79 81 83 85 87 89 91 93 95 97 99 01 03

  47. 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.

  48. 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

  49. 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 NIDA-Sponsored Mini-Convention

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