Message from the Director

As part of the National Institute on Drug Abuse's efforts to be responsive to the future needs of the field and to take advantage of the evolving nature of science and the opportunities it brings in its wake, I will work with NIDA staff, the field, and NIDA's National Advisory Council on Drug Abuse to begin the process of revising NIDA's "Five Year Strategic Plan: Bringing the Power of Science to Bear on Drug Abuse and Addiction."

In addition to supporting a comprehensive and extensive basic and clinical research portfolio, the following areas have been identified as priorities for the Institute:

Prevention Research

Drug addiction is a disease that often begins during adolescence and sometimes even in childhood. This is a period of neurodevelopment that is characterized by dramatic changes in brain structure and function. NIDA will encourage more research on the developing brain and the effects that drugs of abuse have on the brain across the lifespan, from in utero to those in our aging population. Understanding these processes, as well as the role that other factors such as social context play in decision-making and risk taking behaviors will help us to develop improved interventions to prevent the initiation of drug use and its escalation to abuse and addiction.

NIDA will also encourage research into the comorbidity of drug addiction and mental illness. In addition to expanding our research to better understand the neurobiological underpinnings of both disorders, NIDA will encourage research at a more clinical level to elucidate the risk and protective factors for the development of mental health and substance abuse problems across the life span in order to guide the development of prevention and early intervention strategies.

NIDA is also interested in research aimed at understanding the role that the environment plays on neurobiological factors, such as gene expression. By supporting research that simultaneously works to understand the genetic factors involved in the addiction process, we will be able to tease out genetic, social, and cultural risk and protective factors.

Treatment

Bringing effective new medications and behavioral treatments to practitioners will be a primary goal for NIDA. Researchers will be encouraged to harness the tools and knowledge being generated from science to develop new and improved interventions. For example, a series of studies have demonstrated the promise of cannabinoid receptors in treating a number of neurological and addictive disorders, as well as obesity. Finding treatments to help the nearly four million Americans who are addicted to marijuana is a top priority for the Institute, as is the development of new medications to treat prescription drug abuse. In addition, NIDA hopes to foster research on behavioral interventions that take advantage of new imaging tools to monitor plastic changes linked with the interventions themselves and their subsequent effects on addiction.

NIDA will also continue in its efforts to develop medications that can reverse changes in the brain that are caused by chronic drug exposure. For example, chronic drug use causes changes to occur in the brain so that further exposure to drugs or to environmental cues linked to drugs results in what is known as a conditioned response. These conditioned responses often precipitate relapse in former drug users. NIDA is currently conducting research aimed at developing medications that interfere with the expression of conditioned responses. By developing these medications, along with behavioral therapies, and other types of support services, it should be possible to more effectively treat drug addiction and help people return as functioning members of society.

Also important is research that will help bridge the gaps between bench to beside and bedside to community. It is critical that the many exciting discoveries that are being made in the laboratory are translated for use in the community. Likewise, it is important that basic research be guided by what is happening in the community. NIDA will continue to encourage our bench and bedside researchers to communicate and collaborate. We will also accomplish this goal by working with agencies like the Substance Abuse and Mental Health Services Administration (SAMHSA) that have responsibility for implementing substance abuse treatment and prevention programs in communities.

Training

NIDA will use the widest variety of mechanisms to bring researchers to the field of drug abuse, including recruiting and supporting more clinicians. Mechanisms to accomplish this include the use of NIDA's National Drug Abuse Treatment Clinical Treatment Network as a platform for training to engage clinicians and other members of the medical community to pursue addiction research careers, particularly research related to important health services questions.

HIV/AIDS and Other Medical Conditions

Drug use and abuse have been and continue to contribute to the HIV/AIDS epidemic in the USA and in the world. Thus, interventions that target prevention and treatment in drug addiction are means to curtail the growth of this epidemic. This will require a better understanding of how drug intoxication affects behaviors that may put a person at risk for HIV infection. Another area of concern is the burden of drug addiction in the course of other medical illnesses such as asthma, cardiac disease and mental illnesses.

To ensure that these important priorities are addressed, I have asked for input from NIDA's Advisory Council on Drug Abuse. Council serves a crucial role in advising NIDA, and, by extension, the Director, NIH and the Secretary, DHHS, as NIDA identifies, reviews, and supports the highest caliber of scientific research. The Council will assist in the establishment of achievable goals and objectives that will become part of NIDA's revised Strategic Plan.

Since my arrival as NIDA's Director in May 2003, the Council has been invaluable to me. Three Council Subcommittees, which have included outside experts, have already completed program reviews in the important areas of health services research, the National Drug Abuse Treatment Clinical Trials Network and on NIDA's HIV/AIDS portfolio. Many of the recommendations made in these reports are being implemented and are now an integral part of NIDA's strategic planning process. Three of the Council Task Force Reports (Clinical Trials Network presented by David Rosenbloom, Ph.D.; HIV/AIDS Research presented by David Vlahov, Ph.D.; and the Blue Ribbon Task Force on Health Services Research presented by Constance Weisner, D.P.H.) were presented to me on February 12, 2004 and are available at http://www.drugabuse.gov/about/organization/nacda/CouncilPresentations.html.

Council Workgroups are now in the process of providing recommendations for several other areas of NIDA's portfolio. For example, NIDA's Medications Development Workgroup is expected to release its recommendations very soon. NIDA's Special Populations/Health Disparities Workgroup is building on NIDA's "Strategic Plan on Reducing Health Disparities" and "Window on America: Drug Use Among Racial/Ethnic Minorities." Using these publications and with other input, it is expected that this workgroup will release its report by next winter.

We at NIDA look forward to keeping you informed on our progress in developing our strategic plan for the future.

Current and Past Strategic Plans

• Bringing the Power of Science to Bear on Drug Abuse and Addiction - 5 Year Strategic Plan, 2000-2005- by former Director, Alan Leshner. Published September 2000.

The National Institute on Drug Abuse (NIDA) is part of the National Institutes of Health (NIH), a component of the U.S. Department of Health and Human Services. Questions? See our Contact Information. Last updated on Tuesday, August 24, 2004.