NIH 1998 Almanac/The Organization/NIDA/
National Institute on Drug Abuse: Research Programs
Division of Epidemiology and Prevention Research
The Division of Epidemiology and Prevention Research conducts research on epidemiology,
etiology, natural history, and consequences of drug abuse and strategies to prevent drug
abuse among general, special and underserved populations. Major research efforts focus on
identifying risk and protective factors for drug abuse, identifying populations at
high-risk for drug abuse, and exploring the natural history of drug abuse and related
comorbid conditions. Information obtained from these studies guides NIDA in determining
its research priorities.
The division’s programs address questions about what kinds of drugs are being
abused, to what extent and by whom. Activities range from support for surveys designed to
monitor drug use trends among high school students, to developing networks of community
researchers for the purpose of identifying new trends in patterns of drug use and drug
abuse-related comorbid conditions, and to the design, development and testing of
preventive interventions for general and special populations.
The extramural community research program supports studies on the epidemiology and
prevention of drug use and abuse-related consequences including HIV/AIDS, hepatitis B and
C, and violence; the antecedents, determinants, correlates, and consequences of drug use
and abuse and these conditions; the efficacy, effectiveness, and efficiency of
community-based interventions in reducing these drug-abuse-related conditions; and
innovative methodologies to improve community-based epidemiologic and prevention efficacy
research.
The extramural epidemiologic research program funds research on the origins and
patterns of drug use/abuse and the disease of addiction, including surveys among general
and special populations; the identification and study of resiliency and risk factors for
drug use and abuse; etiologic studies on drug use/abuse and the human developmental
process; improved methodological studies and innovative statistical research designs; and
international epidemiologic studies that focus on drug use, etiologic factors, and related
concerns around the world.
The extramural prevention research program supports studies to develop and test
strategies to prevent drug use, to prevent escalation from initial drug use to dependence
among high risk individuals and groups, and to determine the efficacy of population-based,
comprehensive multiple component interventions. New areas of research are looking at the
cost-benefits of preventive services and the role of persuasive communications in drug
abuse prevention.
Division of Basic Research
Elucidating basic behavioral and biomedical mechanisms underlying drug abuse, its
causes, and its hazards is the goal of the Division of Basic Research. Investigations
supported by the division help form the foundation needed to make advances in the
treatment and prevention of drug abuse. The division conducts research focusing on the
behavioral processes underlying the use of abused substances, which includes studies of
drugs’ effects on human and animal behavior, as well as studies of social and other
factors in drug abuse and addiction. NIDA-funded scientists also seek to understand how
abused drugs influence performance, perception and cognitive functions such as learning
and memory.
Because drugs affect the brain and its control over mood and behavior, a significant
part of the division’s research is connected to the broad field of neuroscience. With
a clearer understanding of the brain’s functions (e.g., the neurobiology of drug
reinforcement), and how they are affected by illicit drugs, researchers hope to improve
treatment for drug addiction and to prevent drug dependence. The division also supports
studies on the motivational processes underlying drug use and relapse to drug use such as
craving.
The division monitors a broad spectrum of neurobiological and other biomedical research
including studies that seek to determine: specific mechanisms mediating drugs’
effects on the heart and other organs; mechanisms of drug tolerance and dependence; basic
chemistry of drugs and their analogs; and processes through which the body absorbs,
metabolizes and excretes drugs. In addition, investigators funded by the division explore
the effects of drugs on pregnancy and offspring and short- and long-term consequences of
multiple drug use. The division also supports studies to determine the neurochemical and
behavioral effects of newly developed drugs, with special emphasis on finding nonaddicting
analgesics. Other research develops methodologies for testing new compounds to determine
their potential for abuse.
Division of Clinical and Services Research
The Division of Clinical and Services Research supports a program aimed to enhance the
understanding of the pathophysiology of drug abuse/addictive disorders, their
complications including AIDS, and their treatment, at the clinical level. The work of the
division encompasses physiological/neurobiological, behavioral, medical, developmental,
and services-delivery approaches. In each area the emphasis is on elucidation of
mechanisms underlying drug abuse/addictive disorders and their complications; development,
improvement and evaluation of treatments; and access to quality and cost-effectiveness of
care.
The Clinical Medicine Branch stimulates, plans and develops a national research program
focusing upon the clinical, health, and developmental consequences of drug abuse/addictive
disorders. The program encompasses studies of natural history of infectious (particularly
HIV/AIDS and tuberculosis) and noninfectious complications of drug abuse/addictive
disorders, effects of addiction on human development, efficacy of clinical interventions
for complications of drug abuse/addiction, and patho-physiology/pathogenesis of diseases
associated with drug abuse disorders.
The Etiology and Clinical Neurobiology Branch conducts a national research program
focusing on the clinical neurobiology of drug abuse and addiction. The program targets
questions of how acute and chronic administration of drugs of abuse affects the structure,
function, development and maturation of the human central nervous system. Also supported
are etiological studies to determine how underlying neurobiological (anatomical and
physiological) mechanisms and genetic factors influence susceptibility, development, and
course of drug abuse and addiction.
The branch also supports studies on how drugs of abuse alter cognitive functions and to
understand the role of cognitive processes in drug-seeking and addiction. Other research
attempts to determine the effects of pharmacological/nonpharmalogical treatment of drug
addiction on brain structure and function, neurobiological implications of comorbid
disorders, as well as understanding the neurobiological aspects of HIV infection/AIDS in
drug abusers. Approaches include functional and structural brain imaging and other
state-of-the-art neurobiolgical methods.
The Services Research Branch addresses issues of financing and cost, organization,
management and effectiveness of health services delivered to patients with drug abuse
disorders, as well as health services delivered to such patients in relation to HIV/AIDS.
Investigations are carried out at the patient, program, and system levels.
The Treatment Research Branch focuses on the expansion and improvement of treatments
available to drug abusers and drug dependent persons. This program supports research on
behavioral, approved pharmacological, and nontraditional treatments for drug dependence;
interventions to reduce AIDS risk behaviors; strategies to attract drug abusers to
treatment, retain them, and help them avoid relapse; and development of screening and
diagnostic methods that identify patients’ special needs, enabling them to be matched
to the most effective treatments.
Medications Development Division
Finding new and better pharmacotherapies to treat drug addiction is the mission of the
Medications Development Division. Its founding in 1990 strengthened NIDA’s commitment
to improving drug abuse treatment and preventing the spread of AIDS.
The division funds researchers at every step of the complex medication development
process. By expanding NIDA’s in-house pharmacological research capabilities, forging
drug development agreements with pharmaceutical firms, and establishing a nationwide
network of clinical research sites where medications can be tested, the division
aggressively pursues ways to enhance and quicken the medication development process.
The division continually searches for compounds that may be effective against drug use.
Where appropriate, the division emphasizes the translation of basic research findings
regarding medications to clinical concept testing and development.
Intramural Research Program
NIDA’s Intramural Research Program (IRP), with a staff of over 325, including 68
doctorate-level scientists, FTEs, and contract personnel, is one of the largest research
facilities in the U.S. devoted to studying drug abuse and addiction.
Located in Baltimore, Md., the IRP provides an environment where NIDA scientists can
collaborate within one facility on a variety of research projects crucial to understanding
drug addiction.
Research conducted by intramural NIDA scientists complements many studies supported by
NIDA-awarded grants and contracts across the country and abroad. Areas under investigation
include causes, treatment, and prevention of drug abuse and addiction; biochemical and
behavioral mechanisms underlying the addictive process; physiological bases for
neurotoxico-logical and other harmful effects of drugs; and bases for selective individual
vulnerabilities to abused drugs.
Work ranges from basic molecular studies through laboratory work with animals to
clinical studies with human volunteers. The center uses the latest research technologies,
such as positron emission tomography, to study the action of drugs in the living human
brain and transgenic techniques, in which genetically altered mice are created to examine
the role genes play in vulnerability to drug abuse.
IRP researchers have played central roles in defining molecular sites for cocaine and
opiate action and have used their insights to add to new therapeutic studies.
In addition to its research role, the IRP also serves as a training ground for
researchers from across the world to receive training in its laboratories. Approximately
25 percent of all IRP personnel are trainees.
Special Programs
NIDA Training Programs. To ensure an adequate supply of professionals in the drug
abuse field, NIDA’s research training includes individual fellowships and
institutional training programs. NIDA’s training program emphasizes basic biomedical,
clinical, behavioral, neuroscience, and epidemiological research in drug abuse.
In addition, NIDA supports a Science Education Program in recognition of the need to
improve science education and literacy in the U.S. The purpose of the program is to
provide educators with tools that can be used to effectively interest students in science.
AIDS Program. As the dual epidemics of drug addiction and AIDS have become
formidably intertwined, one epidemic cannot be addressed without considering the other.
The NIDA Office on AIDS incorporates a range of scientific investigation from basic
molecular and behavioral research to epidemiology, prevention, and treatment. Knowledge
from each area is essential in understanding the links between drug abuse and AIDS and in
developing effective strategies for stemming the spread of HIV/AIDS and addressing its
consequences. As the trend of increasing new AIDS cases attributable to drug use
continues, the office is developing approaches and mechanisms to broaden the HIV/AIDS
research base and to foster collaborative national and international research.
Through the AIDS research program, the institute promotes biomedical, behavioral, and
social science research and collaborative activities utilizing the expertise of
nongovernment scientists and AIDS community representatives and fosters an integrated
focus for examining drug-related aspects of HIV transmission and the progression of
HIV-related disease among drug users. Such studies examine the effects of viral factors,
host factors, and cofactors on the risks for infection and disease progression.
Research goals focus on improving drug abuse-related educational and behavioral
strategies to reduce HIV transmission and refining drug abuse treatment apaproaches to
reduce HIV risk behaviors related to drug use and abuse (including pharmacologic and
nonpharmacologic therapies). Additional goals include further study of the epidemiology
and disease progression of HIV infection in drug users, their sexual partners, and their
children; research on basic behavioral and neuroimmunologic processes underlying HIV risk
behaviors and AIDS. Increasing emphasis is placed on research to evaluate access and
availability issues concerning delivery of appropriate and timely health care, drug abuse
treatment, HIV-related treatments and health services for drug users, including adherence
and compliance with treatment regimens.
The AIDS epidemic has profoundly altered the public health consequences of illicit drug
use. Significant changes in the understanding of AIDS have highlighted the role of early
identification and diagnosis of drug abuse problems and effective drug treatment in
reducing further transmission of the virus as well as initiation of medical care and HIV
therapies.
Promising findings have been shown with intravenous drug users receiving HIV testing
and counseling, and HIV risk informationi addressing unsafe sexual practices involving
drug use. Risk reduction strategies aimed at behavioral change offer the best defense
against HIV. It has been well documented that drug users who are in treatment practice
significantly lower rates of risk behavior.
NIDA research has shown that behavior change is possible to save lives and reduce the
tremendous toll in suffering and other costs to society that are associated with drug
addiction and HIV/AIDS. In fact, extraordinary advances in understanding human behavior
and behavior change have resulted from what is being learned from intravenous drug users
and others at high drug-related HIV risk.
Continuing trends show the AIDS epidemic shifting from a disease primarily of gay white
men who aggresively seek all avenues of health care to a disease of primarily of drug
users and their families who seek care only later in the course of the disease and with
less success. NIDA-supported research findings are providing valuable insights for
strategically developing and refining drug abuse outreach and treatment targeted to groups
at high risk for contracting and transmitting HIV.
Research Program on Women and Gender Differences. Prior to 1995, NIDA’s
program on women's health focused on pregnant and parenting women and the effects of drug
use and abuse on the offspring. The program was broadened in 1995 to include research on
drug use, abuse, and addiction in women, regardless of age and reproductive status, as
well as research on gender differences. Leadership for the program is provided by the
women’s health coordinator and the advisory women and gender research group
representing each NIDA program branch.
At NIDA the study of women and gender differences is integrated throughout all program
divisions and consists of four areas: etiology; consequences and impact; prevention; and
treatment and services. Etiology research consists of preclinical, clinical, and
epidemiological field studies aimed at investigating gender differences in the nature and
extent of drug-using behaviors; in the pathways and determinants of initiation,
progression and maintenance of drug use; and in the basic behavioral and neurochemical
mechanisms underlying drug dependence and vulnerability.
The institute supports human and animal basic research as well as field studies
directed at identifying sex and gender differences in the consequences and impact of drug
use, abuse, and addiction. Studies examine gender differences in the reinforcing and
stimulus properties of abused drugs; the role of the menstrual cycle and sex hormones in
modulating drug use and effects; and gender specific biological, physiological, cognitive,
and behavioral mechanisms.
A large HIV/AIDS initiative targets pregnant and nonpregnant women and adolescent
females; addresses drug use factors that may influence the course of the disease,
including modulation of infectivity; and the pathogenesis of progression to AIDS. Also
studied are interventions to reduce HIV risk factors in drug users; issues related to
access, utilization, and adherence to HIV-related medical regimens; and effectiveness of
HIV treatment in drug users.
Among NIDA’s research objectives is the development of gender-sensitive prevention
strategies that address issues specific to females of all ages, including the
identification of risk and protective factors associated with gender value systems and
life experiences, and ethnicity and culture. Additionally, the institute supports a
comprehensive drug abuse treatment program that includes pharmacological,
psychotherapeutic, behavioral, and psychosocial modalities. Studies examine development
and effectiveness of drug abuse treatment models that are unique to women, including
treatments that encompass coexisting psychiatric disorders (e.g., anxiety, depression,
PTSD, and eating disorders).
Research Dissemination. As part of its overall mission to promote the use of
research in reducing the problems of drug abuse in the U.S., NIDA carries out multifaceted
activities to disseminate research results to researchers, prevention and treatment
practitioners, other health care providers, policymakers, and the general public.
NIDA’s public information branch coordinates these activities, which disseminate the
most up-to-date findings by NIDA-supported researchers and other leading investigators in
the drug abuse field through print and audiovisual materials to diverse audiences.
Special Populations. Epidemiologic data show that drug abuse and HIV/AIDS have
disproportionately severe consequences for minority populations. Minority group persons
who abuse drugs are more likely to die and suffer from severe drug-related illnesses and
are less likely to receive appropriate prevention and treatment services. More research is
needed in order to develop a rigorous scientific knowledge base on minority populations
and drug abuse that can support the formation of policy, prevention/intervention efforts,
and a full range of treatment approaches (e.g., pharma-cologic, clinical, behavioral) that
are responsive and appropriate to each popula-tion’s needs.
The Special Populations Office supports activities to encourage research on minority
health issues related to drug abuse and is administratively responsible for some of the
research training programs pertaining to minority and other populations. It also assesses
and makes recommendations regarding research needs and strategies and monitors progress
towards the achievement of these goals.
