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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.


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