Wednesday, September 29, 2010

Prescription Drug Abuse, the DEA’s “Take-Back” Initiative, and CPDD research.

BOSTON,  MA  –  In New England alone, over 25,000 pounds of prescription drugs were collected this past Saturday from 401 of the 4000 locations participating in the Drug Enforcement Administration’s (DEA) national “Take-Back” program, the first of planned bi-annual events.

R. Gil Kerlikowske, Director of the White House Office of National Drug Control Policy (ONDCP), visited one of the Take-Back sites in Philadelphia during the event and pointed out that “More than 70 percent of people who abuse prescription drugs get them from friends or family…”  National Public Radio had an interesting interview focusing on the event, noting that prescription drug abuse affects all socioeconomic levels.

Statistics regarding the DEA Take-Back program’s success along with grim statistics about the prevalence and consequences of prescription drug abuse can be found on the DEA, ONDCP, and National Institute on Drug Abuse (NIDA) websites.

Prescription drug abuse has become a major public health problem, eclipsing most forms of illicit drug abuse and catalyzing a spike in criminal activity.  A report in the New York Times noted that some people now show up at real estate open houses not to look at homes but to search medicine cabinets for pain pills.

CPDD researchers are making progress in understanding the scope of the problem, its causes, and in finding possible solutions.  A number of abstracts presented at the 72nd Annual CPDD meeting in Scottsdale focused on prescription drug abuse.

For example, researchers from Michigan State University reported that more than 3% of people who took prescription pain medications for nonmedical purposes developed dependence soon afterward, and 20% developed some features of dependence (Adelaja et al., CPDD abstract book PDF, page 2).  To view this abstract and other abstracts on this and other topics, download the CPDD meeting abstract book PDF (2nd link under the 2010 "MEETING INFO..." heading on the left panel).

And, the epidemic extends to other types of prescription medications.  In this regard, a recent report in CPDD’s journal Drug and Alcohol Dependence described how non-prescription stimulant use also has been associated with rapid development of dependence at alarmingly high rates.

Clearly, much work needs to be done to stem the tide of prescription drug diversion and abuse by agencies that control the flow of prescription drugs and by researchers working to find new medications that are less likely to be abused.

CPDDBLOG welcomes CPDD member’s thoughts on this issue.

Tuesday, September 21, 2010

Formation of a new Addiction Institute: what could this mean for NIDA and NIAAA training programs?

The Substance Use, Abuse, and Addiction Workgroup (SUAA) of the Scientific Management Review Board (SMRB) recommended last Wednesday (September 15, 2010) to dissolve NIDA and NIAAA and form a new Addiction Institute, which would oversee all NIH-funded addiction related research from those Institutes.  In addition, addiction-related research currently within portfolios of other NIH Institutes would be moved to the new Institute.

Although NIH Director Collins has yet to act on this recommendation, people are beginning to speculate on how consolidation would affect existing NIDA and NIAAA programs, including existing training programs.

Indeed, one of the main reasons cited in support of the SUAA recommendation to form a new Addiction Institute (Working Group Report, Sept. 2010) was to “overcome cultural barriers [that create] significant challenges to training early stage investigators…”  The cultural barriers referred to in the report are that NIDA and NIAAA have “distinct professional societies [College on Problems of Drug Dependence and Research Society on Alcoholism]…and insufficient communication between them, despite commonalities.”

The report stated further that: “By creating a single institute, comprehensive training programs integrating both multi- and interdisciplinary approaches to addiction research could be developed and supported.”

Currently, there are more than 60 NIDA-supported training programs and 28 NIAAA-supported training programs.

The map shows the approximate geographic locations of institutions supporting training programs for NIDA, NIAAA, and for both Institutes.  Of note, only 11 of 64 institutions currently with NIDA or NIAAA training programs support NIDA and NIAAA programs, meaning that simply merging existing training programs is not going to be an effective strategy to achieve the interdisciplinary training goals outlined in the SUAA report.

So, people are wondering how training programs would transition to become more interdisciplinary in structure.

Another question people are considering is the time frame over which existing training programs would be required to migrate their curricula (and possibly) faculty to become more interdisciplinary.  Would transitions have to occur within training program funding cycles or by the time of the next competing renewal application?

And, since research is a key component of training, what would happen to programs based at institutions not having established NIDA- and NIAAA-supported research programs?

What would happen to trainees starting under the current system—would they be allowed to complete their program or would they have to develop more interdisciplinary competencies?

Obviously, there are many details that would need to be worked out to get from where we are to where the SUAA recommends we should be, should NIH Director Collins accept that recommendation and form a new Addiction Institute.

CPDDBLOG welcomes CPDD member’s thoughts on this issue, especially members currently affiliated with training programs.

Wednesday, September 15, 2010

SMRB Vote on SUAA Working Group Recommendations and Report

And the vote is in...

Vote for Option 1, a structural merger (recommendation to form a new addiction institute): carries, 12 in favor, 3 against.

This recommendation will be reviewed by NIH Director Francis Collins, who will determine next steps.

CPDDBLOG welcomes CPDD member’s thoughts on this issue.

Monday, September 13, 2010

Scientific Management Review Board September 14-15 meeting information

The Scientific Management Review Board Meeting will review recommendations regarding a NIDA-NIAAA merger.  Information about the meeting including webcast details can be found here.

Wednesday, September 8, 2010

Update on changes to CPDD's journal Drug and Alcohol Dependence

By Eric C. Strain
Editor in Chief, Drug and Alcohol Dependence

I have been asked to contribute to the CPDD blog regarding the College’s journal, Drug and Alcohol Dependence (DAD), as the new Editor in Chief of the journal.  I’m pleased to do so, and to outline a couple of the changes that have occurred over the past few months with the journal. 

First, there have been several changes in the ranks of the Associate Editors (or AEs).  I should explain that the AEs for DAD are true editors – each manages all aspects of their assignments.  I assign a new submission to an AE, but after that the AE invites reviewers, keeps track of getting reviews, makes decisions about whether to continue to consider the paper, and gives the authors feedback.  There are now seven AEs for DAD (and their topic areas follow each name): Deborah Hasin (Comorbidity, Psychiatric Epidemiology, Etiology, Nosology and Genetics); Kyle Kampman (Treatment and Services); Lin Lu (Neuropsychopharmacology and Treatment); Linda Porrino (Preclinical and Clinical Neuroscience); Craig Rush (Behavioral Pharmacology); Steffanie Strathdee (Etiology, Epidemiology, Prevention and Policy); and, Wim van den Brink (Etiology, Treatment and Human Genetics).  Craig, Lin, Linda, and Kyle are all new AEs as of this summer.

Another change in the wings is that the Instructions to Authors has recently been revised and updated.  Some of these changes are minor (such as fixing urls), but there are a couple of note.  One is that we are now asking that all abstracts be structured.  The second is that there are guidelines for word limits to papers.  We previously had a word limit for Short Communications (2000 words), but now have added recommendations for Regular Articles (4000 words) and Reviews (6000 words).  We also are now encouraging authors to suggest reviewers when they submit a paper. 

Another change is by the College, which has decided to no longer provide a paper copy of the journal to members as a membership benefit.  I’ll let the College fill you in on this change, but it looks like members will no longer get the paper copy starting in January of 2011. 

I want to end by encouraging all to be involved with DAD – the journal publishes terrific work, and it is seeking the best work from all fields of addictions research.  I hope that you will read the journal, submit your papers, and agree to help review.  I believe that addictions research is stimulating, challenging, and exciting – it brings together neuroscientists, clinicians, epidemiologists, policy makers, and countless others, all interested in bettering our understanding of substance abuse.  Don’t hesitate to let me know how DAD can further help to move our field forward.

CPDDBLOG welcomes CPDD member’s thoughts on this posting. 

Tuesday, September 7, 2010

Scientific Management Review Board to make recommendation on a possible NIDA-NIAAA Merger

Some of you may be aware of an upcoming meeting on September 14-15 that could lead to a merger of NIDA and NIAAA.  The Scientific Management Review Board (SMRB) was created as part of the NIH Reform Act of 2006.  The Substance Use, Abuse, and Addiction (SUAA) Workgroup within the SMRB will be making a recommendation as to whether a merger would optimize research and maximize human health.

The pros and cons of a merger have been widely discussed by interested parties including CPDD Past President Linda Porrino, who made a presentation for SUAA (available for download at the presentation tab of the SUAA website) and who commented on the merger in CPDD Newsline (January 2010).

CPDD Charter Fellow and former CPDD President and Nathan B. Eddy Award Winner Mary-Jeanne Kreek also made a presentation (available for download at the presentation tab on the SUAA website).

An interesting discussion of the merger and its potential advantages and disadvantages took place as part of the 123rd NIAAA National Advisory Council Meeting in February 2010.  A summary can be viewed here.

The Research Society on Alcoholism website (RSoA) includes commentary on the potential merger by researchers (RSA e-NEWS: Brief Synopsis of the SMRB Meeting Report) and comments to the SUAA by former NIAAA Directors T.-K. Li (NIH-Substance Use, Abuse and Addiction (SUAA) workgroup testimony by Dr. Ting-Kai Li) and Enoch Gordis (NIH- Substance Use, Abuse and Addiction (SUAA) workgroup testimony by Dr. Enoch Gordis).

Addiction Professional Magazine highlighted concerns that NIAAA research and researchers might get the short shrift in any merger of the two institutes.

And, according to Tom Kelly, member of the Advisory Committee to the NIH Director, reporting at the 100th Advisory Committee meeting (NIH Record, June 25, 2010), the SMRB was split on whether to recommend a functional merger (that facilitates interactions between independent institutes including interdisciplinary research) or a structural merger (that combines institutes).  The NIH Record article quoted NIDA Director Nora Volkow as favoring a structural merger while NIAAA Acting Director Kenneth Warren favored a functional merger but not a structural merger.

Even groups with scientific interests that generally differ from addiction researchers have come out against the precedent of a structural merger, such as the National Alliance for Eye and Vision Research (NAEVR), which in May warned about the possibility that certain types of research could be lost between the cracks if institutes with particular specialties are absorbed into other institutes.

There seems to be general agreement among addiction researchers that functional changes enhancing interactions across institutes (e.g., via interdisciplinary research) could be helpful but that a structural merger, particularly one resulting in a contraction of funding for addiction research, would be an unfortunate and unwise outcome.

CPDDBLOG welcomes CPDD member’s thoughts on this issue.