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Monday, August 30, 2010

NIDA Funded ARRA Grant Wasteful Spending?

In a continuation of a theme discussed in my August 20 posting on how politics and scientific research policy sometimes interact, thanks go out to Ken Grasing for alerting the CPDD membership via the Listserv about the congressional oversight report sponsored by Senators McCain and Coburn (a physician) calling a NIDA-funded ARRA grant wasteful.

This is what their report, entitled "Summertime Blues", said:

"Researchers at Wake Forest University think that, in at least one case, it is good to monkey around with stimulus dollars. The Department of Health and Human Services has sent $144,541 to the Winston-Salem college to see how monkeys react under the influence of cocaine. The project, titled “Effect of Cocaine Self-Administration on Metabotropic Glutamate Systems,” would have the monkeys self-administer the drugs while researchers monitor and study their glutamate levels. When asked how studying drug-crazed primates would improve the national economy, a Wake Forest University Medical School Spokesman said, “It's actually the continuation of a job that might not still be there if it hadn't been for the stimulus funding. And it’s a good job.” He added, “It’s also very worthwhile research.”

Congressional candidates such as Frank Guinta, who is campaigning for a New Hampshire Congressional seat, have called out this grant for elimination as part of his election platform.

As Ken noted in his Listserv email, Alan Leshner, former NIDA Director and current Chief Executive Officer of the American Academy for the Advancement of Science (AAAS), replied to the McCain/Coburn report in an opinion piece written for Politico by calling it a "...cheap shot at important research critical to finding medications for cocaine addiction."

Based on the rhetoric used by Senators McCain and Coburn ("...drug-crazed primates...") and by candidate Guinta ("...We’re using federal stimulus money to watch what happens when monkeys get high...") to describe this research, it seems like some politicians and political candidates have targeted this project and perhaps addiction research in general in their crosshairs.

CPDDBLOG welcomes CPDD member’s thoughts on this issue.

Friday, August 20, 2010

Politics of Addiction Research

On a topic somewhat related to a prior post, no doubt many of you recently applied for ARRA grants via the Recovery Act and some of you even received an award.  Recently, one of those awards became a focus in a skirmish between Republicans and the Obama Administration.  The debate was covered by Greg Sargent, of the Washington Post, in his recent posting entitled “Obama admin skewers GOP attack on stimulus cocaine monkeys”.

Interestingly enough, 2 of our recent CPDD Media Award Winners, Dr. Nancy Campbell, Associate Professor in the Department of Science and Technology Studies at Rensselaer Polytechnic Institute and author of Discovering Addiction, and William C. Moyers, vice president of foundation relations at Hazelden's Center for Public Advocacy, also have weighed in on this subject.

Dr. Campbell wrote, in Chapter 1 of her book "Discovering Addiction":

“What American publics and institutions define as worthy cures for drug addiction depends on who is perceived to be addicted, on what drugs addicts depend, on the meanings attributed to addiction, and on patterns of social status.  The modal late nineteenth-century American addict was an upper- or middle-class white woman maintained on morphine by her physician.  Respectable “medical addicts” gave way to an urban underclass that used narcotics for “nonmedical” purposes or “recreation”.  These new addicts were culturally distinct from their precursors:  these poor, working-class, increasingly African American and while ethnic males were viewed as part of the “dangerous classes.”1  How addicts are treated very much depends on their membership in specific social groups; they cannot be lumped together as raceless, classless, or genderless…”

Mr. Moyers wrote online in the Politics of Addiction:

“…addiction is a bipartisan illness and that it does not discriminate…President Barack Obama's  drug czar, former Seattle Police Chief Gil Kerlikowske, has called for an outright end to the failed "war on drugs," shifting the emphasis from tough law enforcement and international interdiction to prevention and treatment.”

Sheril Kirshenbaum also had an interesting piece echoing these themes at the Discover website.

Whether or not scientists get involved, politics shapes addiction research and law enforcement funding policy, so its worth seeing how different sides debate this issue.

CPDDBLOG welcomes CPDD member’s thoughts on this issue.

Thursday, August 19, 2010

2010 CPDD/NIDA Media Award Winner, Dr. Allan Brandt

For those of you who missed the CPDD meeting Plenary Session, this year's CPDD/NIDA Media Award winner is Dr. Allan Brandt, Dean of the Graduate School of Arts and Sciences at Harvard University.

Dr. Brandt is a member of the Institute of Medicine of the National Academy of Sciences and of the American Academy of Arts and Sciences.  His book entitled “The Cigarette Century: The Rise, Fall, and Deadly Persistence of the Product that Defined America” describes ways science was misused by tobacco manufacturers to market cigarettes.

Dr. Brandt set up an interesting and informative website associated with this book, making his work on this topic a truly multimedia experience.

To meet Dr. Brandt, you can watch an entertaining interview of him by Jon Stewart on Comedy Central’s “The Daily Show”, originally airing on June 13, 2007.

Wednesday, August 18, 2010

Drug Addiction Demand Reduction (Research) Funding Getting Shortchanged?

The Public Policy Forum at the recent CPDD Annual Meeting in Scottsdale included a fascinating discussion about the ways our government and most western governments approach substance abuse.  Dr. John Strang of King’s College London, Dr. Peter Reuter, from the University of Maryland, Robin Room of the Turning Point Alcohol and Drug Center at the University of Melbourne, Australia, and Dr. Tom Babor of the University of Connecticut discussed different control strategies and evidence for their efficacies.

The discussion covered a number of interesting facts including that government funds are allocated primarily to supply side reduction (~75%, roughly the same in most westernized countries), such as eradication of drugs at their sites of production (e.g., burning coca fields in Columbia) and interdiction (finding and confiscating drug shipments before distribution).  This leaves about 25% for demand reduction programs including research and treatment.

The big problem with this math, according to these experts, is that there is very little evidence available demonstrating efficacy of most supply side methods.  In fact, two of the most obvious measurements of supply side efficacy, street prices for cocaine or heroin, are the lowest they have been in years, meaning that there is no apparent supply shortage.  The United States Drug Enforcement Agency reports that drug purity is down, which could in part explain price reductions, but other statistics support the idea that supply side reduction is not particularly effective.

By contrast, there is recent evidence documenting that good research, when turned into good treatment, is effective at reducing substance abuse and dependence.  For example, each dollar invested in substance abuse treatment has been estimated to save taxpayers $7 in overall costs (healthcare, insurance, crime, etc.).

So, where does this leave us?  In this era when its been harder than ever to obtain federal research funding, wouldn’t it be nice if we could find ways to persuade congress to shift a small fraction of federal resources from supply side to demand side efforts, including research?

Imagine shifting a modest 5% of the total supply side funding (a 7% decrease) to demand side funding (a 20% increase)—how many innovative research and treatment programs would be stabilized, how many new programs would be enabled, and how many $7 returns per dollar of federal treatment investment would be accrued?

In his CPDD Plenary Session address several days before the Public Policy Forum, Dr. Tom McLellan, Deputy Director for Demand Reduction in the White House Office of National Drug Control Policy noted that ONDCP is devoting substantial effort to coordinate substance abuse intervention efforts by different federal agencies.  Perhaps efficiencies that result from this program might make modest funding redistributions from supply to demand side a zero-sum gain for research.

CPDDBLOG welcomes CPDD member’s thoughts on this issue.

Sunday, August 15, 2010

Welcome to the CPDD Community Website, a.k.a. CPDDBlog.

Over the past few years, online social networking and media sites have become important portals for communicating information, opinion, and news of many types.  This site is intended to serve as an information portal for CPDD members, the media, and the general public.

While this site is accessible to everyone, contributions will be limited to CPDD members and invited guests.  To post, members are required to submit the current CPDD member password along with their contribution.  Contributions will be reviewed by the moderator prior to posting to insure that the site includes informative and professional content.

We hope that member contributions to this site along with contributions from invited guests will help keep CPDD in focus for members and other interested parties over the entire year, and reinforce the concept that CPDD and its membership are thought leaders in the area of addiction research, treatment, and policy.

Over time, we hope to add links to other informative websites and community sites/Blogs that are relevant to CPDD and its mission.  Please email feedback and/or suggestions for relevant additions to the moderator for consideration (CPDDBLOG@gmail.com).