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Friday, December 30, 2011

How nail-biters and blowouts influence traffic fatalities in association with competitive professional and collegiate sports

CPDDBLOG wishes you a Happy New Year 2012!

In follow up to prior posts on substance abuse during the holidays, New Year’s Day emergency room visits related to underage drinking, and the association between alcohol abuse and organized team sports, this post focuses on alcohol-related fatalities in association with high profile professional and collegiate sporting events. A number of such events including football playoff and bowl games are scheduled to occur over the next few weeks.

An article published by Wood and colleagues this month in the Journal of Consumer Research entitled “ The Bad Thing about Good Games: The Relationship between Close Sporting Events and Game-Day Traffic Fatalities”, reported what appears to be a remarkable link between the competitiveness of such sporting events and traffic fatalities.

The study analyzed data from 271 events including 7 Super Bowls (2001-2007), 37 NBA Finals games from 2001-2007, and 227 NCAA football and basketball high-stakes games taking place from 2001-2008, including regular season games involving teams with established rivalries as well as tournament games (e.g., the Bowl Championship Series and the Final Four). 

The study reported that highly competitive events (e.g., those either close in final score or those subjectively rated “close” by a panel of sports experts on a 5-point “closeness scale”) were more likely to be associated with more game-day traffic fatalities. Moreover, the associations were substantially enhanced when alcohol was involved. 

The phenomenon was quite localized such that game-day traffic fatalities (including alcohol-related fatalities) were not increased in losing team hometowns, but only in winning team hometowns and in game locations (where many winning team fans would be). Overall, the authors reported a 33% increase in risk for traffic fatalities at game locations and in winning team hometowns in association with “nail-biter” versus “blowout” games. 

The authors speculated that their findings may be related to changes in spectators’ testosterone levels, based on research showing that highly competitive sporting events increase and decrease testosterone levels in fans of winning and losing teams, respectively. They cited a study published in Drug and Alcohol Dependence showing that higher testosterone levels can result in more aggressive behavior. If increased post-game testosterone levels lead to more aggressive game-day driving behavior, this could result in more fatal traffic accidents, especially in those consuming alcohol.

The effects of abrupt testosterone increases on driving performance remains to be characterized as the only study assessing effects of testosterone on driving simulator performance involved chronic testosterone administration, and it failed to detect any significant effects.

While the Wood et al. report has a number of limitations, it certainly suggests that additional studies should be undertaken to assess effects of close competitive sports matches on driving fatalities, to determine whether steps could be taken to reduce excess traffic deaths in association with sporting events. 

CPDDBLOG welcomes CPDD member's thoughts on this issue.

Monday, December 19, 2011

‘Recovery’ is increasingly guiding services and policy but research funding remains scant

By Alexandre B. Laudet, Ph.D.
 

‘Recovery’ is increasingly becoming the guiding vision of substance abuse services and policy. SAMHSA (funder of publicly funded services) is promoting the multi-system Recovery Oriented System of Care (ROSC) model and both the President’s Drug Strategy and the Department of Education are calling for the expansion of recovery supports across community-based settings. In this context, Recovery is understood as an ongoing process through which one achieves abstinence, wellness and improved quality of life.

Recovery oriented initiatives strive to be evidence based. Yet the science of recovery remains in its infancy in spite of the size of the population concerned: Rough estimates peg at least
20 million as the number of Americans who consider themselves in sober, stable recovery. Speaking at the launch of the privately-funded National Quit and Recovery Registry, NIDA’s Dr. Volkow stated that ‘Most of the research that has been done up to now has focused on that immediate intervention that would allow a person to stop taking drugs. Much less is known about recovery.’

Having devoted the past decade of my research career to elucidate the recovery experience, I could not agree more. As I noted in 2007, most scientific articles whose title bears on recovery actually measure only short-term abstinence.

Here are highlights of a monograph detailing some key obstacles to building the necessary science of recovery, based on our experience seeking NIH funding for recovery oriented studies. The NIH funding process has historically favored relatively short-term evaluations of professionally driven interventions designed to reduce symptoms among individuals recruited in limited settings- i.e. treatment. That is, addiction research has mirrored the substance use service delivery paradigm that uses an acute care model to address a chronic condition. The approach isn’t optimally suited to promote/support recovery, nor is it adequate to build the evidence basis needed to inform recovery focused services and policy.
 

- It’s believed that most people recover without treatment yet recruiting non treatment recovery samples makes reviewers nervous: it’s challenging to determine (retrospectively) whether they were ever ‘addicts’ based on self-report that are difficult to corroborate (we’ve tried). I.e., there is no true ‘baseline.’

- Recovery support services are ‘non-clinical’- i.e., often peer driven and organically developed; reviewers’ requests for manualization and fidelity of interventions are challenging to address.

- Sample representativeness (external validity) is difficult to address because of the lack of data on the exact size, demographics, clinical history and recovery path of recovery community. Treatment population data are inadequate to infer the representativeness of a recovery sample but often the best we currently have.

Throughout the ages and across cultures today, human beings have sought chemical means of altering their moods and a small proportion becomes ‘addicted’. Substance use and addiction aren’t going away. Recovery is here to stay; it’s increasingly driving federal agencies' initiatives. Our science (and funding for said science) must catch up to the experience and needs of the individuals we seek to help. Key research questions include:


- Specifically what are the key ingredients of recovery- abstinence plus what?

- How do we measure this for services’ internal monitoring and external accountability purposes?

- How is recovery attained when treatment isn’t sought?

- Which services/supports are needed at which stage of recovery and by whom?

- How effective and cost effective are the various forms of recovery supports?

- How can recovery supports be better integrated in primary health care settings and community based venues? Where are they most effective?

- How can we harness the strength of the recovery community to build a workforce of recovery supports as healthcare reform will identify/insure more individuals needing services?

- What constitute barriers to recovery and to seeking recovery supports – especially stigma, policy and lack of awareness that recovery is attainable?
 

Elucidating and promoting a wellness process that unfolds over years, organically, in the community, requires that we ask different questions, using different methods and measuring different outcomes than when studying short-term, professionally driven symptom reduction interventions delivered in specialty care settings. There’s no urine tox screen for recovery…That does not mean scientific standards ought to be compromised but the boundaries of science must be expanded to allow for wellness processes to be understood. We owe the nation a scientific basis to inform recovery-oriented services and policy. 

CPDDBLOG welcomes CPDD member's thoughts on this issue.

Tuesday, December 6, 2011

NIH Institutes ACNP Update

WAIKOLOA, HI – The 2011 NIH Institutes Update for the American College of Neuropsychopharmacology (ACNP) was held Sunday afternoon, December 4. The session was introduced by ACNP President Dr. Eric Nestler, who noted that ACNP was fortunate to have a larger panel of presenters than usual, including representatives from 5 National Institutes of Health (NIH) Institutes.

Panel members were Dr. Neil Buckholtz, Chief of Dementias of Aging Branch, National Institute on Aging (NIA), Dr. Thomas Insel, Director, National Institute of Mental Health (NIMH), Dr. Story Landis, Director of the National Institute of Neurological Disorders and Stroke (NINDS), Dr. Kenneth Warren, Acting Director of the National Institute on Alcohol Abuse and Alcoholism (NIAAA), and Dr. Susan Weiss, Acting Director, Office of Science Policy and Communications, National Institute on Drug Abuse (NIDA).

Dr. Buckholtz began the session by speaking about NIH funding in general, noting that while NIH currently is working with a continuing resolution budget from Congress, there is hope that a budget appropriation will occur this calendar year. He also noted that the lack of an agreement by the Congressional Supercommittee could trigger an 8% budget cut for all of NIH in fiscal year (FY)2013, if nothing is done to avert that cut. He indicated that while the news appears grim, that NIH Institutes have funding to support research projects and he encouraged researchers to continue to submit grant applications, a comment echoed by subsequent panelists.

Key initiatives for NIA include developing and implementing new diagnostic guidelines for Alzheimer’s Disease including guidelines for preclinical research studies, focusing on biomarker studies, supporting translational research, and working with other NIH Institutes to add aging-relevant research initiatives to existing studies.

Next, NIMH Director Dr. Thomas Insel spoke about budget challenges facing NIMH, which in FY2011 awarded the lowest number of research grants (465 new and competing continuation applications) since 1998. This amounts to a 16% success rate, an all time low. He noted that NIMH anticipates increasing the number of FY2012 research grant awards to about 500 (7.5% increase). Dr. Insel spoke about the downward trend in research grant success rates since 2002, due primarily to increased numbers of submissions in the face of stable and declining budget appropriations. He noted that the NIMH funding strategy is designed to protect early stage investigators, fund innovative ideas, fund research project grants, and will reach to fund ideas that peer review committees did not quite get right.

Key NIMH initiatives include the STARRS study assessing suicide in the military, with over 25,000 people currently enrolled, a project assessing recovery after a first break in schizophrenia (RAISE), and a biomarkers project (EMBARC) assessing biomarkers of major depression and treatment response. NIMH also is interested in medications development research, particularly now that big pharma is withdrawing from this research area. It is revamping its intramural research program with new facilities and with a translational focus. NIMH is inviting extramural scientists to help build this program by doing an intramural sabbatical. NIMH also is working to develop the next generation of leaders by fostering development of MD/PhD young investigators.

NINDS Director Dr. Story Landis reported that research project grant (RPG) success rates at her Institute were about 20%, with an increase in the number of RPGs awarded in FY2011 (749) versus FY2010 (699). Early stage investigators were funded up to the 25th percentile. She indicated that NINDS is working to find a better balance between basic, clinical, and translational science and is focused on retaining medical resident researchers.

Dr. Landis discussed an important point in therapeutics development research: many studies cannot be independently replicated, as reported recently. This is resulting in a higher proportion of failed clinical trials than in past. Accordingly, NINDS is focusing on improved experimental design including structured data analysis protocols, as well as on replication studies, to reduce the likelihood of late stage drug development failures. Related to this issue, NINDS is supporting NeuroNEXT, a program that standardizes clinical trial conduct and management.

Dr. Warren, NIAAA Acting Director, spoke next and noted that FY2011 was a very tight year budgetwise, with a total appropriation budget of $458 million. NIAAA funded 150 new and competing continuation awards, with total funding of 685 projects in FY2011.

Dr. Warren reported on a number of goals for NIAAA including development of additional treatment medications and medication combinations, development of better phenotypic animal models, and improvement of human laboratory paradigms. Dr. Warren also indicated that NIAAA is very interested in identifying additional cellular targets for alcohol (e.g., proteins/receptors/intracellular sites).


Other key initiatives include development of an adolescent alcohol use disorder screening guide with questions tailored for different age groups, and support of longitudinal studies in children and adolescents aged 12-21 to determine effects of adolescent alcohol abuse on brain development. Existing cross-sectional studies in this area have linked adolescent alcohol use to brain structural abnormalities, but longitudinal studies are needed definitively establish a link between alcohol exposure and brain changes.

Dr. Warren ended his presentation by summarizing the status of the structural reorganization of NIAAA and NIDA, which he noted actually is more than a merger of the two Institutes, since up to 8 Institutes may be involved in the process. He noted that the initial time table for the reorganization had to be abandoned to accommodate the complexity of the process, which includes developing a strategic plan for substance use and addition research and conducting a research portfolio analysis. The current time table proposes that the strategic plan and portfolio analysis drafts will be released in the fall of 2012 for a public comment period. Then, final recommendations will be made such that reorganization plan funding can be included in the President’s FY2014 budget.

Dr. Susan Weiss, Acting Director, NIDA Office of Science Policy and Communications, was the final panel presenter. She noted that nonmedical use of prescription pain medications now is second only to marijuana abuse in terms of prevalence, and highlighted a recent Centers for Disease Control alert on opioids documenting that hospital treatment admissions and opioid related deaths had more than quadrupled over the past decade. She indicated that NIDA is taking a lead on supporting a planned “Call to Action” by the United States Surgeon General to reduce opioid pain medication abuse.

In terms of funding issues, Dr. Weiss noted that as with other Institutes, NIDA grant application success rates have been lower due to increased numbers of grant applications and reduced funding levels. NIDA is seeking to protect young investigators and has been funding K awards with higher priority scores, and is reaching beyond pay lines to fund promising investigators and ideas. Dr. Weiss made a special note of the NIDA budget allocation to pharmacotherapeutic development, which was 12% of the total budget this past year. She indicated that NIDA’s funding in this area has been stable for a number of years and pharmacotherapeutic development is not occurring to the exclusion of other research areas.


She mentioned a number of priority areas for NIDA including prevention research, clinical trials for a nicotine vaccine and for a new opioid addiction treatment, studies of the medical consequences of addiction, and neuroimaging biomarker studies. She also noted that NIDA is supporting efforts to increase access to large datasets such as the functional connectomes project, which includes more than 2000 resting state functional MRI datasets. Increasing access to these and other datasets could help principal investigators by enabling them to work with data generated by others, resulting in substantial cost savings since subjects would not have to be recruited.

The session ended with a short Open Discussion including 2 questions.

The first question focused on the apparent bias of NIH peer review committees identified in the Ginther report (published in Science in August)—showing that African American applicants have a statistically significant disadvantage in receiving NIH awards.

Dr. Richard Nakamura, who became Acting Director of the Center for Scientific Review in September, commented that NIH is concerned about this issue and is investigating it.


The second question focused on whether there is active management for “distributing the wealth” away from Principal Investigators with multiple research project grants to others, particularly young investigators making the transition from K award to independent funding support. Dr. Landis commented that former NIH Director Zerhouni identified this as a vulnerable transition time. The only Institute with an explicit policy on this issue is NIGMS, which requires its Council to specially review and approve funding of PIs with award that would total more than $750,000 per year. There has been discussion of this issue by Sally Rockey in her blog Extramural Nexus, which can be found here.


CPDDBLOG welcomes CPDD member's thoughts on these issues.

Sunday, December 4, 2011

Follow up #3 to Why we must generously fund NIH: Public health and economic benefits of NIH-funded research


Part 3 of a 3-part follow up.

Part 1 can be found here and Part 2 can be found here.
 

Since the NIH formally was established in 1930, the average life expectancy of Americans has increased by almost one-third, from 59.7 to more than 78 years.

While many societal changes have contributed to this increase, the contribution made by NIH-funded research in several major disease areas, cardiovascular disease, stroke, cancer, and diabetes, has been linked to this increase in a 2009 study entitled “NIH funding trajectories and their correlations with US health dynamics from 1950 to 2004”. The study, authored by Ken Manton and collaborators and published in the Proceedings of the National Academy of Science, also noted a substantial overall economic benefit of NIH research funding, which increased gross domestic product, increased tax revenues, and reduced Medicare costs (as a consequence of improved public health). The overall economic benefit of NIH-funded research was projected to be $885 billion over a 10-year period and in 2006 was estimated at $36 billion. By contrast, the entire fiscal year 2006 NIH budget was $28.7 billion. This means that American taxpayers were getting a 25% rebate for every dollar appropriated to NIH that year. NIH budgets have been close to $30 billion per year for several years, so, if the Manton report projection is accurate, then the rebate to Americans over the 10-year projection period is on average substantially more than 25% per year. Thus, NIH research has and is projected to continue to more than pay for itself, and it is a great value for American taxpayers.


Other studies also have shown that NIH is an economic engine. Take for example the human genome project.  This multi-year program was designed to map human genetics and advance research into the genetic underpinnings of human diseases, to improve treatments for the many disorders linked to genes. The cumulative financial contribution provided by NIH to the program (approximately $8 billion, amounting to more than 75% of the total federal funding of over $10 billion), led to an economic impact between 1988 and 2010 of $796 billion, according to a Batelle report entitled “Economic Impact of the Human Genome Project” published in May 2011. Another study entitled “An Economic Engine”, authored by economist Everett Ehrlich and sponsored by United for Medical Research reported that in 2008, NIH activities resulted in over $84 billion of wages in the medical innovation sector. The report also noted that in 2010, NIH investment resulted in over $68 billion of new economic activity.


So, over many years, NIH, by funding a broad range of research across many disease areas, including projects that initially were of interest primarily from a basic science perspective, or were considered risky, or even some projects that seemed only remotely related to overall public health when first reviewed, has been a leader in and catalyst of scientific discovery. NIH-supported research has stimulated innovation, has been very successful at reducing disease burdens and increasing quality and length of life, and has stimulated our economy.

One could conceptualize NIH as a large index mutual fund designed to capture many winners by investing broadly, since when it comes to science, just like when it comes to investing, it is very hard if not impossible to predict winners at the outset.

By encouraging risk in research but investing broadly, risk is mitigated and the American public wins time and time again with their investment in NIH. Billionaire conservative businessman Mr. David Koch has been quoted in the New York Times (Cancer Research Before Activism, March 4, 2011) as using this type of investment strategy. Mr. Koch, a prostate cancer survivor, explained his reasons for distributing $200 million worth of contributions to multiple cancer research centers, including a $100 million donation to fund the David H. Koch Institute for Integrative Cancer Research at the Massachusetts Institute of Technology. He noted that he had been supporting cancer research widely because a broad investment strategy enabled him to pick a winner in the Kentucky Derby: “I bought a ticket on every horse in the race”. Americans must generously invest in NIH to place our bets widely and ensure that we will discover many winners.


There are many programs American taxpayers support today and many programs are struggling in these lean economic times. Nonetheless, I urge Congress to support NIH and to consider increasing NIH funding, which virtually is certain to provide a handsome return both in terms of public health improvements and economic stimulus to American taxpayers over time.

A summary of this article series can be found at:

http://www.cpddblog.com/2011/11/open-letter-to-congress-why-we-must.html


CPDDBLOG welcomes CPDD member's thoughts on this issue.

Wednesday, November 30, 2011

Follow up #2 to Why we must generously fund NIH: Budget pressures stifle scientific creativity

Part 2 of a 3-part follow up

Part 1 can be found here

Budget pressures on NIH are stifling scientific creativity, and creativity is what makes great science. Budget pressures amplify the risk-aversion noted by Tim Harford in his May 2011 Slate article “Positive Black Swans”, which described the career and life of Nobel Laureate Mario Capecchi, whose 2007 Nobel Prize winning idea in mouse genetics initially was rejected in 1980 by NIH grant reviewers because it was deemed too risky and speculative:

“The NIH's expert-led, results-based, rational evaluation of projects is a sensible way to produce a steady stream of high-quality, can't-go-wrong scientific research. But it is exactly the wrong way to fund lottery-ticket projects that offer a small probability of a revolutionary breakthrough. It is a funding system designed to avoid risks—one that puts more emphasis on forestalling failure than achieving success. Such an attitude to funding is understandable in any organization, especially one funded by taxpayers. But it takes too few risks.”

An analysis by MIT economists Pierre Azoulay, Joshua Zivin, and Gustavo Manso supports the idea that funding strategy strongly influences the degree of creativity, exploration, and innovation that can be achieved by scientists. Their study entitled “Incentives and Creativity: Evidence from the Academic Life Sciences”, began by highlighting the example of Mario Capecchi noted above, and compared productivities of researchers supported by NIH funding to those supported by funding from the Howard Hughes Medical Institute (HHMI). HHMI provides substantial flexibility to the Principal Investigators it funds by offering long grant funding periods (5 years for a first award) and by encouraging creativity that may result in initial failures but lead to long-term successes. By contrast, NIH research grant durations tend to be shorter, about 3 years, and creativity is not fostered by the system which now seems less tolerant of out of the box thinking and of the potential for failures than ever before.

After controlling for the fact that HHMI researchers tend to be more “accomplished” than the average NIH-supported investigator (by comparing the HHMI sample to early career prizewinning NIH researchers, a matched-by-accomplishment sample), Azoulay and colleagues reported major differences between HHMI and NIH researchers. HHMI researchers had more freedom to experiment, fail, and ultimately innovate. The study concluded that the different incentive schemes offered by HHMI and NIH have dramatic effects on creativity and innovation.

This difference is important, as the ability to explore, and fail, is key to scientific innovation and discovery. Neuroscientist David Eagleman, writing about his wide-ranging research in a New Yorker piece entitled “The Possibilian” (April 25, 2011), described an encounter with Nobel Prize winner Francis Crick, who offered advice about a career in research, saying “…The way real science goes is that you come up with lots of ideas, and most of them will be wrong.”

Scientists know that this is true. Ideas are hypothesized, tested, and refined, and many of them are discarded. Sometimes along the way, new ideas germinate from serendipitous observations that were not planned at the outset of an experiment that lead to breakthroughs. Perhaps the most famous “accident” of science involved Alexander Fleming, who in 1928 was researching bacterial cultures. He discovered a mold that was killing his cultures and ruining his experiment—today we know that mold as the antibiotic penicillin, which has saved countless lives.

Photo Credit:
 

Another Nobel Laureate, Arthur Kornberg, writing on this theme in an article entitled “Of Serendipity and Science” (published in Stanford Medicine Magazine, Summer, 1995), lamented the lack of funding for science: “…today we are suffering from the lack of adequate financial support for basic science, a poverty worsened by severe pressures to engage in "strategic" research…the pursuit of curiosity about the basic facts of nature has proved throughout the history of medical science to be the most practical, the most cost-effective route to successful drugs and devices…Investigations that seemed totally irrelevant to any practical objective have yielded most of the major discoveries of medicine”.

So, it seems that offering flexibility, allowing creativity, and supporting seemingly basic and sometimes apparently esoteric research are the most efficient ways to lead to scientific breakthroughs.

While it would not likely be possible for NIH to broadly review and fund research like HHMI, the point here is that subjecting NIH to any budget contraction, either by direct budget cuts or by appropriating flat budgets that don’t take into account inflation, will amplify risk-aversion at the NIH reviewer and program levels. This could squeeze out creativity and innovation and result in fewer bricks being added to our collective wall of scientific knowledge, which could undercut our ability to achieve future scientific and medical breakthroughs.

This is a very bad idea, not only because our investment in NIH has resulted in tremendously positive public health benefits, but also because NIH-funded research is a major economic engine for the United States (see Part 3 to follow).

A summary of this article series can be found at:


http://www.cpddblog.com/2011/11/open-letter-to-congress-why-we-must.html


CPDDBLOG welcomes CPDD member's thoughts on this issue.

Monday, November 28, 2011

Follow up #1 to Why we must generously fund NIH: Scientists toiling in anonymity

Part 1 of a 3-part follow up

While attending a research symposium at the 2010 American College of Neuropsychopharmacology meeting with a young colleague of mine, he whispered in my ear how moving it was to him that researchers had been, for many years, toiling in relative anonymity studying a part of the brain known as the habenula. The habenula is comprised of two tiny spheres each about the size of a large peppercorn, one on each side of the brain. For many years its role in behavior was not appreciated. However, now it is considered very important to addiction researchers. So much so that the Director of the National Institute on Drug Abuse, Nora Volkow, spent a significant amount of time discussing it this past June in her address to an audience of 500 scientists attending the joint Plenary Session of the College on Problems of Drug Dependence Annual Meeting and the International Narcotics Research Conference.

You see, the habenula seems to act as an inhibitory or counterbalancing force to brain areas long known to process rewarding stimuli, the nucleus accumbens and the ventral tegmental area.  Thus, the habenula seems to play a key role in influencing addiction-related behaviors. Of course, this is only one of the many roles researchers have attributed to the habenula. It also appears to be involved in regulating sleep and circadian rhythms, responses to pain, stress, and anxiety, and in reward-based decision-making, a kind of learning that enables us to select actions that are most favorable to us.

Today’s habenula research likely will lead to new and better treatments for addiction and other brain disorders. However, such research would not have happened had not a broad research foundation been built by many scientists who, over the course of more than 50 years of work, have been quietly yet competently laying key groundwork, much of it funded by the National Institutes of Health, NIH.

In fact, most scientific research takes place in the background. Many scientists toil in relative anonymity.  They slowly and painstakingly add brick by brick to the scientific foundation of knowledge, often not knowing whether their research will make a difference in public health until many years after it has been published. Like fine wine, scientific research typically needs time to develop and mature, and can only do so if other researchers happen to add additional bricks to the foundation. Ultimately, if a critical mass of data results, that can catalyze development of new treatments.

This slow process of knowledge accretion is key to scientific discovery. Alarmingly, the process is in great danger today of being seriously disrupted by the budget challenges we face. With the brief exception of Recovery Act (ARRA) funding period, the NIH budget has been taking hits for a number of years, being maintained at or below the level of inflation since 2004. This year’s NIH budget actually could be reduced for the first time, possibly resulting in the lowest research grant application success rate in NIH’s history.  This would result in fewer grants awarded and fewer dollars awarded per grant. As budgets have shrunk, the system as it is now configured has been forced to focus more heavily on apparently “hot” ideas and “leading” researchers.  It has become less able to support novel projects and the potential for scientific discovery they offer. This trend is squeezing out many talented and productive scientists who don’t happen to have a hot idea or a stellar reputation, at the moment. Additional NIH budget cuts consequent to the apparent failure of the Joint Select Committee on Deficit Reduction to reach agreement could be catastrophic.

Now, at first glance, it seems to make sense to reward hot ideas and people with stellar reputations since those ideas and people tend to provide good returns on investment. However, the problem in science is that it takes many years for the scientific community to identify truly groundbreaking concepts and often, hot ideas and researchers of the moment are just that, flashes in the pan.

The hottest ideas and researchers typically are identified (in the moment) in papers published in premier scientific journals.  The journals include Nature, the New England Journal of Medicine, and Science Magazine. Papers in these journals often end up being the most cited work in a field (resulting in the highest scientific impact factors) and researchers publishing in these journals often become the most successful at securing future NIH funding. However, an analysis of articles in these journals suggests that many published papers ultimately make only a small scientific impact (as measured by the number of times a particular paper actually is cited by others). Thus, having a paper published in a premier journal is predictive of, but does not guarantee, high scientific impact. One of these journals, Nature, even commented on the misuse of publication impact factors, noting that:

“Research assessment rests too heavily on the inflated status of the impact factor… Attempts to quantify the quality of science are always fraught with difficulty, and the journal impact factors are among the few numbers to persist. The result is an overemphasis of what is really a limited metric…we have analysed the citations of individual papers in Nature and found that 89% of last year's [2004] figure was generated by just 25% of our papers… None of this would really matter very much, were it not for the unhealthy reliance on impact factors by administrators and researchers' employers worldwide to assess the scientific quality of nations and institutions, and often even to judge individuals. There is no doubt that impact factors are here to stay. But these figures illustrate why they should be handled with caution.” (Nature 435, 1003-1004, 23 June 2005)

Unfortunately, with fewer dollars available and increasing numbers of grant applications being submitted by more researchers, the NIH grant review system is becoming overwhelmed. There is an increasing tendency for grant reviewers, who judge scientific merit, and NIH Program staff, who, based on reviewers’ merit scores, determine which projects will be funded, to focus on applicant characteristics like past publications and journal impact factors. Applicants without papers in high profile publications likely will fare worse in trying to get their grants funded than those with publications in higher impact factor journals. In addition, grant review committees are requiring more preliminary data than in past to prove that an idea works; such data is very hard to come by before funding is available.

Thus, the barriers to NIH research funding have been elevated. This has been sidelining many good ideas and promising researchers, particularly those working in cutting edge areas, in which few people are well-qualified to review the science. Quite unfortunately, in this funding climate, it seems unlikely that the research we identify today as forming the foundation for our current appreciation of the habenula could be initiated. After all, who would believe without prior evidence that a pair of tiny and seemingly obscure brain structures could play a pivotal role in so many behaviors?

A summary of this article series can be found at:

Part 2 can be found here and Part 3 can be found here.

CPDDBLOG welcomes CPDD member's thoughts on this issue.  

Tuesday, November 22, 2011

An open letter to Congress: Why we must generously fund NIH


The National Institutes of Health (NIH) has been a leader in and catalyst of scientific discovery for many years, through its support of a broad spectrum of basic and clinical research across many disease areas. NIH has funded many projects that initially were of interest primarily from a basic science perspective, some that were considered risky, and some that seemed only remotely related to overall public health when first considered. 

This funding strategy has fostered innovation, reduced disease, increased quality and length of life, and stimulated our economy. Statistics show that the lifespan of Americans has increased by almost one-third since the NIH was formally established in 1930. Scientific studies show that NIH research is directly responsible for that increase.
 

Other studies show that NIH research is an economic engine. Consider the Human Genome Project. This multi-year program was designed to map human genetics and advance research into the genetic underpinnings of human diseases, to develop new treatments for people with genetic disorders. NIH’s $8 billion investment (about 75% of total federal funding for the project) produced an economic impact between 1988 and 2010 of $796 billion, according to a Batelle report entitled “Economic Impact of the Human Genome Project”. Another study entitled “An Economic Engine” sponsored by United for Medical Research reported that in 2008, NIH activities resulted in over $84 billion of wages in the medical innovation sector and in 2010, NIH investment resulted in over $68 billion of new economic activity. By many accounts, American taxpayers’ investment in NIH research more than pays for itself.
 

However, NIH’s ability to catalyze innovation and discovery is in danger today of being seriously disrupted by the budgetary challenges we currently face. With the brief exception of the Recovery Act (ARRA) funding period, the NIH budget has been maintained at or below the level of inflation since 2004, effectively reducing funding. The Senate-proposed appropriation actually reduces the NIH budget for the first time. If that budget is adopted and/or if other NIH budget cuts are instituted, NIH will be forced to award fewer grants and fewer dollars per grant. The result will be that many talented and productive scientists and their ideas will be squeezed out of the system, and possibly lost forever.
 

The evidence suggests that budgetary pressures negatively influence scientific creativity. For example, a study by MIT economists led by Pierre Azoulay entitled “Incentives and Creativity: Evidence from the Academic Life Sciences” compared accomplishments of researchers funded by NIH and by the Howard Hughes Medical Institute (HHMI). HHMI offers its grant recipients greater freedom to explore and longer funding periods than NIH. The Azoulay study showed that HHMI researchers tended to produce more innovative ideas that resulted in higher impact research, even after matching the NIH and HHMI researcher samples on career success. Thus, inducing greater budgetary pressures on NIH is likely to stifle scientific creativity and the public health and economic benefits NIH research offers.
 

One could conceptualize NIH as a large index mutual fund designed to invest broadly so it captures many winners, since when it comes to scientific research, just like when it comes to financial investing, it is very hard if not impossible to predict winners at the outset.
 

None other than billionaire conservative businessman Mr. David Koch has been quoted as using this type of investment strategy to support cancer research (Cancer Research Before Activism, New York Times, March 4, 2011). Mr. Koch, a prostate cancer survivor, explained his reasons for distributing $200 million worth of pledges and donations to several cancer research centers, including a $100 million donation to fund the David H. Koch Institute for Integrative Cancer Research at the Massachusetts Institute of Technology. He noted that he had been supporting cancer research widely based on his prior success picking a Kentucky Derby winner: “I bought a ticket on every horse in the race”.
 

There are many programs American taxpayers support today and many programs are struggling in these lean economic times. Nonetheless, I urge Congress to generously support NIH and to consider increasing NIH funding, which virtually is certain over time to provide a handsome return to American taxpayers both in terms of improved public health and economic stimulus.
 

I also urge CPDD members and other interested persons to lobby your representatives in Congress to support NIH research funding over the coming weeks as budget priorities are discussed. You can do this by identifying your representatives here and sharing the URL of this article.  

CPDDBLOG welcomes CPDD member's thoughts on this issue.  

Disclosure: the author is a long-term recipient of NIH funding.

Monday, October 31, 2011

Codeine abuse is associated with dopamine transporter abnormalities

A new report in the November 1 2011 edition of the journal Drug and Alcohol Dependence documents dopamine system abnormalities in association with chronic abuse of codeine-containing cough syrups.

The SPECT imaging study, conducted at the Peking University Shenzen Hospital in China, found that dopamine transporters (DAT), the protein that terminates the action of synaptic dopamine, were reduced in teens with 1 to 5-year histories of daily codeine exposure.

The mechanisms underlying the DAT reduction and the consequences of the abnormality are not yet known, but DAT changes were profound, suggesting that they reflect a significant abnormality of dopamine system function.

Codeine is a controlled substance in the United States, it is considered a mild opioid, and it is widely prescribed as a cough suppressant and to treat moderate pain.  According to the Drug Enforcement Administration, it is widely diverted and like other opioid pain medications, it is widely abused.

Recently, National Football League lineman Johnny Jolly was arrested for codeine possession, after being arrested previously on a similar charge.

Little data exists documenting major biological or behavioral effects associated with chronic codeine abuse.  However, this report, which seems timely since this week is National Drug Facts Week, 2011, clearly documents that codeine abuse should not be taken lightly.

CPDDBLOG welcomes CPDD member’s thoughts on this issue.

Thursday, September 1, 2011

CPDD/NIDA Media Award 2012 Nomination Deadline Approaching


The nomination deadline for the 2012 CPDD/NIDA Media Award is approaching (November 1).  If you wish to nominate an individual or an organization for this award, please send a nomination letter outlining major accomplishments along with a curriculum vitae (for individuals) to kaufman@mclean.harvard.edu.
To be considered for nomination, individuals/organizations must agree to appear at the CPDD 2012 Plenary Session to be held on Sunday morning, June 10, 2012, at La Quinta Resort and Club, Palm Springs, CA.
The past 5 winners of this award were:
Justin Hunt for his film “American Meth”.
Allan Brandt for his book “The Cigarette Century”.
Nancy Campbell for her book “Discovering Addiction”.
Willam Cope Moyers for his book “Broken”.
HBO Producers Sheila Nevins/John Hoffman/Susan Froemke for their multimedia work the “Addiction Project”.
A list of all Media Award winners can be found here.



Sunday, August 14, 2011

Dr. Angela Hawken on Project HOPE

Source: www.youtube.com
Part 2 of the CPDD Annual Meeting Public Policy Forum featured Angela Hawken, Ph.D., Associate Professor of Public Policy at the Pepperdine University School of Public Policy.

Dr. Hawken spoke about the Project HOPE (Hawaii's Opportunity Probation with Enforcement) initiative, an alternative drug offender monitoring and punishment system, which based on early data appears to be superior in a number of ways to Hawaii’s standard management of drug offenders.

Standard management of drug offenders typically involves substantial delays between an arrest for a drug offense and any punishment; offenders often will have been arrested multiple times before they are incarcerated.  Thus, incarceration is not much of a threat to most offenders. And, when incarceration occurs, sentences often are long, which can sever any roots an offender may have to their family, their community, and their job.  This of course makes it harder for parolees to reintegrate into society after release, which may increase recidivism.

By contrast, Project HOPE is based on a behavioral triage model involving intensive randomized urine screening (6 times per month) that rewards offenders for good behavior (timely and clean urine tests) and immediately punishes them (incarceration) for using drugs or for noncompliance.

Thus, offenders have an immediate stimulus to shape their behavior. Punishments while swift are less draconian than in the standard system (2 days in jail for an initial offense).  This minimally taxes the prison system and minimally displaces offenders from their families and jobs, which ends up being much less costly and debilitating to all.

A randomized controlled trial (N=330) comparing Project HOPE to standard management garnered remarkable results: positive urine screens were reduced by more than 70%, incarceration days were reduced by more than 48%, and more than half of the people in the HOPE arm completely stopped using drugs.

These data suggest that the Project Hope strategy is an effective management model with the capacity to more effectively shape offender behavior, resulting in substantial savings in terms of treatment resources and in terms of criminal justice system costs.  The behavioral triage approach currently is being assessed in other states and in juvenile offender populations to determine whether it can be widely applied.

In 2009, Dr. Hawken presented a lecture at the Pepperdine University School of Public Policy in which she compared California Proposition 36 (which she characterized as a poorly implemented approach) to Project HOPE.  A video of that presentation can be viewed on YouTube (4 parts, ~36 minutes).

CPDDBLOG welcomes CPDD member’s thoughts on this issue.

Sunday, July 31, 2011

Methamphetamine Abuse and Parkinson’s Disease

Source: www.3dchem.com
After witnessing methamphetamine’s destructive effects on individuals and families first hand through the eyes of CPDD/NIDA Media award winner Justin Hunt's film American Meth, we now are learning that methamphetamine abuse appears to increase a person’s risk for later development of Parkinson’s Disease.  Parkinson's Disease is a fatal, progressive neurodegenerative disorder that damages the dopamine neurotransmitter system, resulting in movement abnormalities.

In a new study to be published in CPDD’s journal Drug and Alcohol Dependence, a link has been established between methamphetamine abuse resulting in a hospitalization and later development of Parkinson’s Disease.

This large scale population-based California cohort retrospective study assessed medical records of over 40,000 people hospitalized with a diagnosis of methamphetamine abuse (including abuse, dependence, or poisoning). Study investigators compared Parkinson’s Disease incidence to matched cohorts of people hospitalized either with a diagnosis of appendicitis or of cocaine use-disorders.

People in the methamphetamine cohort were found to be at significantly greater risk for devloping Parkinson’s Disease than both comparison groups. Moreover, the median age of Parkinson’s incidence was 6.5 years earlier in the methamphetamine group versus in the appendicitis group, which might suggest that methamphetamine abuse promotes earlier disease onset.

The study authors noted that their findings may be limited to moderate to heavy methamphetamine users in whom methamphetamine-induced damage to dopamine neurons may exacerbate age-associated dysfunction of the dopamine system.

The study confirms earlier findings reported by the same group in a smaller cohort of methamphetamine abusers, and is consistent with a prior report in Drug and Alcohol Dependence showing that former methamphetamine abusers exhibit persistent cerebral blood flow abnormalities in a number of brain areas including the dopamine-rich striatum, known to be affected in Parkinson’s Disease.

Thus, it seems that Parkinson's Disease incidence could increase in coming years as former methamphetamine abusers become senior citizens.

CPDDBLOG welcomes CPDD member’s thoughts on this issue.

Friday, June 24, 2011

Highlights from the NIDA Director’s Address at the joint Plenary Session of the College on Problems of Drug Dependence and the International Narcotics Research Conference

HOLLYWOOD FLORIDA – Dr. Nora Volkow, Director of the National Institute on Drug Abuse, addressed an audience exceeding 500 people at the joint Plenary Session of the College on Problems of Drug Dependence (CPDD) and the International Narcotics Research Conference (INRC) on Wednesday, June 22. She began her address by noting that joint scientific meetings such as this increase the strength of science by enabling new partnerships to form.

Dr. Volkow touched on a number of themes during her address. She noted that the Monitoring the Future Report documents recent successes in the form of declines in adolescent cigarette smoking, consequent to successful no-smoking media advertising, but that an alarming trend exists suggesting increased marijuana use by 12th graders. Marijuana use by this age group is influenced by the public perception of marijuana’s harms, and Dr. Volkow suggested that the public may be developing a false sense of security about the dangers of marijuana as a result of medical marijuana campaigns.

She noted that prescription medications are being abused increasingly by people in all age ranges. While marijuana remains the top drug abused by 12th graders, psychotherapeutic drugs also are being abused by people in this age range. An increase in abuse of opioids, which can be toxic, has been accompanied by an increase in opioid overdose deaths.

Dr. Volkow did not comment at length about the proposed NIDA/NIAAA structural merger, but did mention that it now is delayed for about a year. Dr. David Shurtleff, Acting Associate Director of NIDA, discussed the merger process in detail at the CPDD 2011 Public Policy Forum.

Dr. Volkow did remark that for first time in many years, NIH is being subjected to a budget cut, which is having a large impact across all NIH Institutes including NIDA. The cut amounts to about 1% versus prior year funding, which when combined with a 3% inflation rate, translates effectively to a 4% cut. Dr. Volkow noted that Institute Directors are working to preserve the numbers of grants that will be funded, and are focusing specifically on protecting young investigators, who will be funded at higher scores than regular investigators, to help keep them in the field.

Dr. Volkow next addressed a concern expressed by some in the research community that NIDA is devoting too much of its funding to medications development initiatives. She noted that only 12% of the NIDA overall FY2010 budget was allocated to this part of the portfolio.

Next, Dr. Volkow described some of the successes of the Recovery Act (ARRA) funding program, through which NIDA received $260 million. She noted that the ARRA program, which focused on accelerating research in key areas while providing rapid economic stimulus, helped fund:
  • 1000-subject Phase III nicotine vaccine study in collaboration with GSK, which may result in a vaccine by 2013 
  • 250-subject 6-month randomized controlled trial of probuphine as a treatment for opioid dependence, with results expected later this year 
  • development of an anti-methamphetamine monoclonal antibody, with a clinical trial expected to start in 2012 
  • Pediatric imaging neurocognition and genetics study about brain development, to establish a 1600-participant database that will be open access for all interested researchers; the database is about half-completed
Dr. Volkow noted later in her address that ARRA funding successes in the medications development program have helped to establish a new funding paradigm: the data suggest that it is advantageous to conduct large budget (currently up to $5 million), shorter time frame (currently 3 year) grants with very specific aims.

Next, she commented on research areas in which she believes that opportunities exist and breakthroughs will occur. Dr. Volkow discussed at length the preclinical and clinical data supporting the ideas that genetic variability of cholinergic receptor genes CHRNA5/A3/B4 moderates vulnerability for nicotine dependence and that the habenula plays a key role in modulating the balance between rewarding and aversive stimuli. She noted that the increased appreciation of how withdrawal effects moderate vulnerability to addictive disorders has been transformative.

Another promising development is the increasing use of functional MRI (fMRI) to characterize resting state brain networks, which may advance our understanding of brain signaling in healthy people and in those with addiction disorders. She raised the intriguing possibility that the technique could be used to help identify people who may be vulnerable to developing addiction disorders, and it also may help to identify effective treatments.

The technique works by identifying different brain areas in which fMRI signal oscillations are highly temporally correlated, suggesting that they are functionally connected. Dr. Volkow pointed out that measurements of the resting state brain network, also known as the default mode network, are very stable within healthy individuals and replicable across research sites. She suggested that developing a very large resting state network database could advance substance abuse research and illustrated this point by conducting her own analysis of resting state connectivity from the nucleus accumbens and the habenula using a large open access dataset. She placed habenula and nucleus accumbens seed points and found connectivities consistent with reward and aversion circuitry, respectively (e.g., the amygdala was predominantly connected with habenula but not with accumbens).

Dr. Volkow noted that open access databases (e.g., The Human Connectome) are becoming key tools in advancing science. She indicated that 12 NIH Institutes are working together to develop an open access neuroimaging database. Issues that remain to be resolved are standards for data collection (e.g., eyes open vs. closed; 5 vs 7 vs 10 minute resting state samples), phenotyping (what measures will be included, e.g., body mass index, cognitive performance, etc.), how a repository should be structured, whether it should it be mandatory, and which imaging modalities should be implemented first.

Next, Dr. Volkow commented on a NIDA-sponsored research study published in the New England Journal of Medicine showing that buprenorphine treatment of pregnant opioid-dependent women is better than the standard treatment (methadone) in a number of ways, including by reducing length of hospital stays from 17.5 to 10.0 days. She then projected that this 7.5 day difference, when multiplied by the cost per hospital day ($1,500) and the number of pregnant women needing treatment for opioid dependence (23,000/year), amounted to a potential public health cost savings enabled by this research study of $259 million/year (more than a quarter billion dollars, slightly less than the NIDA ARRA allocation, and if added up over 4 years saves enough to fully fund NIDA at FY2012 budget levels)!

This scales to a remarkable 12.8:1 (1-year) return on investment for a study Dr. Volkow reported cost NIDA $20.3 million, and illustrates that NIH-funded research is a great and lasting value.

Next, Dr. Volkow presented her “Brain of the Year” research study, which documented that second hand smoke is sufficient to affect nicotine receptors in nonsmokers. She asserted that this finding is key because it has the potential to drive public health policymaking decisions, including whether additional restrictions should be instituted to protect children from second-hand smoke.

CPDDBLOG welcomes CPDD member’s thoughts on these issues.

Tuesday, June 21, 2011

CPDD 2011 Annual Meeting Public Policy Forum Part 1: Update from the Hill and Friends of NIDA

Hollywood, FL – CPDD held it’s annual meeting Public Policy Forum on Sunday June 19, during which 3 presentations were given.  The first, made by William Dewey, updated the membership on legislative activities relevant to and lobbying activities on behalf of CPDD.

Bill reported that the 2011 federal budget cut $300 million from the prior year NIH budget, amounting to a 1% overall cut, and that the 2012 federal budget, while yet to be resolved, seems to be targeting a budget level equivalent to the 2008 NIH budget and possibly lower.

He suggested that budget cuts are occurring in part because the perception in Washington is that following the NIH budget-doubling era, NIH researchers are doing well, but researchers on the front lines know that this perception is anything but true.

Bill offered some sobering statistics to back up this assertion: the number of NIH grants awarded this past year was about 8700, down more than 26% from a 2003 peak of about 10,300; the overall grant application success rate was about 19%, down more than 38% from the 2003 peak of 30%.  NIDA statistics are even more disheartening, with a recent funding success rate of about 15%, down by more than 57% versus the 2003 success rate of about 35%.

These funding cuts fly in the face of the facts that:
  •  each $1 spent on substance abuse treatment saves $4-7 in societal costs
  •  22 million Americans (9% of the population) have substance abuse issues
  •  substance abuse costs US taxpayers about $600 billion/year
Bill noted that Van Scoyoc Associates acts as the CPDD lobbying firm, and helps represent CPDD’s interests in Washington DC by educating congress and public officials about the importance of substance abuse treatment and research.

Friends of NIDA (FON) is another advocacy group working on behalf of NIDA’s interests.  Bill noted later during the Public Policy Forum during a discussion of the NIDA/NIAAA merger, that even if NIDA is reformulated into a new NIH Institute, FON will continue to exist and simply change its name.

Ongoing activities supported by these advocacy groups include organizing CPDD Executive Committee member visits to Capitol Hill biyearly to hold information sessions with House and Senate members and staff, scientific expert congressional briefings, medications development briefings, and activities designed to foster early career development of outstanding high school students interested in addiction science careers.

Bill urged CPDD members to contact their Representatives and Senators and lobby for research funding, and to go to Washington DC to directly lobby legislators, if possible.

A review of Part 3 of the Public Policy Forum, Discussion of NIDA/NIAAA Merger, can be found here.

CPDDBLOG welcomes CPDD member’s thoughts on this issue.

CPDD 2011 Annual Meeting Public Policy Forum Part 3: Discussion of NIDA/NIAAA Merger

The last presentation at the CPDD 2011 Public Policy Forum held Sunday June 19 focused on the proposed structural merger of NIDA and NIAAA into a new entity.  Dr. David Shurtleff, NIDA Acting Deputy Director and Dr. Susan Weiss, Acting Director of the NIDA Office of Science Policy and Communications, led the discussion.

Dr. Shurtleff announced that the NIH Director, Dr. Collins, has instituted a delay in the merger process.  The projected time frame for opening of the new Institute, which may be called the National Institute of Substance Use and Addiction Disorders (NISUAD), is October 1, 2013 (Fiscal Year 2014).

Dr. Shurtleff provided a more detailed time line indicating that between now and the Fall of 2012, there will be a complete portfolio analysis and development of an integration plan. During this period, leadership groups overseeing integration will be seeking feedback from stakeholders.

In Fall of 2012, Portfolio Integration and Scientific Strategic Plans will be released followed by public comment periods.  Final recommendations will be made to NIH Director Collins in December 2012, implementation of Scientific Strategic Plan elements not dependent on reorganization will begin in January/February 2013, and the National Institute of Substance Use and Addiction Disorders will begin operating in October 2013.

Drs. Shurtleff and Weiss both noted that scientific portfolio locating decisions will be guided by scientific principles, and indicated that there has been a reassurance that scientific funding won’t change, even though Institute assignments may change.

Dr. Shurtleff referred CPDD members and others wanting to comment on the process to the NIH website soliciting feedback on the merger.

A lively discussion followed the presentation during which a CPDD member asked what would happen in terms of interactions between CPDD and the Research Society on Alcoholism (RSA).

Dr. Martin Adler, CPDD Executive Officer, responded by saying that while no one likes change, it is counterproductive if the 2 societies don’t work together.  He reported that CPDD and RSA are collaborating more than in past. He also noted that the RSA and CPDD websites are directly linked and that the CPDD website now is linked to NIAAA.  Dr. Adler indicated that CPDD’s primary concern with the merger is the lack of involvement in the planning stages, and that CPDD hopes to have more of a say before the final chapter is written.

A review of Part 1 of the Public Policy Forum, Update from the Hill and Friends of NIDA, can be found here.

CPDDBLOG welcomes CPDD member’s thoughts on this issue.

Monday, June 13, 2011

College on Problems of Drug Dependence 73rd Annual Meeting, June 18-23, 2011


More than 1000 scientists will be meeting at the 73rd Annual Meeting of the College on Problems of Drug Dependence (CPDD) to discuss their latest findings on drug abuse and dependence.  The meeting is being held jointly with the International Narcotics Research Conference (INRC).  CPDD is the largest and oldest organization supporting research on the scientific explanation of drug use and dependence.  A broad range of research will be presented addressing mechanisms for development of drug dependence, its prevention, and treatment, at The Westin Diplomat, Hollywood, FL.  Among the many research topics are symposia and workshops on pain management in people with substance abuse disorders (Monday AM, Diplomat 1-2), on synthetic cannabinoids (K2/Spice) as emerging drugs of abuse (Tuesday PM, Regency 1), and on high-tech treatments for substance abuse (Wednesday PM, Regency 3).

On Sunday morning at the Plenary Session (Atlantic Ballroom), achievement awards will be presented to outstanding individuals for their contributions to the field of addiction science.  Those honored include Dr. Michael Kuhar, who will receive the Nathan B. Eddy Award for lifetime contributions to the field, Dr. Thomas Prisinzano, who will be presented with the Joseph Cochin Young Investigator Award, and Dr. Stephen Holtzman, who will be posthumously recognized for his efforts in mentoring junior drug abuse researchers.  Dr. Bertha Madras will receive the Marian W. Fischman Memorial Lectureship Award and present her lecture at the Plenary Session.  The J. Michael Morrison Award will be presented to Dr. Steven Gust and Mr. Justin Hunt will receive the CPDD/NIDA Media Award recognizing him for outstanding contributions to the public understanding of scientific issues concerning drug use disorders.  His film American Meth will be shown Wednesday at 7 pm as part of Film Night (Regency 2). Congressman Patrick Kennedy will receive CPDD’s Distinguished Service Award.  On Monday afternoon at 4:15, Mr. Kennedy will deliver a Presidential Special Lecture entitled “We must be of one mind for research” (Atlantic Ballroom).

Immediately following the Sunday Plenary session, CPDD will hold its Public Policy Forum and discuss several hot topics including the impending merger of the National Institute on Drug Abuse (NIDA) and the National Institute on Alcohol Abuse and Alcoholism (Sunday AM, Atlantic Ballroom). Dr. Nora Volkow, NIDA Director, will address a joint Plenary Session of CPDD and INRC on Wednesday morning (Great Hall 1-2).

Sunday through Thursday afternoon, CPDD members will present new and exciting research findings in poster and oral presentations.  Some of the highlighted presentations include reports on abuse potential of electronic cigarettes (Rees et al., Monday AM, Great Hall 3-6), a low intensity but successful treatment program for veterans with substance abuse issues (Smelson et al., Tuesday AM, Great Hall 3-6), and recommendations for a national drugged driving policy (Dupont et al., Thursday AM, Great Hall 3-6).  This is only a small sampling of the hundreds of reports and information sessions that will be presented.

Search the meeting program and abstract listings by clicking the “2011 Program Book” link at www.cpdd.vcu.edu for topics and themes of interest, times, and locations of presentations.

Media personnel are invited to the plenary and scientific sessions.