Sunday, December 30, 2012

Beware of Alcohol on New Year's Eve

Although it ‘tis the season to celebrate, its also the season during which many people experience problems with alcohol. In past, CPDDBLOG highlighted research from Finland showing spikes in alcohol-associated deaths during the Christmas and New Year holidays

Now, a new research study from Australia documents a remarkable increase in the use of health system services by those intoxicated with alcohol during New Year celebrations.

The report analyzed ambulance, emergency room, and hospital admissions records collected in Melbourne from 2000-2009 to determine whether there were increases in alcohol-associated cases before, during, and after public holidays and major sporting events.

On New Year’s Eve, ambulance calls and emergency room visits involving alcohol intoxication increased by more than 4-fold, while hospital admissions involving alcohol intoxication increased by more than 3-fold those occurring on an average day (Figure). Of all the events analyzed by this study, New Year’s Eve effects were the largest.

Unfortunately, United States statistics also are grim. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), during the year-end holidays, death rates from alcohol-related crashes increase by 3-fold and 40% of traffic fatalities involve intoxicated drivers (PDF).

Thus, if you plan to consume alcohol over the New Year holiday, as the song goes, “you better watch out”.

Fortunately, more and more people are aware of these statistics and are doing things to reduce alcohol-related problems year round. NIAAA’s “Rethinking Drinking” website offers a number of tips to help determine whether one's alcohol consumption may be problematic as well as tips on how to reduce drinking.

For those trying to avoid drinking while attending parties at which there may be social pressure to consume alcohol, the New York Times recently published an article with useful strategies such as identifying oneself as a designated driver.

If you want to ring in the New Year in alcohol-free environments, the Office of National Drug Control Policy published an article including a link to a regional list of sober New Year’s Eve events.

We wish you and yours happy holidays and a happy and safe New Year! 

CPDDBLOG welcomes CPDD member’s thoughts on this issue.

Friday, November 16, 2012

Big News For Addiction Researchers--The Structural Merger is Off

The Office of the NIH Director, Francis Collins, just announced that the plan to create a structural merger of the National Institute on Drug Abuse (NIDA) and the National Institute on Alcohol Abuse and Alcoholism (NIAAA) is being abandoned.

Efforts will continue to functionally integrate the activities of these Institutes.

CPDDBLOG especially welcomes CPDD member’s thoughts on these issues.

Sunday, October 21, 2012

NIH Request for Input into the Scientific Strategic plan for the new substance use disorders research Institute: analysis of results now is available.

Earlier this year, NIH invited the public to comment on which scientific opportunities and public health needs should be included as part of the strategic plan for the new substance use disorders research Institute.  A Request for Information (RFI) was issued inviting suggestions for priority areas of focus for the new Institute.  The RFI specifically requested feedback on a preliminary list of 13 scientific research opportunities and insufficiently addressed public health needs.  The preliminary list was developed by the strategic planning committee charged with drafting a plan for the new Institute, and can be found here.
In June, NIH posted comments received in response to the RFI here.
NIH contracted Ripple Effect Communications, Inc., to review and provide an independent analysis of responses.
Five hundred responses were received during the 3-month comment period, 470 of which were considered unique and responsive to the RFI.  Most of the responses (80%) were submitted by individuals with the balance submitted on behalf of institutions.  Over a thousand different comments were extracted as part of the analysis.  More than half (52%) related to research topics considered priorities, with most comments related to alcohol research and development/progression of addiction disorders research.  The analysis resulted in a 35-page report and 4 appendices, which can be downloaded in PDF form here.
Respondents generally endorsed the preliminary 13-item list presented for comment, and specifically endorsed several items for inclusion in the focus of the new Institute, including:
·       Tobacco use and co-morbidity
·       Designing clinical trials that accurately reflect real-world conditions
·       Understanding the implications of policy research on substance use patterns and trajectories, especially in youth.
·       Enhancing stakeholder interest in developing medications to treat various addictions, including nicotine and alcohol.
Several common themes emerged including:
·       Suggestions that funding allocations should match public health burdens of disease
·       A better balance should be struck in terms of support for biological/biomedical and behavioral/psychosocial approaches
·       Concern that alcohol-related research, if moved to disease-specific Institutes, would be considered lower priorities and receive reduced funding.

With regard to that last point, one comment conveyed an impression that alcohol-related research, when reviewed by certain NIH study sections, was considered lower priority research (report page 13; full comment ID #118).
This concern could extend to research on other substance use disorders and is something that the strategic planning committee will have to consider as they draft the new Institute’s strategic and portfolio integration plans.  The draft plan is anticipated to be released later this year for additional public comment.
The process to form the new Institute seems poised to move forward but with Sequestration looming, will it?
The release of the analysis signals what could become a more active period of the process, at least in terms of public awareness, toward defining, budgeting, and implementing the new substance use disorders Institute.
However, the process could be further delayed or otherwise altered if significant budgetary cuts to NIH occur in January 2013 as a consequence of Sequestration, the process of automatic budget cuts resulting if Congress fails to establish an alternative budget plan by then.
One set of estimates provided by Research!America suggests that Sequestration would induce an automatic 7.8% cut ($2.39 billion) of the current NIH budget (PDF).  This amount is equivalent to about half of the FY11 budget for the National Cancer Institute, the largest NIH Institute, or almost double the amount NIH provided as part of Small Business Innovation Research and Small Business Technology Transfer Research (SBIR and STTR) programs.  In terms of the 2012 budget, a 7.8% cut is slightly less than the 8.2% budget allocation by NIH for “Other Research, Superfund, Office of the Director”, or the cumulative 7.7% allocation for Research Management and Support, Research Training, and Facilities Construction” (PDF).
Either way, the next few months should be very intriguing for those interested in NIH and in the formation of the new substance use disorders Institute.
CPDDBLOG welcomes CPDD member’s thoughts on these issues.

Wednesday, September 19, 2012

Institute of Medicine Report on Substance Use Disorders Among United States Armed Forces, and Recommendations to Move Forward

A comprehensive report on substance use disorders in the United States Armed Forces was just published by the Institute of Medicine (IOM). The report, commissioned by the Department of Defense, summarizes current issues and advances 12 recommendations for improving prevention, screening and diagnosis, and treatment of armed forces personnel with substance use disorders.  The IOM Committee that produced the report included several CPDD members and was Chaired by Dr. Charles O’Brien, CPDD Charter Fellow and winner of the CPDD Nathan B. Eddy and Mentorship Awards.
Substance use disorders are a significant and growing problem within the Armed Forces, and rank very high among mental disorders in terms of the numbers of hospitalizations and ambulatory visits (encounters) and lost days (bed days) experienced by Armed Forces personnel (Figure, data from the IOM Report, Table 2-5).
The report made a number of key recommendations including that access to treatment services should be better coordinated and standardized across service branches and reserve forces, and extended to provide a continuum of care on an outpatient basis in primary care settings.  This change is very much needed because the current system relies too heavily on residential and inpatient care, which not only are more costly and stigmatized, but also tend to be less accessible to many if not most who need care.
The report advised that emphasis be placed on routine screening and brief intervention, to identify and treat individuals at increased risk for developing substance use disorders.  The report also noted that the Armed Forces standard of care, including some of its treatment policies and substance use treatment personnel training, is behind the times and behind what is available to the general public, and needs to be updated.  For example, agonist substitution medications for opioid abuse and dependence (e.g., methadone or buprenorphine) are not allowed per current treatment policy, despite the fact that agonist substitution therapy has been shown to be extremely effective.
The report also recommended reformulating the treatment personnel structure by creating multidisciplinary treatment teams with diverse expertise including up to date clinical treatment training.  Such teams would be better able to provide a continuum of treatment for substance use disorders and comorbid substance use/mental health disorders.  The report also suggested that technology be developed to offer prevention, screening, diagnosis and treatment to service members in need based in remote locations, who do not have access to treatment personnel.
The report including its 12 recommendations, executive summary, and 10 appendices, is available for free download here. 
CPDDBLOG welcomes CPDD member's thoughts on these issues.

Friday, June 15, 2012

CPDD 2012 Annual Meeting Public Policy Forum Highlights

LA QUINTA, CA – The College on Problems of Drug Dependence (CPDD) Public Policy Forum was held on Wednesday morning, June 13, 2012, and Co-Chaired by Dr. William Dewey from Virginia Commonwealth University (Richmond, VA) and Dr. Martin Iguchi from Georgetown University (Washington, DC).

The Forum began with a presentation by Dr. Edward Long, Vice President of Van Scoyoc Associates, Washington DC. Dr. Long described what appears to be a very grim picture of current NIH funding and future funding prospects. He noted that:

NIH purchasing power, after accounting for inflation, is equivalent to 2002 levels; there has been an effective “undoubling” of the NIH budget.

Grant application success rates are down to 18%, and numbers of awards are at 2000 levels.

An 8.4% budget cut is possible if Sequestration (cancellation of budgetary resources) occurs and discretionary budget cuts are applied; NIH-wide, this could lower application success rates to below 10% and reduce the numbers of grants funded by 2,300, or close to 25% of all new and competing grant applications. He reported that FASEB commented earlier this year (April 12, 2012) stating that “Sequestration would deal a devastating blow to medical research”.

Ed did note that a delay in budget cuts may occur, since the nonpartisan Congressional Budget Office (CBO) has predicted that a recession will occur if the threatened cuts in discretionary programs actually occur, something everyone wants to avoid.

Next, Dr. William Dewey reported on Friends of NIDA and commented on the highly distinguished members of the Board of Directors as well as on their efforts to support NIDA. He also mentioned that when CPDD members find themselves in Washington, if they seek to lobby their legislators directly, he can work with Ed Long’s office to arrange appointments with legislative staff members within a day.

The last part of the program involved the presentation of the Martin and Toby Adler Distinguished Service Award to General Barry R. McCaffrey, U.S.A. (Retired). CPDD President Dr. Scott Lukas along with Dr. Martin Adler and Dr. Bill Dewey presented the award to General McCaffrey, who then offered an address entitled “Taking Care of America’s Veterans.”

General McCaffrey began by remarking that “Problems of returning veterans are real, significant, and resolvable.” He noted that in the most recent conflicts, the widespread use of improvised explosive devices (IEDs), which can cause unpredictable devastation at any time, promotes prolonged stress, which can exacerbate stress-related disorders including substance abuse.

General McCaffrey indicated that while most returning veterans come home unimpaired, that veterans face increased rates of post traumatic stress disorder (PTSD), alcoholism, substance abuse, and suicide. He also noted that underlying mental health issues or addiction disorders present in soldiers before deployment tend to increase the likelihood that problems will be present post-combat. He ended his remarks by commenting that the United States Armed Forces is the most respected institution in American society, with a 79% approval rating, and followed by stating that “We much care for our veterans. They have stepped forward to defend us”.

CPDDBLOG welcomes CPDD member’s thoughts on these issues.

Wednesday, June 13, 2012

"Bath Salts" Symposium at the 2012 CPDD Annual Meeting

Symposium I at the 2012 College on Problems of Drug Dependence (CPDD) Annual Meeting in La Quinta, CA focused on a very hot topic in the news these days, “Bath Salt” abuse. In the week just prior to the Annual Meeting, the national media reported on a sensational case of human cannibalism thought to be associated with “Bath Salt” abuse.

The CPDD Symposium did not discuss that case, but focused on what is known scientifically about the many psychoactive substances found in preparations characterized as “Bath Salts”. Understanding what each of those substances can do physiologically is key to understanding their dangers and to determining how best to treat people who need medical assistance after being exposed to those substances.

Symposium presenters included Co-Chairs Michael Taffe from The Scripps Research Institute in La Jolla, CA and Annette Fleckenstein from the University of Utah, in Salt Lake City, UT. Also presenting were Jeffrey H. Moran, from the Arkansas Department of Health, Little Rock, AR, Terry Boos, from the Drug Enforcement Administration (DEA), Springfield, VA, and William Fantegrossi, from the University of Arkansas for Medical Sciences, Little Rock, AR.

Dr. Moran began the session by stating that when referring to bath salts, designer drugs, cathinones, K2, spice, etc., it is important to use scientific terms rather than the slang or street terms for these substances, since each preparation has distinct effects.

This can be challenging since laboratory analysis of 130 samples seized by the Arkansas Designer Drug Research Consortium documented the presence of 254 distinct chemical entities, in 48 different combinations. Substances included in these preparations were the cathinones methylenedioxypyrovalerone (MDPV), 4-methylmethcathinone (methylone, 4-MMC), 3,4-methylenedioxymethcathinone (mephedrone), as well as caffeine, lidocaine, methamphetamine, levamisole, benzocaine, and synthetic cannabinoids. Thus, the formulation of these designer drug preparations is highly heterogeneous. However, Dr. Moran noted that over 70% of the samples included MDPV. He indicated that the Arkansas Department of Health is working to develop clinical and toxicological testing capabilities to more quickly identify components of these complex preparations. 

He showed data documenting an explosion in the numbers of emergency room cases associated with abuse of these substances, and indicated that the data on use patterns and chemical compositions are incomplete because they do not account for cases that don’t end up in emergency rooms and hospitals.

Terry Boos from the DEA reported that 32 different cathinones have been identified to date in the designer drug market. He noted that cathinone and methcathinone have been Schedule I drugs for awhile and that MDPV, methylone, and mephadrone were placed temporarily on the Schedule I list in October 2011 because they pose an imminent hazard to public safety while having no approved medical or manufacturing purpose. Subsequently, MDPV seizures declined, but new analogs were synthesized and replaced MDPV. He characterized the market for these substances as being “dynamic”, and indicated that sophisticated marketing and sales operations are used to funnel product that to date seems to be almost entirely imported from international sources. He noted that under the analogue provision for Schedule I substances, individuals can be prosecuted for using or possessing substances that are not identical to but are substantially similar (e.g., minor chemical modifications of) to already scheduled substances.

Dr. Annette Fleckenstein then reported data from preclinical studies in rats designed to characterize neurochemical mechanisms of mephedrone, methamphetamine, MDMA, and methcathinone. She noted that very subtle structural modifications of these substances can yield profoundly different behavioral, neurochemical, and neurotoxicological effects. For example, methamphetamine and methcathinone induce persistent dopaminergic and serotonergic abnormalities, while MDMA and 4-methylmethcathinone (4-methylation of methcathinone) only induce serotonergic abnormalities.

Dr. William Fantegrossi presented data on the thermoregulatory and behaviorally activating effects of MDPV in mice, and showed that it causes hyperthermia at both cool (20C, 68F) and warm (28C, 82F) temperatures. Mice given MDPV at 20C increased their activity independent of the MDPV dose administered. By contrast, at 28C, activity increased at higher MDPV doses, but at the highest MDPV dose tested, activity level dropped and mice exhibited repetitive (stereotypic) movements. Thus, the effects of some of these compounds are dependent upon temperature.

Dr. Michael Taffe presented behavioral and physiological data from rats administered several of these compounds and similarly reported differential effects based on chemical structure. He then summarized the Symposium and likened the current epidemic of abuse of these compounds to the designer amphetamine abuse epidemic of the 1980’s, remarking that history seems to be repeating itself. He underscored the point that not all cathinones are the same and each confers a different set of health risks.

A newer post describing trends in "Bath Salts" use and its side effects can be found here.

CPDDBLOG welcomes CPDD member’s thoughts on these issues.

Monday, June 11, 2012

Highlights from the NIDA Director’s Report from NIDA at the 2012 CPDD Plenary Session

LA QUINTA, CA – Dr. Nora Volkow, Director of the National Institute on Drug Abuse (NIDA), presented her annual Report from NIDA yesterday morning at the 2012 CPDD Plenary session. She began by thanking CPDD researchers for their wisdom and efforts to advance substance abuse research. She noted that the work of researchers guides NIDA in its efforts to facilitate the development of addiction science and to create the vision for future addiction science research directions.

Dr. Volkow reported that the structural merger process for formulating the new NIH substance use disorders Institute is well underway, and that the timeline now is finite. The draft plan currently is being created and is scheduled for public release in the Fall of this year, at which point, a public comment period will open. In December 2012, the plan and public comments will be presented to NIH Directors, who will configure the final plan that will be submitted to Congress in January or February, 2013. Congress will review the plan and establish its funding allocation in the Spring of 2013, and the new Institute will begin funded operations in FY 2014 (October 2013). Dr. Volkow indicated that NIDA will alert researchers when the public comment period opens in the Fall so they have time to provide feedback.

She then acknowledged NIDA staff who she referred to as “silent warriors” and “altruistic” partners in advancing substance abuse research and treatment.

She presented a slide showing how the NIDA budget is allocated to substance abuse research areas, and she noted that the NIDA funding allocation for new medication development portfolio has remained stable at about 12% for some time, despite concerns expressed by some researchers that funding in other areas is being sacrificed to support the medication development portfolio.

She then turned to the science and highlighted 3 main topics, big dataset science, novel treatment approaches, and HIV research and treatment.

Big dataset science typically involves the use of very large data sets acquired by pooling data from many investigators applying similar experimental designs. Accretion of such data substantially increases statistical power, enabling more detailed and complex analyses of complex systems. Dr. Volkow asserted that the field is heading in the direction of supporting more big dataset science initiatives involving genetics, epigenetics, proteomics, brain imaging, clinical data, and systems biology. She also noted that we are not ready yet to take full advantage of big dataset research, and that we are behind other fields including physics, which have developed processes and systems to conduct this type of work. Dr. Volkow indicated that NIH has a data and informatics working group charged to enhance our abilities to work with large databases. She also indicated that NIDA is working on implementing processes to enable large dataset research with brain imaging data.

In terms of novel treatments, Dr. Volkow noted that NIDA has been supporting big pharma development of dopamine D3 receptor antagonists to treat stimulant disorders, since it is known both from animal and human studies that D3 receptor densities are elevated in subjects exposed to stimulants. Recently, it was appreciated that the approved anxiolytic drug buspirone, which is a high affinity partial agonist at serotonin 5-HT1A receptors, also has very high affinity for dopamine D3 receptors (it also appears to be a high affinity dopamine D4 receptor antagonist). She showed PET imaging data documenting that buspirone reduces dopamine D3 receptor binding in nonhuman primates, supporting additional study of buspirone as a treatment for substance abuse disorders.

The other novel treatment approach Dr. Volkow discussed during her presentation is nicotine and cocaine antibody production. Phase III trials with the nicotine vaccine have achieved only limited success, primarily because only 30% of those immunized sustain adequate antibody levels. Those individuals do reduce nicotine intake, indicating that the mechanism does work. Thus, researchers are working on ways to increase efficiency of antibody production, and also are working on ways to identify individuals who upon immunization are likely to produce high antibody levels. New research using adenovirus vectors, which are extremely efficient at producing high antibody levels that are sustained for long periods, suggests that the adenovirus approach may work well: PET imaging results document that adenovirus anti-cocaine immunized monkeys do not sustain significant brain cocaine levels after cocaine administration, suggesting that this approach may be effective in humans.

The last scientific topic covered in the presentation was the breakthrough finding that antiretroviral treatment (ART) for HIV infection not only slows HIV progression, but also prevents new infections in partners of HIV-infected subjects. The work that led to this discovery was funded by a NIDA Avant-Garde program grant to Julio Montaner in 2008, which itself led to a Canadian government grant to focusing on substance abusing populations and aggressively seek, test, and treat subjects to reduce transmission. Dr. Volkow lamented that despite this research, daily injection drug abusers still are less likely than other HIV positive individuals to receive ART until later in the disease process, meaning that its more likely they can infect others. She noted that this gap in application of evidence-based science supporting early ART must be overcome by instituting a cultural change among treating physicians.

Dr. Volkow ended her presentation by once again highlighting the power and value of big dataset science, citing the recent brain imaging and genetics study of over 400 twin pairs that elucidated the influence of genes on human brain structure.

CPDDBLOG welcomes CPDD member’s thoughts on these issues.

Wednesday, June 6, 2012

Why media training is important for CPDD members and all scientists (a plug for the Media Training Forum on Tuesday at the CPDD Annual Meeting)

Have you ever been contacted by the media to speak about a current event or your or someone else’s research?

Photo Credit:

If so, did you know what to do?

If not, are you ready when a reporter comes calling?

Can you talk about your research in a clear and concise manner understandable to the general public?

Do you know why its important to accept media interview opportunities?

The Media Training Forum scheduled for Tuesday morning at the CPDD Annual Meeting will answer some of these questions and offer tips on media interactions, interviewing, and scientific communications.

Panelists include Bertha Madras, who as Deputy Director for Demand Reduction at the White House Office of National Drug Control Policy (ONDCP) served as a very high profile scientist, and Shari Roan, science reporter and frequent contributor to the Los Angeles Times. Bertha will talk about some of her memorable media experiences while at ONDCP and Shari will offer a reporter’s perspective on what its like to interview scientists.

There will be an opportunity to practice and be coached on your interviewing skills via brief mock interviews that will be videorecorded and played back. During playback, Bertha will coach volunteer participants and the audience. Co-Chairs Marc Kaufman and Kathleen Brady will introduce the session and serve as Discussant, respectively.

We hope to see you in Flores 5 on Tuesday morning from 10-noon. If you can’t make the session but are interested in learning more, you can find a great media training guide online targeted to addiction researchers right here

Monday, June 4, 2012

2012 CPDD/NIDA Media Award Winner Mr. Dirk Hanson

Mr. Dirk Hanson is an author, free-lance writer, blogger, and winner of the 2012 CPDD/NIDA Media Award. He is receiving this award for his contributions that enhance the public understanding of scientific issues concerning drug use disorders, including his book entitled "The Chemical Carousel" and his blog "Addiction Inbox".

CPDDBLOG interviewed Mr. Hanson to find out more about his background and his work.

CPDDBLOG: Tell us a little about your background before you wrote your book on substance abuse, “The Chemical Carousel”.

Dirk Hanson: I came out of a liberal arts educational background. As a journalist, I started working as a business reporter for the Des Moines Register, and after moving to California, I was hired by a trade newspaper in the late 70s to cover a place south of San Francisco known as Silicon Valley. I was one of the first journalists to cover Silicon Valley microchip companies as a full-time beat, and it was all based on solid-state physics, about which I knew nothing at the time. However, I interviewed people like Ted Hoff, inventor of the microprocessor, and Robert Noyce, president of Intel and co-inventor of the integrated circuit. Eventually I took the time to write a book about the emergence of Silicon Valley. That was my introduction to science writing. It was a great training ground. My early interest in computers and artificial intelligence—along with some drug and alcohol misadventures of my own—led me to an interest in neuroscience, drugs of abuse, and addiction.

CPDDBLOG: After authoring 3 books, what led you to concentrate on using blogs as your primary medium and focus your blogging on addiction science?

Dirk Hanson: When I went out to sell my addiction book in 2008, the world of book publishing had changed, to put it mildly. Authors were expected to do most of their own promotion, so as a companion project, I started a blog, Addiction Inbox, for short news on addiction topics, and as an online presence for the book. But the blogging quickly took on a life of its own. I found that it was an ideal platform for me as a writer. And, after the blog gained some attention, it opened up online freelance opportunities for additional articles about drugs and addiction. There is a genuine appetite on the web for straight talk about the neuroscience of dependence, craving, and reward, and for basic information about the biochemistry of addictive substances.

CPDDBLOG: An independent review of your book The Chemical Carousel concluded that it “…is a book for the rest of us: friends and families of addicts, support groups, and healthcare professionals alike”. Since many scientists find it challenging to effectively communicate their message to the general public, do you have any tips on how best to present science to the public?

Dirk Hanson: In both my book and my blog posts, I try to treat my readers as intelligent lay people with an interest in science. I come at it from the perspective of a beat reporter. I’ve interviewed dozens of key researchers in neuroscience, pharmacology, and psychology. I concentrate on explaining brain function, and particularly the function of reward systems. But I’m not an M.D. or a research biochemist or a psychology professor, so my perspective is naturally different from theirs. I don’t think you have to “dumb it down,” but in science writing, you do have to take great precautions to insure accuracy and clarity. And you have to find a tone that is conversational but not condescending or overly technical. Frequently, readers tell me that they like being challenged; they like it when I don’t assume they’re idiots. And because of my own background in the Humanities, I also like to do “softer” pieces, such as book reviews, essays on public health policy, or articles on general science issues like fMRI scans. My specific area of focus is on pharmacological approaches to treatment—fighting fire with fire.

CPDDBLOG: What are your future plans for writing and blogging?

Dirk Hanson: I’d like to explore the possibility of doing shorter e-books on selected drug and addiction topics, for one thing. And I plan to continue freelancing on addiction, pharmacology, and the brain. My most recent freelance piece was an article on schizophrenia and cigarette smoking for The Dana Foundation. In addition, writing a blog turns you into a columnist of sorts, providing fresh material on a regular basis. It takes time and research to keep it active and engaging for readers. But the rewards are there. For example, one of the blog’s discussion threads, on the topic of marijuana withdrawal, has garnered more than a thousand comments since I first posted on the subject. The online audience pretty directly engages with you and your work sometimes.

CPDDBLOG: What does winning the CPDD/NIDA Media Award mean to you?

Dirk Hanson: This award is a wonderful validation from the very people whose work I try to interpret for others. I understand that a journalist is not always a scientist’s best friend, so I deeply appreciate the vote of confidence. Also, I think it helps bring attention to online means of presenting reliable information on addiction to a general readership, and hopefully, advancing the public’s understanding of contemporary addiction research. The online world of science communication is here to stay, and that can only be a good thing in the long run.

CPDDBLOG: Thanks for taking the time to answer these questions, and congratulations on winning our Award.

Dirk Hanson: My pleasure.

CPDDBLOG welcomes CPDD member’s thoughts on this issue.

College on Problems of Drug Dependence 74th Annual Meeting, June 9-14, 2012

More than 1100 scientists will be participating in the 74th Annual Meeting of the College on Problems of Drug Dependence (CPDD) to discuss their latest findings on drug abuse and dependence. 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 its treatment, at the La Quinta Resort & Club, Palm Springs, CA. Among the many research topic presentations are symposia and workshops on the rapidly emerging drug problem, Bath-Salt abuse (Sunday PM, Flores 4), on mobile treatment interventions for substance abuse (Tuesday PM, Flores 6-8), and on drug effects in the developing brain (Wednesday PM, Flores 4).

On Sunday morning at the Plenary Session (Flores 4/5), achievement awards will be presented to outstanding individuals for their contributions to the field of addiction science. Those honored include Dr. Edward Sellers, who will receive the Nathan B. Eddy Award for lifetime contributions to the field, Dr. Joshua Lile, who will be presented with the Joseph Cochin Young Investigator Award, Dr. Kathryn Cunningham, who will be recognized for her efforts in mentoring junior drug abuse researchers, and Mr. Dirk Hanson, who will receive the CPDD/NIDA Media Award for outstanding contributions to the public understanding of scientific issues concerning drug use disorders. In addition, Dr. Nora Volkow, Director of the National Institute on Drug Abuse (NIDA), will present a Report From NIDA, and R. Gil Kerlikowske, Director of the White House Office of National Drug Control Policy (ONDCP), will address the Plenary Session with a presentation entitled “National Drug Control Policy: Emerging Opportunities for Policy and Biomedical Research”.

CPDD will hold its President’s Symposium entitled “Addressing the Challenges of Tobacco and Alcohol Use” (Sunday PM, Flores 4/5). 

Other CPDD award ceremonies occur on Monday morning (Flores 4/5), when Dr. Marilyn Carroll will be presented with the Marian W. Fischman Memorial Lectureship Award and on Wednesday morning during the Public Policy Forum (Flores 4) when General Barry McCaffrey, U.S.A. (Retired), will receive the Martin and Toby Adler Distinguished Service Award. General McCaffrey will present an address entitled “Decreasing Addiction with Emphasis on the Military, Veterans, and Their Families.” 

Sunday through Thursday afternoon, CPDD members will present new and exciting research findings in poster and oral presentations. Highlighted presentations include reports on prescription opioid diversion patterns (Cottler et al., Sunday PM, Flores 6-8), on unmet substance abuse treatment needs among veterans (Golub et al., Monday PM, Flores 6-8), on excess hospital utilization by illicit drug users (Kertesz et al., Tuesday PM, Fiesta), on the reduction in oxycontin exposures since its reformulation to deter misuse (Coplan et al., Wednesday PM, Fiesta), and on how restrictive state laws on graduated driver licensing reduce teen drinking and driving (Cavazos-Rehg et al., Thursday AM, Fiesta). This is only a small sampling of the hundreds of reports and information sessions that will be presented.

To learn more about these events and to find topics of interest, search the freely downloadable meeting program and abstract listings by clicking the “2012 Program Book (pdf)” and “2012 Abstract Book (pdf)” links. 

Media personnel are invited to attend Plenary and Scientific sessions.

Sunday, May 27, 2012

Context of smoking portrayals in movies influences risk for future smoking in adolescents

Are you planning on going to the movies with your kids, renting them DVDs, or allowing them to watch movies online in the near future? If so, you might be interested in the results of a new study just published in Drug and Alcohol Dependence, suggesting that adolescent movie viewers exposed to certain types of tobacco smoking scenes may be at increased risk for initiating smoking.

The study, published by Shadel and colleagues at the RAND Corporation, involved more than 350 boys and girls aged 11-14 years old, who viewed movie clips containing smoking scenes. About one-third of the group viewed clips in which smoking facilitated social interactions, one-third viewed clips in which smoking was portrayed as relaxing, and one-third viewed clips in which smoking was not portrayed as positive or negative. All subjects had previously viewed clips of smoking-free movies selected because their content otherwise matched that of the smoking scene they would view. Risk for smoking was assessed when subjects viewed both smoke-free and smoking scenes, using a modification of a questionnaire previously shown to predict future smoking.

Adolescents exposed to movie scenes depicting social smoking were more likely to experience an increase in future smoking risk. And, among those exhibiting increased future smoking risk, exposure to scenes portraying smoking as facilitating relaxation also was associated with increased future smoking risk.

The authors noted that their study “provides the first experimental evidence that motivated smoking in movies causally affects future smoking risk in young adolescents.”

This is a key area for future research and policy because of the link established between smoking in movies and future smoking risk.

Although the current film ratings system of the Motion Picture Association of America (MPAA; G, PG, PG-13, R, NC-17) does not permit any portrayals of drug use in G or PG films, tobacco and alcohol scenes are not excluded from such films. In this regard, the Centers for Disease Control and Prevention (CDC) published data last July in the Morbidity and Mortality Weekly Report (MMWR) on the number of smoking scenes in the 137 top-grossing movies including youth-rated movies.

The report noted that the numbers of smoking scenes in movies are on the decline versus a peak in 2005. This is due in large part to a 96% reduction in the numbers of smoking scenes in films produced by 3 of the 6 members of the MPAA with published policies on excluding smoking content in  top-grossing youth-rated films (Figure). However, given the link established between smoking scenes and risk for smoking, the MMWR report suggested that an R rating be assigned by the MPAA to movies with any smoking scenes.

CBSNEWS HEALTHWATCH reported that the MPAA members without published policies at the time of the MMWR study were News Corp. (20th Century Fox and Fox Searchlight); Sony (Sony Pictures and Columbia Pictures); and Viacom (Paramount Pictures, MTV Films and Marvel).

To date, these companies have not adopted published policies, and earlier this month, the National Association of Attorneys General sent letters to Rupert Murdoch, Chair and Chief Executive of the News Corporation, as well as to heads of other companies producing movies, urging them to adopt anti-smoking policies for youth-rated movies.

The Shadel study adds to the growing literature documenting risk for smoking after exposure to films containing smoking themes, and provides further evidence that smoking scenes should be banned from youth-rated films.

If you are interested in finding movies that do not contain smoking content, the Smoke Free Movies website, a project of Professor Stanton A. Glantz at the University of California, San Francisco, rates current movies for their smoking content.

CPDDBLOG welcomes CPDD member’s thoughts on this issue.

Monday, April 30, 2012

More Bad News for Methamphetamine Abusers: Increased Risk for Death

The study reviewed records of nearly 820,000 people in California who during hospitalization were diagnosed as abusers or dependent upon alcohol, cannabis, cocaine, methamphetamine, or opioids, within the 16-year period from January 1990 through December 2005.  Death records also were reviewed during this period.  For subjects who died within the study period, the average duration between index hospitalization and death ranged from 7.4 – 10.7 years, with mean duration for methamphetamine abusers of 8.5 years (4122 deaths).  The study did not include polydrug abusers (who were diagnosed as abusing more than one substance).
Standardized mortality rates (SMRs), adjusted for age and for racial and sex differences in substance abuse and death rates, were calculated for each abused substance.  The SMR for methamphetamine abusers was 4.67, meaning that the risk for death was nearly 5-fold that in the general population.  This SMR exceeded SMRs for alcohol, cocaine, and cannabis abusers, and only was exceeded by the SMR for opioid abuse which was 5.71 (nearly 6-fold the death rate in the general population).
The authors noted that their study provides the first data from a large US cohort documenting the SMR in methamphetamine abusers, and suggests that additional steps should be taken to reduce the death rate in this group.
Graphic evidence of the ravages of methamphetamine abuse can be found in the story of Shawn Bridges, a methamphetamine abuser who died in 2007 at age 35.  Shawn recorded some of his struggles in hopes that others might not share his fate.
CPDDBLOG welcomes CPDD member’s thoughts on this issue.

Tuesday, April 3, 2012

Webinar on the Development of a Scientific Strategic Plan for the New NIH Addiction Research Institute

A webinar was held yesterday to discuss development of the scientific strategic plan for the new substance use and addiction disorders research Institute, which will be constituted primarily via a structural merger of the National Institute on Drug Abuse (NIDA) and the National Institute on Alcohol Abuse and Alcoholism (NIAAA).

The webinar, hosted by Lawrence A. Tabak, D.D.S., Ph.D., NIH Principal Deputy Director and Executive Director of the Advisory Committee to the NIH Director, included over 300 participants. Dr. Tabak presented slides describing the process of formulating the new Institute, and he outlined the anticipated time line for the reorganization:

The public comment period to inform the strategic plan remains open until May 11, 2012. Development of the draft plan including research portfolio analysis and integration will continue through the fall of 2012, when the draft plan including research portfolio assignment will be published.

Another public comment period will be opened to provide feedback on the draft plan through the fall of 2012. Final recommendations will be made to the NIH Director in December 2012. The new Institute budget will be proposed in the President’s FY 2014 budget in January or February of 2013, and the first budget period for the new Institute will start in October, 2013. However, the new Institute will effectively commence operations in early 2013, when elements of the final Scientific Strategic Plan not requiring reorganization will begin to be implemented.

Dr. Tabak noted that no final research portfolio assignments have been made yet, that NIH wants stakeholder input to guide portfolio assignment for existing program elements, and that NIH especially seeks recommendations for potential new opportunities to address research needs and areas not currently in focus either at NIDA or NIAAA. He also mentioned that the name that has been circulated for the new Institute, the National Institute of Substance Use and Addiction Disorders (NISUAD), is just a placeholder at this time, and that the actual name for the new Institute has yet to be established.

Dr. Tabak indicated that his slides will be posted online at a later date. A screenshot of his last slide, showing how to contribute ideas via the Request for Information and how to obtain more information about the process, is posted at right.

Dr. Tabak then fielded questions from the audience. CPDD was well represented with questions submitted by CPDD President Scott Lukas, CPDD Executive Officer Martin Adler, and other CPDD members.

Scott asked whether the new Institute’s budget would be the sum of the existing NIDA and NIAAA budgets. Dr. Tabak replied that the budget would not be set until the research portfolio is established, but that since it is anticipated that some research activities will be transferred both to and from other Institutes, the expectation is that the budget will not be a sum of the existing budgets.

Marty asked whether research portfolio elements relevant to HIV would remain in the new Institute. Dr. Tabak indicated that it remains to be decided whether the entire HIV portfolio will remain in the new Institute or be broken up. He again directed stakeholders and other interested parties to comment on research issues such as this by responding to the Request for Information comment period open until May 11, 2012.

Several other questions focused on budgetary issues, including whether or not an analysis has been performed to determine the cost to NIH of creating the new Institute, whether or not this is the right time for this change, and how the budget will support establishment of addiction research in areas of new opportunity or existing need, a key initiative for the new Institute.

Dr. Tabak replied that the budgetary goal for the reorganization is to make it budget-neutral, and that it is not a cost-savings exercise. He anticipates that there may be budgetary savings in future years as a result of economies of scale. With regard to the timing of the reorganization, he said that the timing was selected after close discussion with colleagues both on Capitol Hill and in the Department of Health and Human Services (DHHS), who view the reorganization as a means to enhance science, not reduce budgets. In response to the question about new initiatives and opportunities, he indicated that it is anticipated that NIH budgets will be flat over the next few years, so to accommodate new programs, existing resources will have to be redirected, in part by contraction or attrition of existing programs. Dr. Tabak followed by reporting that NIH experiences turnover/attrition of roughly 20-25% of its portfolio each year, so it is anticipated that resources will become available to support new initiatives.

Most of the other questions focused on specific elements of the research portfolio and where they would be assigned. Dr. Tabak responded to these questions by repeatedly urging stakeholders to provide feedback that will be considered in the planning process.

Stay tuned to CPDDBLOG for updates on the process.

CPDDBLOG welcomes CPDD member’s thoughts on this issue.

Saturday, March 31, 2012

The Project HOPE model is being tested in additional states

A year-long pilot project in Seattle is using methods for intensively monitoring, rapidly prosecuting, and rapidly yet briefly incarcerating drug offenders, shown to be successful in the Hawaii Project HOPE program, described by Dr. Angela Hawken at last year’s CPDD meeting.

The Seattle program, called the Washington Intensive Supervision Program (WISP), focuses on higher risk offenders than the Hawaii program, and it includes offenders abusing a wide range of drugs. The WISP program is overseen by Dr. Hawken.

Dr. Hawken along with colleague Dr. Mark Kleiman submitted a draft report on the WISP program in December 2011, noting that WISP participants experienced 1) reduced drug use as evidenced by a nearly 66% reduction in positive urine tests, 2) a greater than 60% reduction in incarceration time, and 3) a 75% reduction in criminal activity. Thus, the pilot program appears to be showing substantial benefits even in higher-risk drug offenders.

The early success of the WISP program along with the cost savings such programs can bring has stimulated a statewide initiative, which could be the first statewide program of its kind, to alter Washington State’s drug offender probation/parole system by adopting WISP project methods.

Several other states are testing similar programs, including Alaska, Arizona, California, and Nevada.  Further, the National Institute of Justice reported earlier this month that the Bureau of Justice Assistance (BJA) is supporting programs in 4 states designed to exactly replicate Project HOPE, to determine if the program’s benefits are widely achievable. The 4 additional locations are in Arkansas, Massachusetts, Oregon, and Texas. Dr. Hawken will assist these sites in developing and managing their programs.

CPDDBLOG welcomes CPDD member’s thoughts on this issue.

Saturday, February 11, 2012

The Time is Now to Weigh in on the Strategic Plan for NIH's New Addiction Research Institute

News on plans for formulating the new NIH addiction research Institute has been scant for a number of months, but Friday's NIH Guide included a Request for Information Notice (NOT-OD-12-045) inviting public comment on strategic planning for the new Institute. The comment period is open from now until May 11, 2012.

The new Institute, tentatively called the National Institute of Substance Use and Addiction Disorders (NISUAD), will merge the National Institute on Drug Abuse (NIDA) and the National Institute on Alcohol Abuse and Alcoholism (NIAAA), and will include parts of other Institutes relevant to substance use and addiction disorders.

The plan to reorganize NIH substance use and addiction research was recommended by the Scientific Management Review Board (SMRB), and discussed in several prior CPDDBLOG posts including here.

The Request for Information is not seeking comments on whether a new Institute should be formed. Rather, it is looking for feedback on 13 areas already identified as strategic priorities that can be better addressed by the reorganized Institute (highlighted in the Request for Information Notice) and seeking new ideas for scientific opportunities and unmet needs in substance abuse research that could be achieved with the new structure.

All responses provided to the comment site will be posted along with responder names.

This is your chance to help shape the new Institute.  If you provide a response to this Request for Information, please consider posting it on CPDDBLOG as well.

CPDDBLOG welcomes CPDD member's thoughts on this issue.