Extraordinary growth and change have characterized the recent history of the National Institute on Drug Abuse (NIDA). And a retrospective look is particularly pertinent as NIDA approaches its twentieth anniversary and we take stock and plan the future.
Growth and Integration
As a consequence of the recognition that drug abuse and addiction are among the nation’s top public health concerns, and that in their wake are a host of problems (e.g., drug abuse-related HIV infections, AIDS, and tuberculosis), NIDA’s budget grew from $85 million in 1986 to just over $400 million in fiscal year (FY) 1993. This growth has expanded significantly NIDA’s ability to support behavioral and biomedical research programs across the country.
In addition to growth, NIDA became part of the National Institutes of Health due to a congressionally mandated transfer that took effect October 1, 1993. This move not only co-located the science on the disease of addiction with the rest of the nation’s premier biomedical and behavioral research enterprise but also reaffirmed the status of drug abuse as a complex biobehavioral disorder which should command the same degree of compassion and scientific dedication — and funding — as any other disease. This is, of course, good news to the multidisciplinary field of drug abuse research in general, and to the behavioral and social science community in particular.
Behavioral Research and More
As the largest research organization in the world devoted to drug abuse research, NIDA has always supported substantial behavioral research related to the etiology, consequences, prevention, and treatment of drug abuse. And since NIDA supports nearly 90 percent of the drug abuse research conducted in this country, if it’s not supported by NIDA, it’s not likely to get done.
It would not be possible to describe NIDA’s extensive behavioral and psychosocial research portfolio in this space, but below are some of the highlights (see also the list of FY 1992 grantees in the article beginning on page 1 of this issue of the Observer):
Treatment Efficacy. Substantial research efforts at NIDA are devoted to improve the efficacy of drug abuse treatment. The majority of this research focuses on behavioral and pharmacological treatment for cocaine and heroin abuse as well as on the effects of methadone maintenance on drug using behavior. Many studies are examining the effects of behavior therapy cognitive behavioral therapy, and psychotherapy on drug using behaviors.
As part of the Institute’s commitment to developing the most effective treatment for drug addiction, NIDA is launching a Behavioral Therapies Initiative in FY 1994. The fact is that, although many forms of therapy exist, most were not developed or tested specifically for drug abusers. This initiative builds on the knowledge gained from basic behavioral studies to identify, formulate, and systematically test promising existing psychotherapeutic, behavioral, and counseling interventions, as well as to develop and test new therapeutic modalities.
Cognitive Impacts. Other NIDA funded studies are investigating the impact of illicit drug use on learning, memory, awareness, judgment, performance, and the variables that modify cognition, such as arousal, motivation, and attention. Studies are attempting to characterize the acute effects, as well as the chronic and residual effects, of abused drugs. Animal models are allowing for studies of the neural circuitry involved in these behaviors and are facilitating an understanding of how drugs interfere with performance in the workplace.
Developmental Research. One of the most important areas of behavioral drug abuse research at NIDA has been concerned with the effects of parental drug use on the developing fetus. Exposure to drugs gestationally, perinatally, or neonatally due to drug use by the parent(s) may induce long-term cognitive and behavioral deficits. NIDA studies focus on delineating the cognitive and behavioral impact of gestational drug use, as wen a the biological basis for these effects.
NIDA also supports studies on the environmental factors associated with parental drug abuse and the effects on children. For instance, because of their drug-abuse lifestyle, drug-abusing parents may increase stress, psychopathology, and violence in the home environment and engage in inadequate childrearing practices that place their children at risk for intellectual, behavioral and social impairment.
Studies in both humans and animals are helping differentiate the effects of parental drug use on developmental outcomes from other pre- and post-natal factors, such as nutritional and health status, drug abuse lifestyle, neglect, and child abuse. A determination of the relative effects of each of these various factors is critical to developing effective strategies for helping drug exposed children and their families.
Biological Bases of Behavior. NIDA devotes substantial research efforts to understanding the biological bases of drug using behaviors, such as craving and drug seeking. Much of this research uses animal models, but some of the studies, particularly those that involve brainimaging technologies, use human subjects. In FY 1994, in recognition of the importance of behavioral neuroscience to drug abuse research, NIDA is undertaking a Human Neuroscience Initiative which will include the development of neuroimaging approaches to allow for the correlation of neuroanatomical, chemical, and physiological parameters with behavioral and psychosocial assessments.
Craving. For several years, NIDA has been funding studies focusing on the development of a model to explain craving and drug seeking behavior. This model uses the relationship between behavior and neurobiological processes to explain the rewarding nature of drugs, and is helping explain drug-seeking behavior and guide the development of effective behavioral interventions. Ongoing studies continue to expand and refine this model.
HIV-related Research. NIDA’s portfolio includes research focusing on HIV risktaking behaviors, and interventions to change such risk behaviors. Much of this research examines correlates of risk behavior and how psychological and social factors mediate and moderate risk. NIDA also supports research to examine HIV risk-taking behaviors and interventions for reducing such behaviors. These studies focus on reducing such behaviors in the community setting, in intravenous drug users and their sexual partners, as well as in populations at special risk or need, including women and racial and ethnic minority groups and individuals residing in the inner cities.
Scientific Community Helps
The research NIDA supports is comprised of a broad spectrum of approaches and disciplines. No small part of the Institute’s research effort has been, and will continue to be, focused on behavioral and psychosocial approaches to understanding, preventing, and treating drug abuse and addiction. As part of our efforts for the future, NIDA is enthusiastic in our support of APS and the other organizations which have joined with it in ongoing development of the Human Capital Initiative report, Combatting Drug Abuse: A Behavioral Research Agenda for improving the Public Health.
I look forward to the results of these efforts and to the continued interest and support of the behavioral and social science community for NIDA’s programs and priorities. It is only through partnerships such as these that, working together, NIDA, APS, and its membership will ultimately be successful in our joint efforts to overcome drug abuse and addiction and their accompanying behavioral and biomedical consequences which touch the lives of so many Americans.