National Institute on Drug Abuse Bringing the full power of science to bear on drug abuse and addiction Nora D. Volkow, M.D. Director National Institute on Drug Abuse Drug Abuse & Addiction Research: Progress, Priorities, and Opportunities at NIDA Nora D. Volkow, M.D. Director National Institute on Drug Abuse National Institutes of Health
30
Embed
National Institute on Drug Abuse Bringing the full power of science to bear on drug abuse and addiction Nora D. Volkow, M.D. Director National Institute.
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
National Institute on Drug AbuseBringing the full power of science to bear on drug abuse and addictionNora D. Volkow, M.D.DirectorNational Institute on Drug Abuse
Drug Abuse & Addiction Research:Progress, Priorities, and Opportunities at NIDA
Nora D. Volkow, M.D.Director
National Institute on Drug AbuseNational Institutes of Health
Strategy for Development of Scientific Strategic Plan for New SUD Institute
• Identify scientific and public health needs not addressed by NIH
• input from NIH scientific staff• input from external stakeholders (researchers, advocates)
• Assess suggested scientific opportunities and public health needs, in light of missions of NIDA, NIAAA, NCI & other ICs
• Develop a draft scientific strategic plan• Integrate new scientific opportunities identified by NIH & the
public with existing priorities in SUD research• Solicit public input on draft plan
June 2011 - Fall 2012: input from stakeholders February 2012: RFI published Spring 2012: Conduct virtual meetings Spring/Summer 2012: Conduct town hall meetings and
teleconferences with stakeholders
Fall 2012: Release of Draft Scientific Strategic Plan and public comment period December 2012: Final Recommendations to NIH Director January/February 2013: Include President’s FY 2014 Budget Begin implementing Scientific Strategic Plan that is not dependent on reorganization October 2013: National Institute of Substance Use and Addiction Disorders (NISUAD)
Scientific Strategic Plan Development Action Timeline
Solicitation for Public Stakeholder Input
Request for Information
February 8, 2012
Closing date: May 11, 2012
How to Submit a Response : All comments must be submitted electronically to: http://grants.nih.gov/grants/guide/rfi_files/nih_nisuad/add.cfm
Public Meetings
Schedule posted and updated on http://feedback.nih.gov/index.php/category/suaa/
National Institute on Drug Abuse Portfolio FY 2011 Actual
Epidemiology, Services & Prevention Research -- 23%
Basic & Clinical Neuroscience & Behavioral Research -- 45%
Pharmacotherapies & Medical Consequences -- 12%
Intramural Research -- 8%
Clinical Trials Network -- 5%
RM&S -- 6%
NIDA Priority Areas
(New Targets & New Strategies)
Medical Consequences Medical Consequences
(Children & Adolescents) genetics/epigenetics development environment co-morbidity
Treatment InterventionsTreatment Interventions
Prevention ResearchPrevention Research
HIV/AIDS, HCVTeratogenic effects
Big DATA Sets Allow Analysis of Complex Systems
With sequencing costs dropping dramatically, an explosion of very large sequencing datasets is at hand, which present challenges forhigh-level data analysis and for information technology infrastructure. Creighton Exp Rev Mol Diagn 2010
• Genetics
• Epigenetics
• Proteomics
• Brain Imaging
• Clinical Data
• Systems Biology
BIG DATA: Advisory Committee to NIH Director
Data and Informatics Working Group (DIWG)(Drs. Tabak and DeMets)
Molecular Profiling
Phenotyping Imaging Grant Admin.
• The first three subgroups will provide information to the DIWG on policies and investments needed to facilitate data sharing and integration.
• The DIWG will develop recommendations to present to the ACD and the NIH Director on policies regarding the management, integration and analysis of research data and administrative data.
ITManagement
NIDA Priority Areas
(New Targets & New Strategies)
Medical Consequences Medical Consequences
(Children & Adolescents) genetics/epigenetics development environment co-morbidity
Treatment InterventionsTreatment Interventions
Prevention ResearchPrevention Research
HIV/AIDS, HCVTeratogenic effects
METH users had higher [11C]-(+)-PHNO binding in the D3-rich midbrain (SN; +46%), globus pallidus (+9%) and ventral pallidum (+11%), and lower binding in D2-rich dorsal striatum (−4% to −12%)
Higher Binding of the Dopamine D3 Receptor-Preferring Ligand [11C]-PHNO in Methamphetamine Polydrug Users
METH >Controls
Boileau et al., J Neurosci. 2012
Buspirone (D3 receptor antagonist +)
Marketed as Buspar (Bristol Myers-Squibb 1980s) for anxiety disorders (proposed mechanism: 5HT1A receptor partial agonist)
Affinity (Ki)
5HT1A Partial Agonist 4-78 nM
D1R >10 000
D2R Partial Agonist 260nM
D3R Antagonist 3.5 nM
D4R Antagonist 78 nM
Buspirone Reduces Cocaine Self-Administration In Rhesus Monkeys
J. Bergman, N. Mello, et al. submitted
Baseline
With Buspirone0.0 20.0 40.0 60.0 80.0
0.000
0.010
0.020
0.030
0.040
0.050
0.060putamendy1 GP dy1CD dy1CB dy1putamendy2GP dy2
Time (min)
%ID
/cc
Buspirone (0.17mg/kg iv over 20 minutes) almost completely blocked D3 receptors in the monkey brain
Effects of Buspirone on [11C]PHNO (D3/D2R Ligand) Binding in the Baboon Brain
Kim et al., unpublished
Nicotine vaccines
• NicVAX, failed to meet primary endpoint in two phase III studies
• Higher abstinence was observed in subjects with higher immunity to nicotine.
Strategies:
• novel carriers and/or adjuvants for higher immunogenicity
• targeting subjects with robust responses
• Combining with medications.
Fahim et al., CNS Neurol Disord Drug Targets. 2011.
Despite increases in ART incidence of HIV in USA has remained stable at 56,300 new infections per year. ∼ This is likely to reflect in part failure to treat those with SUD.
Of the 1.1 M individuals living with HIV in the US, 21% are estimated to be unaware of their HIV infection. Undetected cases are likely to be higher among individuals with SUD.
Implementing Rapid HIV Testing With or Without Counseling in Drug Tx Centers
• Combined on-site rapid testing participants received more HIV results (82.2%) than off-site testing referral participants (18.4%)
• p < 0.001, aRR 4.52, 97.5% CI (3.57, 5.72)
• *No effect of counseling*0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
80.0%
90.0%
82.2%
18.4%
On-site testing
Off-site testing
American Journal of Public Health | April 19, 2012
0
5
10
15
20
25
30
18.3
11
16.7
2.3
25.3
8.5
23.6
10.310.9
19.7
Pooled Australia Brazil India USA
Hummeniuk R et al., Addition 2012; 107: 957-966.
Brief Intervention Control
Mean Effect Size (% Decrease) in Illicit Substance Involvement
PE
RC
EN
TScreening and Brief Intervention in
Primary Health Care Settings
Sekine et al., J Neurosci. 2008 28(22):5756-61
Microglia are activated in brains of METH abusers
Brain Imaging Studies of Microglial Activation (PET and [11C](R)-PK11195)
SIV Monkeys with encephalitis show
microglia activationVenetti et al., J Clin Invest. 2004 113(7):981-9