National Institute on Drug Abuse
Director's Report to the National Advisory Council on Drug Abuse
(Prepared December 27, 1999)
NIH Funding for FY 2000
On November 29, 1999, the President signed the Omnibus Appropriation Bill for FY 2000, H.R. 3194 [P.L. 106-113] which includes funding for the National Institutes of Health. The final conference agreement on the FY 2000 Labor-HHS-Education appropriations bill, H.R. 3424, was included by cross-reference in the Consolidated Appropriations Act, H.R. 3194 [H. Rept. 106-479]. The House passed the appropriations package on November 18 and the Senate on November 19, 1999.
The conference agreement provides $17.913 billion for the NIH, an increase of $2.3 billion (14.7 percent) over FY 1999. The conference agreement provides funding of $689.4 million for NIDA, an increase of $81.5 million (13.4 percent) over FY 1999.
In an effort to stay within the spending caps and avoid using the Social Security surplus the final conference agreement includes a 0.38 percent across-the-board cut of all discretionary spending and a delay in obligations until September 29, 2000, for significant portions of various program budgets, including NIH, CDC, and HRSA.
Selected Conference Bill Language:
Transfer authorities: remain consistent with FY 1999 appropriation language. The Director, NIH, may transfer up to 1% of any appropriation (OD); HHS may transfer between appropriations up to 1% of any discretionary funds, but it may not increase any single appropriation by more than 3% (sec. 206); The Director, NIH, and the Director, OAR, may transfer up to 3% of funds identified as HIV/AIDS (sec. 207).
Delayed obligations: $3 billion of NIH funds are not available for obligation until September 29, 2000; delayed funds are available until October 15, 2000, pending policy decision (sec. 216).
Reduction to be taken: $17.9 billion Conference Mark does not reflect the across-the-board spending cut of 0.38%.
OD: OAR, $44.953 million; Foundation for NIH: $500,000.
NIAID transfer: Requires transfer of $20 million from NIAID to CDC by January 15, 2000 for the study of the safety and efficacy of vaccines used against biological agents (sec. 221).
Challenge grant program: $20 million earmarked for NIH in Public Health and Social Services Emergency Fund in the Office of the Secretary (no change from Senate report).
NIH Office of the Director
Minority Programs: Minority Access to Research Careers, Minority Biomedical Research Support, Research Centers in Minority Institutions, and the Office of Research on Minority Health programs should continue to be supported at a level commensurate with their importance.
Parkinson's Disease: NIH is requested to develop a report to Congress by March 1, 2000 outlining a research agenda for Parkinson's focused research for the next five years, along with professional judgment funding projections. The NIH Director should be prepared to discuss Parkinson's focused research planning and implementation for FY 2000 and FY 2001.
Biomedical imaging and engineering: NIH is urged to establish an Office of Bioimaging/Bioengineering and to review the feasibility of establishing an Institute of Biomedical Imaging and Engineering. The Office should coordinate imaging and bioengineering research activities, both across the NIH and with other Federal agencies. The NIH shall report to the Appropriations Committees of the House and Senate on the progress achieved by this Office no later than June 30, 2000.
ORMH: The Office of Research on Minority Health is encouraged to expand and strengthen science-based HIV prevention research for a wide range of minority populations.
House Appropriations Committee Report Language for the National Institute on Drug Abuse [HRpt. 106-370]
Centers for Drug Abuse Research and Treatment: The Committee commends NIDA for its strategy of developing and establishing centers for drug abuse research and treatment around the country. Consideration should be given to locating one or more centers in areas where drug trafficking, the production of illegal drugs such as methamphetamine, and drug abuse is more prevalent.
Children and Adolescents: Recognizing the devastating impact of drug addiction on children and youth, the Committee is pleased that NIDA has developed a children and adolescent research initiative. The Committee urges NIDA to work with other NIH Institutes to expand its research portfolio into areas of co-occurring mental disorders, developmental consequences, prenatal exposure, genetic vulnerability, and environmental protective and risk factors. This type of research offers hope of improved prevention of initial drug use and prevention of the health consequences of addiction.
Clinical Trials: The Committee is pleased with NIDA's continuing progress in developing behavioral and pharmacological drug abuse treatments and supports NIDA's new treatment initiative to establish a National Drug Abuse Treatment Clinical Trials Network designed to test the efficacy of promising pharmacological and behavioral treatments through large-scale clinical trials. The Committee is also pleased with NIDA's leadership in forging strong partnerships with treatment researchers and community-based treatment providers as a means of assuring that effective new treatments will be tested in real-life settings and incorporated into ongoing community-based drug treatment programs.
Genetic Vulnerability: Genetics and the environment are two factors that influence drug abuse and addiction. The relationship between the two is complex, requiring continued research in areas of behavioral genetics, psychiatric and epidemiological genetics, molecular genetics, and population genetics. The Committee encourages NIDA to expand its development of research for improving prevention and treatment interventions in this area.
Hepatitis C: The Committee commends NIDA for participating in the trans-Institute request for applications for Hepatitis C and urges enhanced research in this area consistent with the recommendations made by the Hepatitis C Consensus Development Conference.
Medications Development: The Committee encourages NIDA to study the development of anti-addiction medications to clarify the neurological and behavioral benefits of the use of various pharmacological agents and to continue to develop an understanding of how physicians can best utilize these medications. NIDA is also encouraged to expand its support for research to develop medications that are specifically geared to the needs of varied populations as well as research on treatment approaches for application to poly-drug addiction.
Neuroscience: Basic neuroscience provides a foundation for NIDA's research portfolio. The Committee urges NIDA to continue efforts to develop new areas of research in neuroscience and commends NIDA's support for continued research and dissemination of information to the public on the neurobiology of drug addiction to specific drugs of abuse.
Nicotine Research: The Committee recognizes that the health consequences of nicotine addiction are substantial to adults, children, and adolescents and applauds the gains NIDA has made in supporting research that has yielded effective replacement therapies and behavioral interventions. The Committee encourages NIDA to continue to develop research on the prevention, behavioral, and pharmacological treatment of nicotine addiction. The Committee also supports NIDA's ongoing research in the basic sciences, behavioral and medical treatments, and epidemiology of nicotine use and abuse.
Senate Appropriations Committee Report Language for the National Institute on Drug Abuse [SRpt. 106-166]
Methamphetamine: The Committee is very disturbed by the explosion in methamphetamine abuse across the nation. The problem is especially acute in Iowa and other Midwestern states. The Committee urges NIDA to expand its research on improved methods of prevention and treatment of methamphetamine abuse and expects to be briefed on these efforts by December 1, 1999.
Behavioral Science: The Committee understands that behavioral intervention is a critical element in halting drug abuse. The Committee continues to support NIDA's expansion of its behavioral science portfolio and views NIDA as a model of how to approach its behavioral science and public health responsibilities.
Neuroscience: The Committee recognizes that basic neuroscience provides a foundation for NIDA's research portfolio. Basic neuroscience research has advanced the field's understanding of drug abuse and addiction. The Committee urges NIDA to continue its efforts to develop new areas of neuroscience research.
Genetic Vulnerability: The Committee understands that both genes and environment influence drug abuse and addiction. The relationship between the two is complex, requiring continued research in areas of behavioral genetics, psychiatric and epidemiological genetics, molecular genetics, and population genetics. The Committee encourages NIDA to expand its development of this area of drug and addiction research.
Children and Adolescents: Recognizing the devastating impact of drug addiction on children and youth, the Committee commends NIDA's children and adolescent research initiative. The Committee urges NIDA to expand its research portfolio in areas of co-occurring mental disorders, developmental consequences, prenatal exposure, genetic vulnerability, and environmental risk factors.
Hepatitis C: Language similar to House Report.
Clinical Trials: Language similar to House Report.
Medications Development: Language similar to House Report.
Nicotine Research: Language similar to House Report.
Hearings/Briefings of Interest
September 9, 1999 - Scientific Research on Addiction - Dr. Frank Vocci, Director, Division of Treatment Research and Development, NIDA, briefed Marcia Lee, staffer to Senator Joseph Biden (D-DE), Ranking Member, Senate Judiciary Subcommittee on Youth Violence, at her request. The briefing, before Ms. Lee and other staffers, was to discuss S. 486, the Methamphetamine Anti-Proliferation Act of 1999 and focused on current addiction research. Representatives from SAMHSA, the Drug Enforcement Agency, and the Department of Health and Human Services were also in attendance.
October 8, 1999 - NIDA Research Programs - Dr. Timothy Condon, Associate Director, NIDA, briefed Sharon Pinkerton, majority staffer on the House Government Reform Subcommittee on Criminal Justice, Drug Policy, and Human Resources (John Mica, R-FL, Chair) on current NIDA research programs. Ms. Pinkerton, new to the Subcommittee, discussed a wide-range of initiatives with Dr. Condon.
October 21, 1999 - ONDCP Youth Media Campaign - The House Appropriations Subcommittee on Treasury, Postal Service, and General Government (Rep. Jim Kolbe, R-AZ, Chairman) held a hearing on Phase III of the Office of National Drug Control Policy's Youth Anti-Drug Media Campaign. Susan David, M.P.H., testified before the Subcommittee on efforts to track the effectiveness of ONDCP's outreach campaign to combat youth drug use. The Subcommittee also heard testimony from General Barry McCaffrey, Director, ONDCP, and representatives from the entertainment and marketing industry.
November 15, 1999 - Field Hearing on Regional Drug Abuse - Dr. Alan Leshner, Director, NIDA testified at a field hearing in Newcastle, DE, that focused on the region's persistent substance abuse problems. At the hearing, held by Senators Joseph Biden (D-DE) and Arlen Spector (R-PA), Dr. Leshner spoke on the impact of drug use, particularly heroin, on brain function, as well as misperceptions surrounding the snorting of heroin and addiction.
Bills of Interest
H.R. 2634 - Drug Addiction Treatment Act of 1999 - On September 13, 1999, the House Commerce Subcommittee on Health and Environment held a mark-up session on H.R. 2634. This bill was introduced on July 29, 1999, by Representative Tom Bliley (R-VA) as the Drug Addiction Treatment Act of 1999, which would amend the Controlled Substances Act with respect to registration requirements for practitioners who dispense narcotic drugs in schedule IV or V for drug addiction treatment. The bill would allow qualified physicians, as determined by DHHS, to prescribe schedule IV and V anti-addition medications in physicians' offices without an additional DEA registration if certain conditions are met. These include certification by participating physicians that they are a physician licensed under state law; they are trained to treat opiate abuse; they have the capacity to refer patients for counseling and other appropriate ancillary services; the total number of patients shall not exceed a specified number unless the Secretary HHS adjusts the number. Other key provisions include the following: the drug involved must be approved by the FDA for use in maintenance or detoxification treatment and must not have been the subject of an "adverse determination;" if a physician dispenses a narcotic drug in Schedule IV or V in violation of this law, a practitioner may lose his registration with DEA; during the first 3 years either the Secretary or the Attorney General may make a determination that the law should not remain in effect; states can overrule the 3 year grace period with their own legislation if they deem this appropriate. On July 30, 1999, the House Commerce Subcommittee on Health and Environment (Chairman Bilirakis, R-FL) held a hearing on H.R. 2634. A similar measure (S. 324) was introduced in the Senate on January 28, 1999, by Senator Orrin Hatch (R-UT), and referred to the Senate Committee on the Judiciary.
S486/S324 - S 486 was introduced by Sen. Ashcroft (R-MO) on Feb. 25, 1999. The Senate passed S486 by voice vote Nov. 19, 1999. A substitute amendment was added from other drug legislation (HR1428) which was designed to increase the availability of treatment and a provision similar to S324 and HR2634, that would allow certain physicians to prescribe schedule III, IV, and V anti-addiction medications for heroin addiction without additional DEA registration (see HR2634 above). S486, as passed by the Senate, aims to deter the production and distribution of methamphetamine. The measure would increase funding authorizations for federal, state and local law enforcement organizations, prohibit the posting of methamphetamine drug recipes on the Internet -- which are now readily available -- and stiffen penalties for illegal production of the drug. The legislation would authorize $30 million for the Drug Enforcement Administration (DEA) each year through 2004 to train, assist and deploy agents; $25 million per year for law enforcement to combat the drug's use and distribution in "high-intensity trafficking areas;" and $25 million per year for prevention, interdiction and studies of the law's effectiveness.
H.R. 2130/S1561 - Date Rape Prevention Act - Passed by the House on October 12, 1999. Sponsored by Fred Upton, R-MI, this bipartisan bill aimed at curbing the abuse of three sedatives that have emerged as so-called "date rape" drugs, was approved August 5, 1999 by the House Commerce Committee. The measure would add GHB (gamma hydroxybutyric acid, also known as Liquid Ecstasy) and GBL (gamma butyrolactone, a primary component of the GHB) to Schedule I, and ketamine to Schedule III of the Controlled Substances Act. The legislation also would require the Justice Department to assist with the development of forensic tests to detect the ingestion of GHB or related substances; direct the HHS Secretary to submit annual reports to Congress estimating the number of sexual assault cases involving date-rape drugs; and require the HHS Secretary to develop a national awareness campaign to educate people about the dangers of date-rape drugs and the strong CSA criminal penalties that could be imposed on those who abuse them. The Senate on Nov. 19, 1999, stripped the language from the House-passed bill, and inserted the text of S1561, before passing HR2130 and sending it back to the House.
S. 1561 - The Date Rape Control Act of 1999 - On November 18, 1999, the Senate Committee on the Judiciary (Orrin Hatch, R-UT, Chairman) reported S. 1561 to the Senate with no written report. The next day the Senate passed H.R. 2130 in lieu of S. 1561, after amending it to contain the language of S. 1561. The bill, introduced on August 5, 1999 by Senator Spencer Abraham (R-MI) proposed to amend the Controlled Substances Act to require the Attorney General to add gamma hydroxybutyric acid to Schedule I and ketamine to Schedule III. It also would require the Secretary of HHS to submit to Congress reports on the number of incidents of the abuse of date-rape drugs that occurred in the most recent 1 year period, and to develop a plan, in consultation with the Attorney General, for carrying out a national campaign to educate the public on the dangers of date-rape drugs. Finally, the Secretary of HHS would be required to establish an advisory committee to make recommendations to the Secretary on issues related to date rape.
S. 1947 - On November 17, 1999, Senator Orrin Hatch (R-UT) introduced legislation that would provide for an assessment of the abuse of and trafficking in gamma hydroxybutyric acid, flunitrazepam, ketamine and other so-called "club drugs" whose use has been associated with sexual assault. S. 1947 was referred to the Senate Committee on the Judiciary.
S. 976 - The Youth Drug and Mental Health Services Act - Passed by the Senate on November 13, 1999. Originally introduced on May 6, 1999 by Sen. William Frist (R-TN) The Youth Drug and Mental Health Services Act, authorizes SAMHSA and introduces some new youth-related programs. On July 28, 1999 the bill was ordered reported by the full Senate Health, Education, Labor & Pensions Committee with an amendment in the nature of a substitute. Under the bill SAMHSA would end the practice of requiring states to expend a certain portion of federal funds on specified programs, but states would be required to file more comprehensive progress reports. The bill also would set up grant programs under SAMHSA to support: youth and adolescent substance abuse prevention and treatment initiatives; mental health initiatives designed to combat teen violence; mental health and substance abuse programs for the homeless; emergency funds for mental health and substance abuse needs; and treatment services for juvenile delinquents. The bill did not include a provision that would have permitted blending of substance abuse and mental health block grant funds without accountability for the purpose of servicing individuals diagnosed with co-occurring substance abuse and mental health disorders. Instead the bill restated current law. The Committee amended the bill by adopting a charitable choice provision that permits religious organizations to receive federal funds to provide alcohol and drug treatment and prevention services.
The Senate adjourned sine die on November 19, 1999, and the House adjourned sine die on November 22, 1999. Both the House and Senate reconvened for the second session of the 106th Congress on January 24, 2000.
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