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National Institute on Drug Abuse

Director's Report to the National Advisory Council on Drug Abuse

September, 1996


Congressional Affairs


Appropriations


The FY 1997 President's request for NIH is $12.406 billion, an increase of $467 million (or 3.9 percent) over the FY 96 appropriation. Of this, $310 million is included for construction of the Clinical Research Center (CRC). The President's request also asks for a consolidated appropriation for the Office of AIDS Research.


Senate FY 97 NIH Appropriations Hearing

On June 18, 1996, the Senate Appropriations Subcommittee on Labor, HHS, and Education [Sen. Arlen Specter (R-PA), Chairman] held a hearing to consider the President's FY1997 budget request for NIH and the programs and policies of the agency. In opening remarks, Sen. Specter noted that "few activities of government provide greater promise for improving the quality, and reducing the costs, of health care for all Americans than our investment in medical research supported by the National Institutes of Health..." However, he noted that last year NIH was singled out for special treatment in the appropriations process and that he wished that other programs had been treated as well, and named several. Pointing to the $819 million increase provided for NIH in the House Subcommittee mark-up for FY 1997, he said that while the Senate is a great supporter of NIH, he did not want this to turn into a "bidding war," because "every dollar to NIH comes from other programs."

Dr. Varmus opened his testimony with a brief statement describing support for investigator initiated research and the proposed CRC as the agency's two highest priorities. Among major issues discussed at the hearing were the importance of sharing of scientific information, mental health coverage under the health insurance reform bill, and the consolidated AIDS budget. Noting the differences in the House and Senate perspective on Office of AIDS Research funding, Sen. Specter asked why it is important to allocate the funds to OAR and requested that Dr. Varmus provide more information for the record.

House-Passed Labor-Health and Human Services-Education Appropriations Bill (HR 3755):
On July 11, 1996, by a vote of 216-209, the House passed the appropriation bill to fund NIH for FY 97. The House bill includes $12.747 billion for NIH, $90 million of which is for the new CRC. This is $819 million over the agency's FY 96 appropriation. For NIDA the House-passed figure is $487.341 million, an increase of $21.016 million over the amount requested and $29.229 million over the comparable 1996 appropriation.


Excerpts from the House Appropriations Committee Report [HRpt 104-659]



For NIDA (in part)


"Neuroscience.--The Committee recognizes that neuroscience research has fundamentally changed our understanding of addiction and that this understanding provides the foundation for new kinds of treatments. NIDA has made progress in identifying the neurobiological bases of addiction, including craving, which is one of the major factors that can precipitate relapse. NIDA-supported researchers have also made substantial progress in identifying potential anti-cocaine medications. NIDA-supported researchers have made great strides in understanding the brain's opiate system and its role in addiction. The Committee considers neuroscience research a top priority and encourages NIDA to continue its research efforts in this area.

"Medication development.--Basic research has now progressed to the point where at least six molecular targets have been identified, allowing researchers to strategically focus research on anti-addiction medications. The Committee urges NIDA to continue research aimed at developing effective medications for the treatment of addictions, particularly for cocaine. The Committee is pleased that NIDA has issued a program announcement to encourage expedited transition of ground-breaking research from advanced preclinical findings to applied clinical applications. The Committee recognizes this is a valuable tool in advancing the discovery and development of medications for cocaine addiction.

"Behavioral science research.--The Committee understands that behavioral research is important to solving problems of drug abuse and addiction, and that behavioral interventions are the most frequently administered treatments for drug addiction in some cases, the only available treatment. The Committee commends NIDA for its basic and clinical behavioral science activities aimed at better identifying those at risk for drug abuse and developing effective approaches for breaking the cycle of addiction. The Committee also encourages NIDA's HIV/AIDS initiatives because of the increasing link between HIV infection and drug use and related behaviors.

"Social work research.--The Committee supports NIDA's research on families and drug abuse, behavioral and psychosocial treatment research and health services. The Committee also supports NIDA's efforts to increase the number of social work researchers conducting drug abuse research.

"Information dissemination.--The Committee believes that disseminating research findings in a timely manner is an important component of the NIH mission. Therefore, the Committee is pleased to learn of NIDA's "town meetings" with educators, health care providers, State and local anti-drug coalitions, and civic organizations to disseminate research findings and foster information exchange.

AIDS Research (in part)


"The Committee intends that the [NIH] funds allocated for AIDS should be spent in a manner fully consistent with the AIDS research plan developed by the Office of AIDS Research and expects the Director of NIH to use the full authority of his office to ensure that this occurs. The Committee has provided the Director of the Office of AIDS Research, jointly with the Director of NIH, transfer authority to reallocate up to three percent of funds designated for AIDS research among Institutes, subject to normal reprogramming procedures. The Committee encourages NIH to use this authority whenever it believes that an adjustment in the allocation of AIDS funding between Institutes is appropriate to achieve scientific objectives or to facilitate promising research efforts.

"The Committee wants to make clear that it continues to support the Office of AIDS Research (OAR), its leadership, and its coordinated budget planning process and that it expects the individual institutes, centers and divisions to fully cooperate with OAR's work. The Committee has provided funding for the OAR within the Office of the Director and intends that the OAR will maintain its current structure and responsibilities, including the allocation of an emergency discretionary fund.

"Last year, the number of AIDS cases passed the 500,000 mark. AIDS is now the leading cause of death for Americans between the ages of 25 and 44. The disease is spreading most rapidly among African Americans and other at-risk minority populations, adolescents, and women. Therefore, the Committee urges the OAR to carefully monitor these changes and ensure that the research plan includes objectives and strategies to respond to demographic changes in a timely fashion. NIH is also strongly encouraged to strengthen and to include the direct participation of African Americans and other minorities in its AIDS/HIV research, research training, and outreach activities. The Committee expects the NIH to report on its progress in achieving this objective during next year's appropriations hearings.


Third Party Payments


"... NIH is authorized to collect third party payments for the cost of clinical services that are incurred in National Institutes of Health research facilities and that such payments shall be credited to the National Institutes of Health Management Fund: ... all funds credited to the NIH Management Fund shall remain available for one fiscal year after the fiscal year in which they are deposited...


Forward Funding for R29s and R01s


"Opportunities for new investigators.--The Committee understands that NIH would intend to use a portion of the funding increase to provide forward funding for a select group of first-time applicants for investigator-initiated research project grants (R-29s) and first-time R01 investigators. In the case of R-29 awards, the full five years of support would be provided; first-time R01 awards would be provided the recommended period of support. The Committee applauds NIH's plan, recognizing that it would provide a much-needed boost to the next generation of researchers, who face daunting competition for research funding. It would also insulate them from year-to-year fluctuations in grant support. The Committee will watch this experiment with interest to see if it has broader applicability for other components of the grant pool."


FY 97 Budget Resolution [HJRES 178]


The House and Senate agreed to HConRes 178, the FY 1997 federal budget, on June 7. The conference report [HRpt. 104-612] recommends maintenance of the 1996 increases in funding for NIH and assumes priority funding the agency at $11.95 billion in budget authority. Included under Section 431 is a sense of the Senate that "amounts appropriated for the NIH should provide funding for additional research on an anti-addiction drug to block the craving for illicit addictive substances."


NIH Revitalization Act of 1996


On July 17, 1996, the Senate Labor and Human Resources Committee marked up and approved, as amended, S. 1897, the NIH Revitalization Act of 1996 (with all Committee members voting in the affirmative). Several amendments were approved by voice vote by the Committee, including an amendment to establish a pediatric research initiative (Sens. DeWine and Kennedy); one which would increase diabetes related research (Sen. Simon) and a program for research and training relating to Parkinson's disease (Sen. Wellstone). An amendment offered by Sen. Faircloth (for himself and Sen. Harkin) was not voted on by the Committee. It would have required the Secretary to establish a National Center for Pain Research in NIH. Sen. Kassebaum expressed concern about the wording of the amendment and agreed to work with Sen. Faircloth on the appropriate language before the legislation is brought to the Senate floor for a vote. One day earlier, on July 16, Sen. Orrin Hatch (R-UT) had introduced S. 1955 to establish a National Center for Pain Research in NIH.


SAMHSA Reauthorization


H.R. 3847, the Drug Abuse Prevention and Treatment Consolidation and Reorganization Act, was introduced on July 18 by Representative Joe Barton (R-TX) to consolidate and reorganize SAMHSA. It would create a new Drug Abuse Prevention and Treatment Administration which would be headed by an Administrator to be appointed by the President with the consent of the Senate. The DHHS Secretary would have the authority to appoint an Associate Administrator for Substance Abuse Prevention and an Associate Administrator for Substance Abuse Treatment. The new agency would be authorized an appropriation of "such sums as may be necessary" for fiscal years 1996 through 2002. Any programs not transferred to this new agency would be transferred to HRSA.

Other Bills of Interest


Health Insurance Reform Becomes Law

HR 3103 - The Health Insurance Portability and Accountability Act of 1996. On August 1, the House agreed to the conference report (HRpt 104-736) and sent the measure to the Senate. On August 2, the Senate agreed to the conference report, clearing the measure for the President, who signed the bill into law on August 21. Among other things, the legislation provides for increased portability of group health plans; genetic information will not be considered a preexisting condition in the absence of a diagnosis of the conditions related to such information; and discrimination against participants and beneficiaries based on health status are prohibited.


Welfare Reform Becomes Law

The House and Senate agreed to the conference report on the Welfare Reform legislation, H.R. 3734. The President signed the bill August 22. The bill includes a provision making individuals convicted of a drug-related felony ineligible for AFDC and food stamps. No other public benefits would be denied and pregnant women and individuals in treatment would remain eligible for these benefits but would lose eligibility after giving birth or leaving treatment. Family members of those denied benefits would still receive their AFDC and food stamp allocations. States could exempt those effected by the law by passing State legislation.

In the first session of the 104th Congress, an early version of welfare reform legislation [H.R. 4] included language which would have provided authorization of appropriations specifically for NIDA's medications development activities and for SAMHSA's substance abuse block grant. This provision was dropped in later versions of the bill, but a portion of the language was swept into P.L. 104-121, Senior Citizens Right to Work Act, which includes an authorization of appropriations for an additional $50 million for SAMHSA's Substance Abuse Block Grant.


Mental Health Parity

The Mental Health Parity Act of 1996, S.2031, was introduced by Sen. Pete Domenici (R-NM) on August 2. The purpose of the bill is to provide health plan protection for individuals with mental illnesses. Specifically, the legislation would provide parity for lifetime and annual financial caps for mental health insurance coverage. Similar language in the health insurance reform legislation was dropped before final passage.


Animal Research

The animal rights community observed June 18 - 24 "World Animal Awareness Week." Related to preparations for the week, there were several bills introduced in the Congress on issues ranging from "family pet protection" to "consumer products testing," in addition to a number of other bills relating to primate research facilities and other matters related to research animals that came before the Congress for other reasons. The future for most of these animal welfare bills is uncertain. Recent animal welfare bills include S. 1477, "FDA Performance and Accountability Act," introduced by Sen. Kassebaum (R-KS) Chair, Senate Labor and Human Resources Committee, on December 13, 1995. The bill was passed by the Senate on June 20, 1996. Another recently introduced bill is H.R. 3393, "Animal Welfare Act, Amendment (Family Pet Protection Act of 1996)" introduced by Rep. Fox (R-PA) on May 7. Provisions of the bill would ban research facilities from obtaining dogs or cats from dealers who do not breed and raise animals themselves, and implement strong requirements that would effectively restrict research facilities from obtaining unwanted municipal pound animals. It would also disallow private animal shelters from voluntarily making animals available for research and limit individuals to donating no more than one animal to a research facility. On the same day Rep. Canady (R-FL) introduced his version of a pet theft bill, H.R. 3398, "Animal Welfare Act, Amendment."

In addition, two draft bills have brought special attention. First, the Department of Agriculture prepared a draft bill amending the Animal Welfare Act. Among other provisions, this proposal would place greater restrictions on the sale and purchase of research animals by laboratories and research institutions. Second, the "National Chimpanzee Sanctuary Act," has been circulating among some Congressional offices. The purpose of this bill is to provide a national retirement sanctuary for chimpanzees that will assure long-term care for chimpanzees currently housed in laboratories and other facilities.


Methamphetamine

On July 17, Sen. Orrin Hatch (R-UT) introduced S. 1965, the Comprehensive Methamphetamine Control Act of 1996. The purpose of the Hatch bill is to crack down on precursor chemicals while balancing the need to maintain availability of drugs such as pseudoephedrine for legitimate purposes. Sen. Hatch said he remains unconvinced that legitimate products purchased at the retail level are a significant source of precursor drugs for the manufacture of methamphetamine. He included several provisions to limit the potential diversion of legitimate products at the retail level to methamphetamine labs and said that he will monitor the situation very closely. If the data show that retail products containing pseudoephedrine and phenylpropanolamine are contributing to the problem of methamphetamine abuse, he said he will revisit the issue in the 105th Congress. Earlier this session, Sens. Grassley (R-IA) and Feinstein (D-CA) introduced S. 1607, the Methamphetamine Control Act of 1996, for similar purposes.


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