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National Institute on Drug Abuse -  NIDA NOTES
Director's Column
Volume 14, Number 1 (April, 1999)

The Next Generation Of Drug Abuse Research

NIDA Director Dr. Alan I. Leshner

NIDA Director, Alan I. Leshner

The combined power of science and practice will accelerate the development and application of the next generation of drug abuse prevention and treatment programs.








NIDA was established in 1974 to bring the power of science to bear on the Nation's drug abuse problems. The Institute's first 25 years have been marked by groundbreaking scientific discoveries about the biology of the brain and its links to behavior that have revolutionized how drug abuse is viewed, prevented, and treated. (For more information, see "NIDA Marks 25 Years of Progress in Drug Abuse Research".)

At the time of NIDA's inception, many people incorrectly viewed drug abuse as a problem of people with character flaws and weak wills. Today, thanks to the research accomplishments of hundreds of scientists, we have moved far beyond such simplistic ideologies to a better understanding of the complex biological, behavioral, social, and public health aspects of drug abuse. We now know that while initial experimentation with drugs may be voluntary, continuing drug abuse changes the brain in fundamental and long-lasting ways. These brain changes trigger the compulsive drug-seeking and drug-taking behaviors that are the hallmarks of drug addiction.

Over the last quarter century, biological and behavioral research conducted by NIDA's intramural and extramural scientists has clearly shown that drug abuse is a preventable behavior and drug addiction is a treatable brain disease. Based on this science, we have developed and implemented drug abuse prevention programs that can deter young people from drug abuse. We have developed a variety of behavioral and pharmacological treatments that restore a degree of normalcy to brain function and behaviors that have been disrupted by the addiction process. We have learned that a comprehensive approach that combines behavioral and pharmacological treatment is the best way to treat the complex biological, behavioral, and social aspects of drug addiction. And, we have convincingly demonstrated that treatment medications and behavioral treatments reduce drug abuse, drug-related criminal behavior, and the harmful health and social consequences of drug abuse, such as HIV/AIDS.

In the last decade in particular, our intramural and extramural research has yielded an array of drug abuse prevention approaches, pharmacological treatments, and cognitive-behavioral therapies that promise to work better for more people. These improved drug abuse prevention and treatment tools have the potential to reduce the Nation's drug abuse burden significantly in the 21st century. However, as NIDA's constituents have told us, for real progress to be made NIDA must act to ensure that these new research-tested approaches are put into practice in community settings across the Nation. (See "NIDA Constituents Discuss Translating Drug Abuse Research Into Prevention and Treatment".) Accordingly, we are launching the next generation of drug abuse research to speed the adoption of new, more effective drug abuse prevention programs and treatment protocols by community-based prevention and treatment practitioners.

To increase the effectiveness of drug abuse treatment research, we are establishing the National Drug Abuse Treatment Clinical Trials Network throughout the United States. The Clinical Trials Network (CTN) will bring researchers and practitioners together as partners to conduct full-scale testing of promising new medications and behavioral components of drug abuse treatment in a wide range of community drug abuse treatment clinics with patients from a variety of ethnic and social backgrounds. We believe that NIDA's new CTN will revolutionize drug abuse treatment research, sow the seeds of scientific knowledge in every community in the Nation, and nourish the growth of significantly more effective community drug abuse treatment.

The CTN will close the gap that for too long has existed between treatment research and community practice by blanketing the Nation with research nodes that combine treatment research centers and a range of community-based treatment programs. By enabling researchers and practitioners to adapt scientifically based drug abuse therapies to real-world conditions and demonstrate their effectiveness in community settings, the CTN will foster the incorporation of new interventions into community drug abuse treatment programs across the country. The CTN also will enable researchers to take the practical knowledge gained from clinicians back to the laboratory and apply it to the development of even more practical and effective drug abuse treatments. (For more information, see "Clinical Trials Network Will Speed Testing and Delivery of New Drug Abuse Therapies".)

The CTN also will be useful to other aspects of NIDA's research portfolio. For example, multisite clinical trials with diverse patient populations could yield data that would be helpful in elucidating genetic and environmental determinants of vulnerability. Ultimately, increased understanding of the roles played by genetics, environment, and their interaction in shaping an individual's susceptibility to drug addiction will lead to a variety of more targeted drug abuse prevention and treatment approaches.

While we develop the drug abuse prevention programs of tomorrow, we are now integrating the latest research-based drug abuse prevention programs into existing State, county, and community systems and programs that play an important role in community life. For example, county cooperative extension agents, operating under the U.S. Department of Agriculture Cooperative Research, Extension, and Economic Service, have a long history of delivering life-enhancing programs and scientific information to people in rural and urban communities across the Nation. Now NIDA-funded research being conducted at the University of Iowa in Ames is examining whether a research-based family drug abuse prevention program can be provided effectively through this extensive national service delivery system.

Prevention researchers also are attempting to achieve wider dissemination and faster adoption of complex drug abuse prevention programs in community settings by simplifying the programs and offering practitioners more control in delivering them. For example, scientists at Pennsylvania State University in University Park are looking at whether giving teachers the opportunity to modify a research-tested, school-based prevention program to suit individual teaching styles or classroom conditions can build their commitment to the program while still retaining the basic structure and effectiveness of the original protocol.

In NIDA's first 25 years, the power of science has demolished ideologies, myths, and superstitions about drug abuse and addiction; improved the lives of drug abuse patients; and reduced the harmful individual, social, and public health consequences of this destructive disease. In the next 25 years, the combined power of science and practice will accelerate the development and application of the next generation of drug abuse prevention and treatment programs that will make even greater reductions in the Nation's drug abuse problems.

NIDA NOTES - Volume 14, Number 1

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