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Director's Report to the National Advisory Council on Drug Abuse - February, 2005


NIDA Publications

Epidemiologic Trends in Drug Abuse - Community Epidemiology Work Group - Volume I
Executive Summary June 2004
NIH Pub. No.: 05-5364A

This report provides an ongoing assessment of drug abuse in major metropolitan areas of the United States with the purpose of keeping both public and private sector policymakers and researchers informed with current and accurate data.

Epidemiologic Trends in Drug Abuse - Community Epidemiology Work Group - Volume II
Meeting Proceedings June 2004
NIH Pub. No. 05-5365A

This report provides an in-depth analysis of the epidemiologic trends and special reports for a limited audience, made up primarily of drug abuse researchers, who utilize this volume to identify potential areas for further research.

NIDA Notes

NIDA Notes, Volume 19 Issue 3
NIH Pub. No. 04-3478

In the Director's Column, Dr. Nora D. Volkow discusses the role of NIDA research in illuminating the problem of teen vulnerability to drug abuse and addiction. NIDA's ongoing initiatives to understand and combat the problem include a new three-pronged focus: to explore how developmental changes in the adolescent brain increase vulnerability to drugs; to find more effective ways to dissuade teens from abusing drugs; and to study the period of emerging adulthood and identify ways to prevent initiation or escalation of drug abuse during this life transition. Research approaches will range from animal studies on the effects of nicotine and cocaine on the developing brain, to human studies that explore how teens perceive risk and make decisions on matters such as drug abuse that involve risk.

The lead article describes a recent NIDA-supported study finding that a compound that elevates glutamate levels in the brain may help reduce vulnerability to relapse in patients recovering from cocaine addiction. The study found that in rats, reduced glutamate concentrations in the nucleus accumbens (NAc) as a result of cocaine use persist for a considerable time after access to the drug is removed; however, when rats were injected with n-acetylcysteine to increase glutamate concentration before receiving a dose of cocaine, they returned to self-administering the drug at much lower levels than did rats simply injected with cocaine alone. Other Research Findings report:

  • Extinction training in rats addicted to cocaine increased quantities of glutamate receptors in the brain, which made them less likely to resume self-administering the drug than rats not exposed to the behavioral modification.
  • A NIDA-sponsored clinical trial on a combination buprenorphine-naloxone medication for opiate addiction capped a 25-year NIDA initiative that led to the development of a take-home treatment that can be prescribed in a doctor's office.
  • Researchers have tested a sustained-release injectable form of buprenorphine that substantially blocked heroin's effects and relieved craving and withdrawal for up to six weeks.
  • Cocaine and amphetamine intake in rats stimulates the growth of dendrites in the brain, causing a type of structural plasticity that impedes the brain's subsequent ability to change and adapt to novel situations.

Research News covers the proceedings of a conference on prenatal exposure to drugs held in Bethesda, Maryland, in March 2004, which was co-sponsored by NICHD and the National Institute of Health's Office of Research on Women's Health; and the meeting of the CTN Dissemination Subcommittee, which discussed ways to better convey innovations from researchers to practitioners. The Bulletin Board features the new NIDA display "The Science of Addiction," part of the DEA Museum's exhibit "Target America: Opening Eyes to the Damage Drugs Cause," in Times Square in New York City; and Dr. Mary Jeanne Kreek, principal investigator and scientific director of a NIDA Research Center in New York City, who was awarded the Alumni Gold Medal for Distinguished Achievements in Medicine from the Columbia College of Physicians & Surgeons. The Tearoff article focuses on the Web-based training program Prevention Connection: Substance Abuse Prevention Training for Health Promotion Practitioners, which was developed and tested under a NIDA-supported Small Business Innovation Research Grant. It uses an interactive, multimedia approach to train wellness professionals to integrate substance abuse prevention materials and messages into health promotion programs.

NIDA Notes, Volume 19 Issue 4
NIH Pub. No. 04-3478

In the Director's Column, Dr. Nora D. Volkow discusses drug-related damage in unborn children, which includes reduced weight in newborns, behavioral disorders in toddlers, cognitive deficits in young children, and increased vulnerability to drugs in adolescents. The lead article reports that methamphetamine abusers who remain abstinent for nine months or more can partially recover from damage to motor skills, memory, and thalamic metabolism. Other research findings report that brain imaging studies may point to reasons why cocaine addiction and recovery are different for men and women in some aspects, including the reasons for seeking rehabilitation, response to treatment, and vulnerability to relapse. In another story, findings that a schizophrenia treatment weakens some of the effects of cocaine on rodents have been confirmed and extended by investigators in NIDA's Intramural Research Program. The final research article describes a large prospective study examining the rates of tobacco addiction in adults who were prenatally exposed to tobacco. Research News gives an update on drug treatment studies in NIDA's Clinical Trials Network, where researchers and practitioners collaborate in design and execution of the studies. It also includes a report on a conference in which behavioral health professionals are committed to improving treatment systems for people with coexisting disorders. A related story describes new evidence that adults with co-occurring disorders benefit from depression treatment. The Bulletin Board reports on the 2003 National Survey on Drug Abuse and Health finding that in 2003, prescription drug abuse increased and hallucinogen abuse sharply dropped. The Tearoff article describes NIDA's new communication products in print and on the web.

NIDA Notes, Volume 19 Issue 5
NIH Pub. No. 04-3478

In the Director's Column, Dr. Nora D. Volkow discusses the increase in misuse and abuse of prescription medications by adolescents and adults. The lead article reports on two recent studies showing that the age of initiation and the pleasure of response to marijuana in adolescence foreshadow adult outcomes. This issue also reports on The National Survey on Drug Use and Health, which has found that inhalant abuse by teenagers is on the rise. In another story, NIDA-supported economists are offering drug treatment program administrators the comprehensive Drug Abuse Treatment Cost Analysis Program, which features a method to put dollar values on the full range of treatment resources. In the final research article, a recent NIDA study provides no confirmation for previous findings that MDMA (Ecstasy) abusers develop problems recalling words, but suggests that heavy use of the drug does cause persistent deficits in mental processing speed and problem solving. Research News covers a NIDA-sponsored conference on lipids, the messenger molecules crucial for the regulation and control of biological processes, including those influencing the effects of drugs on cell function. The Bulletin Board reports on the eighth annual PRISM Awards, sponsored by NIDA in recognition of the entertainment industry's serious treatment of destructive social issues surrounding drug abuse in film and television. This feature also highlights the appointment of six new members to the National Advisory Council on Drug Abuse. The Tearoff article describes NIDA's latest Research Report on MDMA abuse, part of the continuing effort to provide science-based information to the public.

Upcoming NIDA Publications

Community Drug Alert Bulletin - Prescription Drug Abuse
This publication will summarize current information about the consequences that can result from the abuse of some prescription and over-the-counter (OTC) medications. Classes of drugs to be discussed include benzodiazepines, opiates, sedative/hypnotics, and stimulants. The medicinal value as well as some of the potential health problems that can result from abuse of these drugs will also be discussed. Some data will be presented from what we currently know about who is abusing and how they are accessing these medications. Information will be provided on what can be done to reduce prescription/OTC drug abuse, and how to diagnose and treat individuals who have become addicted to these drugs.

Community Drug Alert Bulletin - Inhalants
This publication will summarize key information on the toxicity of inhalants and the serious health consequences of abusing inhalants. The household and other common sources of these psychoactive vapors will be discussed, as well as the three general classifications of inhalants. Trends showing an increase in use among young teens, based on data from SAMHSA's NSDUH, and NIDA's MTF will be included, as will guidance on where to find further information on health effects of prevention and treatment of inhalants and other drugs.

CTN-Related Publications

During the months August - January, ten editions of the CTN Bulletin Board were distributed. The Bulletin Board is an electronic report on the progress of the protocols, committees, and node activity in the CTN.

A patient recruitment brochure for CTN Protocol - 0017 Reducing the Risk of HIV and Hepatitis-C Infection: A Research Study was published and distributed throughout the CTN.

Other Publications

Bolla, K.I., Eldreth, D.A., Matochik, J.A. and Cadet, J.L. Sex-related Differences in a Gambling Task and its Neurological Correlates. Cereb Cortex. 14(11), pp. 1226-1232, 2004.

Eldreth, D.A., Matochik, J.A., Cadet, J.L. and Bolla, K.I. Abnormal Brain Activity in Prefrontal Brain Regions in Abstinent Marijuana Users. Neuroimage. 23(3), pp. 914-920, 2004.

Cao, J., Lever, J.R., Kopajtic, T., Katz, J.L., Holmes, M.L., Justice, J.B. and Newman, A.H. Novel Azido- and Isothiocyanato- Analogues of [3-(4-phenylalkyl piperazin-1-yl)propyl]-bis-(4-fluorophenyl)amines as Potential Irreversible Ligands for the Dopamine Transporter. J. Med. Chem. 47, pp. 6128-6136, 2004.

Choo, R.E., Huestis, M.A., Schroeder, J.R., Shin, A.S. and Jones, H.E. Neonatal Abstinence Syndrome in Methadone-exposed Infants is Altered by Level of Prenatal Tobacco Exposure. Drug and Alcohol Dependence, 75, pp. 253-260, 2004.

Gustafson, R.A., Kim, I., Stout, P.R., Klette, K.L., George, M.P., Moolchan, E.T., Levine. B. and, Huestis, MA. Urinary Pharmacokinetics of 11-Nor-9-Carboxy-Delta-9-Tetrahydrocannabinol After Controlled Oral Delta-9-Tetrahydrocannabinol Administration. Journal of Analytical Toxicology, 28(3), pp. 160-167, 2004.

Heishman, S.J., Saha, S. and Singleton, E.G. Imagery-induced Tobacco Craving: Duration and Lack of Assessment Reactivity Bias. Psychology of Addictive Behaviors 18, pp. 284-288, 2004.

Huestis, M.A. and Cone. E.J. Relationship of delta-9-tetrayhydrocannabinol in Oral Fluid to Plasma After Controlled Administration of Smoked Cannabis. Journal of Analytical Toxicology, 28, pp. 394-400, 2004.

Kim, I., Oyler, J.M., Moolchan, E.T., Cone, E.J. and Huestis, M.A. Urinary Pharmacokinetics of Methamphetamine and Its Metabolite, Amphetamine Following Controlled Oral Administration to Humans, Therapeutic Drug Monitoring, 26, pp. 664-672, 2004.

Levenson, C.W., Cutler, R.G., Ladenheim, B., Cadet, J.L., Hare, J. and Mattson, M.P. Role of Dietary Iron Restriction in a Mouse Model of Parkinson's Disease. Exp Neurol. 190(2), pp. 506-514, 2004.

Moolchan, E.T. and Schroeder, J.R. Quit Attempts among African American Teenage Smokers Seeking Treatment: Gender Differences. Preventive Medicine 39(6), pp. 1180-1189, 2004.

Preston, K., Umbricht, A., Huestis, M.A. and Cone, E.J. Effects of High Dose Intravenous Buprenorphine in Experienced Opioid Abusers, Journal of Clinical Psychopharmacology, 5, pp. 479-487, 2004.

Radzius, A., Gallo, J., Gorelick, D., Cadet, J.L., Uhl, G., Henningfield, J., and Moolchan, E. Nicotine Dependence Criteria of the DIS and DSM-III-R: A Factor Analysis. Nicotine Tob Res. 6(2), pp. 303-308, 2004.

Robinson, M.L., Berlin, I. and Moolchan, E.T. Tobacco Smoking Trajectory and Associated Ethnic Differences among Adolescent Smokers Seeking Cessation Treatment. Journal of Adolescent Health 35(3), pp. 217-224, 2004.

Rothman, R.B., Jayanthi, S., Cadet, J.L., Wang, X., Dersch, C.M. and Baumann, M.H. Substituted Amphetamines That Produce Long-Term Serotonin Depletion in Rat Brain ("Neurotoxicity") Do Not Decrease Serotonin Transporter Protein Expression. Ann N Y Acad Sci. 1025, pp. 151-161, 2004.

Saito, T., Wtsadik, A., Scheidweiler, K., McCain, M., Fortner, N., Takeichi, S. and Huestis, M.A. A Validated Gas Chromatographic - negative Chemical Ionization Mass Spectrometric Method for delta-9-tetrahydrocannabinol (THC) in Sweat, Clinical Chemistry, 50, pp. 2083-2090, 2004.

Scheidweiler, K.B. and Huestis, M.A. Simultaneous Quantification of Opiates, Cocaine and Metabolites in Hair by LC-APCI-MS/MS. Analytical Chemistry, 76, pp. 4358-4363, 2004.

Thomas, K.M., Hunt, R.H., Vizueta, N., Sommer, T., Durston, S., Yang, Y. and Worden, M.S.. Evidence of Developmental Differences in Implicit Sequence Learning: An fMRI Study of Children and Adults. J. Cogn. Neurosci. 16, pp. 1339-1351, 2004.

Truong, J.G., Newman, A.H., Hanson, G.R. and Fleckenstein, A.E. Dopamine D2 Receptor Activation Increases Vesicular Dopamine uptake and Redistributes Vesicular Monoamine Trasporter-2-Protein. Eur. J. Pharmacol. 504, pp. 27-32, 2004.

Yang Y., Gu, H. and Stein, E.A.. Simultaneous MRI Acquisition of Blood Volume, Blood Flow and Blood Oxygenation Information during Brain Activation. Magn. Reson. Med. 52, pp. 1407-1417, 2004.

Zhan, W., Stein, E.A. and Yang, Y. Mapping the Orientation of Intravoxel Crossing Fibers Based on the Phase Information of Diffusion Circular Spectrum. NeuroImage 23, pp. 1358-1369, 2004.

Rutter, J.L., Bromley, C.M., Goldstein, A.M., Elder, D.E., Holly, E.A., Guerry, D. IV, Hartge, P., Struewing, J.P., Hogg, D., Halpern, A., Sagebiel, R.W., and Tucker, M.A. Heterogeneity of Risk for Melanoma and Pancreatic and Digestive Malignancies: A Melanoma Case-control Study. Cancer, 101, pp. 2809-2816, 2004.

Drs. David Shurtleff, Rita Liu and Cathrine Sasek served as guest editors for a special issue of Neuropharmacology, (Volume 47, Supplement 1, Pages 1-367, 2004) "Frontiers in Addiction Research: Celebrating the 30th Anniversary of the National Institute on Drug Abuse." The special issue featured research papers from 30 neuroscientists including NIDA's Director, Dr. Nora Volkow. Almost all of the contributing authors were NIDA-supported, as Research Center Directors, MERIT (Method to Extend Research In Time) or PECASE (Presidential Early Career Award in Science and Education) Awardees, Senior Scientists, or NIDA-Intramural Research Scientists. All are leaders in their respective fields, providing important insights into this complex problem from various perspectives and at multiple levels of analysis.

Drug Abuse and Suicidal Behavior (ed. Lynda Erinoff, Wilson Compton, Nora Volkow). Drug Alcohol Depend, 76, pp. S1-S105, 2004. This supplement resulted from a March, 2003 workshop sponsored by NIDA. The supplement consists of two editorials, one an overview of the workshop and another highlighting the need for further research on drug abuse and suicidal behavior. There are six papers reporting new data: use of children of twins design to study familial effects; neurobehavior disinhibition as a predictor of substance use and suicidal behavior; a longitudinal study of suicidal behavior in school children; an empirical review of the association between completed suicide and substance use disorders; a longitudinal study of PTSD, drug dependence, and suicidality among Vietnam veterans; and a prospective study of suicidal behavior in a clinical population who had been detoxified. There are also two review articles, one on conceptual issues in understanding suicidal behavior and substance use in adolescents and the other on impulsivity in suicidal behavior and substance abuse.

Womack S., Compton W.M., Dennis M., McCormick S., Fraser J., Horton J.C., Spitznagel E.L., and Cottler L.B. American Journal of Addiction, 13, 295-304, 2004. Early identification of patients with comorbid depression and their subsequent enrollment in an enhanced psychiatric case management (PCM) intervention were examined as an effective way to engage depressed substance abuse patients into psychiatric treatment. Depression was screened using the Global Appraisal of Individual Needs (GAIN) and a DSM-IV checklist. Patients positive on both evaluations were assigned to PCM (n = 10) or to no case management, or treatment as usual (TAU) (n = 10). An examination of outcomes at six weeks indicated that PCM services are feasible and appear to be effective in encouraging use of psychiatric referral by depressed substance abusers.

Compton, W., Horton, J., Cottler, L., Booth, R., Leukefeld, C. and Singer, M., Cunningham-Williams, R., Reich, W., Corsi, K., Staton, M., Fink, J., Stopka, T. and Spiznagel E. A Multi-State Trial of Pharmacy Syringe Purchase. J Urban Health, 81, pp. 661-670, 2004. Although pharmacies have long been recognized for their potential as sites for access to sterile syringes to prevent HIV, little is known about types of pharmacies and the extent to which they may actually be utilized. Researchers identified four states in which attempts to purchase syringes from pharmacies had been documented, and hypothesized that Connecticut would have the highest rate of purchase followed by Colorado, Missouri, and Kentucky. They also hypothesized that minority research assistants would have lower rates of purchase of syringes than white research assistants; that males would have lower rates than females; and that urban rates of purchase would differ significantly from rural. They conducted a standardized, multi-state study in urban and rural areas of the four states, and found that, of 1,600 overall purchase attempts, 35% were refused. Regarding ordering of purchase rates, their hypothesis was partly supported: Kentucky had the most restrictive regulatory environment, in which positive identification was often required for syringe purchase, but the rates in Kentucky (41%) were not significantly different from those in Missouri (47%). On the other extreme, Connecticut, which had the most permissive regulatory environment, had rates of purchase slightly lower (28%) than Colorado (25%). Significant variation in pharmacy syringe purchase was found for urban (40%) vs rural (31%) pharmacies (P<.01). There was no consistent pattern of ethnic or gender bias in rates of syringe purchase. The researchers conclude that, despite numerous potential advantages of pharmacies as sites for access to sterile syringes to complement needle exchange programs, pharmacy purchase of syringes faces significant obstacles.

Grant, B.F., Stinson, F.S., Dawson, D.A., Chou, S.P., Dufour, M.C., Compton, W.M., Pickering, R.P. and Kaplan, K. Prevalence and Co-occurrence of Substance Use Disorders and Independent Mood and Anxiety Disorders: Results From the National Epidemiologic Survey on Alcohol and Related Conditions. Arch Gen Psychiatry. 61, pp. 807-816, 2004. To address uncertainties in the prevalence and comorbidity of substance use disorders and independent mood and anxiety disorders, this study presented nationally representative data on the prevalence and comorbidity of DSM-IV alcohol and drug use disorders and independent mood and anxiety disorders (including only those that are not substance induced and that are not due to a general medical condition). Participants were adult (age 18+) household and group quarters' residents in the United States in 2001-2002. Results were that the prevalences of 12-month DSM-IV independent mood and anxiety disorders in the US population were 9.21% (95% confidence interval [CI], 8.78%-9.64%) and 11.08% (95% CI, 10.43%-11.73%), respectively. The rate of substance use disorders was 9.35% (95% CI, 8.86%-9.84%). Only a few individuals with mood or anxiety disorders were classified as having only substance-induced disorders. Associations between most substance use disorders and independent mood and anxiety disorders were positive and statistically significant. The authors concluded that substance use disorders and mood and anxiety disorders that develop independently of intoxication and withdrawal are among the most prevalent psychiatric disorders in the United States. Associations between most substance use disorders and independent mood and anxiety disorders were overwhelmingly positive and significant, suggesting that treatment for a comorbid mood or anxiety disorder should not be withheld from individuals with substance use disorders.

Compton, W.M. and Pringle, B. (2004). Services Research on Adolescent Drug Treatment: Commentary on Dennis (et al.) The Cannabis Youth Treatment (CYT) Study: Main Findings from Two Randomized Trials. Journal of Substance Abuse Treatment, 27, pp. 195-196, 2004.

Sussman, S., Stacy, A.W., Johnson, C.A., Pentz, M.A. and Robertson, E. A Transdisciplinary Focus on Drug Abuse Prevention: An Introduction. Substance Use & Misuse, 39(10-12), pp.1441-1456, 2004.

Delany, P.J., Fletcher, B.W., Shields, J.J. and Conway, K.P. Creating A Collaborative Model for Treating Substance Abusing Offenders. In D. Fishbein (Ed.), The Science, Treatment, and Prevention of Antisocial Behaviors: Evidence-based Practices, Vol. II. (Chapter 13, pp. 1-13): Civic Research Institute: Kingston, NJ, 2004.

Pringle, B. and Flanzer, J. Substance Abuse Treatment Services. In R. G. Steele, & M. C. Roberts (Eds.), Handbook of Mental Health Services for Children, Adolescents, and Families. New York: Kluwer/Plenum, 2004.


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