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Director's Report to the National Advisory Council on Drug Abuse
May, 2002

International Activities

At the invitation of the Thai government, NIDA officials and grantees visited Thailand in February 2002, to plan with Thai researchers to conduct clinical trials of treatments for methamphetamine-dependence. Clinical investigators will be trained in behavioral therapies that will serve as a platform for future pharmacotherapy trials. Additionally, discussions were held regarding potential clinical studies for the treatment of methamphetamine psychosis. Dr. Frank Vocci, DTR&D, and Dr. Steven Gust, International Program, joined grantee Dr. Walter Ling, UCLA, in meetings with representatives from the Thai Royal Family, the Ministry of Public Health, and multiple sites that provide both inpatient and outpatient treatment for drug abuse and psychosis. H.R.H. Princess Ubolratana, who holds a Master's Degree in Public Health from UCLA, will serve as honorary co-investigator for the project. Because the incidence of methamphetamine psychosis is thought to be higher throughout Southeast Asia than in the United States and appears to follow a different course than that documented in the literature, NIDA hopes to learn more about the nature of psychosis while assisting the Thai government in learning more about the situation in that country and providing advanced training for Thai clinical investigators. The first training is scheduled for May 7-12, 2002; additional training will be conducted throughout the next year and will include a number of short-term exchanges by experts from both countries. The project builds upon relationships forged through NIDA-supported research activities and conferences such as the Pacific Regional Conference on Methamphetamine and Other Amphetamine-Type Stimulants organized by the International Program in November 2000.

Dr. Minda Lynch, DNBR, represented NIDA at the EuroConference on Modeling Addiction, held during April 2002, in Austria. The conference addressed the ability of genetic, neurochemical, electrophysiological, and behavioral experimental models to predict human patterns of drug abuse and dependence. It was supported by the European Commission and was organized by former NIDA INVEST Fellow Dr. Gerald Zernig (1993-1994) and Dr. Alois Saria, both of the University of Innsbruck Medical School. NIDA travel support was also awarded to Dr. Sherie L. Kendall, University of Kentucky; Drs. Edie Seldon Sears and Eric C. Donny, Johns Hopkins University; and Dr. Norma Alonzo, Georgetown University. Keynote speakers included Dr. James Woods, University of Michigan; Dr. Harriet DeWit, University of Chicago; and Dr. Michael J. Kuhar, Emory University.

On May 13, 2002, NIDA staff presented at the United States-European Union "Demand Reduction Seminar: Developing Evidence-Based Demand Reduction Policies", in Washington, D.C. Mr. Richard A. Millstein, NIDA Deputy Director, spoke on "Advances in the Science of Addiction Through Neuroscience and Behavioral Research," Dr. Frank Vocci, Director, DTR&D, on "Medications Development," and Dr. Betty Tai, Director, CCTN, on "Treatment Clinical Trials: Blending Clinical Practice and Research".

NIDA grantee Dr. Marilyn McDonald, University of Wisconsin-Madison, and her Russian colleague, Dr. Tatiana Grechanaia, International Association Against Drug Abuse and Drug Trafficking, began work in April 2002, on a collaboration supported by the International Competitive Design Awards for Innovative Drug Abuse and HIV/AIDS Prevention Efforts awarded by NIDA for participants in the 1999 U.S. - Russia Binational Workshop: Drug Abuse and Infectious Disease Prevention Strategies. The team will develop a Russian version of the drug abuse prevention program, Families and Schools Together (FAST). Three other binational teams and an individual Russian researcher have already begun working on projects funded by the awards.

NIDA welcomed the 2001-2002 INVEST Research Fellows with an orientation program at the Division of Intramural Research in Baltimore on February 28, 2002, and a grant-writing seminar at the Neuroscience Center on March 1, 2002. Dr. Zhao Min, China; Dr. Tatiana Tsarouk, Russia; and Dr. Debasish Basu, India, met with the following DIR staff: Drs. David Epstein, David Gorelick, Marilyn Huestis, Eric Moolchan, and Kenzie Preston, Clinical Pharmacology and Therapeutics Research Branch; and Dr. Alane Kimes, Neuroimaging Research Branch. At NIDA headquarters, Dr. Tsarouk met with Dr. Eve Reider, DESPR; Dr. Zhao met with Dr. Melissa Racioppo, DTRD; and Dr. Basu met with Dr. Harold Gordon, DTRD. The INVEST Fellows are working with the following NIDA grantees: Dr. Howard Liddle, University of Miami (Dr. Zhao); Dr. Elaine Thompson, University of Washington (Dr. Tsarouk); and Dr. Joel Gelernter, Yale University (Dr. Basu). The Hubert H. Humphrey Drug Abuse Research Fellows joined the INVEST Fellows for the grant writing seminar to discuss the NIH grant process and international research and training opportunities. Presenters included: Dr. Steven W. Gust, International Program; Dr. Mark Swieter, Office of Extramural Affairs; Dr. Cindy Miner, OSPC; and Natalie Tomitch, Fogarty International Center. Four Humphrey Fellows are supported by NIDA: Dr. Monica Beg, Bangladesh; Dr. Petra Exnerova, Czech Republic; Ms. Olga Toussova, Russia; and Dr. Svitlana Pkhidenko, Ukraine.

The 2001-2002 NIDA Hubert H. Humphrey Drug Abuse Research Fellows have established their professional affiliations. Part of their 10-month Fellowship includes an approximate 6-week professional affiliation to put into practice the academic learning phase of their fellowships and gain practical hands-on experience to bring back to their home countries. Dr. Monica Beg, Bangladesh, will be working with Dr. Steffanie Strathdee, Department of Epidemiology, Johns Hopkins University. Dr. Beg will work on study design, instruments, staff training, and quality assurance aspects of intervention programs. Dr. Petra Exnerova, Czech Republic, will be working with Mike Townsend at the Partnership for a Drug Free America. During her affiliation Dr. Exnerova will work on a drug prevention media campaign. Dr. Svitlana Pkhidenko, Ukraine, will be working with Dr. George Bigelow, Director of Behavioral Pharmacology Research Unit, Johns Hopkins University. Dr. Pkhidenko will be working on the design of innovative behavioral and pharmacological substance abuse treatment interventions and their potential for implementation in Ukraine. Dr. Olga Toussova, Russia, will be working with Dr. David Metzger, University of Pennsylvania. Dr. Toussova will be working on data analysis, literature searches, effectiveness evaluations and the development of skills to analyze and interpret data.

Dr. Feng Wei, a 2001-2002 Hubert H. Humphrey Research Fellow studying at Johns Hopkins University, will be working at NIDA's Center for Clinical Trials Network for his professional affiliation. The professional affiliation is an opportunity for the research fellows to put into practice the academic learning phase of their fellowships and gain practical hands-on experience to bring back to their home countries. Dr. Wei is the Director of the Center of Treatment and Rehabilitation on Drug Dependence of Shunyi District, the largest private treatment and rehabilitation hospital in Beijing.

Four researchers have been selected as the 2002-2003 NIDA Hubert H. Humphrey Drug Abuse Research Fellows: Dr. Amit Chakrabarti, India; Dr. Winston De La Haye, Jamaica; Mr. Alisher Latypov, Tajikistan; and Dr. Ye Swe Htoon, Myanmar. A clinical pharmacologist, Dr. Chakrabarti chairs the Department of Pharmacology at Sikkim Manipal Institute of Medical Sciences where he teaches undergraduate medical and postgraduate students, treats patients at the De-Addiction Clinic, conducts research in psychopharmacology, and serves on the animal ethics committee. During his Fellowship, Dr. Chakrabarti will focus on expanding his knowledge of epidemiology, treatment, and prevention research. A psychiatrist, Dr. De La Haye is chief resident at University Hospital of the West Indies in Jamaica, where he treats patients with psychiatric and addiction disorders. As a Medical Officer for the Ministry of Health and the Jamaica Defense Force, Dr. De La Haye assisted in drug interdiction efforts, which fostered his interest in demand reduction efforts and the correlation between drug abuse and violence. During his Fellowship, Dr. De La Haye will study U.S. models for drug abuse education, prevention, and treatment. An economist and public information specialist, Mr. Latypov works at his country's Drug Control Agency, where he works with local and foreign media organizations, writes the agency's monthly bulletin, and translates both written and oral material. He helps coordinate training courses, workshops, and conferences on drug abuse issues organized by UNDCP and nongovernmental organizations. Mr. Latypov will spend his Fellowship year concentrating on the development of comprehensive, research-based national drug control policies, prevention interventions, and treatment strategies. Dr. Ye Swe Htoon is a field officer for the Border Area Development Association, where he organizes health, sanitation, and education projects in Northern Myanmar. He was a founder of the Border Area Development Association and the Myanmar Anti-Narcotics Association, which conducts drug education and prevention programs. He has also worked with the International Red Cross and UNDCP, launched programs for the nongovernmental organizations MŽdecins sans FrontiŹrs and Maltesa, and developed collaborations with the Myanmar Ministries of Health and Home Affairs. During his Fellowship, Dr. Ye Swe Htoon will focus on the integration of drug abuse policy, prevention, and treatment programs with public health policy on the national, regional, and international stage. NIDA sponsors the competitive, 10-month Fellowships in cooperation with the U.S. Department of State, the Institute of International Education, and The Johns Hopkins University. Through a combination of academic courses and professional experience, Fellows learn about NIDA-supported drug abuse research and the application of research to the development of prevention programs, treatment protocols, and government policy.

The 2002 WHO/NIDA/CPDD International Traveling Fellows have been selected. They are: (1) Yehuda D. Neumark, Ph.D., Dr. Neumark is a lecturer in epidemiology in the department of social medicine at the School of Public Health and Community Medicine, Hebrew University of Jerusalem in Israel. Following the Annual CPDD Meeting and the NIDA International Forum, Dr. Neumark will travel to Richmond, Virginia to visit with Dr. Robert Balster and his colleagues at Virginia Commonwealth Institute to consider directions for future collaboration in the research of inhalant drug use; (2) Arun Kumar Sharma, M.D., Dr. Sharma is a lecturer in the department of community medicine at the University College of Medical Sciences in Sahadara, Delhi, India. Following the Annual CPDD Meeting and the NIDA International Forum, Dr. Sharma will work with Dr. Samuel Friedman and his colleagues at the National Development and Research Institutes in New York to 1) develop a draft of a research plan that will study the drug-using and sexual networks of drug injectors in New Delhi and 2) to study the relationships between network variables and levels of drug-related and sexual risk behaviors and prevalences of HIV and selected STIs.

Jonathan Pollock, Ph.D., DNBR, Joe Frascella, Ph.D., DTR&D, and Jag H. Khalsa, Ph.D., CAMCODA, organized a mini-symposium on Drug Abuse and Neuropsychiatric Issues at the "International Workshop on Brain Banking", that was organized by Dr. Piotr Kozlowski of NINDS, NIH (Bethesda Marriott Pooks Hill), March 11-12, 2002. Over sixty neuropathologists, neurologists, and other neuroscientists from nine countries including the United States participated in a two-day workshop that was co-sponsored by NINDS, NIDA, and NIA. They discussed issues related to brain tissue banking and recommended that the NIH give a serious thought to the establishment of brain tissue repositories to conduct innovative research on causes and consequences of brain diseases. A summary of the workshop will appear on the websites of NIDA, NIA and NINDS. The abstracts will be published in a special supplement to the Journal of Pathology.

Jag Khalsa, Ph.D., CAMCODA, Frank Vocci, Ph.D., Director, DTR&D, and Steven Gust, Ph.D., Acting Director, International Program, organized for the first time, a mini-symposium on Drug-Drug Interactions at the 3rd International Workshop on Clinical Pharmacology of HIV Therapy, Washington, DC, April 11-13, 2002. This was a follow-up to Dr. Khalsa's short note in JAMA , and a presentation at the 2nd International Workshop on Clinical Pharmacology, Amsterdam, April 2001, where it was felt that drug-drug interactions relevant to NIDA's interest should be further discussed in this international forum. At this meeting, a group of clinical pharmacologists pointed out a further need for NIDA to support research on underlying mechanisms of interactions between drugs of abuse, drug addiction treatment medications such as methadone, LAAM, buprenorphine, and antiretroviral drugs.

Drs. Elizabeth Robertson and Eve Reider, DESPR and Dr. Steven Gust met with Dr. Jairo Werner, President of the Helosia Matomho Research Institute, Niteroi, Brazil. Discussions included an overview of the NIDA and recent advances in the prevention and treatment of addiction.

Ana Anders and Pam Goodlow, Special Populations, OD, Beverly Jackson, OSPC and Dr. Eve Reider, DESPR met with the Western Hemisphere, "Drug Demand Reduction Efforts" group. The group included representatives from seven different countries in Central and South America including: Mr. Carlos Acosta, Argentina, Mr. Alvaro Gomez, Chile, Ms. Lizu Lee-Chacon, Costa Rica, Ms. Sandra Juarez Lopez De Temaj, Guatemala, Ms. Maria Elena Ramos Rodriguez and Ms. Maria Christina Santoscoy Gutierrez, Mexico, Mr. Jesus Rodriguez, Venezuela and Mr. Elexis Ruiz, Dominican Republic. Discussion areas included media and public awareness campaigns and treatment and prevention programs.

Drs. Timothy Condon, Associate Director, NIDA, and Steven Gust met with Dr. Shen Jie, Deputy Director, Chinese Center for Disease Control and Prevention and Director, National Center for AIDS/STD Control and Prevention, Mr. Qiang Zhengfu, Director, Department of International Cooperation, Chinese Center for Disease Control and Prevention and Dr. Zunyou Wu, Director, Department of Health Education and Behavioral Intervention, National Center for AIDS/STD Control and Prevention. Discussions centered on ways to form collaborations between these Departments and NIDA, particularly in the area of drug abuse and HIV/AIDS.

Drs. Jerry Flanzer and Pete Delaney, both of DESPR, met with Mr. Liu Huiming, Deputy Chief, Drug Prohibition Section, Jilin Province. Topics discussed included prevention and treatment programs and drug treatment centers, and economics of treatment and prevention.

Dr. Thomas Hilton presented a paper co-authored with Drs. Flanzer, Cartwright, and Fletcher, all of DESPR, entitled "Resistance to Innovation Among US Drug Abuse Treatment Providers: When Organizational Knowledge Interferes With Organizational Learning" at the 3rd International Conference on Organizational Knowledge, Learning and Capabilities - Athens, Greece, April 5-7, 2002.

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