NIDA Dedicated to Unlocking All Aspects of Drug Abuse

The National Institute on Drug Abuse (NIDA) funds approximately 2,000 extramural research studies—in addition to intramural projects—each year with hopes of reducing the prevalence of illicit drug use and diversion of prescription medications in the United States. NIDA Director Nora Volkow, M.D., who will deliver a lecture as part of the “Advances in Addiction Research” session at APA’s annual meeting in May, discussed with Psychiatric News the latest research coming from the agency, as well as the future of substance abuse treatment.

“There is a lot of new research going on at NIDA,” Volkow said. “A lot of it relates to genetic and epigenetic processes associated with the brain during developmental periods in order to understand the negative consequences of substance abuse at various stages of life.” She explained that this specific focus is one of much concern because of the increasing regular use of marijuana among American teenagers, which was indicated in responses to the NIDA-sponsored 2013 Monitoring the Future survey (Psychiatric News, February 7).

“It’s important to know how the brain of an adolescent transitions to that of an adult and how changes during that transitional period increase one’s vulnerability for drug use and risky behavior. This kind of research is one of our top priorities,” stated Volkow, “and we plan to address these issues with panel discussions in the near future.”

Other ongoing research cited by Volkow included investigations of medicines and vaccines for the treatment of substance use disorders (SUDs), as well as new molecular therapies for such indications.

“We have innovative opportunities that relate not just to vaccines but also to monoclonal antibodies, which have long half-lives and alleviate the need to ingest medication repeatedly. Also, we have new enzymes that are engineered to rapidly metabolize an illicit substance before the drug enters the brain. This is the era of new medication and technological development,” Volkow noted.

This year, according to Volkow, NIDA has decided to put more emphasis on SUDs and comorbid psychiatric illnesses, as well as the association of drug abuse and violent acts and behaviors.

Another area to which the institute is giving more attention is the diversion of prescription medications. “This is very relevant to psychiatrists because some psychotherapeutic agents can be diverted and result in addiction—in particular stimulant medication and to a lesser extent barbiturates,” explained Volkow. Though analgesics, another class of frequently abused medications, are not often prescribed by psychiatrists, Volkow said that more psychiatrists will be faced with treating those who have diverted or become addicted to such pain therapies.

NIDA is currently working with multiple federal agencies to decrease illicit substance use and drug diversion among certain high-risk populations, including veterans and those incarcerated by state judicial systems. NIDA is also one of four government health institutes involved in the new Brain Initiative, launched last year by President Obama.

“We are involved in research in all areas as it relates to drug abuse—basic science and neuroscience, prevention, implementation, and epidemiology,” added Volkow.

When asked about the future of research and clinical practices related to drug abuse, Volkow responded, “By then we will have a much better knowledge of how the brain works and use that knowledge to strengthen those sequences in the brain that are damaged by drugs through technology that may rely on the delivery of magnetic or electrical stimulation or even biofeedback processes. Hopefully there will be a transformation in the culture such that substance abuse disorders are screened and treated as a first line intervention for specialized care.” ■