National Institute On Alcohol Abuse And Alcoholism Research Articles

NIAAA celebrates one year anniversary of diversity initiatives

A year ago, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) formalized its office advancing the principles of diversity, equity, inclusion and accessibility (DEIA) both internally and in its scientific programs.

AUDIT‐C shows reliability when used online in patient portals

The Alcohol Use Disorders Identification Test–Consumption (AUDIT‐C) is a validated screen, but until recently has not been evaluated in routine conditions for adult primary care patients. A new study has found that AUDIT‐C screens have “excellent” test‐retest reliability, which assesses the consistency of results when given at two different times. Excellent test‐retest reliability means that there are similar results across separate test administrations, and the study, supported by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), shows that the AUDIT‐C can be used reliably in adult primary care patients. The study, led by Claire B. Simon, M.D., of the University of Washington in Seattle, used electronic health record (EHR) data from Kaiser Permanente. For the study, more than 18,000 adult primary care patients completed two AUDIT‐C screens at 1 to 21 days apart as part of routine care in 2021. Screen results were reliable whether completed in person or online through patient portals. However, reliability was higher when the patient completed both screens using online patient portals, compared to completing both screens in the clinic or one in the clinic and one online. Therefore, completing two screens may be a better option than just doing one. The study, High test–retest reliability of the Alcohol Use Disorders Identification Test–Consumption (AUDIT‐C) questionnaire completed by primary care patients in routine care, is published in the February 2024 issue of Alcohol, Clinical and Experimental Research. The researchers also found that reliability was lower for American Indian/Alaska Native (AI/AN) patients and multiracial patients.

Obituary: Kenneth R. Warren, Ph.D.

Last month, Kenneth R. Warren, Ph.D., died. The deputy director of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) since 2008, Warren was also acting director from 2008 to 2014. He retired in 2015.

Equivalence of Alcohol Use Disorder Symptom Assessments in Routine Clinical Care When Completed Remotely via Online Patient Portals Versus In Clinic via Paper Questionnaires: Psychometric Evaluation.

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) recommends the paper-based or computerized Alcohol Symptom Checklist to assess alcohol use disorder (AUD) symptoms in routine care when patients report high-risk drinking. However, it is unknown whether Alcohol Symptom Checklist response characteristics differ when it is administered online (eg, remotely via an online electronic health record [EHR] patient portal before an appointment) versus in clinic (eg, on paper after appointment check-in). This study evaluated the psychometric performance of the Alcohol Symptom Checklist when completed online versus in clinic during routine clinical care. This cross-sectional, psychometric study obtained EHR data from the Alcohol Symptom Checklist completed by adult patients from an integrated health system in Washington state. The sample included patients who had a primary care visit in 2021 at 1 of 32 primary care practices, were due for annual behavioral health screening, and reported high-risk drinking on the behavioral health screen (Alcohol Use Disorder Identification Test-Consumption score ≥7). After screening, patients with high-risk drinking were typically asked to complete the Alcohol Symptom Checklist-an 11-item questionnaire on which patients self-report whether they had experienced each of the 11 AUD criteria listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) over a past-year timeframe. Patients could complete the Alcohol Symptom Checklist online (eg, on a computer, smartphone, or tablet from any location) or in clinic (eg, on paper as part of the rooming process at clinical appointments). We examined sample and measurement characteristics and conducted differential item functioning analyses using item response theory to examine measurement consistency across these 2 assessment modalities. Among 3243 patients meeting eligibility criteria for this secondary analysis (2313/3243, 71% male; 2271/3243, 70% White; and 2014/3243, 62% non-Hispanic), 1640 (51%) completed the Alcohol Symptom Checklist online while 1603 (49%) completed it in clinic. Approximately 46% (752/1640) and 48% (764/1603) reported ≥2 AUD criteria (the threshold for AUD diagnosis) online and in clinic (P=.37), respectively. A small degree of differential item functioning was observed for 4 of 11 items. This differential item functioning produced only minimal impact on total scores used clinically to assess AUD severity, affecting total criteria count by a maximum of 0.13 criteria (on a scale ranging from 0 to 11). Completing the Alcohol Symptom Checklist online, typically prior to patient check-in, performed similarly to an in-clinic modality typically administered on paper by a medical assistant at the time of the appointment. Findings have implications for using online AUD symptom assessments to streamline workflows, reduce staff burden, reduce stigma, and potentially assess patients who do not receive in-person care. Whether modality of DSM-5 assessment of AUD differentially impacts treatment is unknown.

Predictors of National Institute on Alcohol Abuse and Alcoholism (NIAAA) Alcohol Recovery among Individuals in Alcohol Treatment: Implications for Social Work.

The National Institute on Alcohol Abuse and Alcoholism's (NIAAA) definition of alcohol use disorder (AUD) recovery stipulates two criteria: remission from DSM-5 AUD and cessation of heavy drinking. Importantly, these criteria allow for consideration of nonabstinent alcohol treatment outcomes. However, researchers have yet to assess potential predictors of the NIAAA recovery outcome. The current study examined associations between mental health and coping predictors of NIAAA recovery status in an AUD treatment sample. At baseline (BL) and end-of-treatment (EOT) research interviews in a clinical trial, participants (N = 118) completed questionnaires assessing alcohol dependence, mental health, and confidence levels in reducing heavy drinking, as well as alcohol use and DSM-5 AUD symptom endorsement. Logistic regression models tested the associations between chosen predictors and the odds of achieving NIAAA recovery. Twenty-four percent of individuals (n = 28) met both criteria for NIAAA recovery at EOT. Higher levels of BL state anxiety and anxiety sensitivity predicted lower odds of achieving NIAAA recovery, while greater confidence to reduce heavy drinking predicted increased odds of NIAAA recovery. Social workers are encouraged to continue assessing and addressing mental health in AUD treatment to help individuals with alcohol problems achieve their AUD recovery goals.

Outcomes of patients with alcohol-associated hepatitis and acute kidney injury - Results from the HRS Harmony Consortium.

The development of acute kidney injury (AKI) in the setting of alcohol-associated hepatitis (AH) portends a poor prognosis. Whether the presence of AH itself drives worse outcomes in patients with cirrhosis and AKI is unknown. Retrospective cohort study of 11 hospital networks of consecutive adult patients admitted in 2019 with cirrhosis and AKI. AKI phenotypes, clinical course, and outcomes were compared between AH and non-AH groups. A total of 2062 patients were included, of which 303 (15%) had AH, as defined by National Institute on Alcohol Abuse and Alcoholism (NIAAA) criteria. Patients with AH, compared to those without, were younger and had higher Model for End-stage Liver Disease-Sodium (MELD-Na) scores on admission. AKI phenotypes significantly differed between groups (p < 0.001) with acute tubular necrosis occurring more frequently in patients with AH. Patients with AH reached more severe peak AKI stage, required more renal replacement therapy, and had higher 90-day cumulative incidence of death (45% [95% CI: 39%-51%] vs. 38% [95% CI: 35%-40%], p = 0.026). Using no AH as reference, the unadjusted sHR for 90-day mortality was higher for AH (sHR: 1.24 [95% CI: 1.03-1.50], p = 0.024), but was not significant when adjusting for MELD-Na, age and sex. However, in patients with hepatorenal syndrome, AH was an independent predictor of 90-day mortality (sHR: 1.82 [95% CI: 1.16-2.86], p = 0.009). Hospitalised patients with cirrhosis and AKI presenting with AH had higher 90-day mortality than those without AH, but this may have been driven by higher MELD-Na rather than AH itself. However, in patients with hepatorenal syndrome, AH was an independent predictor of mortality.

Endpointsfor Pharmacotherapy Trials for AlcoholUse Disorder.

Alcoholuse disorder (AUD) is a debilitating disorder, yet currently approved pharmacotherapies to treat AUD are under-utilized. The three medications approved by the US Food and Drug Administration (FDA) for the indication of AUD are disulfiram, acamprosate, and naltrexone. The current landscape of pharmacotherapies for AUD suggests opportunities for improvement. Clinical trials investigating novel pharmacotherapies for AUD traditionally use abstinence-based drinking outcomes or no heavy drinking days as trial endpoints to determine the efficacy of pharmacotherapies. These outcomes are typically measured through patient self-report endorsements of their drinking. Apart from these traditional outcomes, there have been recent developments in novel endpoints for AUD pharmacotherapies. These novel endpoints include utilizing the World Health Organization (WHO) riskdrinking level reductions to promote a harm-reduction endpoint rather than an abstinence-based endpoint. Additionally, in contrast to patient self-report measurements, biological markers of alcohol use may serve as objective endpoints in AUD pharmacotherapy trials. Lastly, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) definition of recovery from AUD and patient-oriented outcomes offer new frameworks to consider endpoints associated with more than alcohol consumption itself, such as the provider-patient experiences with novel pharmacotherapies. These recent developments in new endpoints for AUD pharmacotherapies offer promising future opportunities for pharmacotherapy development, so long as validity and reliability measures are demonstrated for the endpoints. A greater breadth of endpoint utilization may better capture the complexity of AUD symptomatology.

HealthCall: Smartphone Enhancement of Brief Interventions to Improve HIV Medication Adherence Among Patients in HIV Care.

Heavy drinking among people living with HIV (PLWH) reduces ART adherence and worsens health outcomes. Lengthy interventions are not feasible in most HIV care settings, and patients infrequently follow referrals to outside treatment. Utilizingvisual and video features ofsmartphone technology, we developed HealthCall as an electronic means of increasing patient involvement in a brief intervention to reduce drinking and improve ART adherence. The objective of the current study is to evaluate the efficacy of HealthCall to improve ART adherence among PLWH who drink heavily when paired with two brief interventions: the National Institute on Alcoholism and Alcohol Abuse (NIAAA) Clinician's Guide (CG) or Motivational Interviewing (MI). Therefore, we conducted a 1:1:1 randomized trial among 114 participants with alcohol dependence at alargeurban HIV clinic. Participants were randomized to one of three groups: (1) CG only (n = 37), (2) CG and HealthCall (n = 38), or (3) MI and HealthCall (n = 39). Baseline interventions targeting drinking reduction and ART adherence were ~ 25min, with brief (10-15min) booster sessions at 30 and 60days.Theoutcomewas ART adherence assessed using unannounced phone pill-count method(possible adherence scores: 0-100%)at 30-day, 60-day, 3, 6, and 12months. Analyses were conducted using generalized linear mixed models with pre-planned contrasts. Of the 114 enrolled patients, 58% were male, 75% identified as Black/African American, 28% were Hispanic, and 62% had less than a high school education. The mean age was 47.5years (standard deviation [SD] 10years) and the mean number of years since they were diagnosed with HIV was 18.6 (SD 7.6). Participants assigned to HealthCall to extend the CG had increased levels of ART adherence at 60-day and 6-month follow-up (compared to CG only), although there was no statistically significant difference by 12-month follow-up. Participants who were assigned to HealthCall to extend the MI never had statistically significant higher levels of ART adherence. These results suggest that the use of a smartphone app can be used to initially extend the reach of a brief drinking intervention to improve ART adherence over a short period of time;however, sustained long-term improvements in ART adherence after intervention activity ends remains a challenge.

Inula britannica ameliorates alcohol-induced liver injury by modulating SIRT1-AMPK/Nrf2/NF-κB signaling pathway

ObjectiveInula britannica is a traditional Chinese medicinal and functional food with various effects such as anti-liver injury, hypoglycemia, antioxidants, and anti-tumor. The aim of this study was to investigate the protective effects and mechanisms of the ethanolic extract of I. britannica (EEIB) on alcohol-induced liver injury in mice. MethodsFifty-six female C57BL/6 mice were randomly divided into seven groups: control group (Con), ethanol feeding model group (EtOH), Silibinin positive treatment group (EtOH + Silibinin 100 mg/kg), EEIB treatment group (EtOH + EEIB 100, 200, and 400 mg/kg), and EEIB control group (EEIB 400 mg/kg). The National Institute on Alcohol Abuse and Alcoholism (NIAAA) ethanol-feeding model was used to study the effects of EEIB on alcohol-induced lipid metabolism, inflammation, oxidative stress, and fibril formation in mice by histopathological evaluation, immunofluorescence staining, Western blotting analysis and molecular docking. ResultsEEIB reduced liver indices to different degrees to normal levels and improved liver morphology in mice. EEIB inhibited alcohol-induced liver injury by activating the sirtuin 1 (SIRT1)-adenosine monophosphate-activated protein kinase (AMPK) signaling pathway in the liver of alcohol-fed mice, in which sesquiterpenes may be the potential active ingredients, and also down-regulated the expression of alpha-smooth muscle actin (α-SMA), collagen alpha (Collagen I), tumor necrosis factor-alpha (TNF-α) and attenuated alcohol-induced liver injury. In addition, EEIB also activated the nuclear factor erythroid 2-related factor 2 (Nrf2) signaling pathway, which alleviated alcohol-induced liver injury at the level of oxidative stress. Notably, the EEIB control group demonstrated that EEIB had no toxic effects in mice. EEIB reduced alcoholic liver injury in a dose-dependent manner. Its therapeutic efficacy was comparable to, if not better than, that of Silibinin when administered at a dose of 400 mg/kg. ConclusionEEIB showed significant therapeutic effects on alcohol-induced liver injury in mice, and its mechanism of action was related to the SIRT1-AMPK, nuclear factor-kappa B (NF-κB), and Nrf2 signaling pathways, in which sesquiterpenes may be the potential active ingredients.

NIAAA/NIDA animal study: Diet drug may help treat AUD

Researchers at the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and the National Institute on Drug Abuse (NIDA), and collaborators from The Scripps Research Institute, have found that semaglutide (brand name for the injection drug is Wegovy) — a gut hormone that promotes a feeling of fullness and thus promotes weight loss — can help reduce alcohol consumption and binge‐like drinking. The research is based on a rodent model. Published in the June 2023 issue of the journal JCI Insight, the study adds to growing preclinical evidence that the glucagon‐like peptide‐1 (GLP‐1) system plays a role in alcohol and other substance use disorders, and that GLP‐1 receptor agonists show potential for treating people with alcohol use disorder (AUD).

NIAAA reports primary care checkups “plus” SBIRT works

As the name suggests, screening, brief intervention, and referral to treatment (SBIRT) for alcohol can both identify people who are at risk for, or who have alcohol‐related problems, and for those who need treatment, provide connections, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) reported last week. But more is needed, and a recent study showed that primary care follow‐ups and checkups can work for alcohol use disorder (AUD).

NIDA and NIAAA quietly drop “preaddiction” RFI

A “Request for Information” (RFI) document issued last year (see NIDA and NIAAA call for information on use of ‘preaddiction’, ADAW April 15, 2023;https://onlinelibrary.wiley.com/doi/10.1002/adaw.33745) from the National Institute on Drug Abuse (NIDA) and the National Institute on Alcohol Abuse and Alcoholism (NIAAA) on the use of the term “preaddiction” has been dropped. There was no official announcement of this, unless you were at the College on Problems of Drug Dependence annual meeting in June 2023, when the decision was presented by NIDA and NIAAA. “Responses to the RFI revealed broad consensus around the need to improve early intervention before substance use progresses to addiction,” NIDA and NIAAA press offices told ADAW last week. “However, the majority of respondents shared concerns that establishing a new diagnostic term would not be constructive. Based on this feedback, NIDA and NIAAA are not encouraging implementation of new diagnostic terms at this time. Instead, other research strategies to help identify people at high risk, improve addiction prevention and early intervention, and address the many barriers that impede the delivery of effective prevention interventions and engagement in care will be pursued. As one example, NIDA, NIAAA, and others are supporting a consensus study by the National Academies of Sciences, Engineering, Medicine (NASEM) to provide a roadmap of steps needed to develop and finance a sustainable infrastructure at the national and/or state level for implementing evidence‐based interventions for preventing psychiatric disorders like addiction.” Work on that NASEM consensus study just began last week (see https://www.nationalacademies.org/our‐work/blueprint‐for‐a‐national‐prevention‐infrastructure‐for‐behavioral‐health‐disorders).

NIAAA on harm reduction and contingency management

Even the National Institute on Alcohol Abuse and Alcoholism (NIAAA) is getting in on the harm reduction act. In fact, for heavy drinkers, or any drinkers, reducing the amount consumed is a benefit. Requiring abstinence can scare people away from treatment altogether, and those are generally the people who need it most. Now, the NIAAA, which has talked to ADAW in the past about the pros and cons of attempts to reduce drinking (see https://onlinelibrary.wiley.com/doi/10.1002/adaw.33179), has come out with advice for the public on the benefits of reducing heavy alcohol consumption.

NIAAA launches new website for teens on drinking

Last week the National Institute on Alcohol Abuse and Alcoholism (NIAAA) launched “Facts About Teen Drinking,” with research‐based information. While underage drinking rates are declining, it's still important for teens to know how alcohol affects their health, how to identify the signs of a problem, and where to get help, according to the federal research agency. Go to https://niaaaforteens.niaaa.nih.gov/.

Model of disease severity in alcoholic hepatitis and novel prognostic insights.

Harmful alcohol consumption is one of the leading risk factors for global disease burden and injury condition, causing death and disability early in life, with over 3 million deaths worldwide every year. Alcoholic hepatitis (AH) is a clinical syndrome characterized by hepatic failure with recent onset of jaundice, consequence of a heavy chronic alcohol drinking. The disease severity ranges from mild to severe cases, with high short-term mortality. Individual variety regarding disease outcome and therapeutic response complicates the prognosis stratification. Thus, novel parameters and continuously sought for a better disease outcome assessment. To highlight new parameters that accurately assess 30-day mortality (short-term) in patients with AH and to develop a new severity score that uses readily available parameters accessible to any clinician. This is a prospective study on patients diagnosed with AH between 2022-2023. We identified 70 patients with AH who met the National Institute on Alcohol Abuse and Alcoholism (NIAAA) criteria for diagnosis after exclusion of patients with severe comorbidities that could influence disease outcome. Clinical and paraclinical parameters were assessed at least on admission and day 7. Mortality at 30-day was considered the endpoint. The database was composed using Microsoft Excel (Microsoft Corporation) and the data was analyzed using SPSS Statistics version 26 (IBM Corporation). A total of 70 patients were included in the study with a mortality at 30-days of 22.9% (n=16). The independent variables associated with increased short-term mortality identified using the univariate analysis were: fever, infection, esophageal varices, prothrombin time PT, INR, total bilirubin, CRP, LDH and CHI (creatinine height index). Using multivariate regression we determined a novel prognostic score, with criterion for retaining variable being p<0.05. Total bilirubin day 7, CRP, PT, fever and CHI resulted after the analysis and were included into a new mortality score. Our Prognostic Model Score obtained an area under the ROC of 0.950 (95% CI: 0.890-0.980, p<0.001), with a cut-off value of 13.75 (Sn=87.5%, Sp=91%). Regarding the consecrated prognostic scores, MDF and Lille score obtained good AUROCs=0.839 and 0.881, respectively (p<0.000), with cut-off values comparable with literature (MDF=34.35 vs 32) and (Lille=0.475 vs 0.450). The discriminatory power for ABIC (p=0.58), GAHS (p=0.16), MELD-Na (p=0.61) was not significant. We obtained a new prognostic score for the assessment of 30-day mortality in AH that includes markers of inflammation (CRP, fever) and markers of sarcopenia (CHI) along parameters of hepatic disfunction (total bilirubin and PT). Amongst consecrated prognostic models, MDF and Lille scores were representative for our study, while ABIC, GAHS and MELD-Na did not attain statistical significance. Our score is unique by the addition of CRP and this could prove to be a useful tool in AH severity stratification.

In Case You Haven't Heard

Everyone is writing a story about “dry January,” so who are we to be silent? With many writers saying it's okay if it's not total abstinence, that even cutting back will improve health, we say finally! As ADAW wrote in this space in October, there is no better place for information than the National Institute on Alcohol Abuse and Alcoholism (NIAAA). Go to https://www.rethinkingdrinking.niaaa.nih.gov/ and you will find worksheets and more. There are quizzes to help you and your patients make choices. The merits of reduced drinking, as well as the appeal of the concept for people who don't want to stop drinking entirely, have been documented by researchers like Katie Witkiewitz, Ph.D. over years of study. She also found that abstinence‐only approaches discourage drinkers from even trying. You can drink less per day, skip drinking days altogether, whatever works for you. As they say, “better is better.” And if you want help, there are groups. Witkiewitz is quoted in the “NIAAA Spectrum” online article titled “Incorporating Harm Reduction Into Alcohol Use Disorder Treatment and Recovery,” (see https://www.spectrum.niaaa.nih.gov/fall2023feature). If you can't be “dry,” you can at least improve the quality of your life — and your liver — by consuming less. If you want to be dry, for January, and maybe into the beyond, more power to you. If you already are, cheers!

Fenofibrate inhibits MOXD1 and PDZK1IP1 expression and improves lipid deposition and inflammation in mice with alcoholic fatty liver

AimsAlcoholic liver disease (ALD) can develop into cirrhosis and hepatocellular carcinoma but no specific drugs are available. Fenofibrate is therapeutically effective in ALD, however, the exact mechanism remains unknown. We explored the hub genes of ALD and the role of fenofibrate in ALD. Main methodsThe hub genes of ALD were screened by bioinformatics method, and their functional enrichment, signalling pathways, target genes and their correlation with immune microenvironment and pathogenic genes were analysed. We also analysed the binding affinity of fenofibrate to proteins of hub genes using molecular docking techniques, and the effects on hub gene expression, lipid deposition, oxidative stress and inflammation in the liver of National Institute on Alcohol Abuse and Alcoholism (NIAAA) model mice. The regulatory effects of fenofibrate on MOXD1 and PDZK1P1 were investigated after gene silencing of peroxisome proliferator-activated receptor-α (Ppar-α). Key findingsHub genes identified, including monooxygenase DBH-like 1 (MOXD1), PDZK1-interacting protein 1 (PDZK1IP1) and solute carrier 51 β (SLC51B), are highly predictive for ALD. Hepatic MOXD1 and PDZK1IP1 expression was elevated in patients with ALD and NIAAA model mice, with no significant difference in SLC51B expression between the groups. Fenofibrate binds tightly to MOXD1 and PDZK1IP1, inhibits their hepatic expression independently of PPAR-α signalling, and ameliorates lipid deposition, oxidative stress and inflammatory responses in NIAAA model mice. SignificanceMOXD1 and PDZK1IP1 are key genes in ALD progression; fenofibrate improves liver damage in NIAAA model mice by downregulating their expression. Our findings provide insight for improving diagnostic and therapeutic strategies for ALD.

NIDA: Why injecting is more addictive than oral use

The shorter the amount of time between administration and a drug's effects, the more addictive it is. This has been known for decades. It's one of the reasons why smoking nicotine is so addictive — smoking as a route of administration goes directly from the lungs to the brain. This applies to crack cocaine as well. Insufflation (through the nose) is also very rapid. Injection into a vein is not as fast as inhalation, as the drug must first go through the bloodstream to get to the brain, but it is very fast. Slowest of all is oral administration, especially “extended release” therapeutic formulations. But a new clinical trial sponsored by the National Institute on Drug Abuse (NIDA) and the National Institute on Alcohol Abuse and Alcoholism (NIAAA) suggests that a “salience network” in the brain is responsible for the difference between intravenous and oral response to a drug.

In Case You Haven't Heard…

Nobody on social media with a substance use presence has missed the many ads for various alcohol reduction strategies — applications to put on your phone that remind you how to cut back on drinking. These are valuable, but not free. Typical charges are $80/month. You can get the same thing, but better, from the National Institute on Alcohol Abuse and Alcoholism (NIAAA). Go to https://www.rethinkingdrinking.niaaa.nih.gov/ and you will find worksheets and more. There are quizzes to help you and your patients make choices. What you don't get is a personal “counselor,” which the apps provide, but this is not a counselor, it's a marketer to make sure you keep up your monthly payments. You may feel there is a personal connection, but there isn't. We can't be sure if it's even a marketer, or just a robot, artificial intelligence‐fashion. No criticism there, that is the way of apps. But it's not necessary. By the way, if you do want real person support, there are mutual support groups: Alcoholics Anonymous, Smart Recovery, and more. But the key is that many people are not ready to stop drinking and telling them [that] they have to may discourage them from even trying, as researcher Katie Witkiewitz, Ph.D. has proven (see https://onlinelibrary.wiley.com/doi/10.1002/adaw.33179). In fact, Witkiewitz is quoted in the current NIAAA's Spectrum article online entitled “Incorporating Harm Reduction Into Alcohol Use Disorder Treatment and Recovery,” (see https://www.spectrum.niaaa.nih.gov/fall2023feature). NIAAA said it does not want to be seen as “competing” with apps, but we have no problem seeing them that way. And they win the contest.

New director for NIAAA intramural division: David Lovinger, Ph.D.

Last week the National Institute on Alcohol Abuse and Alcoholism (NIAAA) announced that David Lovinger, Ph.D. has been selected as the scientific director for the Division of Intramural clinical and biological research. Lovinger obtained his undergraduate degree from the University of Arizona and his Ph.D. in psychology from Northwestern University. He conducted postdoctoral research at NIAAA before joining the Vanderbilt University School of Medicine in 1991. In 2001, Lovinger was recruited back to NIAAA and became Chief of the Laboratory for Integrative Neuroscience. He has served as Acting Scientific Director of NIAAA since 2022. Lovinger's research focuses on the neurobiological bases of behavior, how alcohol affects the connections between neurons, and the neural mechanisms involved in alcohol use and alcohol use disorder. In his role as Scientific Director, Lovinger will provide scientific, programmatic, and administrative leadership for the Division of Intramural Clinical and Biological Research. He will also be responsible for promoting an inclusive environment that values diverse perspectives, encouraging collaboration, facilitating mentoring and training, and conducting innovative research. “I am honored to be chosen for this position,” Dr. Lovinger said. “I look forward to working with the members of this great institute to build the future of intramural research.” Intramural refers to research that takes place on NIAAA campus under the auspices of NIAAA employees, as opposed to extramural research which is conducted by outside scientists).