National Institute On Drug Abuse Research Articles

NIDA‐funded study supports telehealth buprenorphine

Starting buprenorphine treatment for opioid use disorder (OUD) through telehealth was associated with an increased likelihood of staying in treatment longer compared to starting treatment in a non‐telehealth setting, according to a new study analyzing Medicaid data from 2019–2020 in Kentucky and Ohio. Published in JAMA Network Open, the study, “Telemedicine Buprenorphine Initiation and Retention in Opioid Use Disorder Treatment for Medicaid Enrollees,” by Lindsey R. Hammerslag, Ph.D., and colleagues, was released Oct. 18. The research adds to what the National Institute on Drug Abuse (NIDA) calls a “growing body of evidence” supporting telehealth initiation of buprenorphine treatment.

NIDA study: 24 mg of buprenorphine better than 16

A study published in JAMA Network Open last week that was funded by the National Institute on Drug Abuse (NIDA) found that higher doses of buprenorphine are better than lower doses to promote treatment retention.

The national institute on drug abuse diversity scholars network: success for a diverse addiction science workforce.

There is a well-known lack of diversity in many Science, Technology, Engineering, and Mathematics (STEM) fields. The gap in awarded National Institutes of Health (NIH) grants for scientists from underrepresented populations at the early stages of their careers contributes significantly to this lack of diversity. The National Institute on Drug Abuse (NIDA) Diversity Scholars Network (NDSN) program implemented a new model in 2016 to provide support to underrepresented early-career investigators (ECIs) by equipping them to navigate the competitive NIH grant process. NDSN has a demonstrable track record of providing equity through educational opportunities by enhancing the grant funding success of participants. Of 59 participants from 2016 through 2021, 53% received funding within the first two years after completing the program and 69% by four years. NDSN scholars surmount systemic funding barriers by building relationships with scientific coaches, mentors, NIDA Program Officials and intentionally engaging in network building, which all contribute to the funding success of ECIs. NIDA's NDSN program provides a model for retaining underrepresented ECIs that not only benefits individual scholars, but also the institutions they serve and society as a whole.

Affective Science Research: Perspectives and Priorities from the National Institutes of Health.

Affective science is a broad and burgeoning field, and the National Institutes of Health (NIH) support research on a similarly broad range of topics. Across NIH, funding is available for basic, translational, and intervention research, including research in non-human animals, healthy populations, and those with or at risk for disease. Multiple NIH Institutes and Centers have specific programs devoted to topics within the affective science umbrella. Here, we introduce the funding priorities of these six: the National Cancer Institute (NCI), National Center for Complementary and Integrative Health (NCCIH), National Institute of Mental Health (NIMH), National Institute on Aging (NIA), National Institute on Drug Abuse (NIDA), and National Institute on Minority Health and Health Disparities (NIMHD). We then discuss overlapping themes and offer a perspective on promising research directions.

Racial inequities and addiction research

What accounts for variation across racial and ethnic groups in drug use and harms related to substance use? While explanatory mechanisms for racial and ethnic disparities include differential access to and use of health services, a myriad of other factors, including racism and historical trauma, contribute to drug-related disparities. Furthermore, the addiction scientific workforce, like the full biomedical research enterprise, lacks diversity. This deficit undercuts U.S. scientific leadership and is a major challenge for the field. To address these entrenched problems, the National Institute on Drug Abuse (NIDA) is prioritizing research on health disparities and supporting multiple efforts to enhance scientific workforce diversity. Studies on substance use trends and emerging threats must measure disparities and track progress in reducing disparities, but also acknowledge the limitations of race and ethnicity-based data. Researchers must take the bold step of proposing studies that elucidate causal mechanisms which have the potential to be ameliorated by novel policies and practices. Critically, the impact of racism on all aspects of the substance use trajectory must be assessed to better tailor prevention, harm reduction, treatment, and recovery-support interventions to the specific circumstances of those who need them. Particular attention should be given to people who are incarcerated, who are experiencing homelessness, and who have a history of adverse childhood experiences. Training the next generation of the addiction science workforce needs to address structural barriers to participation with partnerships between funders, such as NIDA, and grantee organizations.

HEAL Preventing Opioid Use Disorder: a Vision for Research to Increase Access to Prevention Services.

Launched in 2018, the National Institutes of Health (NIH) Helping to End Addiction Long-term Initiative®, or NIH HEAL Initiative, is an aggressive effort to speed scientific solutions to stem this national public health crisis. Investments in new strategies to prevent opioid misuse are a key component of this comprehensive response to the opioid epidemic. In 2019, funded through the NIH HEAL Initiative® and administered by the National Institute on Drug Abuse (NIDA), HEAL Preventing Opioid Use Disorder (HEAL Preventing OUD) research program began, filling the gap of needed upstream prevention interventions. The vision for HEAL Preventing OUD is that: Healthcare organizations and public systems will be able to make evidence-based preventive intervention services accessible to all persons who experience risk for opioid and other substance misuse or use disorder. Realizing this vision will require research investments in four strategic areas: (1) risk identification; (2) intervention development; (3) social determinants, health equity, and policy; and (4) dissemination, implementation, scale up, and sustainment. There exists tremendous potential for prevention to be a viable solution for the ongoing opioid crisis, particularly through investments in upstream, equitable, and sustainable prevention services.

National Institute on Drug Abuse (NIDA) research priorities to support the development of incentive-based treatments for substance use disorders

The purpose of this commentary is to highlight current research priorities of National Institute on Drug Abuse (NIDA) Division of Therapeutics and Medical Consequences (DTMC) regarding the development and testing of incentive-based interventions for the treatment of substance use disorders (SUDs). This manuscript summarizes the NIH Stage Model for behavioral intervention development, briefly reviews existing research on incentive-based treatments for SUDs that falls within the scope of DTMC at NIDA and highlights the development of digital therapeutics-based incentive interventions as an exemplar and high priority area. We briefly review how digital therapeutics approaches may address some common limitations to dissemination of incentive-based interventions and highlight opportunities for integrating incentive-based approaches into pharmacotherapy efficacy trials. Finally, we mention several related funding opportunities for researchers interested in developing incentive-based approaches for SUD treatment. The overall goal of this commentary is to inform the research community of current NIDA priority areas for intervention development and funding.

Examining Sustained Recovery from Substance Use Disorder — A Delicate Process

The National Institute on Drug Abuse (NIDA) defines longterm recovery as a process of change through which people improve their health and wellness, live self-directed lives, and strive to reach their full potential.1 Even people with severe and chronic substance use disorders can, with help, overcome their illness and regain health and social function; this is called remission.1

NIDA and NIH invite research into drug‐checking tools

More drug‐detecting tools and other ways to prevent overdose deaths are urgently needed, according to a Commentary in the June 12 issue of The New England Journal of Medicine. Nora Volkow, M.D., director of the National Institute on Drug Abuse (NIDA), and Lawrence A. Tabak, D.D.S., Ph.D., acting director of the National Institutes of Health, call for addressing the current gaps in the research, development, and implementation of fentanyl test strips and other rapid drug‐detecting tools that could help prevent overdose deaths. Barriers to these tools exist at the state and local levels.

Social Disparities Increase Risk of SUDs

Back to table of contents Previous article Next article Annual MeetingFull AccessSocial Disparities Increase Risk of SUDsNick ZagorskiNick ZagorskiSearch for more papers by this authorPublished Online:16 Jun 2023https://doi.org/10.1176/appi.pn.2023.07.7.53AbstractAt APA’s 2023 Annual Meeting, National Institute on Drug Abuse Director Nora Volkow, M.D., highlighted the relationship between early stress and brain development.The COVID-19 pandemic made many hidden truths more abundantly clear, National Institute on Drug Abuse (NIDA) Director Nora Volkow, M.D., said during a presentation at APA’s Annual Meeting in May. Among them was the power of social determinants of health—as racial and ethnic minorities, those with less income, and people with psychiatric illness bore the brunt of negative health outcomes.Social determinants of health are also strong risk factors for substance use disorders, Volkow continued.She noted that brain imaging data indicate that the environment plays a stronger role than genetics in guiding brain development between the ages of 5 and 8 years. In households with dysfunction, stress, and/or financial difficulties, children tend to receive more negative environmental stimulation and less positive stimulation.Making use of new imaging data from over 7,500 9- and 10-year-old children enrolled in NIDA’s Adolescent Brain and Cognitive Development (ABCD) Study, Volkow together with Dardo Tomasi, Ph.D., a staff scientist at the National Institute on Alcohol Abuse and Alcoholism, evaluated the relationship between family income and brain structure. Their analysis revealed that children from higher-income families appeared to have larger and thicker frontal cortices as well as higher cognitive test scores compared with children from lower-income families.Another brain imaging study of babies born during the COVID-19 pandemic uncovered a similar pattern: Greater levels of maternal stress and anxiety were associated with worse connectivity between the amygdala and frontal cortex in the infants. Lower social support was a significant predictor of clinically elevated prenatal maternal distress, the study found.Such early changes in brain structure may increase the risk of later problems with substance use, Volkow noted, as data show that people who are more sensitive to negative conditioning (for example, learning quickly not to touch a hot stove after getting burned) and/or have blunted reward conditioning are at higher risk of addiction.Showing a correlation is one thing, but is there evidence that correlation can be changed?Well, yes, Volkow noted. She pointed to one controlled intervention in which 1,000 low-income mothers from several U.S. cities were randomly allocated either a $333 or $20 monthly stipend after the birth of their child. About 400 of the babies were selected for EEG scans at one year of age, and the EEG data found that babies of mothers with the high-cash stipend had more robust and active brain activity than the babies of mothers who received the low-cash stipend.“This simple monetary intervention probably reduced the mother’s stress [related to] how she would support her child and maybe let them spend more time together,” Volkow said. There was a clear positive neurodevelopmental outcome.Volkow acknowledged that the United States may not have the resources right now to implement some of these early-life interventions on a large scale, but building up the infrastructure is one of NIDA’s priorities. Just attenuating the impact of poverty can boost childhood development and prevent susceptibility to substance use down the road, she said. ■Resources“Associations of Family Income with Cognition and Brain Structure in USA Children: Prevention Implications”“Prenatal Maternal Distress During the COVID-19 Pandemic and Associations With Infant Brain Connectivity” ISSUES NewArchived

Anti‐poverty programs can improve mental health in children

Researchers have found that states with stronger social safety nets have lower disparities in brain development and mental health of children 9 to 11 years old. The research, supported by the National Institute on Drug Abuse (NIDA) found that the disparity in brain structure between children from high‐ versus low‐income households was more than a third lower in states with greater cash assistance than in those offering less, and the disparity in mental health symptoms was reduced by nearly a half.

NIDA study finds link between ADHD stimulant medication and stimulant misuse

Researchers at the University of Michigan have found a strong association between prevalence of prescription stimulant therapy for attention‐deficit/hyperactivity disorder (ADHD) and rates of prescription stimulant misuse according to a study published last week in JAMA Network Open. The study, funded by the National Institute on Drug Abuse (NIDA) and part of the Monitoring the Future database, highlights the need for schools to make sure students don't share their medication, according to NIDA.

Taiwan study cautions against methadone for drivers; NIDA responds

A recent literature review from Taiwan, “Risk of motor vehicle collisions after methadone use: A systematic review and meta‐analysis” by T.Y. Tsai and colleagues, found that methadone use is associated with an almost doubled risk of motor vehicle collisions, and concluded that “clinicians should exercise caution in implementing methadone maintenance therapy for drivers.” The study, published in the current issue of Drug and Alcohol Dependence, flies in the face of what is known in this country about methadone maintenance: that it is safe for driving when taken in therapeutic doses. We asked the National Institute on Drug Abuse (NIDA) to comment on the study. Here is what they said.

NIDA and NIAAA call for information on use of ‘preaddiction’

The lead federal agencies on substance use disorder (SUD) research are calling for input on how to identify and intervene in the mild or early stages of the disease. Last month, the National Institute on Drug Abuse (NIDA) and the National Institute on Alcohol Abuse and Alcoholism (NIAAA) issued a request for information (RFI) inviting feedback on the use of a term like “preaddiction.”

NIDA comments on Taiwan methadone‐driving study

A recent literature review from Taiwan, “Risk of motor vehicle collisions after methadone use: A systematic review and meta‐analysis” by T.Y. Tsai and colleagues, found that methadone use is associated with an almost doubled risk of motor vehicle collisions, and concluded that “clinicians should exercise caution in implementing methadone maintenance therapy for drivers.” The study, published in the current issue of Drug and Alcohol Dependence, flies in the face of what is known in this country about methadone maintenance: That it is safe for driving when taken in therapeutic doses. ADAW asked the National Institute on Drug Abuse (NIDA) to comment on the study. Here is what they said.

Study protocol for an efficacy trial of the “PrEP for Health” intervention to increase HIV PrEP use among people who inject drugs

BackgroundHIV incidence has recently increased among people who inject drugs (PWID) across the United States, with outbreaks occurring in states with long-standing syringe service programs (SSPs) including Massachusetts (MA). Antiretroviral pre-exposure prophylaxis (PrEP) is an evidence-based HIV prevention strategy recommended for PWID, but uptake in this marginalized population is extraordinarily low.MethodsWe describe the design and procedures for a National Institute on Drug Abuse (NIDA)-funded (R01) randomized controlled trial (RCT) testing the efficacy of “PrEP for Health,” a multicomponent behavioral intervention to increase PrEP uptake, adherence, and persistence among HIV-negative PWID attending SSPs in two areas of the U.S. Northeast that are heavily affected by injection-related HIV transmission. Participants are equally randomized to receive the “PrEP for Health” intervention (involving individually tailored HIV and PrEP education, motivational interviewing, problem-solving skills and planning, and ongoing navigation support) or an enhanced standard of care (eSOC) control condition involving a brief educational video on the utility of PrEP for HIV prevention. Co-primary outcomes are PrEP uptake (using medical/pharmacy records) and adherence (using tenofovir quantification in hair samples); a secondary outcome is PrEP persistence (using medical/pharmacy records) over 12 months. Major assessments occur at baseline, 1-, 3-, 6-, and 12-month follow-up visits. Planned analyses will examine intervention efficacy, specific hypothesized conceptual mediators of the intervention effect (e.g., self-perceived HIV risk; PrEP knowledge, interest in use, motivation, and behavioral skills) and epidemiologically linked moderators (e.g., age; gender; condomless vaginal or anal sex).DiscussionFindings from our extensive preliminary research with the study population revealed that a multicomponent, theory-based intervention targeting PrEP knowledge, motivation, self-efficacy, behavioral skills, and structural barriers to PrEP access is urgently needed for PWID who are at risk of HIV acquisition. We also learned that SSPs represent a highly acceptable service setting for delivering such interventions. In this study, we are evaluating the efficacy of the “PrEP for Health” intervention. If efficacious, findings from our implementation evaluation could help guide its dissemination to diverse SSPs and possibly other community-based settings accessed by this population.Trial registrationClinicalTrials.gov number NCT04430257, registered June 12, 2020.

Experts Reflect on What New Law Might Mean for Cannabis Research

Experts Reflect on What New Law Might Mean for Cannabis Research

Trends in stigmatizing language about addiction: A longitudinal analysis of multiple public communication channels

IntroductionStigma associated with substance use and addiction is a major barrier to overdose prevention. Although stigma reduction is a key goal of federal strategies to prevent overdose, there is limited data to assess progress made in reducing use of stigmatizing language about addiction. MethodsUsing language guidelines published by the federal National Institute on Drug Abuse (NIDA), we examined trends in use of stigmatizing terms about addiction across four popular public communication modalities: news articles, blogs, Twitter, and Reddit. We calculate percent changes in the rates of articles/posts using stigmatizing terms over a five-year period (2017–2021) by fitting a linear trendline and assess statistically significant trends using the Mann-Kendall test. ResultsThe rate of articles containing stigmatizing language decreased over the past five years for news articles (−68.2 %, p < 0.001) and blogs (−33.6 %, p < 0.001). Among social media platforms, the rate of posts using stigmatizing language increased (Twitter [43.5 %, p = 0.01]) or remained stable (Reddit [3.1 %, p = 0.29]). In absolute terms, news articles had the highest rate of articles containing stigmatizing terms over the five-year period (324.9 articles per million) compared to 132.3, 18.3, and 138.6 posts per million for blogs, Twitter, and Reddit, respectively. ConclusionsUse of stigmatizing language about addiction appears to have decreased across more traditional, longer-format communication modalities such as news articles. Additional work is needed to reduce use of stigmatizing language on social media.

NIDA‐CDC: No bupe OD deaths from bupe telemedicine

A study published last week in JAMA Network Open by the National Institute on Drug Abuse (NIDA) and the Centers for Disease Control and Prevention (CDC) found that the proportion of opioid overdose deaths involving buprenorphine did not increase in the months after prescribing flexibilities were put in place during the COVID‐19 pandemic. The data provides further evidence that expanding treatment access may help patients, and is consistent with last year's study, also by NIDA and the CDC showing that increased methadone take‐homes did not result in increased methadone overdose deaths.

NIDA misquotes its own study in initial press release

Last week, the National Institute on Drug Abuse (NIDA) issued a press release accompanying its study, co‐sponsored with the Centers for Disease Control and Prevention (CDC), which showed that flexibilities in buprenorphine prescribing did not lead to more fatal overdoses involving buprenorphine (see story, page 4).