131st Meeting Minutes

Minutes – February 13, 2019

The National Advisory Council on Drug Abuse convened its 131st meeting at 9:00 a.m. on February 13, 2019 in Conference Rooms C & D, 6001 Executive Boulevard, Bethesda, Maryland. The closed portion of the meeting held on February 13th was for reviewing applications for Federal grant assistance and was open only to Council members and Federal employees. The open portion, which was open to the public, began at 10:30 a.m. and was also video cast. The Council adjourned on February 13, 2019 at 4:21 p.m.

Council Members Present
Judith Auerbach, Ph.D.
Julie Blendy, Ph.D.
Linda Chang, M.D.
H. Westley Clark, M.D., J.D.
Arthur Dean, M.A.
Karl Deisseroth, M.D., Ph.D.
Lakshmi Devi, Ph.D.
Carlos del Rio M.D.
Gail D’Onofio, M.D.
Marie Gallo Dyak
Jay Giedd, M.D.
Kenneth Mackie, M.D.
Lisa Marsch, Ph.D.
Edward Nunes, M.D.
Robert Rancourt, J.D.

Council Members Absent
John Carnevale, Ph.D.
Christian Heidbreder, Ph.D. 
Steffanie Strathdee, Ph.D.  

Council Chair
Nora Volkow, M.D.

Executive Secretary
Susan Weiss, Ph.D.

Federal Employees Present

Members of the Public Present
Jenena Brissett—NIDA Contractor 
Carol Cushing—NIDA Contractor 
Shannon Givens—NIDA Contractor 
Michelle Griffin, M.A.—NIDA Contractor
Nahla Hilmi, M.P.H.—NIDA Contractor
Eve Jelstrom, M.B.A.—Emmes
Nicolas Johnston, M.S.—NIDA Contractor
Molly Natchipolsky, B.S.—NIDA Contractor
Lizette Nkongho—NIDA Contractor
Victor Prikhodko, M.B.A.—NIDA Contractor
Ann Rea, M.A.—NIDA Contractor
Ingrid Sandoval—American Association of Neurological Surgeons
Marushka Silveira, Ph.D.—NIDA Contractor
Albert Terrillion, Dr. P.H.—Community Anti-Drug Coalitions of America
Barbara Vann—CSR, Incorporated
Robert Yates, M.S.—SRI International 

Closed Portion of the Meeting – February 13, 2019

1. Call to Order

   This portion of the meeting was closed to the public in accordance with sections 552b(c) (4) and 552b(c) (6), 4.
   Title 5, U.S. Code and section 10(d) of the Federal Advisory Committee Act, as amended (5 U.S.C. Appendix 2). 
   
   Dr. Nora Volkow, Director, NIDA, called the meeting to order and welcomed the Council and staff. She reminded those present that the Federal Advisory Committee Act applies to Council meetings and that this portion of the meeting was closed to the public. 
   
   Dr. Susan Weiss, Executive Secretary, summarized relevant NIH policies, provided detailed instructions on Council review procedures, and reminded those present about NIH confidentiality and conflict of interest policies. 

2. Application Reviews

   Drs. Kurt Rasmussen, Rita Valentino, Carlos Blanco, and Elena Koustova the Directors of NIDA’s Division of Therapeutics and Medical Consequences, the Division of Neuroscience and Behavior, the Division of Epidemiology, Services and Prevention Research, and the Office of Translational Initiatives and Program Innovations, respectively, presented their Division’s assigned and peer reviewed applications for consideration by the Council. For each, Council provided unanimous en bloc concurrence with the initial scientific review. Three Administrative Supplements, two MERIT Awards, one Appeal, and ten Special Council Review applications were presented to Council for review, and Council concurred with program assessments. The initial reviews of all Trans-NIH Initiatives, including NIH Common Fund, Blueprint and BRAIN applications as well as foreign applications and applications with a secondary assignment to NIDA also received Council concurrence. 

   Council and staff were recused from the Council meetings during discussion of, and voting on, individual applications from their own institutions or other applications for which there was a conflict of interest, real or apparent. Conflicts of interest statements were signed by each member of the Council. Members were not required to leave the room if an application in conflict with that member was acted upon en bloc. 

Open Portion of the Meeting

1. Call to Order

   Dr. Nora Volkow, Director, NIDA, called the open portion of the meeting to order and welcomed all attendees. She reminded the Council and audience that the meeting was open to the public in compliance with the Government in the Sunshine Act and indicated that time would be provided for public comment. Dr. Volkow welcomed four ad-hoc council members: Drs. Carlos del Rio, Lakshmi Devi, Gail D’Onofrio, and Christian Heidbreder. 

   She then called attention to future Council meeting dates: February 13, 2019, May 14, 2019 (NACDA), May 15, 2019 (CRAN), and September 5, 2019. 

2. Consideration of the Minutes of Council

   The Minutes of the September 2018 NIDA Advisory Council were unanimously approved as written. 

3. NIDA Director’s Report (NIH Videocast @ 0:01:58) — Nora Volkow, M.D., Director, NIDA

   Dr. Volkow provided an overview of NIDA’s budget and portfolio with an emphasis on opioid appropriations and provided updates on the Adolescent Brain Cognitive Development (ABCD) study and the Helping to End Addiction Long-term (HEAL) initiative. She noted trends in drug use including an increase use of vaping devices in adolescents and increases in marijuana use in adults. She emphasized the need for drugs to treat cannabis withdrawal symptoms and highlighted results from a recently published randomized control trial that successfully treated cannabis withdrawal and dependence with a fatty acid amide hydrolase inhibitor. Further, she discussed the success, but underutilization of medication assisted treatment (MAT) for opioid use disorder (OUD), its implementation in both healthcare and justice settings, and need for expanded therapeutic options. She also noted that NIDA is expanding its Clinical Trials Network to respond to the opioid epidemic; initiating the HEALing Communities Study, to respond to the continuum of OUD treatment and prevention needs in highly affected areas, studying the effects of prenatal opioid and other drug exposure on development, and partnering with NIAAA on prevention initiatives, especially in college age youth and young adults. Dr. Volkow concluded her presentation by recognizing the expansive events of the National Drug and Alcohol Facts week. 

   Council thanked Dr. Volkow for her presentation and a discussion followed (NIH Videocast @1:20:20). 

4. HHS Efforts to Combat the Opioid Crisis (NIH Videocast @ 1:57:58) — ADM Brett Giroir, M.D., U.S. Department of Health and Human Services 

   Admiral Giroir provided updates on the ongoing Opioid Crisis and the five-point strategy HHS is implementing to combat it. He underscored the necessity of addressing the pain crisis in the U.S. before the opioid crisis will be solved and acknowledged the challenges posed by poly-drug use, synthetic opioids, and increases in infectious diseases (particularly HIV and Hepatitis C). Admiral Giroir also spoke about the importance of relying on evidence-based treatment, stressing recovery is possible with proper treatment. He highlighted results thus far, such as increasing naloxone prescriptions and emphasized the need for data tracking, particularly among those affected by neonatal abstinence syndrome. Efforts thus far have depended on a crisis framework, but the response must transition to models that work over time. Admiral Giroir concluded by presenting newly introduced initiatives aimed at ending the HIV epidemic. 

   Dr. Volkow and Council members thanked ADM Giroir for sharing his presentation and a discussion followed (NIH Videocast @ 2:32:58).

5. Changing the Culture to Address Sexual Harassment (NIH Videocast @ 2:42:18) — Carrie Wolinetz, Ph.D., Associate Director for Science Policy, NIH 

   Dr. Wolinetz discussed the overdue need for addressing sexual harassment in the sciences while acknowledging the policies and procedures in place to improve gender equity and combat sexual harassment were not sufficient. She highlighted the National Academies of Sciences, Engineering, and Medicine Sexual Harassment of Women report, the types and predictors of sexual harassment, and emphasized the critical role organizational climate plays in perpetrating sexual harassment and discrimination. In addition, she spoke about the immediate actions NIH can take and the more difficult task of changing culture over time. One such effort is through the Advisory Council to the Director Working Group on Changing the Culture to End Sexual Harassment. 

   Dr. Volkow and Council members thanked Dr. Wolinetz for her presentation and a discussion followed (NIH Videocast @ 2:58:07). 

6. Neural Circuit Dynamics of Brain States and Drug Action (NIH Videocast @ 3:06:03) — Karl Deisseroth, M.D., Ph.D. D.H. Chen Professor of Bioengineering and of Psychiatry and Behavioral Sciences, Stanford University and NACDA Member  

   Dr. Deisseroth presented some of the ongoing work in his laboratory using novel technologies to understand neural circuit dynamics of underlying behaviors in real time. He detailed past work that led to his current line of research and showed new data on the effects of drugs of abuse on place cells. To further understand these behaviors, he introduced new technology for imaging brain-wide single cell activity dynamics in both deep and surface level areas of the brain and for probing the genomic and functional changes over time. 

   Dr. Volkow and Council members thanked Dr. Deisseroth for his presentation and a discussion followed (NIH Videocast @ 3:39:02). 

7. Concept Clearances (NIH Videocast@ 3:46:00) — NIDA Staff

   Susan Wright, Ph.D., Health Scientist Administrator, Division of Neuroscience and Behavior (DNB) presented: Leveraging Big Data Science Approaches to Elucidate the Neurobiological Basis of Substance Use Disorder (NIH Videocast @ 1:54:35) 

   Olivier Berton, Ph.D., Health Scientist Administrator, DNB presented: Exploiting Precision Pharmacology Techniques to Understand Opioid Receptor Signaling in Specific Circuits, Cell Types, and Subcellular Compartments 

   Amy Lossie, Ph.D., Health Scientist Administrator, DNB presented: The Rat Opioid Genome Project 

   John Satterlee, Ph.D., Health Scientist Administrator, DNB presented: Exploiting Single Cell Technologies to Understand the Effects of Persistent HIV and Chronic Opioid Exposure on the Brain and Data Coordination and Analysis Center for Single Cell and Other Molecular HIV/SUD Data 

   Woody Lin, Ph.D., Health Scientist Administrator, DNB presented: Assessing Effects of Cannabinoids on HIV-associated Neuroinflammation 

   Anne Tsai, Ph.D., Health Scientist Administrator, DNB presented: Targeting Inflammasomes in Drug Abuse and HIV 

   Richard Jenkins, Ph.D., Health Scientist Administrator, Division of Epidemiology, Services and Prevention Research (DESPR) presented: Cohorts of HIV/AIDS and Substance Abusing Populations and PrEP for HIV Prevention among Substance Using Populations 

   Sarah Duffy, Ph.D., Deputy Branch Chief, DESPR presented: Advancing the Study of Recovery Support Services for Those Treated with Medications for Opioid Use Disorder 

   Marsha F. Lopez, Ph.D., Branch Chief, DESPR presented: National Drug Early Warning System 

   Tanya Ramey, M.D., Ph.D., Medical Safety Officer, Division of Therapeutics and Medical Consequences (DTMC) presented: Clinical Outcome Assessments for Clinical Trials of Substance Use Disorders as FDA-qualified Drug Development Tools 

   Elena Koustova, Ph.D., M.B.A., Director, Office of Translational Initiatives and Program Innovations (OTIPI) presented: Digital Health Technologies to Address the Social Determinants of Opioid Addiction 

   Irina Sazonova, Ph.D., Health Scientist Administrator, OTIPI presented: Blockchain Technology to Improve SUD Care and Rapid Assessment of Drug Abuse: Smart City Tool 

8. Public Comments (NIH Videocast @ 4:41:15) 
   Albert Terrillion from the Community Anti-Drug Coalitions of America thanked NIDA for their partnership on two publications related to informing the community about electronic nicotine delivery systems and the opioid crisis and NIDA’s participation in the National Leadership Forum where they awarded Dr. Volkow the National Leadership Award.

9. Adjourn (NIH Videocast@ 4:22:36) 
   The 131st meeting of the National Advisory Council on Drug Abuse was adjourned at 4:21 p.m.  

Certification

I hereby certify that the foregoing minutes are accurate and complete.

Note: Informational materials provided to the public at the open session of the meeting may be obtained from the Executive Secretary.