Minutes of the 78th Meeting of the National Advisory Council on Drug Abuse

May 16-17, 2001

The National Advisory Council on Drug Abuse convened its 78th meeting at 1:10 p.m. on May 16, 2001 in Conference Room C, Neuroscience Center, National Institutes of Health, 6001 Executive Boulevard, Bethesda, Maryland. Dr. Alan I. Leshner, Director, NIDA, chaired the overall meeting and Mr. Richard A. Millstein, Deputy Director, NIDA, chaired the application reviews. The meeting on May 16 was for the purpose of reviewing applications for federal grant assistance and was open only to Council members and federal employees. The meeting reconvened on May 17 at 9:00 a.m. and was open to the public. The Council adjourned May 17 at 11:00 a.m.

Council Members Present:

Hortensia D. Amaro, Ph.D.
Andrea G. Barthwell, M.D.
Kathleen T. Brady, M.D., Ph.D.
Rand D. Conger, Ph.D.
Gerald H. Friedland, M.D.
Steven C. Hayes, Ph.D.
Kenneth J. Hoffman, M.D., M.P.H. (ex officio)
Nancy J. Kaufman, R.N., M.S.
G. Alan Marlatt, Ph.D.
A. Thomas McLellan, Ph.D.
Kathleen R. Merikangas, Ph.D.
Scott A. Reines, M.D., Ph.D.
Perry F. Renshaw, M.D., Ph.D.
David L. Rosenbloom, Ph.D.
Kathy Sanders-Phillips, Ph.D.
James E. Smith, Ph.D.
Jose Szapocznik, Ph.D.

Council Members Absent:

Robert C. Malenka, M.D., Ph.D.
Richard T. Suchinsky, M.D. (ex-officio)

Council Chairs Present:

Alan I. Leshner, Ph.D.
Richard A. Millstein, J.D.

Executive Secretary:

Teresa Levitin, Ph.D.

Federal Employees Present:

National Institute on Drug Abuse

Other Federal Employees Present:

David Armstrong, Ph.D. - Center for Scientific Review, NIH
Julius Cinque, Ph.D. - Center for Scientific Review, NIH
Christine Melchior, Ph.D. - Center for Scientific Review, NIH

Members of the Public Present:

Susan Camaione - MasiMax Resources, Inc.
Nicole Cardello - Physicians Committee for Responsible Medicine
Bill Corrigall - CAMH
Marie Dyak - Entertainment Industries Council
Glen Fischer - Management Assistance Corporation
M.B. Haten - MasiMax Resources, Inc.
Robert Mills - MasiMax Resources, Inc.
Geoffrey Mumford, Ph.D. - American Psychological Association
Al Nugent - Midwest Research Institute

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), Title 5, U.S. Code and Section 10(d) of the Federal Advisory Committee Act, as amended (5 U.S.C. Appendix 2).

   Mr. Richard A. Millstein, Deputy Director, NIDA, called the meeting to order and welcomed the Council and staff. He provided an overview of the agenda for the meeting, and reminded those present that the Federal Advisory Committee Act applies to Council and that the meeting was closed to the public. Dr. Teresa Levitin, Executive Secretary, summarized Council functions and voting policies and procedures. She also reminded those present about NIH confidentiality and conflict of interest policies.

2. Application Reviews

   In turn, the Director or a designee for the Division of Treatment Research and Development; the Division of Epidemiology, Services, and Prevention Research; the Division of Neuroscience and Behavioral Research; the Center on AIDS and Other Medical Consequences of Drug Abuse; and the Office of Science Policy and Communications presented their applications for consideration by the Council. For each, Council provided concurrence with the initial scientific reviews en bloc. A MERIT application was also reviewed and approved.

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

   For this Council, 480 applications, requesting $438,726,759 in Total Years Direct Costs, went to review. Of these, 314 were scored by the Scientific Review Groups, representing $67,580,266 in First Year Direct Costs and $293,646,685 in Total Years Direct Costs. Council concurred with the SRGs in time and amount. The Council approved three administrative supplements and one new MERIT award.

1. Call to Order

   Dr. Alan I. Leshner called the open portion of the meeting to order and welcomed the Council members, NIDA staff, and visitors. He 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.

2. Consideration of the Minutes of the 77th Council

   The Minutes of the February 13-14, 2001 meeting were approved as written.

3. NIDA Director's Report

   Dr. Leshner began his presentation by reviewing staff changes. He then reported that Dr. Kathleen Brady, Council member, was named "South Carolina Woman of Achievement" by Governor Jim Hodges, and he added his congratulations for Dr. Brady's achievements.

   Budget

   Dr. Leshner announced that the President's Budget request for FY 2002 proposes a FY 2002 budget of $907.369 million for NIDA. This represents a 16.2% increase, the largest in NIDA's history. He indicated that this proposal reflects the administration's understanding that science is the route to addressing the nation's drug abuse problems, and it also reflects the administration's recognition of the quality and extent of NIDA's research. The increase will allow NIDA to move forward with new initiatives, and projections are that 1,410 total research project grant awards will be possible in FY 2002, with a success rate of 38%.

   Shaping the Research Agenda

   Dr. Leshner reminded those present that the printed Director's Report has details and information on meetings and activities not discussed in his presentation. He then highlighted some recent meetings of interest. In January, NIDA, with the National Center on Addiction and Substance Abuse at Columbia University and the National Institute of Mental Health, sponsored a conference entitled, "Food for Thought: Substance Abuse and Eating Disorders." This conference examined the science of addiction in the context of eating disorders. In March, NIDA sponsored, "Who Wants to be a NIDA Neuroscientist," at the National Museum of Health and Medicine. This event, co-sponsored by the Dana Alliance for Brain Initiatives and NIH, was part of Brain Awareness Week and taught middle school children about neuroscience and brain research.

   NIDA and the National Institute of Diabetes and Digestive and Kidney Diseases co-sponsored the "1st Annual Meeting of RFA-funded Microarray Researchers" in January. A day-long symposium, "The Challenge of Psychostimulant Addiction: Both Reward Circuitry and Inhibitory Deficits May Help Explain Why It's So Difficult for Our Patients to Say No," was held at the American Society of Addiction Medicine's annual conference in April. Also in April, Council Member Dr. Steven Hayes and NIDA staff member Dr. Lisa Onken co-chaired a workshop for currently funded Stage I translational behavioral treatment development researchers.

   To address the needs of special populations, NIDA sponsored several meetings. The African American Researchers and Scholars Work Group and the Asian/Pacific Islander Work Group met in March in Rockville. The NIDA Women and Gender Research Group sponsored a seminar, "Gender Differences, Women Drug Abusers, and HIV Risk: Lessons Learned and Future Prospects," in February.

   Upcoming meetings will address a number of topics from new perspectives. In June, a meeting, "Like Drugs for Chocolate: Separate Rewards Modulated by Common Mechanisms," will occur as part of the Society for the Study of Ingestive Behavior meeting at the University of Pennsylvania. A meeting on stigma is planned for September. This trans-NIH meeting will address disease-associated stigma from a number of perspectives, including epidemiology, theory, methods, interventions, and ethical and legal concerns. NIDA will sponsor a workshop, "Bridging Neurobiological, Behavioral, and Prevention Sciences (2)," in May in order to interest early career scientists in drug abuse research. This meeting is part of the 2001 Annual Meeting of the Society for Prevention Research. A number of meetings and symposia will also occur at the annual meeting of the College on Problems of Drug Dependence in June.

   Initiative Implementation

   Dr. Leshner noted that NIDA's resources will support new initiatives across all the programmatic domains of the Institute. For example, a national prevention research network is needed to encourage practitioners and researchers to work together more effectively and to learn from each other.

   One challenge in NIDA's research planning is that new drugs of abuse constantly emerge and a rapid response is needed. For example, in response to the appearance of club drugs, NIDA has issued an RFA soliciting research applications and is planning a meeting in July to discuss MDMA. This symposium, "MDMA/Ecstasy Research: Advances, Challenges, and Future Directions," will be held at the NIH Campus and involves staff from all NIDA Divisions.

   Prescription drug abuse is also being addressed with new initiatives. Dr. Leshner presented information on the non-medical use of prescription medications. Of the estimated nine million people in the U.S. who used prescription drugs non-medically last year, 25% did so for the first time. In April, NIDA launched a prescription drug initiative with the American Association of Retired Persons, the American Academy of Family Physicians, the American Pharmaceutical Association, the National Association of Chain Drug Stores, the National Community Pharmacists Association, the National Council on Patient Information and Education, and the Pharmaceutical Research and Manufacturers of America. NIDA has released a research report on prescription drug abuse, as well as a program announcement.

   NIDA is also addressing research on therapeutic communities. The Therapeutic Community Association of America and NIDA are collaborating, and they jointly sponsored a meeting that led to the development of a Request for Applications. The issues to be addressed include organization and financing. The issue of whether therapeutic communities, as a whole, work is resolved; their effectiveness has been demonstrated. The reasons for this effectiveness remain to be better understood, and NIDA is interested in supporting research on therapeutic community program elements.

   Bridging the Disconnect

   The media are providing more accurate, science-based information on drug abuse. The Fifth Annual PRISM Awards were held in April. These awards, co-sponsored by NIDA, the Entertainment Industries Council, and the Robert Wood Johnson Foundation, are given for accurate depictions of drug, alcohol, and tobacco use and addiction in television and motion picture productions.

   NIDA is planning the Second National Conference on Drug Abuse Prevention and Research for August. This will provide a review of research on drug abuse prevention and result in a revision of the "red book" on drug abuse prevention. A number of new research reports have been released, and the availability of Spanish language brochures and information is growing. NIDA has reorganized its website, and Dr. Leshner asked Council members to provide feedback on the new site, which he views as transitional toward an even better site in the future.

   Council complimented NIDA on the gene microarray work and noted that the growth of proteomics and associated technological developments present an important opportunity for science. Council also complimented NIDA's involvement in the stigma meeting and encouraged incorporation of child abuse, victimization, and neglect concerns. Council urged NIDA to consider formal usability studies of NIDA's website in order to enhance its development and usefulness. Council urged further attention to the issue of integrating drug abuse and primary medical care. Another recommendation was for the Institute to undertake research on training and dissemination to reach physicians. This effort could profit from inclusion of persons familiar with how pharmaceutical representatives reach physicians and educate them. Finally, the continuing need for a rapid response to emerging drugs was noted.

4. Subcommittee Reports

   Child and Adolescent Subcommittee: Dr. Kathy Sanders-Phillips reported for the Child and Adolescent Subcommittee. The subcommittee heard from NIDA staffer Dr. Karin Johnson. It also generated a number of ideas for NIDA's consideration, such as an inhalants initiative. The members expressed enthusiasm for the mentoring program that was organized by NIDA at the 2001 meeting of the Society for Research in Child Development. The subcommittee recommended that it meet with NIDA's child and adolescent work group to discuss possible initiatives and programs, such as examining definitions of drug abuse in children and adolescents for different types of drugs.

   Dr. Leshner noted that child and developmental issues are in all the Institute's programs and that the child and adolescent work group is one productive means of coordinating NIDA's programs. He suggested that Dr. Johnson's presentation to the subcommittee be given to all of Council, and he noted that NIDA has just updated its research report on inhalants.

   Expanding Membership on Scientific Review Groups: Dr. Steven Hayes reported on the history and progress of NIDA's work to incorporate public members, or consumers, into its treatment and services research review groups. The plans to incorporate consumer members relied heavily on specification of the types of members needed, careful screening and selection, and thorough training. Dr. Hayes complimented NIDA staff for their work in these areas. Four consumer members have now participated actively in review meetings and made important contributions. Names of new, potential public members are needed. Dr. Leshner urged Council to continue to help identify potential consumer members.

   Health Disparities Subcommittee: Dr. Andrea Barthwell spoke for the subcommittee. The group has reviewed NIDA's Strategic Plan for Reducing Health Disparities and agrees with its recommendations. Further, they suggest several actions for implementation. An updated definition for health disparities and minority research would assist in tracking expenditures and progress in the health disparities research portfolio. A notice in the NIH Guide and a site on NIDA's web could also be devoted to health disparities and heightening researchers' awareness of health disparities activities.

   Dr. Leshner indicated that there is, indeed, widespread misunderstanding of the nature of health disparities research and the impacts of health disparities in the nation. He suggested that a "Myth/Fact Statement" could be developed.

   Blending Corrections/Criminal Justice Subcommittee: Dr. David Rosenbloom reported on the meeting of this subcommittee, which examines the blending of public safety and public health perspectives in drug abuse. He presented background information on the overlap between criminal justice and drug abuse concerns and described barriers to using scientific findings to address drug abuse in the criminal justice system. More work is needed to assist in the coordination of research activities, to help disseminate findings, to expand the quality and timeliness of NIDA's portfolio, and to assist in coordination with other agencies. NIDA staff could work with local and state authorities to increase communication with researchers. Other Council members noted that youth in criminal justice systems have unique needs, that attention is needed to racial and ethnic issues, that mental health and comorbidity concerns need to be taken into account, and that military correctional settings could be studied.

5. Other Council Comments

   Council recommended continued attention to the review of NIDA applications at the Center for Scientific Review (CSR).

6. Public Comments

   There were no comments from the public.

Dr. Leshner adjourned the 77th meeting of the National Advisory Council on Drug Abuse at 10:57 a.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.