Minutes of the 82nd Meeting of the National Advisory Council on Drug Abuse

September 18-19, 2002

The National Advisory Council on Drug Abuse convened its 82nd meeting at 1:00 p.m. on September 18, 2002 in Conference Room C, Neuroscience Center, National Institutes of Health, 6001 Executive Boulevard, Bethesda, Maryland. Dr. Glen R. Hanson, Acting Director, NIDA, chaired the overall meeting and Mr. Richard A. Millstein, Deputy Director, NIDA, chaired the latter part of the September 19 meeting and the application reviews. The meeting on September 18 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 September 19 at 9:00 a.m. and was open to the public. The Council adjourned September 19 at 2:40 p.m.

Council Members Present:

Kathleen T. Brady, M.D., Ph.D.
Dorothy K. Hatsukami, Ph.D.
Steven C. Hayes, Ph.D.
Kenneth J. Hoffman, M.D., M.P.H. (ex officio)
Robert C. Malenka, M.D., Ph.D.
Thomas McLellan, Ph.D.
Scott A. Reines, M.D., Ph.D.
Perry F. Renshaw, M.D., Ph.D.
Kathy Sanders-Phillips, Ph.D.
Peggy B. Sapp
James E. Smith, Ph.D.
Jose Szapocznik, Ph.D.
David Vlahov, Ph.D.
Robert L. Woodson, Sr., M.S.W.
Nancy R. Zahniser, Ph.D.

Council Members Absent:

Norman B. Anderson, Ph.D.
Nancy J. Kaufman, R.N., M.S.
G. Alan Marlatt, Ph.D.
David L. Rosenbloom, Ph.D.
Richard T. Suchinsky, M.D. (ex-officio)

Council Chairs Present:

Glen R. Hanson, Ph.D., D.D.S.
Richard A. Millstein, J.D.

Executive Secretary:

Teresa Levitin, Ph.D.

Federal Employees Present:

National Institute on Drug Abuse, NIH, DHHS

Other Federal Employees Present:

David Armstrong, Ph.D. - Center for Scientific Review, NIH, DHHS
Maribeth Champoux, Ph.D. - Center for Scientific Review, NIH, DHHS
Christine Melchior, Ph.D. - Center for Scientific Review, NIH, DHHS
Luci Roberts, Ph.D. - Center for Scientific Review, NIH, DHHS
Peggy Schnoor - OD, OSP, NIH, DHHS

Members of the Public Present:

Grace Bowen - MasiMax Resources
Roxanne Burkhart - Capitol Associates
Sue Camaione - MasiMax Resources
Glen Fischer - Management Assistance Corporation
Pat Ford-Roegner - National Assoc. of Addiction Professionals
Rebecca Goodman - Society for Research in Child Development
Barbara Jacobs - Education and Training Programs
Andrew Kessler, J.D. - American Psychological Society
Susan Loveland - American College Health Association
Kimberly Martin - MasiMax Resources
Robert Mathias - MasiMax Resources, Inc.
Geoffrey Mumford, Ph.D. - American Psychological Association
William Narrow, M.D. - American Psychiatric Association
Lou Ann Saxena - MasiMax Resources
Trina Stevens - MasiMax Resources
Daniel Tisch - MasiMax Resources

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 meetings and that the meeting was closed to the public. Mr. Millstein introduced new Council member, Mrs. Peggy Sapp, and other Council members introduced themselves in turn. Dr. Teresa Levitin, Executive Secretary, summarized voting policies and procedures, provided detailed instructions on Council review procedures, and 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 Epidemiology, Services and Prevention Research; the Office of Science Policy and Communications; the Center on AIDS and Other Medical Consequences of Drug Abuse; the Center for the Clinical Trials Network; the Division of Neuroscience and Behavioral Research; and the Division of Treatment Research and Development presented their applications for consideration by the Council. For each, Council provided concurrence with the initial scientific reviews en bloc. Requests for MERIT extensions and administrative supplements were 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, 745 applications, requesting $903,943,224 in Total Years Direct Costs, went to review. Of these, 405 were scored by the Scientific Review Groups (SRGs), representing $106,513,726 in First Year Direct Costs and $523,293,575 in Total Years Direct Costs. Council concurred with the SRGs in time and amount. The Council approved 18 administrative supplements and one MERIT extension.

1. Call to Order

   Dr. Glen R. Hanson called the open portion of the meeting to order and welcomed the Council members, NIDA staff, and visitors. Dr. Hanson introduced new Council member Mrs. Peggy Sapp. He noted that new member Dr. Norman Anderson was unable to attend. Dr. Hanson expressed NIDA's appreciation of service to those Council members whose terms were expiring: Dr. Kathleen Brady, Ms. Nancy Kaufman, Dr. G. Alan Marlatt, Dr. Perry Renshaw and Dr. Kathy Sanders-Phillips. A certificate of appreciation and plaque were presented to those present. Dr. Hanson 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 Council

   The Minutes of the May 22, 2002 meeting were approved as written.

3. NIDA Director's Report

   Dr. Hanson welcomed and introduced new staff members and reported on other recent changes at NIDA. He announced that Capt. Steve Oversby has recently joined the Center for Clinical Trials Network (CCTN) as a Health Scientist Administrator. Capt. Oversby is a Licensed Professional Addictions Counselor and a Licensed Clinical Psychologist who brings 10 years of recent clinical experience in the mental health field to the CCTN. Dr. Hanson introduced Dr. Petra Exnerova, from the Czech Republic, who has joined the Services Research Branch. Dr. Exnerova will be at NIDA for a 6-month interval studying how NIDA applies theory-based research to the effective development of treatment and prevention programs. She is helping to develop mechanisms that will assist the establishment of a research infrastructure in the field of substance abuse in the Czech Republic. Other new staff were also introduced.

   Initiative Implementation

   Dr. Hanson reported that at Dr. Zerhouni's invitation the NIH Institute Directors held a meeting for the purpose of identifying trans-NIH initiatives unique to NIH and its mission. This group consisted of Institute Directors and outside experts in a variety of areas and included Nobel Laureates. Specific projects that NIH should be involved in were identified; these included attracting people into clinical research, improving access to enabling technologies and resources, and encouraging novel, high-risk, high-payoff research. Also discussed was how NIH interfaces with other agencies and interacts with private companies and private concerns.

   Dr. Hanson commended the Office of Extramural Affairs for their hard work this summer in reviewing 398 grant applications during 24 review meetings.

   Dr. Hanson reported that several new initiatives had recently been released. One Request for Applications (RFA), Chronic Stress and Its Relation to Drug Abuse and Addiction, will look at the role of stress in drug abuse and addiction and is very timely due to the recent events in our country. Another new RFA, Guidance for Behavioral Treatment Providers: Research on Knowledge and Skill Enhancement, will deepen community treatment providers' knowledge and skills to administer behavioral treatments. Dr. Hanson also called attention to several newly released Program Announcements (PA): the Genetic Epidemiology of Substance Abuse Disorders PA and the Economic Evaluation of Drug Abuse Treatment and Prevention Services for HIV/AIDS PA. He reported that the Cutting-Edge Basic Research Award (CEBRA) program was initiated about a year and a half ago to attract novel, high-risk research. Ninety-one applications were received and 29 have been funded. These applications include research on studying neurotransmitter release using a neurochemical chip; studying bacterial homologs of dopamine transporters; sampling and detecting neuropeptides in nanoliter volumes; and developing a mouse model of HIV infection and drug addiction.

   Dr. Hanson gave an update on the NIH Extramural Loan Repayment Program. He noted that this trans-NIH program is intended to provide a financial incentive for new clinical investigators to contractually agree to engage in clinical research by providing payment for a portion of awardees' loans. NIDA committed $1.7 million in FY 2002 to this program, funding 35 eligible applications.

   Dr. Hanson congratulated the Office of Science Policy and Communications for publishing the Science and Practice Perspectives, Vol. 1. This publication, developed by NIDA to enhance the use of research and rapid adaptation of research-based practices in drug abuse treatment, is expected to be released twice a year.

   Budget

   Dr. Hanson reported that the budget for FY 2001 had increased 12.2%, the FY 2002 budget increased 13.9% and the FY 2003 proposed budget has an estimated 8.6% increase. He noted that with only a 2.2% increase for FY 2004 anticipated, careful budgetary planning would be required.

   Shaping the Research Agenda

   Dr. Hanson highlighted several recent meetings. NIDA and the Office of National Drug Control Policy (ONDCP) co-sponsored the 2002 ONDCP Demand Reduction Technology Symposium in Cambridge, MA in July. At the meeting NIDA staff spoke about applying technology to understanding addiction and future directions of technology in drug abuse research. NIDA's Center on AIDS and Other Medical Consequences of Drug Abuse (CAMCODA) held a meeting in May entitled "Strategies to Improve the Replicability, Sustainability, and Durability of HIV Prevention Interventions for Drug Users." Experts in the field of HIV prevention exchanged information on their current research and addressed gaps and future directions in this area. Dr. Hanson also noted that NIDA had a substantial presence at the 64th annual College on Problems of Drug Dependence (CPDD) meeting in Quebec City, Canada. Workshops on medication development, career development, and grant writing were conducted by NIDA staff. Staff also organized a meeting on neuropeptidergic responses to psychostimulant drugs of abuse and on building international research on drug abuse treatment innovations. NIDA also had substantial involvement at the XIV International AIDS Conference in Barcelona, Spain. CAMCODA staff, NIDA grantees and other individuals and organizations conducted eight satellite sessions relating to substance abuse and AIDS at this meeting. Dr. Hanson noted that NIDA staff would conduct poster sessions and symposia at the Society for Neuroscience meeting to be held in November 2002 in Orlando, Florida. An array of topics from proteomics and mass spectrometry, systems neurobiology and drug abuse, mechanisms of reward, neuropeptides, and synaptic change and addiction are planned. One symposium, the Neurobiology of Relapse, will be dedicated to the memory of Dr. Roger Brown and will identify his great contributions to the neuroscience program at NIDA.

   Dr. Hanson reported that NIDA has collaborated with other NIH components on several new Program Announcements (PAs) and Requests for Applications (RFAs). These initiatives will target studies in a number of areas such as bioinformatics, research integrity, genetic studies in zebra fish, animal stem cell research, stigma and global health research, HIV prevention in treatment settings, mood disorders and nicotine addiction, and studies with homeless persons with alcohol, drug abuse or mental disorders. Dr. Hanson announced that a new committee has been meeting to identify areas for new and continuing collaborative research between NIDA and NIAAA. Dr. Hanson noted the many exciting areas and activities for joint work reported by the committee and he also presented priority areas of gene/environment interaction, neuroeconomics, AIDS, medications development, and behavioral therapy for further joint activity.

   Dr. Hanson reported that the 7th Annual Prism Awards, held in May 2002 and co-sponsored with the Robert Wood Johnson Foundation and the Entertainment Industries Council, was shown to members of Congress and others in July, and was aired across the country by Tribune Broadcasting in August.

   Dr. Hanson announced that a new public service announcement targeting steroid abuse has been distributed. He also announced that NIDA's Research Report on Marijuana would soon be published. This report targets marijuana abuse in this country and discusses consequences of use. Dr. Hanson also announced that the 2003 Calendar, a science-based resource on drug information, would feature Asian Americans/Native Hawaiians and other Pacific Islanders.

   Council Steering Committee - Dr. Thomas McLellan

   Dr. Hanson announced that a Council Steering Committee was recently formed consisting of Drs. Hatsukami, Szapocnik, Hayes and Ms. Kaufman, with Dr. McLellan as Chair. Dr. McLellan reported that the Committee held its first meeting. Recommendations from the Committee included: 1) having Council subcommittees work with members of the NIDA staff to examine issues that cut across the various divisions and 2) holding additional meetings to examine the portfolio and discuss options and opportunities. He noted that holding a half-day meeting during Council to discuss the subcommittee recommendations could accomplish this. Dr. Hanson noted that this Committee would be a useful resource for new ideas and suggestions.

   Expanding Membership in Scientific Groups Subcommittee - Dr. Steven Hayes

   Dr. Hayes gave the final report of the Expanding Membership in Scientific Groups Subcommittee. He noted that the initiative to expand membership in NIDA's scientific review groups by adding public members began in February 2000. The Subcommittee had recommended that public members could potentially increase the quality of reviews by providing a different perspective and perhaps help foster the fit between science practice and consumer needs. The Subcommittee had suggested using the public members in the treatment and services review groups, NIDA-E and NIDA-F. Specific goals were set and implemented the following year. The subcommittee met periodically to guide development and implementation and to conduct evaluation. Dr. Hayes noted that the entire Council was invited to submit nominations, and four individuals are now serving on NIDA-E and NIDA-F. The subcommittee was also involved in drafting a guide for public reviewers. NIDA staff provided extensive training, include a mock review for the public members. An evaluation showed that the public members worked well with the scientific members and that the review process benefited from their contributions. With the specific objectives achieved, it was recommended that the Subcommittee be disbanded.

4. SAMHSA and NIDA: Forging New Working Relationships - Mr. Charles Curie

   Mr. Millstein introduced Mr. Charles Curie, Administrator of the Substance Abuse and Mental Health Services Administration (SAMHSA). Mr. Millstein noted that the White House appointed Mr. Curie as Administrator in November 2001 and that SAMHSA is the lead federal agency for improving the quality and availability of substance abuse prevention, addiction treatment and mental health services in the United States. Mr. Curie explained that the SAMHSA science-to-services agenda is a partnership with NIDA, the National Institute on Alcohol Abuse and Alcoholism and the National Institute of Mental Health working to unleash the power of research knowledge to achieve the common good. He thanked NIDA for helping in the translation from knowledge development to implementation of effective community-based substance abuse and mental health services. He noted that SAMHSA's emphasis is on establishing evidence-based practices among communities, services providers, consumers and their families; and on identifying new, emerging community trends that can help inform the next agenda for substance abuse and mental health services research. He noted that the challenge is to shorten the lag time between research and practice. SAMSHA is participating in an interagency agreement with NIDA, the National Criminal Justice Drug Abuse Treatment Services Research System (CJ-DATS). CJ-DATS was established by NIDA to integrate public health and public safety approaches for criminal justice-involved individuals with addictive disorders. Rigorous scientific research will be conducted across multiple settings, i.e. jails, prisons, and the community.

   Mr. Curie reported that another example of the science-to-services cycle in action is SAMHSA's Addiction Technology Transfer Centers (ATTCs). In an interagency agreement with NIDA, each ATTC has received $100,000 from NIDA to perform technology transfer activities for the dissemination of new evidence-based knowledge specifically related to the results of NIDA research. Mr. Curie noted that in the wake of September 11, two interagency agreements between SAMHSA, NIDA and NIMH have been established. One will assess substance abuse and mental health-related responses in New York to the attacks on the World Trade Center. Another will identify best practices for screening and assessment of substance abuse and mental health disorders among disaster victims and response personnel. He also noted that SAMHSA's Center for Substance Abuse Prevention has provided $250,000 to NIDA in FY 2002, and will continue to do so for up to four years, to collaborate in the establishment and utilization of a research infrastructure to develop and test services models that integrate prevention, treatment and public health approaches for families in need of care. Mr. Curie concluded by adding that there are a number of other new collaborations under discussion, including one focused on adolescent residential treatment programs and another focusing on current serious and violent offender reentry. He also added that these are the first collaborative steps to help unlock the power of research knowledge to achieve the common good.

5. Fluctuations in Brain Temperature: From Stress to Drugs of Abuse - Dr. Roy Wise

   Mr. Millstein introduced Dr. Roy Wise, Chief, Behavioral Neuroscience Research Branch, Intramural Research Program, NIDA. Dr. Wise reported on research conducted by the Intramural Program on brain temperature fluctuations in laboratory rats during drug self-administration. Discrepant results were discovered using two methods to measure fluctuations of brain chemicals, the voltammetry method and the microdialysis method. Dr. Wise noted that NIDA was interested in knowing what the fluctuations were in the behaving animal. He commented that stress induces body hyperthermia and induces fever-like conditions in humans and laboratory animals. Since drugs of abuse are stressors, NIDA is interested in the degree to which drugs of abuse cause fluctuations in temperature. Of interest was how much fluctuations in brain temperature contribute to fluctuations in body temperature and the neurotoxicity associated with certain drugs of abuse, such as ecstasy or methamphetamines that cause brain damage particularly in overheated animals. Dr. Wise noted that NIDA was interested in understanding the fluctuations cause by drugs of abuse compared with the fluctuations a normal animal sees in its normal life. He reported that after self-administration of heroin, the brain temperature went up faster and further than the body temperature. The range of temperatures after cocaine self-administration is similar to those seen after sexual behavior or stress. He reported that the same dose of the drug given in a social setting becomes more lethal than if the drug is given to the animal in isolation. He noted that this was a prelude to studies recording single cell activity and the reward system of the brain. Dr. Wise concluded that NIDA was interested in actually measuring physical evidence of neurotoxicity and correlating it with the temperature changes that vary from one animal to the next.

6. Council Comments

   Mr. Millstein opened the floor to comments from Council. Council suggested that NIDA consider exploration of new research opportunities in advanced technologies, especially proteomics, bioinformatics and molecular imaging. Mr. Millstein commented that NIDA has several workgroups looking at new technologies and new ways of doing business. Another suggestion for emphasis was international drug use and the transmission of HIV and Hepatitis C in developing countries and in the United States.

7. Public Comments

   Mr. Millstein opened the floor to comments from members of the public. Susan Loveland from the American College Health Association noted the importance of including college-age students in national studies of drug and alcohol abuse.

The 82nd meeting of the National Advisory Council on Drug Abuse was adjourned at 2:40 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.

Teresa Levitin, Ph.D.