Objective 3.1: Develop and test novel treatments based on the science of addiction
Recent advances in our understanding of the genetic, epigenetic, and neurobiological mediators of addiction have led to the identification of a range of potential therapeutic targets. New interventions are particularly needed for SUDs, such as cocaine, methamphetamine, and cannabis use disorders91, for which there are currently no FDA-approved medications. In addition, developing new and improved treatment options for opioid use disorders remains a high priority due to the scope of the current opioid overdose epidemic.47 NIDA will focus on supporting a robust translational pipeline of compounds, biologics, and nonpharmacological interventions (e.g., TMS, behavioral interventions) to be developed as potential treatments for SUDs.
President Obama’s new Precision Medicine Initiative aims to develop the research infrastructure to begin to delineate individual biological factors that contribute to treatment outcomes. This initiative will set the groundwork for developing treatment strategies based on a person’s unique DNA profile to achieve the greatest health benefit with fewer side effects (pharmacogenomics). Research has identified genetic variations that influence response to drugs as well as risk for SUDs, including genes for enzymes that metabolize drugs, neurotransmitter receptors and transporters, and enzymes that mediate neurotransmitter synthesis or degradation.50,105,106 Understanding how genetic variations contribute to response to treatment will support the development of better-targeted therapeutic interventions.
Approaches
- Build upon discoveries from basic science to develop and test new medications and behavioral treatment interventions that specifically target the underlying neurobiological mechanisms of SUDs
- Develop and test novel nonpharmacological approaches to treat SUDs
- Expand testing of pharmacogenomic approaches for treating SUDs
- Explore how health care technologies can be used to improve patient identification, diagnosis, and personalized treatment