# Presentation: 572106

## Linking Public Health Research to Neuroscience

**Linking Public Health Research to Neuroscience**

**Wilson M. Compton, M.D., M.P.E.**
**Director, Division of Epidemiology, Services and Prevention Research**
**National Institute on Drug Abuse**

**CALDAR Summer Institute**
**14 August 2006**

## Priority Areas for NIDA

**Priority Areas for NIDA**

## DESPR Organization and Vision

**DESPR seeks to improve **
**the nation’s public health by **
**promoting **_**integrated approaches**_** to **
**understand and address **_**interactions**_** **
**between individuals and environments **
**that contribute to the **_**continuum of problems**_** **
**related to drug use.*****  ***
***Our goal is to develop scientific knowledge with clear application to ***_***practice and public policy***_***.***

## DESPR:  2006 Major Research Questions

- What new theoretical approaches can inform our research?
- What intrapersonal and environmental factors interact with each other and with genetic factors, across development?
- How can we blend science and services to measurably impact public health outcomes?

## Methods of the NESARC:

- N = 43,093
- Response rate: 81%
- Nationally-representative survey of adults (age 18+)
- Over-sampling of Blacks, Hispanics/Latinos, young adults
- Reliable and valid questionnaire:  AUDADIS
- Longitudinal: second wave July 2004 – Fall 2005

***National Survey of Alcohol and Related Conditions (NESARC)***

## Illicit Drug Use Disorders:Lifetime and 12-Month Abuse/ Dependence 

**%**

## Addiction is a Developmental Disorder:  Onset is During Adolescence

## Implications?  

***Implications?  ***
***Links to Neuroscience?**** *

## Recent Studies Have Shown that Maturation of the

**Brain areas where volumes**
**are smaller in adolescents than young adults  **

***Source: Sowell, E.R. et al., Nature Neuroscience, 2(10), pp. 859-861, 1999***

**Recent Studies Have Shown that ****Maturation**** of the**
**Brain’s Gray Matter Moves from ****Back to Front**** **

## Amygdalo-cortical Sprouting Continues 

***Source:  Cunningham, M et al., J Comp Neurol 453, pp 116-130, 2002.***

**Amygdalo-cortical Sprouting Continues **
**Into Early Adulthood**

**Low-power light photomicrographs of immunoperoxidase-labeled, biocytin-containing **
**amygdalofugal varicose fibers within the mPFC of animals at 6 stages of development**

***During Adolescence the ***
***COGNITION-EMOTION ***
***Connection is Still***
***Undergoing Development***

## In Adults, Emotional Self Regulation Is Normally

**Sexual Arousal Condition**

**Attempted Inhibition Condition**

**Attempted Inhibition**
** ****Condition**

**In Adults, Emotional Self Regulation Is Normally**
**Implemented By A Neural Circuit Comprising**
**   ****Various *****Prefrontal Regions*****...**
** **
**                                        ****& *****Subcortical ***
***                                              ******Limbic Structures***

## Animals Pre-Exposed to Nicotine During 

**During A Between Session **
**Progressive Ratio Schedule for **
**Nicotine Self Administration**

**Animals Pre-Exposed to Nicotine During **
**Peri- and Post-Adolescence Differed  **

**For Transcript Levels of Different**
**Subunits of the nAChRs in **
**the Ventral Midbrain**

## What about Socio-Demographic Correlates of Abuse and Dependence?

## Illicit Drug Use Disorders: Lifetime and 12-Month Odds Ratios for Sex

**O.R.**

## Illicit Drug Use Disorders: Lifetime and 12-Month Odds Ratios for Race/Ethnicity

**O.R.**

## Illicit Drug Use Disorders: Lifetime and 12-Month Odds Ratios for Age

**O.R.**

## Illicit Drug Use Disorders: Lifetime and 12-Month Odds Ratios for SD Factors

**O.R.**

## Illicit Drug Use Disorders: Lifetime and 12-Month Odds Ratios for SD Factors

**O.R.**

***Education***

***Income***

## Implications of 

***Socio-Demographic Correlates?**** *

## Potential Causes of Trends?

***NESARC v. NLAES: Increases in ***
***Marijuana Abuse/Dependence***

## Environmental Phenotyping Communities as a Possible Link to Genetic Research?

***Gene environment interactions are likely to be key!***

**Environmental Phenotyping Communities as a Possible Link to Genetic Research?**

**Risk Factors:**
**Family Conflict**
**Poor Parental Supervision**
**Low School Commitment**
**Community Instability**

## Effects of a Social Stressor on Brain Dopamine D2 Receptors and Propensity to Administer Drugs

**Individually**
**Housed**

***Morgan, D. et al. Nature Neuroscience, 5: 169-174, 2002.***

**Effects of a Social Stressor on Brain Dopamine D2 Receptors and Propensity to Administer Drugs**

- National Institute on Drug Abuse, 8/00

## Treatment/Help Seeking for Drug Use Disorders

## Treatment/Help Seeking for Lifetime Drug Abuse and Dependence 

**%**

## Lifetime Probability of Treatment/Help Seeking for Drug Abuse/Dependence

## Treatment/Help Seeking for Lifetime and 12-Month Drug Abuse/ Dependence (1)

**%**

**Treatment/Help Seeking for Lifetime and 12-Month Drug Abuse/ Dependence (1)**

## Treatment/Help Seeking for Lifetime and 12-Month Drug Abuse/ Dependence (2)

**Treatment/Help Seeking for Lifetime and 12-Month Drug Abuse/ Dependence (2)**

**%**

## Implications?  

***Implications?  ***

## Circuits Involved In 

**Circuits Involved In **
**Drug Abuse and Addiction**

**All Should Be Considered In**
**Strategies to Prevent and **
**Treat Addiction**

## Cocaine Craving:

**Cocaine Film**

**Cocaine Craving:**
**Population (Cocaine Users, Controls) x Film (****cocaine**** )**

**Garavan et al A .J.  Psych 2000**

**IFG**

**Ant Cing**

**Cingulate**

**Signal Intensity (AU)**

**Controls      Cocaine Users**

## Cocaine Craving:

**Cocaine Craving:**
**Population (Cocaine Users, Controls) x Film (****cocaine****, ****erotic****)**

**Garavan et al A .J.  Psych 2000**

**IFG**

**Ant Cing**

**Cingulate**

**Signal Intensity (AU)**

**Controls      Cocaine Users**

## Slide 32

## Summary

- Linking epidemiology and other public health to neuroscience is essential to understanding the etiology of drug addiction and to improving treatment and prevention interventions.
- BUT ...

## Summary

- Linking public health and basic research is more than putting the studies side by side.  Linking the work requires systematic extension of our methods, theories and

***Are you ready for this paradigm shift?***

**extraordinary *****creativity*****.**

## Summary: Drug Abuse Research Needs a Systems Approach

**DRUGS **
**OF **
**ABUSE**

***Summary:***** Drug Abuse Research Needs a Systems Approach**

***Epidemiology provides contexts and targets.***

**social**

**genome**

**protein expression**

**neuronal circuits**

**behavior**