# Presentation: 818324

## State of DESPR Division Report

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

- January 25, 2006
- DESPR All-Hands Meeting

## integrated approaches 

**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 provides a 

**foundation for NIDA’s **
**Public Health Mission.**

- Providing a
- public health
- research
- foundation
- for drug abuse
- prevention
- and treatment

## NIDA

**NIDA**

**National Institute ****on**** Drug Abuse**

**Special Populations Office**

**EEO**

**Office of**
**Extramural **
**Affairs**

**Teresa Levitin, PhD**

**Office of Planning**
**& Resource**
** ****Management**

**Laura Rosenthal**

**Office of **
**Science Policy & **
**Communications**

**Timothy Condon, PhD**

**Center for the**
**Clinical Trials **
**Network**

**Betty Tai, PhD**

** ****Intramural **
**Research**
**Program**

**Barry Hoffer, MD, PhD**

**Office of the Director**

**Nora D. Volkow, MD**

** ****Director**

**Timothy P. Condon, Ph.D.**

**Deputy Director**

**Laura S. Rosenthal**

**Associate Director**
**for Management**

**Director, AIDS Research**

** ****Division of Clinical**
**Neuroscience, **
**Development &**
**Behavioral**
**Treatment**

**Joseph Frascella, PhD**

**Division of**
**Epidemiology, **
**Services & **
**Prevention Research **

**Wilson Compton, MD, MPE**

## DESPR:  2005 Major Research Questions

- What intrapersonal and environmental factors interact with each other and with genetic factors to cause drug abuse, addiction and outcomes such as HIV/AIDS?
- What novel ways to blend science and services will improve prevention and treatment outcomes?
- How can we measurably impact public health prevention and treatment outcomes?

## 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?
- How can we blend science and services to measurably impact public health outcomes?

## Epidemiology 2005 Key Research Question

- What are the specific interactions between individual (genetic, biologic, psychiatric, temperament, etc.) and environmental (familial and larger social contexts, including physical or built environment) factors in the etiology of drug abuse (and sexual risk behaviors/consequences)?

## Epidemiology 2006 Key Research Goals

- Maximize Return on Investments
- Expand Our Focus on Translation Research
- Interactions of intrapersonal and environmental factors
- Translation of epidemiology research into clinical interventions

## Services 2005 Key Research Questions

- Is the quality of drug abuse treatment delivered in usual routine care settings adequate, appropriate, and cost-effective?  Can the design and implementation of drug abuse treatment in routine care be improved?
- What is the most effective role of faith and spirituality in treating drug abuse?  What is the mechanism of action?

## Services 2006 Key Research Goals

- Improve the QUALITY of care, through research on:
- Financing
- Technology
- Workforce

## Prevention 2005 Key Research Questions

- What specific factors (e.g., intra-individual, contextual, program) account for long-term and cross-over prevention effects?
- Can the prevention effect sizes be improved by tailoring interventions to account for factors such as learning style, timing of onset of problem behaviors, and constellation of problem behaviors?
- Do prevention program have the potential to prevent health disparities in drug abuse and HIV/AIDS?

## Prevention 2006 Key Research Goal

- Develop and maximize use of high quality preventive interventions in real world settings through research on
- Individual factors
- Relationship of drug abuse prevention to HIV prevention
- Environmental strategies
- Community-based participatory research

## DESPR Goals and Plans 2005

| Goal | 2 Year Plans | 5 Year Plans |
| --- | --- | --- |
| Study Interactions | Phenotype Studies
Pathways
SATH-CAP | Nesting/Bridging 
Trans-NIH Wellness
CJ-HIV Disparities |
| Blend Science and Services | State/Community Infrastructure
Define EBPs | Studies in Existing Progams:  SPF-SIG, CTN, CJ-DATS, ATTCs, etc. |
| Measurably  impact Outcomes  | Prevention Services
Chronic Illness Models | Collaborate (NCI, NHLBI, States, CBOs, SAMHSA, etc.) |

## DESPR Goals and Plans 2006

| Goal | 2 Year Plans | 5 Year Plans |
| --- | --- | --- |
| New Theories | Phenotype Studies
Meetings and PA
TPRCs
 | New Paradigms from Longitudinal Epi, Basic Science and elsewhere |
| Study Interactions | Pathways
SATH-CAP
CJ-HIV Disparities | Nesting/Bridging 
Trans-NIH Wellness
 |
| Blending  Science and Services / Impact Outcomes | State/CBO RFAs
Defining EBPs 
Prevention Services
Chronic Illness Models | Studies in Existing Progams:  SPF-SIG, CTN, CJ-DATS, ATTCs, etc. 
Collaborate (NCI, NHLBI, States, etc.) |

## And now...DESPR’s FINDINGS OF THE YEAR!!!

## Cigarette Smoking Declines Markedly Since Mid-1990’s

_**ERB**_**:**

## Life Course View of Addiction Refines Understanding of Recovery & Benefit Cost

_**SRB**_**:**

**Notes:**
MacLeod and colleagues demonstrated in a RCT significant differences in 90-day continuous abstinence rates, with the combination treatment showing greater efficacy than NRT alone at both 3 months and 6 months. 

Zhu also studied the California quitline as an adjunct to NRT, but the control group was not compelling (those who dropped out of the counseling program).

Sydney, Australia

## PRB:

**Universal Family-based Prevention Interventions Reduce Methamphetamine**

_**PRB**_**:**

## DESPR:

_**DESPR**_**:**

## What resources do we have to support our goals in FY2006?

- Monetary resources
- 	2.  Human resources

## Environmental Challenges/Opportunities

- New NIDA Organization
- Budget REDUCTIONS
- NIH Roadmap
**Staff Departures**
- Brown
- Cartwright
- Conway
- Davenny
- Erinoff
- Martin
- Seitz

**Staff Arrivals**
- Denisco
- Hijjawi
- Lehman
- Nutt
- Rugh
- Sims

## FY 2005 Set Aside Programs ($3.3m total)

- HIV/AIDS Among AA Drug Users in Criminal Justice
*	**	**FY05 $0.5m Supplements**	*
- Secondary Analysis of NESARC and NSPY
- 	*FY05 $1.8m RFA with NIAAA*
- State Agency Diffusion Research
- 	*FY05 $1.0m RFA **	**	*

## FY 2006 Set Aside Programs 

**($13.6m total *****WITH MULTIPLE PARTNERS*****)**

- Enhancing Practice Improvement in Community-Based Care
*	**	****FY06 $1.9m RFA with SAMHSA and NIMH***
- Non-Injection Drug Abuse and HIV/AIDS
- 	***FY06-08 $3.0m PASs***
- Social Neuroscience
- 	***FY06-08 $3.0m***
- Prescription Opioid Use and Abuse in the Treatment of Pain
*	****FY06 $5.7m RFA with NIA and NIDCR****	*
- Illicit Drug Markets
- 	***FY06 $1.0 RFA with NSF***

## Future Monetary Resources :  

***Where will the money come from?***

***“******Trimmable” Areas:***
- Well-developed Prevention Programs
- Stand-alone descriptive epidemiology
- Non-experimental outcome studies
- Services studies on the influence of social and individual factors on access and utilization of services

## Human Resources, N = 37 + DEAS

**PREVENTION RESEARCH BRANCH (10)**
**Chief**
**Deputy**
** ****7 Scientific Staff (1 Recruit + 2 TBD) + 1 Contractor**

**EPIDEMIOLOGY RESEARCH BRANCH (11)**
**Chief**
**Deputy**
**9 Scientific Staff (3 Recruits)**

**SERVICES RESEARCH BRANCH **
**(10)**
**Chief**
**Deputy**
** ****7 Scientific Staff (1 TBD) + 1 Contractor**

**OFFICE OF THE DIRECTOR (6)**
**Director**
**Deputy Director**
**Associate Director**
**Senior Scientist**
**Statistician**
**TBD**
**1 Support Staff**

**WORKGROUPS**
- AIDS/HIV
- Health Disparities
- Translational Research
- Research Training

## Workgroups for 2006 to Achieve 

**DESPR’s Goals**

- AIDS/HIV:  _Lambert_, Campbell, Flanzer, Jones, Reider
- Health Disparities:  _Jones_, Campbell, Crump, Rugh
- Translational Research:  _Ginexi_, Pringle, Etz, Denisco
- Research Training:  _Bukoski_, Crump, Etz, Flanzer
*	*_*CROSS NIDA and CROSS NIH GROUPS!*_

## Selected Meetings for 2006

**DESPR Research Training Institute**
**Mapping Drug Abuse:  AAG Satellite Meeting**
**State RFA Grantees and NASADAD**
**Opioid Abuse and Pain.**
**Children of Criminal Justice Involved Parents**
**Drug Courts**
**Social Epidemiology in the Neuroscience Era**
**Disasters**
**Trajectories**

## Scientific Challenges to DESPR Staff

- How can we handle the difficult funding environment?
- How can we integrate our work with basic neurosciences and genetics more effectively, (in *both* Type 1 and Type 2 translation)?
- How can we develop, adopt and test innovative theories in the studies we support?

## Personal Challenges to DESPR Staff

- How will your program support the NIDA and DESPR priorities?
- How are you “making your mark” on the field?
- How can our leadership support the staff and the scientists in our field?

## Summary

- Talented and hard-working staff developing innovative programs of public health drug abuse research can be very successful.

- The challenges are great, uncertainties loom ahead, and opportunities abound.

## The State of DESPR is Strong!

## Division of Epidemiology, Services and Prevention Research

*Providing a foundation for NIDA’s public health mission.*