Professional Documents
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Priority Areas For NIDA: Prevention Research
Priority Areas For NIDA: Prevention Research
Treatment Interventions
(New Targets & New Strategies)
HIV/AIDS Research
Addiction is a Developmental Disease:
It Starts Early
100 67%
26%
10 5.5%
1.5%
1
Child Teen Young Adult Adult
<12 12-17 18-25 >25
Basic Science Tells Us that Adolescents’
Brains Are Still Developing…
MRI Scans of Healthy Children and Teens Over Time
Copyright ©2004 by the National Academy of Sciences Gogtay, Giedd, et al. (2004) Proc. Natl. Acad. Sci. USA 101, 8174-8179
When Reading Emotion…
Adults Rely More on the Frontal Cortex
While Teens Rely More on the Amygdala
30
* *
20
10
Becomes Subordinate
Stress remains
0
S.003 .01 .03 .1
Cocaine (mg/kg/injection)
Morgan, D. et al. Nature Neuroscience, 5: 169-174, 2002.
What Other Environmental
Factors Contribute to Addiction?
•Psychosis
•Depression
•Anxiety
•Panic attacks
Treatment Interventions
(New Targets & New Strategies)
HIV/AIDS Research
Why Can’t Addicts Just Quit?
Non-Addicted Brain Addicted Brain
Control
Control
Memory Memory
Pharmacological
Behavioral Therapies
(medications)
In Social Context
Treatment Can Work
We Are Using Science to
Develop Even Better Treatments
100
90
Percent of Patients Who Relapse
80
70
60
50
40
50 to 70%
50 to 70%
40 to 60%
30 to 50%
30
20
10
0
Drug Type I Hypertension Asthma
Addiction Diabetes
McLellan et al., JAMA, 2000.
Addiction is Similar to Other
Chronic Illnesses Because:
Therefore…
Full recovery is a challenge
but it is possible …
[C-11]d-threo-methylphenidate
high
with prolonged
abstinence from
methamphetamine
Methamphetamine Abuser
(1 month detoxification) low
Methamphetamine Abuser
(24 month abstinent)
Volkow et al., J. Neuroscience, 2001.
Treatment Reduces Drug Use and Recidivism
Delaware Work Release Therapeutic Community (CREST) + Aftercare
3 Years After Release (N=448)
p < 0.05,
compared to No Treatment group
Percentage of Participants
Drug-Free Arrest-Free
In Treating Addiction…
We Need to Keep Our Eye on
the Real Target
Priority Areas for NIDA
Prevention Research (Children & Adolescents)
genetics
environment
development
co-morbidity
Treatment Interventions
(New Targets & New Strategies)
HIV/AIDS Research
Drug Use Has Played a Prominent
Role in the HIV/AIDS Epidemic
In Several Ways
Disease Transmission
• IV Drug Use
• Drug User Disinhibition Leading to
High Risk Sexual Behaviors
Progression of Disease
Acceleration of HIV Degeneration of
Dopamine Cells With Cocaine
40
Injection drug use
30
20 Heterosexual contact
0
1985 1987 1989 1991 1993 1995 1997 1999 2001 2003
Year of Diagnosis
Source: Centers for Disease Control and Prevention (CDC)
NIDA International
Program Components
Information Dissemination
Why focus on drug abuse
internationally?
I. Drug abuse is a global 15.9
phenomenon 13.7
7.9
Millions of Users
Cannabis
Amphetamines
5 percent of people aged 15-64 26.2 Ecstasy
Cocaine
Opiates
160.9
II. Intertwined dual-epidemics of
UNODC 2005 World Drug Report
drug addiction & HIV/AIDS
www.drugabuse.gov