presented by Nora D. Volkow, M.D., Director, National Institute on Drug Abuse National Institutes of Health Department of Health and Human Services
Testimony Before the House Subcommittee on Labor-HHS-Education Appropriations
Mr. Chairman and Members of the Subcommittee:
I am pleased to present the President’s fiscal year (FY) 2016 budget request for the National Institute on Drug Abuse (NIDA) of the National Institutes of Health (NIH). The FY 2016 budget request for NIDA is $1,047,397,000, which is $31,692,000 more than the FY 2015 level.
As a part of NIH, the Nation’s premier biomedical research agency, NIDA has the mission to bring the power of science to bear on drug abuse and addiction. NIDA’s research is strategically designed to respond to emerging national trends and scientific opportunities to rapidly conduct and effectively disseminate research, to improve prevention and treatment, and inform policy as it relates to substance use and addiction. For example, as you are aware, the Nation is in the midst of an epidemic of opioid abuse, which resulted in close to 25,000 overdose deaths, from both prescription opioids and heroin, in 2013. NIDA is working closely with its Federal partners on the Secretary of Health and Human Services’ Action Plan to address opioid-drug related overdoses and deaths by supporting a broad portfolio of research to improve opioid prescribing practices; enhance naloxone (an overdose antidote) development, access, and distribution; and expand the use of medication assisted treatment for opioid addiction. Another current public health priority for NIDA involves the rapidly changing landscape of State marijuana policies. NIDA is supporting a robust portfolio of research to understand the impact of these changes on public health and ways to prevent marijuana use among youth and treat cannabis use disorders that may increase in response to these shifting policies.
To help answer critically important questions about the impact of substance use on the structure and function of the developing brain and its consequences on physical and mental health, cognition, decision making, and risky behaviors, NIDA is partnering with a number of other NIH Institutes on the Adolescent Brain Cognitive Development (ABCD) study – a landmark longitudinal study to prospectively examine the neurodevelopmental and behavioral effects of substance use from pre-adolescence (ages 9-10) until young adulthood, the decade of greatest risk for substance use initiation. This study, unprecedented in scope and ambition, will utilize the latest neuroimaging and behavioral assessment tools in order to examine relationships among various genetic, environmental, and developmental variables and potentially lead to improvements in the precision of substance use prevention and treatment interventions. Allow me to briefly elaborate on our plans for FY 2016 in four major areas of research that capture the breadth of NIDA’s focus.
NIDA strongly believes in the value of basic research, which provides foundational knowledge upon which we build our understanding of health and disease to support the development of better prevention and treatment interventions. In FY 2016, NIDA will continue to partner with other NIH Institutes on the President’s BRAIN Initiative, a bold multi-agency effort that is already accelerating the development and application of advanced technologies that will revolutionize our ability to visualize and interrogate the circuitry and functioning of the human brain. These advanced technologies will allow researchers to elucidate both the impact of drug use on the brain and the neural basis of substance use disorders at the molecular and circuit level. This foundational knowledge will allow researchers to understand how genetic, epigenetic, behavioral, and environmental factors influence an individual’s vulnerability for addiction and other related modalities including pain and mental illness. This initiative will ultimately feed into the President’s new Precision Medicine Initiative, supporting the development of interventions such as transcranial magnetic stimulation (TMS) or deep brain stimulation targeted to an individual’s unique neurobiological and genetic profile.
Clinical and Translational Science
Scientific advances are accelerating our ability to elucidate the complex risk and protective factors that influence substance use and related disorders, which will enhance the effectiveness and precision of interventions and treatments for individuals with diverse needs. An urgent goal in this context is the development of new and more effective medications. Because progress in this area is often hindered by the cost and time required to develop neuroactive medications and a lack of engagement by the pharmaceutical sector in this field, NIDA is fostering synergistic alliances to spur translational research. This initiative supports research that will advance pharmaceuticals toward Food and Drug Administration approval by leveraging the combined strengths and resources of NIDA and outside organizations including academic institutions, pharmaceutical and biotechnology companies, private foundations, and small businesses. For example, NIDA is collaborating with pharmaceutical companies to evaluate the efficacy of a repurposed weight loss medication, lorcaserin, for the treatment of substance use disorders and to develop an abuse deterrent formulation of the widely abused painkiller Oxycontin, using pro-drug technology.
Substance use disorders and other drug-use-related harms remain prevalent. It is critical to ensure that scientific advances are translated into improvements in public health. In FY 2016, NIDA will continue to work closely with Federal and non-governmental partners to support the dissemination and application of promising findings and evidence-based strategies. For example, NIDA will continue to support its NIDAMED initiative to educate health care professionals on identification, prevention, and treatment of substance use disorders with a particular focus on adolescents.
Another focus for NIDA is enhancing the national research infrastructure to support advancements in science by fostering a diverse and talented biomedical workforce trained to efficiently leverage scientific and technological advances that can improve our ability to mitigate, prevent, or even reverse the effects of substance abuse. In FY 2016, NIDA will continue its commitment to being at the forefront of training the next generation of innovative researchers by supporting both pre-doctoral and postdoctoral-level scientists and by working to increase the number of underrepresented researchers in the drug abuse field, including women and minorities, through our sponsored career development and research training opportunities. NIDA will continue to actively support the NIH-wide Big Data to Knowledge (BD2K) R25 program and the Avenir Award program to support education and training of the scientific workforce to meet the Nation’s evolving biomedical research needs.
Drug use and addiction are complex conditions. The FY 2016 budget request will allow NIDA to support cutting-edge research that takes advantage of the most powerful technologies and latest emerging opportunities to advance our understanding of substance use and addiction and its prevention and treatment.