Pathways of Addiction Opportunities in Drug Abuse Research (1996) / Chapter Skim
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Executive Summary
Executive Summary
Pages 1-12
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Those mechanisms include: stable funding; use of a comprehensive public health framework; wider acceptance of a medical model of drug dependence; better translation of research findings into practice; raising the status of drug abuse research; and facilitating interdisciplinary research. The ultimate aim of the nation's investment in drug abuse research is to enable society to take effective measures to prevent drug use, abuse, and dependence, and thereby reduce adverse individual and social consequences and associated costs.
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Although the committee uses the term drug in its generic sense, to encompass alcohol and nicotine, the report focuses, at NIDA's request, on research opportunities relating to illicit drugs; research on alcohol and nicotine is discussed only when the scientific inquiries are intertwined. Because the report sometimes ranges more broadly than illicit drugs, how
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Behavioral models are useful for developing drug abuse pharmacotherapies; improving treatment engagement and compliance; developing novel procedures for both strengthening weak positive behaviors and attenuating strong drug-related behaviors; addressing questions related to mechanisms of craving and relapse; and promoting better understanding of drug use over the life span of drug users. Increased understanding of various drugs' mechanisms of action can also lead to better understanding of behavior and of vulnerability to
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By utilizing increasingly sophisticated research techniques and methods, future neurobiological studies at all levels of inquiry -- molecular, cellular, and system -- will provide essential information for developing drug abuse treatment and prevention measures. Advances in neuroscience have shown that pain and addiction research have more in common than a shared clinical pharmacology.
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Research should be supported in the following areas: developing better animal models of the motivational aspects of drug dependence (with particular emphasis on protracted abstinence and propensity to relapse) ; genetics research; brain imaging; the neuro biology of co-occurring psychiatric disorders and drug abuse; ani mal models of the effects of HIV infection on the brain; the neuro toxicity of drug dependence; immunological approaches to drug abuse treatment; and pain and analgesia.
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Research areas should include the role of the following: family factors in the etiol ogy of drug use and abuse; psychopathology as a precursor to drug use and abuse in adolescents and adults; risk and protective factors related to drug use and abuse, especially during discrete develop mental stages; and childhood risk and protective factors that are associated with adult drug abuse and dependence. PREVENTION Drug abuse prevention research parallels recent trends in mental and physical health promotion and the emerging new discipline of prevention science.
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CONSEQUENCES The ramifications of drug abuse extend far beyond the individual drug abuser, because the health and social consequences of drug abuse -- HIV/AIDS, violence, tuberculosis, fetal effects, crime, and disruptions in family, workplace, and educational environments -- have devastating impacts on society and exact a cost of billions of dollars annually. The committee focused on three areas that involve pronounced social consequences and where the need for strategic preventive interventions are greatest: (1)
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Specifically, epidemiological studies of the prevalence and correlates of HIV infection in vulnerable populations of drug users and IDUs; and studies of effective risk reduction strategies for changing sexual risk behaviors and drug injection behaviors are needed. Fetal and Child Development Drug abuse can have a significant impact on the health of children who either are exposed to nicotine, alcohol, or illicit drugs, prenatally through maternal drug abuse or grow up in a drug-abusing household.
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The committee recommends that the appropriate federal and pri vate agencies continue to support research to improve and evaluate the effectiveness of drug abuse treatment. This includes studies on optimal strategies for matching patients to the most appropriate treatment modalities; development of medications for the treatment of drug abuse and dependence; the efficacy of pharmacotherapies and psychosocial therapies to treat individuals with co-occurring
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In response to the escalating costs of treatment, managed drug abuse care proposes to contain costs, increase access, and ensure quality. It entails many changes from traditional fee-for-service coverage, including changes in the organization, financing, and delivery of services -- most recognizably through case management which seeks to match patients to the most appropriate, yet least restrictive, treatment setting.
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, and other public and private sponsors of drug abuse research to incorporate policy-relevant studies of drug control within a com prehensive scientific agenda. This report sets forth drug abuse research initiatives for the next decade based on an assessment of what is now known and a calculated judgment about what initiatives are most likely to advance our knowledge in useful ways.
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Prepared for the Office of National Drug Control Policy, Washington, DC. SAMHSA (Substance Abuse and Mental Health Services Administration)
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