June 14–17, 2013
San Diego, California
NIDA Director Nora D. Volkow, M.D., opened the 18th Annual National Institute on Drug Abuse (NIDA) International Forum, reviewing the Institute’s international research priorities, binational agreements, and research training fellowships. Dr. Volkow highlighted the global reach of the six NIDA International Program fellowships, which have supported 408 drug abuse professionals from 103 countries, and invited suggestions on how to increase the impact of the research training fellowships. She added that there has been a lack of qualified candidates for the NIDA Hubert H. Humphrey Drug Abuse Research Fellowships recently and asked participants to encourage applications from their colleagues.
NIDA International Program Director Steven W. Gust, Ph.D., chaired the meeting, which was cosponsored by the Australasian Professional Society on Alcohol and Other Drugs (APSAD) and focused on research partnerships that successfully design, test, evaluate, and implement evidence-based drug abuse interventions and policies. More than 285 participants from 52 countries attended the meeting June 14–17, 2013, in San Diego, California. A joint College on Problems of Drug Dependence (CPDD)/NIDA International Forum poster session featured presentations on international research by 139 scientists from the United States and 39 other countries.
Adrian Dunlop, M.B.B.S., Ph.D., past president of APSAD, described the multidisciplinary organization’s efforts to promote substance abuse research, improve clinical practice standards, and disseminate research findings throughout the Asia Pacific region. The chair of the CPDD International Committee, Jan Copeland, Ph.D., University of New South Wales, Australia, announced that CPDD would expand its support of the WHO/NIDA/CPDD International Traveling Fellowship in 2014 by providing CPDD registration to the fellow for 3 years. Dr. Copeland encouraged participants to take advantage of the networking opportunities provided by the NIDA International Forum and the CPDD meetings to prepare their applications for the International Traveling Fellowship, saying that she had developed her best collaborations and most enduring support through scientists she met during the meetings.
Awards of Excellence
NIDA International Awards of Excellence, which recognize individuals for outstanding contributions to international cooperation in drug abuse research and training, were presented for:
- Excellence in mentoring, to Wendee M. Wechsberg, Ph.D., who directs the Substance Abuse Treatment Evaluations and Interventions research program at RTI International.
- Excellence in international leadership, to Vladimir Poznyak, M.D., Ph.D., who coordinates the World Health Organization (WHO) Management of Substance Abuse Programme.
- Excellence in collaborative research, to Yih-Ing Hser, Ph.D., who directs the Center for Advancing Longitudinal Drug Abuse Research at the University of California, Los Angeles (UCLA), and to Min Zhao, M.D., Ph.D., who is vice president of the Shanghai Jiao Tong University School of Medicine in China.
Plenary Session Panel Discussions
The plenary session also featured updates on new collaborations and research initiatives from WHO, the European Research Area Network on Illicit Drugs (ERANID), and the Italian Department of Anti-Drug Policies and two plenary panel discussions on: (1) using performance and outcome data to assess treatment services; and (2) the role of Cochrane Collaboration systematic reviews of evidence-based interventions on international treatment guidelines and U.S. health care reform.
During the collaboration updates discussion, Dr. Poznyak noted that illicit drug use is now among the top 20 risk factors for the global burden of disease, and that the combined burden caused by tobacco, alcohol, and illicit drug use is larger than any other risk factor. He summarized WHO priorities for mental health and substance use disorders, including improving health information systems, evidence, and research; increasing access to services; and facilitating public health aspects of policy discussions. New tools include a discussion paper on preventing and reducing opioid overdose mortality; guidelines for identification and management of substance use in pregnancy that will be released in early 2014; and the forthcoming revision of the International Statistical Classification of Diseases and Related Health Problems (ICD), ICD-11. Claudia Rimondo, M.A., Italian Department of Anti-Drug Policies, reviewed activities undertaken through the binational agreement between NIDA and Italy. She also introduced the Global Community on Neuroscience of Addiction, which brings together researchers, clinicians, prevention and recovery professionals, and policymakers to share information, scientific protocols, methods, and good practices in addiction neuroscience. Els van Gessle, M.A., M.Sc., Netherlands Organisation for Health Research and Development (ZonMw), coordinates the ERANID association of funding agencies and associated partners that represents 12 organizations in 11 countries. ERANID will fund joint research projects to improve the accessibility of research findings and facilitate adoption of evidence-based policies related to drug use, including demand and supply reduction. The first call for applications will be issued in 2014.
Richard A. Rawson, Ph.D., UCLA, and Traci Rieckmann, Ph.D., Oregon Health & Science University, co-chaired the panel on how treatment programs use data on patient characteristics, program services, perceptions of care, patient outcomes, and program performance to evaluate their services. Bronwyn Myers, Ph.D., Medical Research Council of South Africa, described how a service quality measurement project was pilot tested and engaged stakeholders, government agencies, and service providers to build support and capacity for nationwide implementation. Brian Rush, Ph.D., Canadian Centre for Addiction and Mental Health, discussed the development and implementation of a provincial monitoring system in Ontario that combines within-treatment assessment of client progress with continuous posttreatment follow-up to encourage clients to return to treatment if necessary. The system provides valuable information for both addiction researchers and community treatment providers. Desiree Crevecoeur-McPhail, Ph.D., UCLA, reported on how one U.S. county standardized data collection and helped service providers understand and accept the data to implement performance measures, benchmarks, and process improvement plans for addiction treatment programs. Nguyen Nhu, M.D., Ph.D., FHI360/Vietnam, reviewed how patient-level variables and coordinated care measures helped to improve HIV/AIDS and addiction treatment in Vietnamese methadone maintenance treatment programs.
Robert Ali, M.D., University of Adelaide School of Medical Sciences, described the mission of the independent, nonprofit Cochrane Collaboration and the Cochrane Drug and Alcohol Group (CDAG). CDAG provides a standardized, systematic way to review evidence from studies of substance abuse prevention, treatment, and rehabilitation interventions, identifying effective and ineffective interventions and suggesting areas where further research is required. Linda Gowing, Ph.D., University of Adelaide, described how evidence was assessed by two CDAG reviews of opioid withdrawal medications. The reviews concluded that buprenorphine was effective and antagonists administered under heavy sedation or anesthesia were ineffective in treating opioid withdrawal. Walter Ling, M.D., UCLA, chaired the panel and concluded by describing the potential role of CDAG reviews in meeting the increased demand for services and evidence-based clinical practice guidelines that will be prompted by changes in U.S. health care laws.
In addition to the plenary and poster sessions, six breakout sessions explored aspects of evidence-based addiction treatment in more depth:
- What Is SBIRT and Why? – Redonna Chandler, Ph.D., NIDA Division of Epidemiology, Services and Prevention Research, and Geetha Subramaniam, M.D., NIDA Center for the Clinical Trials Network (CCTN), co-chaired a session on the effectiveness of screening, brief intervention, and referral to treatment (SBIRT). Speakers reviewed the need for more comprehensive SBIRT approaches that address alcohol, drugs, and HIV/AIDS that are suitable for use in emergency departments, primary care settings, and with adolescents; improved screening tools; physician training programs for SBIRT and other substance use treatment protocols; and ways data from electronic health records can benefit researchers, clinicians, and patients.
- International Networking and the Global Need for Data in Drug Policy – NIDA International Program Associate Director Dale S. Weiss and J. Randy Koch, Ph.D., Virginia Commonwealth University, co-chaired the NIDA International Networking Session. Speakers discussed the International Society of Addiction Journal Editors writing mentorship program, the role of drug abuse in the global burden of disease, and how increased attention to the burden of noncommunicable diseases provides opportunities to discuss the global public health impact of substance abuse. Panelists from the Czech Republic, Israel, Mexico, and Russia provided examples from their regions on how policies can improve drug abuse prevention, treatment, and research.
- AAPI-ACTION: Advancing Clinical Translation, Innovations, Opportunities, and Networks – Linda Chang, M.D., University of Hawai’i, chaired this session about initiatives to advance translational research, training, and international collaboration among Asian American/Pacific Islander (AAPI) scientists, clinicians, and community members. Speakers reported on risk reduction counseling for Taiwanese methadone patients, HIV vaccine development research in China, the 2013 Global Health Prevention and Treatment Conference, and initiatives supported by the NIDA AAPI Researchers and Scholars Work Group.
- Advancing the International Uptake of State-of-the-Art Addiction Medicine Into Clinical Practice – Jeffrey Samet, M.D., M.A., M.P.H., Boston Medical Center, chaired a discussion of strategies adopted by different countries to disseminate and promote adoption of evidence-based clinical practices. Speakers reviewed a Canadian fellowship program accredited by the American Board of Addiction Medicine; an Australian approach that supports experts’ international training and collaborative research with partners in low- and middle-income countries; NIDA tools for clinical practice, physician training, and continuing medical education; and a NIDA-funded Chief Resident Immersion Training program that improves chief resident physicians’ substance use knowledge, clinical practice, and teaching skills.
- Using the CTN Model To Improve Treatment – Petra Jacobs, M.D., and Carmen Rosa, M.S., CCTN, co-chaired a discussion of the Clinical Trials Network (CTN) accomplishments, INVEST/CTN Fellowship, and collaborative research on CTN protocols being conducted in Canada, China, Italy, Mexico, and Peru. Canadian speakers described the Urban Health Research Initiative/CTN partnership investigating Vivitrol to treat opioid dependence and the newly created Canadian Research Initiative in Substance Misuse that is similar to the CTN. Other speakers reported on the CTN/Mexican Institute of Psychiatry technology transfer project to establish a clinical trials organization in Mexico and Ukrainian research into methadone maintenance treatment supported through an INVEST/CTN Fellowship.
- The Future of Addiction: Treatment Planning Tools, Evidence-Based Practice, and Global Infrastructure – Thomas F. Babor, Ph.D., M.P.H., University of Connecticut School of Medicine, chaired the session focused on the future of addiction research and treatment, reviewing how workforce field mapping, bibliometrics, and communication and collaboration networks are being used to estimate the size, volume, trends, locations, and modes of science in the addiction field. Speakers also reviewed the advances in implementation science to ensure that treatment providers use evidence-based interventions correctly and needs-based planning models for substance use services and support being developed in Canada and Australia.