2022-2026 NIDA Strategic Plan
Cross-Cutting Priorities

Train the Next Generation of Scientists

NIDA is committed to educating and inspiring the next generation of researchers. NIDA training programs are designed to cultivate and retain a diverse workforce capable of advancing all aspects of addiction science, capitalizing on scientific breakthroughs, and meeting emergent public health needs. NIDA’s innovative training programs, which are designed to attract scientists at all stages of the career continuum, include the NIDA Summer Research Internship Program for students at an early career stage; the NIH and NIDA diversity supplement program for postbaccalaureate and graduate students, postdoctoral fellows, and investigators from underrepresented backgrounds; and the NIDA Diversity Scholars Network Program for postdoctoral, early-stage, and new investigators. NIDA’s Intramural Research Program (IRP) also has programs to support and train post-baccalaureate and postdoctoral fellows from all backgrounds. We also provide resources and training through the NIDAMED Initiative to help health care providers care for people with, and at risk for, SUDs. NIDA will continue to implement innovative approaches to attract and retain scientists and clinicians, including those from underrepresented backgrounds, who can meet future challenges in addiction research.

Identify and Develop Approaches to Reduce Stigma

People with SUDs are often viewed negatively and unsympathetically by other members of society, including their own families, colleagues, and health care providers. The continued criminalization of drug use—unevenly applied to Black people and other people of color—creates a form of social sanctioning of stigma, legitimizing not only negative portrayals of drug use and addiction but also tangible expressions of social rejection in the form of punishment and other dangers. Stigma can prevent people from disclosing their drug use to health care providers and engaging in care. When care is sought, the stigmatizing views of providers may prevent an individual from receiving adequate care. For these reasons, NIDA is prioritizing research to combat stigma and improve engagement in treatment.

Understand Sex, Sexual Orientation, and Gender Differences

SUDs can manifest differently among cis-gender heterosexual women and men, and individuals who identify as lesbian, gay, bisexual, transgender, or questioning (LGBTQ+). Women typically proceed to addiction faster than men and are more likely to take drugs to relieve stress or pain, and women who use substances have comorbid mental illnesses more often. During the pregnancy and postpartum periods, women are more vulnerable to substance use and its consequences, including long-lasting impacts on their infants. Women also respond differently to certain treatments than men. There is a vital need to better understand how biological differences translate to sex differences in addiction phenotypes and treatment response, and to translate these findings into interventions tailored for women. In addition, it is imperative to consider the unique experiences that arise from marginalizing people based on gender identity and sexual orientation. People who identify as LGBTQ+ face forms of discrimination and other challenges not encountered by people who identify as cis-gender heterosexual. As a result of these and other stressors, individuals in these communities are at increased risk for substance use. NIDA will continue to prioritize research to understand substance use risk factors among LGBTQ+ individuals and to develop evidence-based interventions specialized for these communities.

Identify and Develop Approaches to Reduce Health Disparities

Disparities in substance use and access to interventions are tied to social, economic, and/or environmental disadvantages. Disparities affect many groups, including people living in rural settings characterized by vast stretches of land and few treatment options, low-resource communities where costs of transportation or child care may be prohibitive, and racial and ethnic groups who face discrimination on a broader scale. Racial disparities in access to SUD care are particularly striking, adversely affecting people who already face systemic racism and other barriers to health care. NIDA has renewed its focus in this area through our Racial Equity Initiative, and NIDA-supported research must focus on solutions to reduce—and ultimately eliminate—all health disparities. This includes foundational research to identify specialized needs and intervention targets to inform the development of culturally responsive and tailored interventions that can be implemented equitably.

Understand Interactions Between Substance Use, HIV, and Other Comorbidities

SUDs rarely occur in isolation: Many individuals who use drugs use multiple substances and have other co-occurring mental illnesses or other health conditions such as HIV and the hepatitis C virus (HCV), chronic pain, cardiovascular disease, and cancer. Foundational research is needed to identify shared risk factors for SUDs and mental illnesses, as well as biological and environmental mechanisms that contribute to mental health and other comorbid conditions as these can become targets for treatment or prevention. Clinical and health services research is needed to better integrate substance use treatment into general medical and specialty care, to retain individuals in treatment once they begin, and to develop effective new strategies for delivering care for substance use and co-occurring illnesses.

Leverage Data Science and Analytics to Understand Real-World Complexity

The interdisciplinary field of data science uses quantitative and analytical approaches, processes, and systems to extract knowledge and insights from increasingly large and complex data sets, providing unprecedented opportunities to improve our understanding of drug use and addiction. Advances in data science, computational science, and other relevant disciplines allow researchers to find meaningful trends within these data, including understanding patterns within genetic or neural activity data, identifying candidate drug targets and therapeutic molecules, and processing behavioral and health care utilization data. Statistical analyses, computational modeling and machine learning are being used to fuel predictive findings, which can help anticipate and respond to future crises.

However, the standardization, analysis, interpretation, and quality control of big data sets present formidable challenges that require new infrastructure, training paradigms, interdisciplinary teams, and a culture of data sharing. There is also increasing recognition of the importance of detecting—and mitigating—bias within data sets and the statistical methods, artificial intelligence, and machine learning algorithms applied to them. Such bias may cloud the interpretation of results and has the potential to inadvertently contribute to racism and racial disparities (e.g., by attributing certain findings to race without considering underlying societal causes), a particular concern for the field of addiction, where stigma and discrimination are entrenched.

For these reasons, NIDA is committed to the FAIR (Findable, Accessible, Interoperable, Reusable) principles, which are a cornerstone of data stewardship and ensure the reusability of digital assets. NIDA will also continue to support research to develop bibliometric tools and citation analyses for assessing the rigor and reproducibility of scientific publications; tools for facilitating rigorous study design and analysis; and resources for promoting best data practices. This includes training for graduate students and postdoctoral fellows in experimental design and data analysis. As the field of data science moves forward, NIDA will continue to promote cutting-edge technologies, create or enhance programs that include diverse perspectives, address gaps and opportunities in training and workforce development, foster data stewardship and sustainability, encourage broad research use of clinical health care data, and engage communities to develop new partnerships and enhance data science activities. NIDA’s investment in this “science of science” is aimed at improving the practice of science itself.

Develop Personalized Interventions Informed by People with Lived Experience

An individual’s environment, experience, and biology together determine that person’s risk for developing SUDs and related conditions, the trajectory the person will take, and the interventions that will be the most effective treatment. For example, genome-wide association studies (GWAS) have revealed genetic variants associated with the effectiveness of particular methadone doses in certain populations, responsivity to smoking cessation treatments, and even to smoking prevention interventions. As our understanding of how individual variability affects health outcomes grows, so does the potential to develop individually tailored interventions based on these data. 

Personalized addiction medicine must consider a person’s treatment goals as well as that person’s unique and changing life circumstances. For example, it is now recognized that while abstinence may be a desired outcome for some, others may benefit from interventions that reduce drug use, alleviate withdrawal symptoms such as insomnia or depression, or lead to safer drug use practices. Perspectives from people with lived experience laid the foundation for this understanding and their voices should be included in the process of new intervention development.

This work will be aided by large-scale research initiatives such as the NIDA-led Adolescent Brain Cognitive Development (ABCD) Study® and HEALthy Brain Child Development (HBCD) Study, and the NIH All of Us research program; the expanding use of electronic medical records; and advances in information science and analytics that make it possible to harness the vast quantities of data collected. Likewise, digital therapeutics, an area in which NIDA has made a significant investment, have the potential to provide comprehensive, personalized health care services where and when patients need them. NIDA will continue to support research to further illuminate the factors that contribute to heterogeneity in drug use, SUD, and related outcomes and to develop tailored, patient-centered interventions to prevent and treat them.