Train the Next Generation of Scientists
NIDA is committed to educating and inspiring the next generation of researchers. NIDA extramural research training programs are designed to cultivate and retain a research workforce capable of advancing all aspects of addiction science, capitalizing on scientific breakthroughs, and meeting emergent public health needs. NIDA’s Intramural Research Program (IRP) 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 who can meet future challenges in addiction research.
Identify and Develop Approaches to Reduce Health Disparities
Disparities in substance use and access to interventions are tied to social, economic, and environmental factors. Disparities affect many groups, including people living in rural settings with few treatment options and low-resource communities where costs of health care, transportation or childcare may be prohibitive. There are also differences in how SUDs manifest among women and men. 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 sex differences translate to differences in addiction phenotypes and treatment response, and to translate these findings into interventions tailored for the people who need them. NIDA-supported research must focus on developing solutions that reduce—and ultimately eliminate—all health disparities. This includes foundational research to inform the development of tailored interventions.
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 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 factors 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 analysis, 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.
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, 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 metabolism of methadone which affect the doses needed in certain populations, responsivity to smoking cessation treatments, and even to smoking prevention interventions. As our understanding of how individual variability impacts 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, some may benefit from interventions that focus on reducing drug use or alleviating withdrawal symptoms such as insomnia or depression. 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.