A. Legislation, Budget, and Policy
Substance Abuse Insurance Parity At the end of each year, there is a sunset date for the 1996 Mental Health Parity Act. That act, passed in 1996, required insurers to include mental health (not substance abuse) coverage under certain conditions, and had an original sunset date of September 30, 2001. The 2001 sunset date, now December 31 of each year, has been extended by Congress every year. In 2007 both the Senate (Senators Domenici and Kennedy/S. 558) and House (Congressmen Kennedy and Ramstad/H.R. 1424) had mental health parity bills which would have made substance abuse coverage mandatory under certain (but different under the two bills) conditions. Neither of those bills became law. Late in December, Congress merely extended, for another year, the current status quo mental health parity law.
FY 2008 Appropriation On Wednesday, December 26, after four continuing resolutions, President Bush signed Public Law 110-161 (Consolidated Appropriations Act, 2008), providing an appropriation for NIH. Under the 2008 appropriation NIAAA’s budget is $436.2 million, an increase of 0.2 million above the FY 2007 appropriation. A summary of the FY 2008 appropriation is provided below.
FY 2009 President’s Request The FY 2009 budget request for the NIAAA is $436.7 million, including HIV/AIDS, an increase of $0.4 million and 0.1 percent over the FY 2008 appropriation. The budget request for HIV/AIDS research is $27.0 million. The highlights of some of the major components of the FY 2009 budget request are:
Research Project Grants Under the President’s Request, the institute plans to support approximately 206 competing research project grants (RPGs) which would equal an approximately 28.6 percent success rate for competing RPGs. The request would hold the average cost of competing RPGs at the FY 2008 level. There will be no inflationary increases for recurring direct costs in non-competing continuation RPGs.
Alcohol Research Centers The centers program budget will support 17 research centers at $27.3 million.
Other Research $12 million is provided to support 86 research career awards in FY 2009. Cooperative agreements will be funded at $8.7 million, supporting the Collaborative Study on the Genetics of Alcoholism and Alcohol Associated Outcomes Among HIV+/- Aging Veterans.
Research Training Research training is provided $11.3 million for 287 pre- and post-doctoral trainees in full-time training positions, which is flat with FY 2008. Stipend levels for pre-and post-doctoral NRSA fellows will increase 1 percent in FY 2009 but there will be no other increases for tuition or training related expenses.
Research and Development Contracts Research and development contracts are provided $34.4 million.
Intramural Research Program $47.6 million has been allocated to maintain the intramural research program’s overall level of effort for FY 2009.
Research, Management, and Support (RMS) RMS activities are provided $26.0 million for FY 2009.
Below is a summary of the FY 2009 President’s budget request (dollars in thousand:
|FY 2007 Actual||FY 2008 Appropriation||FY 2009 President’s Budget|
|Grants and Contracts||$353,415||$352,317||$351,650|
|Research Training (NRSA)||11,345||11,345||11,345|
|Research Management and Support||25,278||25,657||26,042|
|Total, NIAAA (including AIDS)||436,057||436,259||436,681|
|Percent increase over prior year||0.05%||0.1%|
|AIDS (dollars in overall Budget)||(26,942)||(27,017)||(27,017)|
B. Director’s Activities
Asian Pacific Digestive Diseases Week On October 18, Dr. Li gave the opening lecture at the International Symposium on Alcoholic Liver and Pancreatic Diseases and Cirrhosis, part of the Asian Pacific Digestive Diseases Week in Kobe, Japan. NIAAA council member Hidekazu Tsukamoto, professor of pathology at the Keck School of Medicine, University of Southern California, was the principal organizer of the symposium. Dr. Li’s talk was entitled “Alcohol and Organ Damage: Understanding the Mechanisms, Quantifying the Risks.” At the meeting, Dr. Li received an award from the Japanese Society of Gastroenterology, citing his extensive and long-term contributions to addressing the adverse health effects of alcohol. Samir Zakhari, director of NIAAA’s Division of Metabolism and Health Effects (DMHE), was a co-organizer of the symposium and chaired a session on oxidant stress and inflammation; intramural scientist Bin Gao, gave a talk on innate immunity and alcoholic liver fibrosis.
Alcohol Policy and Research in the U.S. and Korea The Korean National Institute of Health and the Korean Center for Disease Control and Prevention (KCDCP) sponsored a workshop entitled “Second Workshop on Alcohol Diseases: Alcohol Policy and Alcohol Research in the United States and Korea” in Seoul, South Korea October 22. Dr. Li gave a presentation on “Alcohol Epidemiology: Implications for Diagnosis and Treatment.” Dr. Zakhari, intramural scientist B.J. Song, and NIAAA deputy director Kenneth Warren also gave presentations at the meeting, which culminated in the signing by Drs. Li and Jon-Koo Lee, director general of the KCDCP, of a Letter of Intent to increase cooperation in the fields of biomedical and behavioral research between the United States and Korea. Specific research interests noted in the letter of intent include epidemiology of alcohol problems, prevention, alcohol and chronic diseases, clinical trials, development and evaluation of innovative treatment, and pharmacogenetics/pharmacogenomics.
American Indian and Alaskan Native Heritage Month Symposium In observance of American Indian and Alaska Native Month, NIH held a research symposium on November 7 featuring NIH-supported investigators speaking on research projects focused on health issues among American Indians in New Mexico, Arizona, and the Pacific Northwest. Dr. Li introduced the keynote speaker, NIAAA grantee R. Dale Walker, a professor of psychiatry and public health and preventive medicine at Oregon Health and ScienceUniversity, Portland. Dr. Walker’s NIAAA-supported research focuses on treatment processes and outcomes among urban American Indians with alcohol-related problems.
Friends of NIAAA Coalition Hosts Congressional Briefing A number of key organizations in the NIAAA liaison community, led by the American Psychological Association (APA), have formed a Friends of NIAAA coalition. Similar “Friends of” groups exist in support of other NIH institutes. Typically, these stakeholder-organized coalitions comprise patient groups, scientific and professional societies, and concerned individuals committed to supporting biomedical and behavioral research.
On November 15, the newly-established Friends of NIAAA, working in conjunction with the Addiction, Treatment, and Recovery Caucus in the U.S. House of Representatives, organized an educational briefing for Congressional staffers on Capitol Hill. The briefing focused on underage drinking, and speakers included Dr. Li; former NIAAA associate director Mark Goldman, Distinguished Research Professor and Director of the Alcohol and Substance Use Research Institute at the University of South Florida; Sandra A. Brown, professor of psychology and psychiatry at the University of California, San Diego; and Mimi Fleury, founder of the Community of Concern. Steve Breckler, APA's executive director for science, made introductory remarks. Seventeen organizations co-sponsored the briefing, which drew ninety-nine attendees, including multiple representatives from twenty-eight House and seven Senate offices.
Members of the Friends of NIAAA coalition reconvened on January 31 to begin planning additional activities for the coming year. For a more detailed summary of the November 15 briefing, visit http://www.apa.org/ppo/issues/1107drink.html .
International Conference on Applications of Neuroimaging to Alcoholism Dr. Li gave a keynote lecture entitled “NIAAA Overview of Imaging in Alcoholism” at the 2 nd International Conference on Applications of Neuroimaging in Alcoholism, held January 19 to 20 at YaleUniversity. The meeting was hosted by the NIAAA-fundedCenter for the Translational Neuroscience of Alcoholism (John Krystal, principal investigator). Conference sessions addressed applications to alcoholism of imaging techniques including MRI, fMRI, DTI, MRS, PET, and SPECT.
C. NIAAA Staff and Organization
Veronica Alvarez, Ph.D. Veronica Alvarez joined NIAAA in January as a tenure track scientist and acting chief of the Section on Neuronal Structure within the Laboratory for Integrative Neuroscience. Dr. Alvarez earned her Ph.D. from the University of Buenos Aires and did postdoctoral research at Oregon Health and SciencesUniversity and at HarvardUniversity. She will establish and conduct an independent research program focused on neuronal morphology, structural plasticity and neuronal function in relation to development, addiction, and neurological disorders.
Peter Delany, Ph.D. Capt. Peter Delany has left NIAAA to join the Substance Abuse and Mental Health Services Administration (SAMHSA) as director of the Office of Applied Studies, where he was a senior program management officer before coming to NIAAA in 2006. At NIAAA, Dr. Delany was a health scientist administrator in the Division of Treatment and Recovery Research responsible for the development and management of NIAAA’s program in health services research.
Laurie Foudin, Ph.D. Laurie Foudin , health scientist administrator in DMHE, retired in December. She came to NIAAA in 1985 as a visiting scientist and became a health scientist administrator the following year. Dr. Foudin initially oversaw the neuroscience portfolio until the reorganization of the portfolio in 1987. From 1987 to 1997 she was the Small Business Innovation Research/Small Business Technology Transfer (SBIR/STTR) coordinator for the institute. From 1988 to 2003 Dr. Foudin oversaw the basic research portfolio on fetal alcohol spectrum disorders (FASD) within the then Division of Basic Research. She was also a staff collaborator on three FASD-related cooperative agreements: the D.C. Initiative to Prevent Infant Mortality; the Collaborative Initiative on FASD; and the Prenatal Alcohol, SIDS, and Stillbirth Research Network. Dr. Foudin was the NIAAA representative on many trans-NIH committees, including the NIH Training Advisory Committee from 1997 to 2005 and the Interagency Coordinating Committee on FAS from 2006 until her retirement.
Rebekah Geiger NIH presidential management fellow (PMF) Rebekah Geiger has begun a three month rotation in the Financial Management Branch (FMB). Ms. Geiger has an M.S.W. from the University of Michigan and has interests in health insurance cost, health disparities, the role of preventative healthcare in improving global health, and women’s health. Prior to joining NIH as an at-large PMF, she completed a two-year internship at the ProvidenceCenter for the Healing Arts at the AssarianCancerCenter in Novi, Michigan. While at NIAAA, Ms. Geiger will be working with FMB staff to learn all aspects of the Federal budget process as well as the day-to-day management of the NIAAA budget.
Max Guo, Ph.D. Max Guo has been selected as deputy director, DMHE. Dr. Guo joined NIAAA in 2002 as a program director of genetics and genomics. Since 2006, he has also served as a co-leader of the NIAAA team on mechanisms of alcohol action and injury team and the SBIR/STTR coordinator for NIAAA. Dr. Guo has worked effectively in NIAAA’s trans-disciplinary organizational structure to promote the use of new technologies, alternative animal models, and an integrated approach to study alcohol-induced disorders. In the past several years, Dr. Guo also represented NIAAA on a number of NIH Roadmap activities. Dr. Guo received his bachelor degree in biology from Peking University of China. After receiving a Ph.D. degree from OhioStateUniversity in 1992, he did his postdoctoral training on cancer biology with Nobel Laureate J. Michael Bishop at University of California, San Francisco. Before joining NIAAA in 2002, he was a tenure-track assistant professor of oncology and the director of the MicroarrayCenter at the SydneyKimmelComprehensiveCancerCenter at JohnsHopkinsMedicalSchool. From 2005 to 2006, Dr. Guo also worked as a program director for genetics, genomics, gene therapy, and biotechnology in the Division of Lung Diseases at the National Heart, Lung, and Blood Institute.
Roger Hartman Roger Hartman retired in January after 5 ½ years as a health science administrator at NIAAA, most recently in the Division of Epidemiology and Prevention Research. Prior to coming to NIAAA, he was a senior health policy analyst for the Office of the Assistant Secretary of Defense (Health Affairs/ TRICARE Management Activity) and served as head of the Treatment and Rehabilitation Branch, U.S. Navy Drug and Alcohol Abuse Program. He served on active duty, U.S. Navy, from 1969 to 1977, and retired as a Commander, U.S. Naval Reserve in 1990. His work at NIAAA included college and underage drinking initiatives; alcohol education projects; and activities associated with National Alcohol Screening Day.
Dale Hereld, M.D., Ph.D. Dale Hereld joined DMHE as a program director in January. Dale obtained both M.D. and Ph.D. degrees as well as postdoctoral training from the Johns Hopkins University School of Medicine. He subsequently joined the faculty of the medical school of the University of Texas Health Science Center at Houston, where his research focused on elucidating mechanisms of G protein-coupled receptor function and regulation. Dr. Hereld's specific areas of expertise include signal transduction and chemotaxis. His nearly thirty publications have appeared in prominent journals that include Science,Molecular Biology of the Cell, Molecular Microbiology, the Journal of Biological Chemistry, and the Journal of Immunology. In addition, Dr. Hereld has been the recipient of a Medical Scientist Training Program Award, a Damon Runyon Postdoctoral Research Fellowship, and the American Heart Association-Texas Affiliate's Lyndon Baines Johnson Research Award.
Howard Moss, M.D. The American Psychiatric Association (APA) has named Howard Moss a Fellow of the association. Newly designated APA Fellows will be formally recognized at a convocation ceremony during the APA’s annual meeting in Washington, DC, in May.
Jessica Rodriguez NIH management intern Jessica Rodriguez has begun a rotation at NIAAA where she will be working with associate director for administration Robin Kawazoe through May 2008. Ms. Rodriguez has a B.A. in communications focusing on public speech from the University of Maryland, College Park and is pursuing an M.B.A. at the University of Maryland, UniversityCollege. She began her career at NIH with the National Institute of Allergy and Infectious Diseases, where she monitored the execution of the immunological and infectious disease grant operating activity. Prior to joining NIH, she completed a year-long management training program with Chevy Chase Bank followed by multiple branch management positions.
Norman Salem, Ph.D. Norman Salem, Jr., retired in January after over 30 years at NIAAA and the National Institute of Neurological Disorders and Stroke. He has been chief of the Laboratory of Membrane Biochemistry and Biophysics within NIAAA’s intramural research program since 1991; prior to that he was a section chief in the Laboratory of Clinical Studies, NIAAA. During his tenure here, his laboratory was internationally known for work on essential fatty acids, particularly the omega-3 fatty acid, docosahexaenoate (DHA). Dr. Salem authored or co-authored about 220 publications while at NIH. He will continue to pursue his interests in essential fatty acids in the biotech industry; he joins Martek Biosciences Corporation as chief scientific officer this month. He will be responsible for the discovery, medical research, molecular biology, and analytical groups there. Martek supplies DHA for use in infant formulas in the United States and many other countries and conducts and sponsors research in this area.
Kenneth Warren, Ph.D. Kenneth Warren has been selected as deputy director, NIAAA. Dr. Warren has had a long-term career at NIAAA having joined the institute in 1976 as a staff member of the then Division of Research. Over the next few years he served as executive secretary for NIAAA’s Biomedical Research Review Committee, then chief, Biomedical Research Branch, and deputy director of the Division of Extramural Research. In 1984, Dr. Warren was named director, Office of Scientific Affairs (OSA), a post he held until 2005. During the period of his leadership of OSA the office’s numerous responsibilities included peer review, national advisory council and extramural advisory board activities, committee management, grants management, and communications. From 2002 to 2007, Dr. Warren also served as the institute’s associate director for basic research and over the past year he has also served as acting director, Office of Science Policy and Communications.
Dr. Warren received a Ph.D. in biochemistry from MichiganStateUniversity in 1970. Following postdoctoral work, he took the position in 1974 of chief of the Section of Biochemistry in the Department of Cellular Physiology, Division of Medicine at the Walter Reed Army Institute of Research.
One of Dr. Warren’s accomplishments has been the initial development and long-term fostering of NIAAA’s research program on fetal alcohol syndrome, for which he received a superior service award from the Public Health Service in 1982, and the Henry Rosett Award from the Fetal Alcohol Syndrome Study Group of the Research Society on Alcoholism (RSA) in 2002. Dr. Warren was also a recipient of the Seixas Award from RSA in 1994.
NOFAS Hall of Fame The National Organization on Fetal Alcohol Syndrome (NOFAS) has named Dr. Warren to the organization’s Fetal Alcohol Spectrum Disorders (FASD) Hall of Fame. The NOFAS website ( http://www.nofas.org/) provides an overview of Dr. Warren’s long-time efforts in the development and guidance of research on FASD, including his role in the first national research workshop on FAS, national health advisories on the hazards of alcohol use in pregnancy, and Federal and Institute of Medicine reports on alcohol and pregnancy. He continues to play a lead role in international initiatives on research in South Africa and other countries, and chairs the Interagency Coordinating Committee on Fetal Alcohol Syndrome.
D. Research Priority Emphasis and Core Support Teams
Supplement in Pediatrics on Underage Drinking Based on the work of NIAAA’s Underage Drinking Research Initiative, a series of seven papers were developed by NIAAA staff and the steering committee of more than 25 experts assembled to advise the institute on this initiative. The papers will be published as a supplement to Pediatrics this spring entitled Underage Drinking: Understanding and Reducing Risk in the Context of Human Development. This publication will not only reach the 65,000 pediatricians who subscribe to this journal, but many others as well. (The supplement has been accepted and is scheduled to appear in April.)
Surgeon General Commendation In September, Vivian Faden and Patricia Powell received a commendation from Acting U.S. Surgeon General Kenneth Moritsugu. The commendation reads: “For Outstanding Support and Service to the Office of the Surgeon General as Co-Sponsor and Co-Coordinator of the Surgeon General's Call to Action to Prevent and Reduce Underage Drinking.”
E. NIAAA Research Programs
Collaboration with INSERM NIAAA and the French Institut National de la Santé et de la Recherche Médicale held the third in a series of joint research symposia on October 3. The symposium, U.S./French Research Collaborations in Alcohol Abuse and Alcoholism, was held at NIAAA (the first was held at NIAAA in October 2005, the second at INSERM headquarters in Paris , France , in January 2007). These symposia, held under the terms of a letter of intent between NIH and INSERM, have been conducted with the aim of building research collaborations between alcohol investigators in the U.S. and France. The topic areas covered in this meeting were neuroimaging, epidemiology, molecular toxicity of alcohol in liver and brain, diagnostic criteria for alcohol-use disorders, and fetal alcohol spectrum disorders. Dr. Li opened the meeting; NIAAA staff Bridget Grant, Howard Moss, Zhaoxia Ren, Kenneth Warren made presentations at the meeting and Sam Zakhari was a discussant.
To date, results of this meeting include four research proposals under development under the new NIAAA program announcement for international collaborative research, two French post docs in neuroimaging research placed in U.S. alcohol research labs, one U.S. post doc in epidemiology being offered a position in an INSERM research unit in Paris, and a second U.S. candidate being seriously considered for a post doc position at the INSERM/CEA (French Atomic Energy Commission) in Orsay, France.
In January, Dr. Li and Peggy Murray met with Professor Arnold Munich (science counselor to President of the FrenchRepublic, Nicolas Sarkozy) Thiery Damerval, deputy director of INSERM, and Jean Francois Delfraissy (director of the French National Agency for AIDS and Infectious Diseases). The meeting was held on the Bethesda campus of NIH and focused on a review of the successful outcomes from the NIAAA/INSERM collaboration and areas of continued interest in alcohol research for France.
NIAAA Review Branch Reorganization NIAAA’s Extramural Project Review Branch has been reorganized. There are now four study sections (AA-4 is new):
- AA-1, Biomedical Research Review Subcommittee, scientific review officer (SRO), Philippe Marmillot
- AA-2, Epidemiology, Prevention and Behavior Research Review Subcommittee, SRO, Lorraine Gunzerath
- AA-3, Clinical, Treatment and Health Services Research Review Subcommittee, SRO, Katrina Foster
- AA-4, Neuroscience Review Subcommittee, SRO, Beata Buzas.
NIH has received, or is expecting, numerous applications in response to RFAs. Below is a summary of applications that have been received for 2008 RFAs.
- RFA-AA-08-003 Exploratory/Developmental Alcohol Research Centers (P20): 11 applications
- RFA-AA-08-004 Resource Core Alcohol Research Centers (P30): 1 application
- RFA-AA-08-005 Specialized Alcohol Research Centers (P50): 6 applications
- RFA-AA-08-006 Comprehensive Alcohol Research Centers (P60): 2 applications
- RFA-AA-08-001 The Role of Mitochondria in Alcohol-Induced Tissue Injury (R21): 19 applications
- RFA-AA-08-002 The Role of Mitochondria in Alcohol-Induced Tissue Injury (R01): 23 applications
NIH Roadmap Dr. Zakhari represents NIAAA on the program staff for the trans-NIH Stem Cell Task Force and Implementation Committee, charged with implementing the President’s stem cell executive order on research on human pluripotent stem cells from non-embryonic sources. He is co-chairing two subcommittees.
Publications by Extramural Staff
Recent publications authored or co-authored by extramural staff included the following:
Svetlana Radaeva (intramural scientist Bin Gao is also a coauthor):
Hu, W., Ferris, S.P., Tweten, R.K., Wu, G., Radaeva, S., Gao, B., Bronson, R.T., Halperin, J.A., Qin, X. Rapid conditional targeted ablation of cells expressing human CD59 in transgenic mice by intermedilysin. Nature Medicine 14:98-103, 2008.
Zakhari, S. Overview: How is Alcohol Metabolized by the Body? Alcohol Research & Health 29:245-254, 2007.
Neuman, M.G., Sha, K., Esguerra, R., Zakhari, S., Winkler, R.E., et al. Inflammation and repair in viral hepatitis C. Digestive Diseases and Sciences. (Epub ahead of print, November 10)
Zakhari, S., Li, T.-K. Determinants of alcohol use and abuse: Impact of quantity and frequency patterns on liver disease. Hepatology 46:2032-2039, 2007.
The following items represent examples of the breadth and quality of research supported by NIAAA.
Gene Variant Affects Alcohol Consumption in Mice Using a combination of genetic analysis techniques and carefully targeted breeding of mice with different levels of alcohol consumption, scientists have identified a gene variant that influences alcohol preference in the animals. Many genes can potentially contribute to alcohol related behavior, and individual genes may have subtle effects, making it difficult to pinpoint and characterize individual genes involved in the alcohol response. In this study, scientists crossed strains of mice with the aim of producing animals with different levels of alcohol preference but that were otherwise almost identical genetically. This permitted identification of a quantitative trait locus—a stretch of DNA that plays a role in determining alcohol preference—and candidate genes within that stretch. Subsequent analysis included measurement of whether the activity of the candidate genes differed among mouse strains with different levels of alcohol consumption. Existing databases on gene function helped narrow the search to a gene— Grm7—that encodes a receptor for the neurotransmitter glutamate. Previous research suggests that the receptor plays a role in information processing and stress responses. Continuing research will aim to confirm the role of Grm7 in alcohol consumption and to identify a counterpart gene in humans. Genes affecting alcohol consumption can provide clues to the physiology of alcohol responses and targets for the development of medications to treat alcohol dependence. (Vadasz, C., Saito, M., Gyetvai, B.M., Oros, M., Szakall, I., Kovacs, K.M., Prasad, V.V.T.S., and Toth, R. Genomics 90:690-702, 2007)
Brief Intervention Helps Patients in Hospital Emergency Departments Reduce Drinking Emergency care seeking patients who underwent a regimen of alcohol screening and brief intervention reported lower rates of risky drinking at three-month follow-up than did those who received only written information about reducing their drinking, according to a nationwide collaborative study supported NIAAA and the SAMHSA. Investigators at 14 university-based emergency centers throughout the United States used a brief questionnaire to assess the alcohol use patterns of 7,751 emergency patients, regardless of whether they had signs of alcohol use on admission. They found that more than one-fourth of the patients exceeded the limits for low-risk drinking—defined by NIAAA as no more than four drinks per day for men and three drinks per day for women and not more than 14 drinks per week for men, and seven drinks per week for women. More than 1,100 patients who exceeded these limits agreed to continue to participate in the study. The brief intervention in this study consisted of a “brief negotiated interview” designed to review the patient’s current drinking patterns, assess readiness to change, offer advice about low-risk drinking guidelines, and negotiate an agreement with regard to drinking goals. Three months later, individuals in the intervention group reported drinking three fewer drinks per week than those in the control group, and more than one-third of individuals in the intervention group reported drinking at low-risk levels, compared with about one-fifth of those in the control group. (Academic ED SBIRT Research Collaborative. Annals of Emergency Medicine 50:699-710e6, 2007)
Diagnostic Criteria for Alcoholism A diagnosis of alcoholism is made when a person meets three out of seven diagnostic criteria as specified in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition ( DSM-IV). This study reexamined data from NIAAA’s National Epidemiologic Survey on Alcohol and Related Conditions to assess to what extent individual criteria accurately predicted a positive diagnosis and to characterize patterns in the criteria met by those with alcoholism. The criterion “activities given up” had the most predictive value; about 95 percent of individuals who were positive for this were also diagnosed with alcoholism. Two others—continued drinking despite physical/psychological problems and time spent in alcohol-related activities—were endorsed by more than 50 percent of those diagnosed with alcoholism. Counting the number of positive criteria, however, did not necessarily reflect severity of alcoholism. Analysis of patterns of criteria met by individuals with alcoholism yielded six clusters or sets of criteria that constitute subtypes of alcoholism. The authors point out that future research can address whether treatment approaches could be tailored to these subtypes. (Moss, H.B., Chen, C.M., and Yi, H.-y. Alcoholism: Clinical and Experimental Research 32:306-313, 2008)
Endocannabinoids Key to Habit Formation Using a combination of behavioral training and neurogenetics, intramural scientists have found a particular class of neurotransmitters—the endocannabinoids—to be key to the development of habitual behavior in mice. By varying the pattern with which animals are rewarded in response to a trained behavior—in this case lever pressing for a food reward—scientists can elicit either goal-directed or habitual responding. When behavior is goal directed, the intensity with which animals respond in anticipation of rewards decreases when the reward’s value is diminished. With habitual behavior, the mice continue to respond with the same intensity whether or not the reward value is diminished. In this study, mice with targeted mutations in the gene for a receptor (CB1) for endocannabinoids failed to develop habitual behavior after the same reward pattern elicited habitual responding in mice with functioning CB1 receptors. A drug, administered during training, that blocks CB1 receptors also prevented nonmutant mice from developing habitual behavior, adding confirmation that endocannabinoid signaling was key to habit formation. Previous research has implicated endocannabinoids in addictive behaviors; studies such as the current one can help dissect the neurobiology and behavioral processes that underlie addiction. (Hilário, M.R.F., Clouse, E., Yin, H.H., and Costa, R.M. Frontiers in Integrative Neuroscience published online November 2, 2007)
Rat Model Suggests Memory Effects by Alcohol in Third Trimester Alcohol given to newborn rats—a period of development that is analogous to the third trimester of pregnancy—caused permanent reduction in the generation of new neurons from progenitor cells in the hippocampus, a part of the brain that is central to memory formation. Among the effects manifested by individuals exposed to alcohol prenatally as a result of heavy drinking by their mothers are learning disabilities and problems with short term memory. Damage by alcohol to the generation of new cells in the hippocampus may be a mechanism underlying these deficits, and this study suggests that such damage could be a result of third-trimester binge-type drinking by pregnant mothers. (Klintsova, A.Y., Helfer, J.L., Calizo, L.H., Dong, W.K., Goodlett, C.R., and Greenough, W.T. Alcoholism: Clinical and Experimental Research 31:2073-2082, 2007)
Alcohol, Cigarettes, and Naltrexone Individuals who abuse alcohol are more likely to smoke, and smoke heavily, than those who abstain from alcohol. This study looked at whether alcohol intoxication affects cigarette craving in heavy drinkers who were also light smokers, and whether the drug naltrexone altered the results. Participants were given intravenous alcohol; as blood alcohol levels rose to 0.6, craving for cigarettes also rose. With naltrexone, the craving for cigarettes did not increase as much with rising BAC. The authors conclude that intoxication, even without external cues for alcohol, increases craving for cigarettes; naltrexone may be helpful as a treatment for people who drink heavily and would like to stop smoking. (Ray, L.A., Miranda, R., Jr., Kahler, C.W., Leventhal, A.M., Monti, P.M., Swift, R., and Hutchison, K.E. Psychopharmacology 193:449-456, 2007)
Alcohol’s Immune Effects in Liver Disease Chronic alcohol use accelerates liver fibrosis (scarring) in individuals with hepatitis C infection. The mechanism of this effect of alcohol is not well understood; it is not entirely the result of accelerated damage to liver tissue. Results of this intramural study suggest specific mechanisms by which alcohol impairs the immune system’s ability to forestall fibrosis. The investigators induced liver damage in mice by feeding them carbon tetrachloride, a liver toxin. Some of the mice also received chronic alcohol. Liver fibrosis was greater in the alcohol-fed mice; the investigators found that alcohol disrupted signaling by immune molecules that regulate the activity of natural killer (NK) cells, a class of immune cell that plays a key role in limiting liver fibrosis resulting from viral infection. Alcohol also compromised the ability of the immune system to limit activation of hepatic stellate cells, which generate scar tissue in the liver in response to injury. Therapies are needed that can interrupt the progression of liver disease; understanding how alcohol compromises immune function in the liver may provide approaches for new treatments. (Jeong, W.-I., Park, O., and Gao, B. Gastroenterology 134:248-258, 2008)
Insight into Neurotransmitter Sensitivity to GABA One of the well established effects of alcohol on the brain is its ability to enhance signaling by the neurotransmitter GABA. GABA is an inhibitory neurotransmitter, acting to slow the activity of neurons. The effects of alcohol on GABA are inconsistent, however. This study demonstrated that a specific intracellular signaling molecule, PKCє, could alter the response of cellular receptors to GABA. PKC is a protein kinase—an enzyme that regulates cell functions by adding phosphate to proteins (protein phosphorylation). In this study, investigators used genetic technology to develop cells in which PKCє could be selectively inhibited; they also generated mice lacking the gene for PKCє. They found that PKCє regulates the sensitivity of GABA A receptors (the type of GABA receptors most sensitive to alcohol) and pinpointed the mechanism for this regulation—phosphorylation of a GABA A subunit. Mice lacking PKCє are more sensitive to the effects of alcohol. The work helps explain the variability of the response of GABA A receptors to alcohol; the information may provide avenues for future development of targeted medications. (Qi, Z.-H., Song, M., Wallace, M., Wang, D., Newton, P.M., McMahon, T., Chou, W.-H., Zhang, C., Shokat, K.M., and Messing, R.O. The Journal of Biological Chemistry 282:33052-33063, 2007)
Donor Alcohol Use and Lung Transplants Nineteen percent of organ donors are reported to have a history of alcohol abuse; such a health history increases the risk of problems after heart transplantation. These investigators transplanted rat tracheas into recipient rats. Some donor rats had had alcohol in their diet before the transplantation. Pre-transplant alcohol exposure increased airway disease in recipients of the tracheas from alcohol-fed rats. To trigger airway disease, at least a slight immunological mismatch was required between donor and recipient. When a mismatch was present, alcohol exposure increased levels in the transplanted tissue of TGF- b1, a regulatory protein that is central to the development of fibrosis in airways. The authors predict that future research will identify that alcohol abuse in donors is a risk factor for post-transplant lung disease. (Mitchell, P.O. and Guidot, D.M. American Journal of Respiratory and Critical Care Medicine 176:1161-1168, 2007)
Brain and Behavior in FAS Using state-of-the-art methods to analyze magnetic resonance images (MRIs), scientists have been able to extract detailed information on the thickness of the cortex in the brains of young people exposed to alcohol before birth as a result of heavy maternal alcohol consumption. By comparing this information with similar measurements in young people without prenatal alcohol exposure, the investigators were able to show for the first time correlations between alcohol-related changes in cortical thickness and measures of cognitive function. The work also added detail to previous findings of regional changes in cortical thickness due to alcohol exposure. The thickness of the cortex—the outer layer of gray matter covering the surface of the brain—is increased in individuals with fetal alcohol spectrum disorder, a term that refers to the range of deficits that can result from prenatal alcohol exposure. Under normal circumstances, the cortex thins during development; the authors point out that a thicker cortex does not indicate a larger amount of healthy brain tissue. The study adds to the understanding of how exposure to heavy alcohol before birth disrupts brain development. (Sowell, E.R., Mattson, S.N., Kan, E., Thompson, P.M., Riley, E.P., and Toga, A.W. Cerebral Cortex published online ahead of print doi:10.1093/cercor/bhm039)
Peptide Counters Damage by Prenatal Alcohol in Mice A peptide incorporated into the diets of pregnant mice reduced the harmful effects of alcohol on the eyes of their fetuses. Damage to the eyes of alcohol-exposed fetuses coincides with central nervous system damage. The peptide (SAL) is a fragment of a nerve growth factor that has been shown to reduce the effects of alcohol on fetuses when delivered to their mothers intraperitoneally, that is, directly into the abdomen. The authors point out that despite recognition of fetal alcohol syndrome (FAS), incidence of FAS has not decreased. This study suggests that SAL given orally could be effective in preventing brain damage in children whose mothers consume alcohol while pregnant. (Parnell, S.E., Chen, S.-y., Charness, M.E., Hodge, C.W., Dehart, D.B., and Sulik, K.K. Alcoholism: Clinical and Experimental Research31:2059-2064, 2007)
F. Scientific Meetings
European Presentations: Alcohol Metabolism Dr. Zakhari gave the keynote lecture at the 11 th annual meeting of the European Society for Biomedical Research on Alcoholism in Berlin, Germany, September 23 to 26. He was also invited by CharlesUniversity, Prague, Czech Republic, to give a seminar on alcohol metabolism and its consequences, and to discuss various projects with graduate students concerning their research.
Gordon Conference on Endocannabinoids George Kunos, director of NIAAA’s Division of Intramural Clinical and Biological Research, and David Lovinger, chief of the Laboratory of Integrative Neuroscience, were invited speakers at the Gordon Conference on Endocannabinoids that was held in Switzerland September 30 to October 5. Dr. Kunos’ talk was entitled “Endocannabinoids and Energy Homeostasis: Central and Peripheral Mechanisms;” Dr. Lovinger’s, “Regulated Endocannabinoid Release Contributes to Retrograde Signaling.”
American Association for the Study of LiverDiseases Dr.
Kunos was invited to give the Hyman Zimmerman State-of-the-Art Lecture at the annual meeting of the American Association for the Study of Liver Diseases in Boston. The November 5 lecture was entitled “Endocannabinoids and the Liver: The Metabolic Syndrome to Liver Fibrosis.”
Brain Research: Improving Global Harmony Norman Salem was invited to give a presentation at a conference on brain research that is part of the Olympiad of the Mind conference series sponsored by the International Science, Technology, Economics and Politics for Society Foundation. The meeting took place at The National Academies in Washington, DC, November 15 to 16. Dr. Salem’s talked was entitled “Deficiency of Dietary Omega-3 Fatty Acids in the Western World Leads to Brain Omega-Deficiency and Altered Behavior.” The Olympiads of the Mind seek to bring together experts from diverse disciplines to address global problems.
International Digestive Diseases Symposia Vishnu Purohit was an invited speaker at the Seoul International Digestive Disease Symposium Seoul, Korea, November 20 to 22. He presented two lectures: the first on m olecular pathogenesis in alcoholic liver disease—inflammation, fibrosis, and cancer; and the second on molecular mechanisms of alcoholic fatty liver. In Japan, Dr. Purohit co-chaired a session at a symposium on Metabolomic Systems Biology and Liver Diseases, KeioUniversity, Tokyo, October 22. He also co-chaired a session at the International Symposium on Alcoholic Liver and Pancreatic Diseases, Kobe, Japan, October 18-19.
Presentations on Diagnosis and Treatment Mark Willenbring, director of NIAAA’s Division of Treatment and Recovery Research, gave presentations or chaired workshops at numerous national and international meetings. These included a meeting at the National Center for Addiction Medicine in Reykjavik, Iceland, September 28 to October 6, where he gave talks on trends in alcohol use and prevention and treatment in the U.S.; and the annual meeting of the International Society of Addiction Medicine in Cairo, Egypt, October 18 to 25, where he gave a presentation on recent advances in treatment of alcohol use disorders and chaired a symposium on diagnosis. In November, he gave a talk on new developments in diagnosis and treatment of alcohol use disorders for the Hepatology Associates Course at the annual meeting of the American Association for the Study of Liver Diseases in Boston. NIAAA sponsored a symposium on Addiction and Sleep at the annual meeting of the AmericanAcademy of Addiction Psychiatry in Coronado, CA, November 28 to December 2; Dr. Willenbring represented NIAAA, including chairing workshops at the meeting. He also gave presentations at two NIAAA-sponsored meetings on mechanisms of behavior change in Baltimore, January 8 to 9, and Atlanta, January 14 to 16.
Leadership to Keep Children Alcohol Free Two new members joined the Leadership to Keep Children Alcohol Free this fall: William H. Janes, director of the Florida Office of Drug Control, was designated by Florida Governor Charlie Crist in October to represent Florida in the Leadership, and Dawn Gibbons, First Lady of Nevada, joined in November. Former First Lady of Kentucky Glenna Fletcher joined the Leadership Foundation.
First Lady Mary Easley resigned from the Leadership, for which she was a co-chair, to focus on helping the families of the North Carolina National Guard, which has been hard hit with deployments. Maine First Lady Karen Baldacci accepted the position as the new co-chair, in December.
New Mexico First Lady Barbara Richardson welcomed U.S. Acting Surgeon General Kenneth Moritsugu to the State on September 25 for a 2-day visit promoting his Call to Action To Prevent and Reduce Underage Drinking. Dr. Moritsugu participated in a medical roundtable discussion and addressed a public forum in Santa Fe about underage drinking and its significant role in risky sexual behavior, unplanned pregnancies, death from injuries, and academic failure, and the effect it has on the developing brain. Dr. Moritsugu also visited Albuquerque to discuss helping teens make good decisions about alcohol as part of Governor Bill Richardson's DWI Research Speaker Series.
Dr. Moritsugu visited North Dakota on September 10 and 11, where he and First Lady Mikey Hoeven attended events to promote his Call to Action. The Surgeon General and the First Lady spoke at the 2007 Alcohol & Substance Abuse Summit in Bismarck.
The new Acting Surgeon Steven K. Galson is continuing efforts related to the Call to Action. As part of a national tour to address underage drinking, Dr. Galson gave two talks on the subject in Oklahoma City on January 30 and 31. The first talk was at a Town Hall meeting at the OklahomaHistoryCenter; the second at the University of Oklahoma College of Public Health.
At the end of September ,the National Highway Traffic Safety Administration chose programs in two Leadership States to receive grants to conduct high-visibility enforcement campaigns. The recipients were Project Extra Mile in Omaha, Nebraska, and the Coalition for Alcohol and Drug Free Teenagers of Chapel Hill and Carrboro in North Carolina.
Conference on Medical Education in Substance Abuse The Third National Leadership Conference on Medical Education in Substance Abuse took place in Washington, DC, on January 16. The Office of National Drug Control Policy sponsored the conference, whose aim was to identify strategies to foster the use of screening and brief intervention in the management of substance use and abuse. NIAAA joined several other agencies in co-sponsoring the meeting; Dr. Li gave a talk entitled “Screening and Brief Intervention: Reducing the Burden of Harmful Alcohol Use on Public Health.” NIAAA staff participating in the meeting discussions included Vivian Faden, Ralph Hingson, Bob Huebner, Howard Moss, Peggy Murray, and Deidra Roach.
News Media Contacts Mark Willenbring spoke with numerous representatives of the news media on alcohol-related issues. Interview topics included a JAMA study on topiramate, pharmacotherapies for alcohol dependence, alcohol recovery and relapse, and alcohol dependence and abuse. News outlets included the Associated Press, ChicagoTribune, LA Times, St. Louis Post-Dispatch, Wall Street Journal, Reuters Health, CNN Radio, Fox News Radio, JAMA Medical News, and the National Review of Medicine ( Canada).
Florida International University On November 5, Abe Bautista gave a presentation on “Review and Grantsmanship at NIH/NIAAA” to faculty and staff at Florida International University, Miami Children’s Hospital, and the Spectrum Programs Inc./Miami Behavioral Health Center in Miami, FL.
New Video Conference Series T o provide constituent organizations with direct access to NIAAA's scientists and the latest alcohol research, the institute has initiated a new, interactive video conference series.
The series is designed to deliver free, accurate, and timely information quickly and easily to a wide range of individuals and groups. Participants access the webcasts through their personal computers, thereby avoiding the inconvenience and costs of travel.
Each video conference features a presentation on a specific alcohol research topic, led by an expert NIAAA scientist and designed specifically for our liaison community. Participants are able to follow the presentation and the slideshow in real time, and communicate directly with the NIAAA scientist afterward.
The video conference series will feature two to three webcasts each year. Mark Willenbring gave the first presentation in the series on December 12, entitled Alcoholism Isn’t What It Used to Be: New Research on the Nature and Diagnosis of Alcohol Use Disorders . More than 400 participants logged on to participate in the webcast. The presentation was recorded and will be archived on the NIAAA website in the coming weeks. For information about the video conference series, email Fred Donodeo firstname.lastname@example.org .
Presentations on Underage Drinking During the fall and winter, Vivian Faden gave a series of presentations on NIAAA and underage drinking research. On December 3, she made presentations on NIAAA and underage drinking to the Trimbos Institute (the National Institute of Mental Health and Addiction in the Netherlands). She gave a keynote lecture entitled “Findings From and Framework for the Surgeon General’s Call to Action to Prevent and Reduce Underage Drinking” at the National Council on Alcoholism and Drug Dependence 2007 Conference of Affiliates on October 10, and the same talk on October 3 at a Community Anti-Drug Coalitions of American Study Feasibility Meeting and again on October 30 to a delegation from Finland. S he also gave a presentation on NIAAA’s underage drinking research initiative to the National Institute on Drug Abuse clinical trials network on November 8.
H. Multi-Media Products from NIAAA
Online Training for the Clinician’s Guide In late February we plan to release our new online training program for clinicians,Video Case Studies: Helping Patients Who Drink Too Much. The program, based on the NIAAA Clinician’s Guide, features four 10-minute, interactive video case studies and a 17-minute tutorial. The case studies present four patients in different clinical settings with a range of alcohol-related problems and different stages of readiness to change. They are led by expert clinicians: Barbara Turner, past president of the Society of General Internal Medicine; Louis Baxter, president-elect of the American Society of Addiction Medicine; Grace Chang, associate professor of psychiatry at HarvardMedicalSchool; and NIAAA’s Mark Willenbring. Continuing education credit will be provided through Medscape. More than 9,000 clinicians have taken NIAAA’s text-based continuing education course on Medscape since last March. We will promote the new program through collaborations and outreach to professional organizations, medical schools, medical news outlets, state medical societies, health maintenance organizations, and other avenues for reaching our target audiences.
New College Update Released In the ongoing effort to disseminate the latest information to help inform campus drinking prevention and intervention efforts, NIAAA recently released an updated research bulletin, What Colleges Need to Know Now: An Update on College Drinking Research. The bulletin was mailed to every college and university president in the United States, and a targeted print and electronic promotional effort will follow. This publication is the first NIAAA document on college drinking research since the landmark report of the Task Force on College Drinking, A Call to Action: Changing the Culture of Drinking at U.S. Colleges, in 2002. The original Task Force report has been influential in efforts to prevent and treat problems with alcohol and other drugs.
The new bulletin includes updated statistics on college drinking and its consequences, showing increases in deaths, violence, and sexual assaults since the original task force report was issued. It also provides new research and new insights on individual and environmental interventions. Data now indicate that brief interventions and motivational interviewing are effective for students who are mandated to receive this intervention. With respect to environmental interventions, the bulletin summarizes new research that investigated the successful use of community partnerships for college-specific audiences.
Finally, the bulletin includes science-based information on a number of new topics that were not addressed in the original report, including alcohol poisoning, the treatment gap on campus, statistics on college students vs. non-college peers, the problem of college drinking as a global issue, and a refined definition of binge drinking developed by NIAAA. The bulletin can be accessed online at http://www.collegedrinkingprevention.gov/1College_Bulletin-508_361C4E.pdf .
Lesson Plans Added to the CoolSpot By adding new features and updated content, the Communications and Public Liaison Branch continues to expand and diversify its “tween” website, www.TheCoolSpot.gov. In November 2007, the most recent month for which we have data, there were 62,567 visits to the website (about 2,600 per day) which is about average for recent months. About 53 percent of those visits were from the United States. Following the recent addition of a variety of audio features, NIAAA has just completed a significant expansion of the Teacher & Volunteer Corner of the site, designed in partnership with middle school educators. This section now contains innovative, interactive lessons to help teachers and volunteers introduce and reinforce the key learning objectives about peer pressure, resistance skills, and other important topics presented in the Cool Spot. The lessons in this section are designed for use in middle-school classrooms or after-school programs for students ages 11 to 13. They also serve as engaging, ready-made lessons for substitute teachers.
The Teacher & Volunteer Cornernow includes:
- Interactive Quiz An interactive quiz gives immediate feedback to 10 questions that reinforce the site's most important learning objectives for facts about alcohol, types of pressure to drink, and ways to recognize and resist that pressure.
- Introductory Lesson and Answer Key This Introductory Lesson is provided as a supplemental activity or for students who quickly finish the interactive quiz. It will send them to specific pages of The Cool Spot and further reinforce the site's most important learning objectives.
- Role-Playing Lesson: The Peer Pressure Bag of Tricks Students will role-play and discuss six scenarios of different types of spoken and unspoken peer pressure.
- Role-Playing Lesson: Know Your NOs Students and teacher will demonstrate the words and body language of four less effective and one more effective way to say no to drinking.
NIAAA Alcohol Alerts An Alcohol Alert was published in October on underage drinking. The Alert is a synopsis of the Acting Surgeon General’s Call to Action To Prevent and Reduce Underage Drinking.
NIAAA Newsletter In December, CPLB posted another issue of the NIAAA Newsletter containing stories on the November 15 meeting cosponsored by the Friends of NIAAA, a recap of the Emmy award shared by NIAAA and NIDA for HBO's Addiction Project, and brief notices about the FY2008 budget and the updated NIAAA Five year Strategic Plan, as well as sections highlighting newly available publications and upcoming events.
NIAAA Website: Newly Designed/Updated Sections As one of its priorities for 2007, the reestablished NIAAA Internet Subgroup recommended redesigning the Extramural Research and Frequently Asked Questions (FAQs) for Extramural Researchers sections on the Web. The redesigned extramural research section was posted on the NIAAA Web site in late September 2007 (http://www.niaaa.nih.gov/grant-funding/funding-opportunities). The main changes include:
- Merging two levels of funding and grantee/applicant information into a more user-friendly layout enabling easier navigation throughout the section. The information is separated into six sub-sections: Funding Opportunities, About NIAAA Extramural Research, Resources for Applicants/Grantees, Submission and Peer Review, Research and Development Contracts, and NIAAA-Funded Collaborative Research Programs;
- Direct access to the NIH Guide to Grants and Contracts for information on funding opportunity announcements (FOAs) and RFAs; and
- Updated FAQs for Extramural Researchers with new Q&As on applicant and funding information. For easier navigation, the FAQs section has been separated into categories:
- Research Areas of Interest and Priorities
- Funding Opportunities
- Submission and Peer Review
- Funding Policies
- Resources for Applicants/Grantees
NIH News in Health The cover article of the December 2007 issue of NIH News in Health focused on ways to drink safely during the holidays. News in Health is produced by the NIH Office of Communications & Public Liaison; NIAAA’s Dennis Twombly is quoted in the piece. About 8,000 copies of News in Health are distributed to community health clinics, senior centers, and libraries. Stories are also picked up by small newspapers and the publication is available on the web athttp://newsinhealth.nih.gov/ .
Rethinking Drinking This new brochure for a lay audience provides research-based information about what constitutes heavy drinking, signs of an alcohol use disorder, strategies for change, and resources for support. In November, it was focus tested with 56 heavy drinkers in Baltimore and Chicago. The research report confirmed that the brochure contains a lot of valuable and useful information, much of which the participants didn’t know. The results also told us that we should make further changes to help readers grasp concepts about the prevalence, risk, and nature of alcohol use disorders. Revisions are continuing and the next version will be focus tested once more, on a limited basis, before printing this spring.