The Division of Treatment and Recovery Research (DTRR) stimulates and supports research to improve behavioral treatment for alcohol use disorder (AUD) and identify the organizational and financial factors that influence the adoption of evidence-based behavioral treatments into everyday practice settings.  The Division’s goals include:

Mission and Goals

  • Improving the effectiveness of behavioral interventions through studies on:
    • underlying mechanisms of behavior change
    • translation of neuroscience research findings to novel behavioral treatments
    • specialized behavioral therapies for understudied populations
  • Understanding the dynamics of post-treatment recovery through studies on:
    • the neurobiological, psychological, environmental, and social factors that influence post-treatment recovery
    • trajectories of recovery in subgroups of people with different cultural and socioeconomic backgrounds, cognitive abilities, and medical histories
    • factors associated with so-called natural recovery
    • continuing care treatments that aim to support long-term recovery   
  • Increasing the use of evidence-based behavioral treatments in real-world practice settings through studies on:
    • facilitators and barriers to adoption of evidence-based treatments
    • strategies to improve the quality of care among underserved populations
    • the impact of policy and financing on the delivery of alcohol treatment services
    • ways to improve access to high quality treatment services
    • ways to de-implement ineffective or harmful treatments
  • Improving treatments for co-occurring PTSD, anxiety, depression, and alcohol use disorder through studies on:
    • combinations of behavioral interventions for co-occurring PTSD, anxiety, depression, and AUD
    • factors that influence treatment effectiveness
    • combined behavioral treatments and pharmacotherapies, developed in collaboration with the Division of Medications Development.
  • Harnessing new technology to increase the accessibility and reach of behavioral interventions through studies on:
    • mobile and web-based interventions  
    • computerized versions of empirically-supported treatments
  • Improving clinical research methods through studies on:
    • efficient, adaptive clinical trial designs and statistical analyses that allow treatment adjustments based on the changing disease status of the patient
    • new statistical models and methods for evaluating treatment effectiveness  
    • statistical approaches that capture changes in outcomes over time and convey results that are more clinically intuitive.
  • Improving alcohol treatment outcomes for women through studies on:
    • the comparative effectiveness of standard treatment approaches, such as group counseling and relapse prevention, in single-gender vs. mixed-gender groups   
    • the effects of gender-specific treatment approaches, compared with standard treatment  
    • the impact of coexisting conditions, including other substance use and mental health disorders, on alcohol-related health care, illness, and death among girls and women  
    • innovative strategies for alcohol screening, diagnosis, and brief intervention for high risk girls and women in diverse settings, including prenatal care and specialty health care  
    • the effectiveness of different interventions to reduce the quantity and frequency of drinking among girls and women of different ages  
    • innovative strategies to improve coordination of care for women and their families across alcohol treatment services and other components of integrated health systems
  • Increasing the number of behaviorally-oriented clinical researchers (primarily clinical psychologists) who receive NIAAA training and career development grants (F’s, K’s—especially, the K99/00).

Consortia and Centers

Consortia     

  • Alcohol and HIV/AIDS: The DTRR portfolio includes four Alcohol and HIV/AIDS Consortia that serve as laboratories where promising behavioral and pharmacological interventions for co-occurring alcohol misuse and HIV/AIDS are evaluated for real-world effectiveness in people living with HIV and AIDS. Collectively known as the Consortia on HIV/AIDS, Alcohol, and Aging Research Translation (CHAAART), these include:
    • Consortium to Improve Outcomes in HIV/AIDS, Alcohol, Aging, and Multi-Substance Use (COMpAAAS; Yale University): This consortium started in 2001 as the Veterans Aging Cohort Study (VACS), a three-site observational study of military veterans with HIV/AIDs and harmful alcohol use. It has grown to include eight VA hospitals, more than 7,000 patients, and observational, operations, and intervention research cores.
    • Alcohol Research Consortium in HIV (ARCH; Johns Hopkins University):  Including both observational and intervention research cores, this consortium focuses on the development of interventions for harmful drinking among women living with HIV/AIDS, and on improving the management of co-occurring HIV/AIDS and AUD in primary care settings.
    • Southern HIV Alcohol Research Consortium (SHARC; University of Florida):  This consortium focuses on the development of interventions for harmful drinking among women living with HIV/AIDS, and on enhancing contingency management as a treatment option for people living with these co-occurring disorders. 
    • Alcohol and HIV:  Biobehavioral Interventions and Interactions (Brown University):  Key focus areas in this consortium include the development of interventions for alcohol and HIV/AIDS in sexual minority men, and elucidating the effects of alcohol on the central nervous system in people with HIV/AIDS.

 

  • PTSD and Comorbidity:  Trauma Survivors Outcomes and Support (TSOS) Trial: A Policy-Relevant, U.S. Trauma-Care System Pragmatic Trial for PTSD and Comorbidity. This trial is currently being conducted at 24 Level 1 trauma care centers across the United States. This project will enable a series of innovations in the efficient development and implementation of a large-scale, policy-relevant, pragmatic randomized clinical trial targeting PTSD and comorbidity for injured patients cared for at U.S. trauma centers.

Research Centers

  • The Charleston Alcohol Research Center (2P50AA010761): This center embraces multidisciplinary and translational research approaches, integrating both basic research and clinical investigations centered on the common theme of treatment and treatment implications for alcohol use disorder.
  • The University of Connecticut Alcohol Research Center (5P60AA003510-40):  This research program focuses on vulnerability to alcohol use disorder and promising biological and psychosocial interventions.

Conferences

Frequently Asked Questions

What is the process for applying for funding?  

See the NIAAA application process homepage for information about grant applications, the peer review process, and understanding how applications are selected for funding.  You can also find instructions in the Funding Opportunity Announcement to which you are applying.   

What are the most important things to do when considering applying to DTRR? 

Plan to talk with a Program Director as you start your process, well before submitting an application. This is a good way to learn about programmatic priorities and steps in the application process. See the names and focus areas below to find the appropriate staff member (or the contacts for the funding opportunities above), and send an email to request setting up a call.  Before talking with the NIAAA contact, craft a 1-page prospectus to shape your thinking and help you and the Director discuss your idea.  Describe your research proposal, why you find it interesting, and the link between your proposed research methods and getting to the answers you hope to reach. 

Does NIAAA support secondary analysis projects?

Yes. There are a number of important questions related to treatment development and treatment delivery that can be addressed through secondary analysis of existing data sets.  Such projects must demonstrate innovation as well as the potential to inform clinical or treatment services research questions with meaningful public health impact.  Researchers should consult PAR-16-234 and PA-16-395 for examples of the kinds of secondary analyses that NIAAA supports, and as always, talk to a Program Director before applying.

Can an NIAAA grant fund the delivery of treatment services?

NIAAA funds hypothesis-driven scientific research on the causes, consequences, prevention, and treatment of alcohol use disorder.  As a general rule, grant funds cannot be used to support the delivery of treatment services outside the context of the research study (e.g., as an arm of a clinical trial).  Researchers should contact a Program Director to discuss the specifics of proposals.  Treatment programs seeking operational support should contact one of our sister agencies: The Substance Abuse and Mental Health Services Administration (SAMHSA) or the Health Resources and Services Administration (HRSA). 

 

What is the definition of recovery from Alcohol Use Disorder (AUD)?

Recovery from AUD

Recovery is a process through which an individual pursues both remission from alcohol use disorder (AUD) and cessation from heavy drinking1. An individual may be considered “recovered” if both remission from AUD and cessation from heavy drinking are achieved and maintained over time. For those experiencing alcohol-related functional impairment2 and other adverse consequences, recovery is often marked by the fulfillment of basic needs, enhancements in social support and spirituality, and improvements in physical and mental health, quality of life, and other dimensions of well-being3. Continued improvement in these domains may, in turn, promote sustained recovery.

Remission from DSM-5 AUD

Remission from DSM-5 AUD Remission from alcohol use disorder (AUD), as defined by DSM-5 criteria4, requires that the individual not meet any AUD criteria (excluding craving). Remission from AUD is categorized based on its duration: initial (up to 3 months), early (3 months to 1 year), sustained (1 to 5 years), and stable (greater than 5 years).

Cessation from Heavy Drinking

Cessation from heavy drinking is defined as drinking no more than 14 standard drinks5 per week or 4 drinks on a single day for men and no more than 7 drinks per week or 3 drinks on a single day for women6. Cessation from heavy drinking can be categorized based on the duration: initial (up to 3 months), early (3 months to 1 year), sustained (1 to 5 years), and stable (greater than 5 years).

 

1See definitions: “Remission from AUD” and “Cessation from Heavy Drinking”

2Alcohol-related functional impairment varies among individuals and may involve intimate, family, and social relations; financial status; vocational functioning; legal affairs; and residence/living arrangements.

3Self-care, personal growth, subjective experiences (e.g., happiness), engagement in community, concern for others

4DSM-5 Criteria for AUD Diagnosis

  • Consumed more alcohol or spent more time drinking than intended.
  • Want to limit or halt alcohol use but haven’t succeeded.
  • Spends an inordinate duration drinking, being ill and undergoing the after-effects of alcohol use.
  • Strong cravings for alcohol.
  • Consuming alcohol or becoming ill because of it has kept the person from properly attending to household duties and children, or resulted in difficulties performing on the job or at school.
  • Continued drinking in spite of it causing problems with family and loved ones.
  • Discontinue or are only sporadically involved with things that were once enjoyable or important to be able to drink.
  • Have repeatedly been in situations during the consumption of alcohol that have increased the chance of being injured (using machinery, driving).
  • Even though a person feels sad or distressed, or it affects an already existing health problem, the person continues to drink. Or, after episodes of forgetting or going blank about the events during drinking, the individual continues to use alcohol.
  • Have to increase drinking to get the results he/she wants. (The usual amount of alcohol provides little results.)
  • When alcohol wears off, causing symptoms like such as insomnia, difficulty staying asleep, aggravation, nervousness, sadness, stomach upset and nausea and/or perspiring. Or, the person felt items were there, but they are actually not.

5In the United States, one "standard" drink (or one alcoholic drink equivalent) contains roughly 14 grams of pure alcohol, which is found in the following: 12 ounces of beer or 5 ounces of wine or 1.5 ounces of distilled spirits/hard liquor

6The risks associated with different levels of alcohol consumption for health and functioning vary across individuals. Compared to continued heavy drinking, cessation from heavy drinking (as well as other potential significant reductions in heavy drinking) is associated with decreased risk of physical, mental, and functional impairment. Abstinence, however, is considered the safest course, especially in certain subgroups, including, individuals managing medical conditions such as liver disease, bipolar disorder, abnormal heart rhythm, and chronic pain, women who are pregnant or trying to become pregnant, individuals who are taking medications that interact with alcohol, and individuals who cannot maintain a non-heavy drinking level over time.

 

Our Staff

Name Position Focus Area*
Raye Z. Litten, Ph.D.
Acting Division Director
alcohol biomarkers; Comorbidity PTSD; medications development
Brett T. Hagman, Ph.D.
Program Director
Behavioral treatments; Mechanisms of behavior change (MOBC); Recovery research; Research methods and statistics
Laura E. Kwako, Ph.D.
Program Director
Behavioral treatments; Health care systems; Precision medicine; Recovery.; SBIRT; Service integration; Treatment services research, including availability, utilization, and quality
Deidra Roach, M.D.
Program Director
Alcohol and HIV/AIDS; Alcohol use disorder (AUD) and co-occurring mental health disorders; Harmful drinking among women; treatment of HIV/AIDS and harmful drinking; AUD and co-occurring mental health and medical disorders; and fetal alcohol spectrum disorders
Mariela C. Shirley, Ph.D.
Program Director
College and college-age prevention; Genes and social environment; Military and veterans; Prevention Research Centers and Training Program; Psychiatric comorbidity; Screening and brief interventions
Maureen B. Gardner
Public Health Analyst
Project management for major public health initiatives
Joan Romaine
Public Health Analyst
Project management for public health initiatives, including with faith leader audiences in the US.

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