The Division of Treatment and Recovery is an extramural NIAAA Division that focuses on developing treatments for alcohol use disorder (AUD), increasing their use in real-word settings, and understanding the process of recovery as individuals make progress in overcoming AUD. The Division is comprised of two branches: the Medications Development Branch (MDB) and the Treatment, Health Services, and Recovery Branch (THSRB).

Medications Development Branch:

The Medications Development Branch (MDB) plans, stimulates, develops, and supports pharmacotherapy research to AUD. This includes advancing promising medications through the drug development pipeline: identifying lead compounds and optimizing their structure for potency, stability, selectivity/specificity, bioavailability, testing for preclinical efficacy (e.g., alcohol animal models), completing IND requirements (pharmacokinetic evaluations, toxicology, and formulation/manufacturing), supporting phase 1 studies (pharmacokinetic evaluations, pharmacodynamics/target engagement, safety, alcohol interaction, and abuse liability), conducting human laboratory studies and clinical trials, and directing secondary analyses to improve methodology of pharmacotherapy clinical trials for the treatment of AUD. MDB is also committed to research precision medicine to predict favorable responders (both efficacy and safety) to a specific medication, alcohol/psychiatric comorbidity, especially post-traumatic stress disorder, internal and external collaborations to advance the development of medications for AUD, and training programs to assure that adequate numbers of highly competent scientists are engaged in current and future research on medications development.

High priority MDB activities include:

  • developing and testing novel and repurposed medications for the treatment of AUD;
  • advancing precision medicine by identifying  subgroups who respond favorably to experimental compounds. This includes developing novel computational analytical approaches using a combination of patient characteristics and biomarkers. Discovering new biomarkers is a high priority that includes the integration of “multi-omics” signature profiles involving expression of genes, RNA, proteins, and metabolites; brain endogenous metabolites, electrophysiological variation, individual cell imaging and other biological mechanisms such as hiPSC-based neuronal models 
  • developing new pharmacological treatments to treat patients with AUD and psychiatric comorbidity (e.g., post-traumatic stress disorder); 
  • stimulating research that develops and evaluates alcohol biosensors for the purpose of objectively measuring real-time alcohol intake;
  • developing and implementing a standardized human laboratory paradigms program for screening/testing promising medications; and
  • promoting the initial evaluation of promising new compounds in human patients via the NIAAA SBIR Investigational New Drug (IND)-enabling program.

Treatment, Health Services, and Recovery Branch:

The Treatment, Health Services, and Recovery Branch (THSRB) stimulates and supports research in broad categories such as health services, behavioral therapies and mechanisms of behavioral change, recovery, translational research, and innovative methods and technologies for AUD treatment and sustaining recovery. Other areas of interest include topics focusing on special-emphasis and underserved populations, including HIH-designated US health disparity populations, as well as those with co-occurring disorders, and fetal alcohol spectrum disorders (FASD). In all studies, at all levels from FASD to elderly, efforts are made to include participants that reflect the diversity of the population at large.  High priority THSRB activities include:

  • Improving health services research: focusing on four main areas: 1) make evidence-based treatment more accessible to patients; 2) make treatment settings more appealing to patients; 3) make treatments more affordable; and 4) disseminate and implement evidence-based behavioral and pharmacological treatments into professional healthcare practices. Other areas include:
    • Improve access to evidence-based treatments by identifying and developing strategies to reduce the barriers (personal and structural) that prevent people with AUD and alcohol misuse from seeking and receiving appropriate care
    • Explore the treatment gap as it relates to gender, age (from adolescence through older adulthood), race/ethnicity, socio-economic status, immigration status, and health literacy, and improve service delivery systems and innovations to facilitate access to care
    • Remove the stigma of AUD and integrate AUD treatment into mainstream health care
  • Improving the effectiveness of behavioral interventions:
    • Evaluate evidence-based behavioral therapies in real world treatment settings, especially for culturally diverse and special emphasis and underserved populations
    • Disseminate clinical practice findings from mechanism of behavioral change studies that have shown promise in enhancing the effectiveness of behavioral therapies
    • Use dynamic and person-centered statistical modeling approaches to evaluate how heterogeneity impacts alcohol use behavior within specific AUD treatments
  • Understanding the dynamics of post-treatment recovery (see NIAAA’s research definition of recovery) :
    • Explore the neurobiological, psychological, environmental, and social factors that influence post-treatment recovery
    • Determine trajectories of recovery in subgroups of people with different cultural and socioeconomic backgrounds, cognitive abilities, and medical histories
    • Identify factors associated with so-called natural recovery and how these factors can be applied to change the behavior of those in treatment
    • Explore continuing care treatments that aim to support long-term recovery   
  • Understanding how the social determinants of health (i.e., environmental, social, cultural, and economic factors) influence outcomes and sustainability in health disparities:
    • Remove barriers that keep racial, ethnic, and sex/gender minorities from seeking and receiving appropriate health care
    • Implement effective treatments that are tailored for these populations in diverse clinical and other settings
    • Determine how social/cultural factors influence treatment accessibility, effectiveness, and long-term recovery
    • Develop measures to assess care delivery models to better address the issues underlying health disparities
  • Improving treatments for co-occurring PTSD, anxiety, depression, and AUD:
    • Integrate treatments for co-occurring AUD and mental health conditions to address the heterogeneity that exists among patients
    • Identify which types of services, service providers, and treatment settings work best for which subgroups
    • Determine how the treatment of one disorder can influence the risks, progression, and outcome for the other disorder
  • Harnessing new technology (e.g., mobile, computer, web-based applications, artificial intelligence/machine learning, geo-locations, and robotics) to increase the accessibility and effectiveness of a variety of treatments:
    • Use new technologies to disseminate evidence-based behavioral treatments among hard-to-reach populations, improve effectiveness of telemedicine, and enhance the continuum of care  
    • Investigate new digital technology ways of capturing real-time data in clinical trials and treatment protocols
  • Improving clinical research methods:
    • Develop efficient, adaptive clinical trial designs and statistical analyses that allow treatment adjustments based on the changing disease status of the patient
    • Explore new statistical models and methods for evaluating treatment effectiveness and recovery
    • Investigate statistical approaches that capture changes in outcomes over time and convey results that are more clinically intuitive.
  • Improving alcohol treatment outcomes for women:
    • Compare effectiveness of standard treatment approaches, such as group counseling and relapse prevention, in single-gender vs. mixed-gender groups   
    • Develop new strategies for alcohol screening, diagnosis, and interventions and tailor them to women in diverse settings, including prenatal care and specialty health care  
    • Understand 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  
    • Examine the effects of stress, early childhood trauma, childhood adverse events, and co-occurring disorders on women’s drinking  
  • 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

Alcohol and HIV/AIDS: The TRSB 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

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.  

Who should I contact within the Division about my research proposal?

Answer: 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. 

Can an NIAAA grant fund the delivery of treatment services?

NIAAA funds hypothesis-driven scientific research on the causes, consequences, prevention, and treatment of AUD.  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). 

Our Staff

Name Position Focus Area*
Raye Z. Litten, Ph.D.
Acting Division Director
alcohol biomarkers; Comorbidity PTSD; medications development
Joanne B. Fertig, Ph.D.
Acting Deputy Director, Medications Development Branch (MDB)
Comorbidity smoking; IND-enabling SBIR; medications development
Daniel E. Falk, Ph.D.
Program Director, Medications Development Branch (MDB)
Biostatistics; Clinical trial design; medications development; Outcome measures
Julie Simonds M.S.
Program Specialist, Medications Development Branch (MDB)
Jenica Patterson, Ph.D.
Program Director, Medications Development Branch (MDB)
co-occurring disorders; IND-enabling SBIR; medications development; translational research
Brett T. Hagman, Ph.D.
Program Director, Treatment, Health Services, and Recovery Branch (THSRB)
Behavioral treatments; Mechanisms of behavior change (MOBC); Recovery research; Research methods and statistics
Laura E. Kwako, Ph.D.
Program Director, Treatment, Health Services, and Recovery Branch (THSRB)
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, Treatment, Health Services, and Recovery Branch (THSRB)
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, Treatment, Health Services, and Recovery Branch (THSRB)
Adolescents/young adults; AUD and insomnia; co-occurring substance abuse and PTSD; innovative methods and technologies for AUD treatment and recovery; older populations; translational research
Maureen B. Gardner
Public Health Analyst, Treatment, Health Services, and Recovery Branch (THSRB)
Project management for major public health initiatives
Joan Romaine, M.P.H.
Public Health Analyst, Treatment, Health Services, and Recovery Branch (THSRB)
Project management for public health initiatives, including with faith leader audiences in the US.

Featured Publications

  1. Medications Development to Treat Alcohol Use DisorderA summary laying out NIAAA’s vision (i.e., long-range goals and key objectives) for ensuring the development and delivery of new and more efficacious medications to treat AUD over the next decade.
  2. Discovery, Development, and Adoption of Medications to Treat Alcohol Use Disorder: Goals for the Phases of Medications DevelopmentA description of the phases of medication development as they apply to AUD, and specific goals of each phase, to advance medications for the next decade. This aim of this article is to provide a guide that will aid the alcohol research community in planning, testing, and developing medications for AUD.
  3. Alcohol Medications Development: Advantages and Caveats of Government/Academia Collaborating with the Pharmaceutical Industry. A discussion of how collaborations-building partnerships among various stakeholders (e.g., government, academia, pharmaceutical and biotechnology companies) can expedite the medication development process for AUD.
  4. Research Opportunities for Medications to Treat Alcohol Use DisorderA commentary posing a number of issues (research opportunities) that must be addressed in order to advance the alcohol research field and to make medications a mainstream treatment for problematic drinking. These issues are framed from the perspective of the various stakeholders involved, including clinicians, patients, regulatory agencies, the pharmaceutical industry, and third-party payers.
  5. Heterogeneity of alcohol use disorder: understanding mechanisms to advance personalized treatmentA review of past and new approaches for characterizing various phenotypes and mechanisms underlying AUD, and an introduction to a new classification system to guide future research.
  6. Potential Medications for the Treatment of Alcohol Use Disorder: An Evaluation of the Clinical Efficacy and SafetyA review of potential (non-FDA-approved) medications being used off-label by clinicians to treat AUD. 

Extramural Programs

MDB supports several extramural clinical programs that investigate the safety and efficacy of medications for the treatment of AUD.

NIAAA Human Laboratory Program (HLAB):
HLAB is a pilot program started in 2016 designed to screen compounds for effectiveness using alcohol human laboratory paradigms.

NIAAA Clinical Investigations Group (NCIG):
NCIG is a clinical trials network started in 2007 to test the safety and effectiveness of promising medications in proof-of-concept, Phase II clinical trials.

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