Revised November 2011
We have a public health mandate to stop the devastating scourge of drug abuse and addiction afflicting this country. Translating the knowledge we have gained into new medications could revolutionize the way we treat addiction and even how we prevent drug abuse from occurring in the first place. It is a gaping need.
Despite many promising scientific leads, we still have no medications approved to treat stimulant, cannabis, inhalants, or polysubstance abuse, all of which can have catastrophic consequences.
NIDA is working hard to leverage research in partnership with private entities to help bring a medication to market, but it is an uphill battle. Many pharmaceutical companies shy away from medications development for illicit drug use disorders because of a perceived lack of economic incentive, the stigma still attached to illicit drug addiction, plus concerns about liability related to the overall health of individuals with substance use disorders. Yet we need private-sector involvement to harness the full clinical potential of scientific discovery.
Unfortunately, the pharmaceutical industry is reducing its investment in psychotherapeutics research and medications development,iv which not only reduces availability of medications for other mental illnesses, but contracts the pool of available medications for secondary uses, including the treatment of drug addiction.
Accumulated knowledge and recent discoveries have revealed numerous molecules and circuits that could serve as the basis for new approaches to medications development. To achieve the goal of accelerating medications development, NIDA is focusing on the scientific opportunities in the following research areas.
Advances in science and policy should provide incentives for engaging pharmaceutical companies. Capitalizing on new approaches that target brain circuits and molecules common to multiple addictions, including alcohol and tobacco, can help increase market share for resulting medications. Also, implementation of the Affordable Care Act stands to expand access to substance abuse treatment and open up the market for addiction medications.
Having viable medications available to treat substance use disorders, so costly to our society, would help these conditions become recognized as medical disorders, reducing the associated stigma and facilitating the proper treatment of people suffering from the disease of addiction. Given the dearth of medications available for this purpose (including for nicotine addiction), support of medications development for drug abuse and addiction will have a major impact on public health and the overall economy.
i http://www.cdc.gov/tobacco/data_statistics/fact_sheets/health_effects/effects_cig_smoking/index.htm
ii Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Applied Health Statistics and Quality (2010). The DAWN Report: Highlights of the 2009 Drug Abuse Warning Network (DAWN) Findings on Drug-Related Emergency Department Visits. Rockville, MD. Available at: http://oas.samhsa.gov/2k10/DAWN034/EDHighlights.htm
iii Adams CP and Brantner VV. Spending on new drug development. Health Economics 19:130-141, 2010; —Estimating the cost of new drug development: Is it really 802 million? Health Affairs 25:420–28, 2006. DiMasi JA, Hansen RW, Grabowski HG. The price of innovation: new estimates of drug development costs. Journal of Health Economics 22:151-185, 2003.
iv Associated Press, March 2, 2010: "AstraZeneca shuffles, eliminates Del. R&D jobs." The Motley Fool, February 26, 2010: "Drug Company Cost Cuts: Careful What You Wish For" (http://www.fool.com/investing/general/2010/02/26/drug-company-cost-cuts-careful-what-you-wish-for.aspx?source=isesitlnk0000001&mrr=1.00).