Introduction

There has never been a better time to look at the future of drug abuse and addiction research. Twenty-five years of NIDA-funded studies on the biological, behavioral, and social bases of drug abuse and addiction have brought us tremendous increases in our understanding of drug abuse and addiction and what we can do about them. This very strong science base, coupled with the availability of new biomedical technologies, has brought us to the cusp of even greater discoveries that will provide further insights about the root causes and consequences of illicit drug and tobacco abuse. These advances, in turn, offer unprecedented opportunities to develop new therapies and interventions for both treating and preventing drug abuse and addiction, and for dealing with their many direct and indirect effects.

There has never been another time in the history of biomedical science when so many new tools, particularly those of modern molecular biology, genomics, and real-time neuroimaging, have enabled researchers to make stunning advances in understanding how the human body functions at all levels, from basic cellular processes to complex behaviors. Problems that were once thought to be insurmountable are falling to scientific progress almost daily, and the optimism that pervades biomedical science in general, and drug abuse research in particular, bodes well for the future. For example, while there are still major questions about why drugs can have such powerful and long-lasting effects on those who abuse them, we now have insights about the molecular details of how every drug of abuse exerts its actions on the human brain and other organs. As a result, it is reasonable to believe that vexing questions will be answerable in ways that will generate new treatments and preventive measures for drug abuse and addiction.

NIDA's goal on the threshold of the 21st century is to seize upon these scientific advances and opportunities to significantly reduce the health and social consequences of drug abuse and addiction. Without a doubt, science will provide the means to accomplish this goal, not only in the conduct of state-of-the-art basic research, but also in our expanding effort to apply scientific understanding to the development of new treatments and prevention strategies. Indeed, NIDA has already begun to establish the vehicles for accomplishing this: the National Drug Abuse Treatment Clinical Trials Network (CTN), launched in the fall of 1999, and a solid foundation of prevention research that forms the basis of our new generation of prevention research.

As the CTN grows over the next 5 years, its goal will be to bring researchers and practitioners together as partners to conduct full-scale testing of promising new medications and behavioral treatments in a wide range of community drug abuse treatment clinics with patients from a variety of ethnic and social backgrounds. NIDA believes that its new CTN will revolutionize drug abuse treatment research, sow the seeds of scientific knowledge in every community in the Nation, and nourish the growth of more effective drug abuse treatment.

The CTN will strive to close the gap that for too long has existed between treatment research and community practice by blanketing the Nation with "research nodes," which combine treatment research centers and a range of community-based treatment programs affiliated with those centers. By enabling researchers and practitioners to adapt science-based drug abuse therapies to real-world conditions and demonstrate their effectiveness in community settings, the CTN will foster incorporation of new interventions into treatment programs across the country. The CTN also will enable researchers to take the practical knowledge gained from clinicians back to the laboratory and apply it to the development of even more practical and effective drug abuse treatments.

The CTN also will be useful to other aspects of NIDA's research portfolio. For example, multisite clinical trials with diverse patient populations could provide a valuable resource to researchers interested in elucidating genetic and environmental determinants of vulnerability. Ultimately, increased understanding of the roles played by genetics, environment, and their interaction in shaping an individual's susceptibility to drug addiction will lead to a variety of more targeted drug abuse prevention and treatment approaches.

In 1997, NIDA published the first research-based guide to preventing drug use among children and adolescents. The prevention principles explained in "Preventing Drug Use Among Children and Adolescents" to be taken to a new and greater level of specificity. NIDA is launching a new prevention research initiative that will seek to identify how these prevention principles can best be translated into practice. Prevention programs cannot simply be replicated in any new setting, but must be adapted to the special characteristics of different locales and settings as well as to differences in the needs and responses of audiences that vary in gender, ethnicity, and age. As we develop the drug abuse prevention programs of tomorrow, NIDA will aggressively promote the integration of the latest research-based drug abuse prevention programs into existing State, county, and community systems and programs that play an important role in community life.

Members of minority populations are disproportionately affected by the consequences of drug abuse. Accordingly, NIDA is taking extra effort to understand the causes of and factors contributing to these inequalities. In the next 5 years, NIDA will be intensifying its efforts in all areas of its portfolio, including basic, clinical, and epidemiological research, to increase our understanding of the link between drug abuse and various diseases that predominantly affect underserved populations, so that treatments, interventions, and prevention programs that are culturally relevant can be developed to eliminate health disparities.

In the next 5 years, NIDA will also continue its strong commitment to the training and support of future drug abuse researchers, including minority researchers. In the past 10 years, NIDA has been aggressively expanding the National Research Services Act awards to increase the number of scientists conducting drug abuse and addiction research. In addition, NIDA has been a leader among NIH institutes in developing other funding opportunities for investigators early in their careers. To achieve the goals of this strategic plan, NIDA recognizes the importance of maintaining this tradition.

NIDA remains committed to sharing its research findings with the broadest community possible. We know that we cannot just disseminate research findings through journal articles in the hopes that busy treatment and prevention providers or policymakers will have time to read, analyze, and implement a particular finding. That is why we will make every effort to translate these findings in a way that is both useful and used. As we move into the new millennium, NIDA will continue to expand its dissemination efforts to ensure that not only the Nation's treatment and prevention providers, but everyone, will benefit from the fruits of NIDA research.

In NIDA's first 25 years, the power of science has begun to dismantle ideologies, myths, and superstitions about drug abuse and addiction; improve the lives of drug-addicted patients; and reduce the harmful individual, social, and public health consequences of this destructive disease. In the next 5 years, the combined power of science and practice will accelerate the development and application of the next generation of drug abuse prevention and treatment programs to ensure even greater reductions in the Nation's drug abuse problems.