NIDA Reprises Online Chat Day

Q & A NIDA Director Dr. Nora D. Volkow answers student questions on Drug Facts Chat Day.

NIDA staffers responded to 1,300 questions about drug abuse and addiction during the Institute's second annual Chat Day. Students and teachers from 100 schools in 23 states sent 11,000 queries from classroom computers. Nearly 40 NIDA scientists and science communicators responded to the queries during the day-long program. Although the sheer number of inquiries prevented personal replies to every questioner, the NIDA team's answers covered the issues that students asked about most often.

"Reaching people in their teen years with accurate information is one of the most important addiction-prevention efforts we can make," says NIDA Director Dr. Nora D. Volkow, who was one of the scientists responding to questions. "The unexpectedly high volume of questions underscores how much teens—and their teachers—want to learn real facts about drug use."

The queries covered a wide range of substances, including alcohol, cigarettes, marijuana, methamphetamine, cocaine, prescription medications, inhalants, steroids, heroin, LSD, over-the-counter medications, and lesser known substances like hallucinogenic mushrooms and salvia, a psychoactive herb. Some sample exchanges:

Q: What makes drugs addictive?
A: Drugs are addictive because they affect parts of the brain that are involved in feelings of pleasure (drugs increase the chemical dopamine in the reward system). When something activates the reward system it makes you want to do it again and again. But there's a catch—when you take drugs repeatedly, the brain changes. The reward system becomes less sensitive so you need more of a drug to feel good, and those things in your life that used to feel good—like eating an ice cream sundae, listening to music, hanging out with friends—lose their ability to give you pleasure. Ultimately, it all backfires, and drugs become the main motivating force in your life in an attempt to try and feel normal.

Q: What is the strongest/most dangerous drug?
A: Opiates such as heroin or prescription painkillers can cause a person to stop breathing. Cocaine can cause seizures, mental problems like anxiety and psychosis (losing touch with reality), and problems with your heart. Drugs can even cause your heart to stop beating. Methamphetamine can cause strokes, heart disease, and problems with thinking. PCP can cause people to stop breathing and can cause psychosis.

Q: My boyfriend tells me if I do weed, then he won't leave me. I love him, but I don't want to do it. I guess you can say that if he wants me to do that, then he's not being a good boyfriend.
A: You'll have to decide for yourself whether your boyfriend is good for you or not. But... good for you for knowing that marijuana, besides being illegal, is a health hazard. There are many negative effects of smoking marijuana. It can cause loss of coordination and affect memory, judgment, and perception. Under the influence of marijuana, you could fail to remember things you just learned, watch your grade-point average drop, or crash a car. Some people may suffer sudden feelings of anxiety and have paranoid thoughts, which is more likely to happen when higher doses are used or when it is taken orally. It's difficult to tell what the effects of marijuana will be because they vary based on the person, their drug history, how much marijuana is taken, and its strength.

Many students asked about the effects of using drugs or alcohol during pregnancy, how they could get help for a friend or family member, and whether addiction could be inherited. To read the Chat Day transcript and find answers to frequently asked questions, see www.nida.nih.gov/chat/.

Three Scientists Receive Grants for Innovative AIDS Research

NIDA announced the first three recipients of its new Avant-Garde Award, which supports groundbreaking research to prevent and treat HIV/AIDS in drug abusers. The awardees will each receive $500,000 per year for 5 years.

Julio Montaner, M.D., head of the Division of AIDS at the University of British Columbia and director of the British Columbia Centre for Excellence in HIV/AIDS in Vancouver, will study HIV/AIDS treatment and prevention outcomes in injection drug users (IDUs). Current evidence indirectly suggests that expanded use of the therapy known as highly active antiretroviral treatment (HAART) will not only decrease sickness, hospitalization, and death among IDUs infected with HIV but also decrease the rate of new HIV infections. Dr. Montaner's project will provide HAART to IDUs in the Vancouver neighborhood considered British Columbia's epicenter of both HIV and drug use. The work will test innovative strategies for monitoring HIV in this hard-to-reach population, evaluate novel approaches to providing care and enhancing adherence to the treatment, and track the sources of new infections using social and sexual networks and HIV gene sequencing. Dr. Montaner says that unless society finds a way to deal with HIV among IDUs in a compassionate and supportive fashion, we will not succeed in controlling the broader HIV epidemic.

Ileana Cristea, Ph.D., an assistant professor in the Department of Molecular Biology at Princeton University, Princeton, New Jersey, will investigate how HIV usurps a person's cellular machinery for its own purposes and how the human cell responds. She recently developed a technique that visualizes proteins in live cells and identifies their interactions. In her project, her research team will use the technique to characterize the interactions of 11 enzymes that play a role in a process called chromatin remodeling, which HIV uses to conceal itself within host cells. The team also plans to search for mechanisms that regulate the fate of a cell after HIV infection. Dr. Cristea says that the work may provide new therapies for purging latent viruses from their cellular reservoirs.

Jerome Groopman, M.D., professor of medicine at Harvard Medical School and chief of the Division of Experimental Medicine at the Beth Israel Deaconess Medical Center in Boston, Massachusetts, plans to develop agents to block the spread of HIV within the body. To inhibit HIV passage between cells and through lymphatic channels, Dr. Groopman and his team will exploit a newly discovered ligand-receptor system. The project's goal is to contain the virus at the site of the initial infection, where it can be targeted with a combination of antiviral treatments. Dr. Groopman says that the work may lead to a paradigm shift in HIV therapy.

Conferees Discuss Ways to Eliminate Disparities in Care

Many African-American and Latino drug abusers with HIV and hepatitis C (HCV) avoid screening and treatment for their infection because they distrust the health care system and fear discrimination on the part of providers, according to NIDA-funded researcher Dr. Carmen Masson and colleagues at the University of California, San Francisco.

This and other barriers to care faced by minorities and the poor were discussed at the National Institutes of Health Summit on the Science of Eliminating Health Disparities, held December 16-18, 2008, in National Harbor, Maryland. The summit brought together more than 4,000 scientists, clinicians, policymakers, educators, and health advocates from the United States and abroad, including a dozen NIDA officials and 15 NIDA-funded researchers. "The summit presented the collective contribution of NIH and NIH-funded researchers to new knowledge related to eliminating health disparities," says Dr. LeShawndra Price, a member of the NIH Planning Committee and the Health Disparities Workgroup in NIDA's Division of Epidemiology, Services and Prevention Research. "The meeting highlighted the progress of research aimed at improving prevention, diagnosis, treatment, and services and considered strategies to maximize the research's public health impact."

Dr. Masson reported on a study of 100 men and women infected with either HIV or HCV who took part in syringe exchange and methadone maintenance programs in New York and San Francisco. Dr. Masson and colleagues found that, in addition to distrusting the health care system and expecting to be stigmatized, these patients had misconceptions about HCV transmission, received inadequate HIV post-test counseling, and lacked followup on treatments.

The following NIDA-funded studies were also presented:

• "Always Be Straight With Me": Black Patients' Experiences in Racially Discordant Mental Health Encounters, by Dr. Margarita Alegría, Harvard Medical School and Center for Multicultural Mental Health Research;
• Developing and Sustaining a University-based Research Infrastructure Serving Latinos with Substance Abuse and HIV/AIDS, by Dr. Mario De La Rosa, Florida International University;
• Environmental Strategies for Mental Health Promotion, by Dr. Debra Furr-Holden, Johns Hopkins Bloomberg School of Public Health; and
• Reducing Substance Use and HIV Health Disparities Among Hispanic Youth: The Familias Unidas Program of Research, by Dr. Guillermo Prado, University of Miami.

Along with the research reports, the meeting showcased best practices, highlighted achievements in minority health care and health disparities research, and provided a forum for networking and future dialogue. The National Center on Minority Health and Health Disparities planned the meeting in collaboration with other NIH agencies and several private and nonprofit partners.

Volume 22, Number 4 (October 2009)