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National Institute on Drug Abuse marks 20 years of International Forum

July / August 2015 | Volume 14, Issue 4

Pakistani man squats on ground against wall while injecting needle into forearm
Photo from Amitiel Welfare Society, Pakistan,
courtesy of Photoshare

A man in Bahawalput, Pakistan, injects himself with
drugs from a used syringe.

By Cathy Kristiansen

From Pakistani heroin users sharing needles, to South African prostitutes agreeing to unsafe sex for money to buy methamphetamine, drug addiction is a global problem integrally linked to the spread of HIV and other diseases. To tackle these and other related problems, the NIH's National Institute on Drug Abuse (NIDA) supports international scientists as they make vital research discoveries and build much-needed expertise in low-resource countries. For 20 years, NIDA has hosted an annual International Forum to foster research collaborations and the exchange of scientific information by drug abuse researchers from around the world.

Scientific knowledge gained in the U.S. or elsewhere can deepen understanding of the drivers of drug use, but countless local factors also contribute to addiction - the culture, economic environment, educational opportunities, availability of health services and other influences. To design effective intervention programs and convince policymakers to fund them, locally obtained evidence is key.

"No single country can solve these problems by acting alone," according to NIDA Director Dr. Nora Volkow. "Through international collaboration and scientific exchange, we can translate our domestic successes in reducing the consequences of drug abuse to other countries, as well as allowing us to learn from their strides in disease prevention."

NIDA, which was established in 1974, directs its $1 billion annual budget toward research not only into psychoactive drugs - such as cocaine, heroin and amphetamines - but also into tobacco and a number of other addictive substances. NIDA's International Program works globally to form partnerships, promote new research initiatives, build research capacity and disseminate knowledge.

Drug addiction takes an enormous toll on people's productivity, quality of life and longevity, both directly and from related conditions such as HIV, hepatitis C and suicide, according to the WHO. Up to 7 percent of people aged 15-64 years reported using an illicit drug at least once the previous year, and between 16 and 39 million people worldwide suffer from problem drug use - yet only a sixth receive treatment, UN data show.

People who inject drugs have high rates of HIV infection for a number of reasons. They often share needles and syringes, which can contain remnant blood from an infected person, and are more likely to ignore safe sex precautions. Societal influences, such as stigma and the threat of incarceration, can discourage people who inject drugs from seeking HIV testing or treatment, and thereby raise the risk to themselves, others in their community and the wider population. The UN says about a third of HIV cases outside sub-Saharan Africa are spread by unsafe injecting practices.

NIDA's grantees have investigated previously neglected populations with high rates of HIV infection, including those who inject drugs, at-risk youth, sex workers and men who have sex with men. Their findings have helped shape unique interventions and strategies specifically tailored for each group. As well as injectable substances, NIDA supports global research into other forms of addiction, whether tobacco, khat, marijuana or other products that impair people's health over time, and its grantees study many related aspects, such as smoking in pregnancy, treatments to help wean people from heroin and the effect of addiction on the brain.

NIDA also places a high priority on training scientists around the world, partnering with Fogarty's Global Health Program for Fellows and Scholars (see the related article, Fogarty Fellow documents drugs and HIV risk in Kenya), and supporting a number of other research training programs for scientists at various stages of their careers.

"By investing in research capacity building in strategic world regions, we aim to develop self-sustaining scientific networks of addiction experts that will generate knowledge on the causes, prevention and treatment of drug abuse that will benefit us all," said Volkow.

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