Significant Items In House And Senate
NATIONAL INSTITUTES OF HEALTH
National Institute on Alcohol Abuse and Alcoholism
SIGNIFICANT ITEMS IN HOUSE AND SENATE
APPROPRIATIONS COMMITTEE REPORTS
FY 2000 House Appropriations Committee Report Language (H.R. Report 106-370)
Item
Alcohol Liver Disease - Alcohol liver disease (ALD) is a major cause of morbidity and mortality in this country and developing effective interventions for this disease is important. The Committee is pleased by the NIAAA funded research on ALD, such as the role of cytokines in the inflammatory response, and encourages the Institute to enhance its research on treatment. (p. 101)
Action taken or to be taken
Scientists have made significant progress in understanding the biological mechanisms that lead to organ damage in alcoholic liver disease (ALD), the fourth leading cause of death among urban U.S. males and a source of costly morbidity. Among the findings are that reactive oxygen species (namely, producers of free radicals, which cause harmful changes in many molecules) and Tumor Necrosis Factor (TNF), a protein that causes an inflammatory response, play major roles in ALD. NIAAA-funded investigators are researching numerous methods to either inhibit TNF expression in liver cells directly through genetic manipulation or by specific insertion of TNF-inhibitors into liver cells. In FY 1999, the Institute expanded this research area through a Program Announcement (PA), entitled "Mechanisms of Alcohol-Induced Hepatic Fibrosis," which solicits grant applications elucidating new therapeutic approaches for the fibrosis seen in alcoholic liver diseases. Since TNF is implicated in many major diseases (for example, cancer, arthritis, and multiple sclerosis), advances in discovering how to selectively express cytokines associated with organ damage will benefit a variety of disciplines.
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Dietary Recommendations for Alcoholics - Almost 14 million American adults meet the medical criteria for a diagnosis of alcohol abuse or alcoholism at a significant cost to society. There is much that is unknown in the treatment of those with an alcohol problem. For example, at present alcoholics in treatment receive conflicting dietary guidance. Some treatment programs encourage sweets as a way to stave off the craving for alcohol while others advocate a diet void in sweets in order to prevent sugar-induced mood swings. The Committee encourages NIAAA to pursue research in this area. (p. 101)
Action taken or to be taken
The complexity of the biochemistry of appetite regulation is becoming increasingly evident, resulting in a profusion of research. NIAAA-funded scientists now are in the early stages of investigating whether common biochemical pathways regulate appetites for food, alcohol, water, drugs, and other substances. Alcohol and food intake are both consummatory behaviors. Thus, there may be common mechanisms underlying uncontrolled eating and excessive alcohol intake.
In FY 1999, the Institute issued a Program Announcement (PA), entitled "Peptide Regulation of Alcohol Intake," to identify peptides and their receptors that regulate alcohol consumption. Evidence indicates that hormones regulating food intake and energy balance (such as neuro-peptide Y), may act upon the same neural circuitry in the brain that controls alcohol consumption. Other areas with the potential for further investigation include the hypothalamic- pituitary-adrenal axis, opioid peptides, and the renin-angiotensin system. The goal of this research is to elucidate how these mechanisms interact to form circuits in the central nervous system that regulate appetitive behaviors, particularly pathological alcohol consumption. Understanding these pathways will help scientists search for ways of therapeutically altering them.
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Domestic Violence - The abuse of alcohol too often correlates with domestic violence. While domestic violence is the culmination of a complex set of interactions in the environment of the abuser, NIAAA is pursuing research that would identify the impact of alcohol on the brain and behavior of the abuser. In this way, an agent or a behavior modification that may counteract these effects may be identified, thus preventing domestic violence from occurring. The Committee commends NIAAA for pursuing this line of research and encourages its continuation. (p. 101)
Action taken or to be taken
The NIAAA has identified alcohol-related violence as a priority area of research. In addition to participating in two NIH-wide Requests for Applications (RFA) related to child neglect and violence within the family, a special forthcoming issue of the Institute's premiere journal, Alcohol Research and Health (jointly sponsored by the NIAAA and the National Institute of Justice (NIJ), U.S. Department of Justice), will focus on alcohol and violence, including domestic violence.
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Fetal Alcohol Syndrome - Fetal Alcohol syndrome (FAS) is a leading preventable cause of mental retardation and birth defects in the United States. The Committee is pleased with the new Request for Applications on prevention of FAS and encourages NIAAA to enhance research on the prevention of drinking during pregnancy and on effective treatments for children who have been exposed to alcohol during gestation. The Committee also commends NIAAA for its leadership in chairing the Interagency Coordinating Committee on Fetal Alcohol Syndrome (ICCFAS). The Committee encourages NIAAA to consider developing a National Clearinghouse on Alcohol-Related Birth Defects to serve as a national resource to educate the public about the dangers of drinking alcohol during pregnancy using science-based prevention and education strategies. (p. 101)
Action taken or to be taken
FAS research at NIAAA is supported in both the intramural and extramural programs and accounted for approximately 6.7% percent of the Institute's budget in FY 1999. Prevention of FAS is a high priority for the Institute. All meritorious candidates submitted in response to a recent request for applications have been funded. Research continues in a large community-based trial of comprehensive interventions to prevent FAS and other alcohol-related birth defects among four Plains Indian tribes, with two other Native American communities serving as comparison sites. A project to develop a screening tool and determine the prevalence of drinking in women in prenatal clinics in the District of Columbia also was cosponsored by the National Institute of Child Health and Human Development (NICHD). Data collection now has been completed, and data analysis is under way.
To aid the health care community in addressing the problem of FAS, the NIAAA has developed two manuals for use in clinical practice. These manuals soon will be ready for distribution. One is designed to train health practitioners who treat women of childbearing age on the assessment of risk drinking and on referral and intervention methods. The other provides a guide for pediatricians on screening children for FAS. The NIAAA plans to pilot test the effectiveness of both manuals with primary care health professionals. In addition, the NIAAA is preparing a Request for Proposals to establish a FAS clearinghouse.
The NIAAA will continue its leadership of the Interagency Coordinating Committee on Fetal Alcohol Syndrome (ICCFAS). Member organizations include seven organizations within the U.S. Department of Health and Human Services (DHHS), the Office of Special Education in the U.S. Department of Education (DoED), and the Office of Juvenile Justice and Delinquency Prevention in the U.S. Department of Justice (DOJ). To promote information exchange and to assure high quality research, the NIAAA sponsored an investigator workshop at the October 1999 ICCFAS meeting.
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Genetics - The NIAAA funded Collaborative Study on the Genetics of Alcoholism has discovered areas of the genome that are potentially related to alcoholism. The Committee is aware that data from this study will be released to the scientific community soon and encourages access to and continuing analysis of the data by the broader scientific community. (p. 102)
Action taken or to be taken
Approximately 50-60 percent of total population vulnerability to alcoholism is mediated by genetic factors. The NIAAA-funded Collaborative Study on the Genetics of Alcoholism (COGA) has found significant evidence for genetic linkages on several chromosomes. These chromosomal regions are likely to contain genes that influence alcohol-related behavior. This powerful new data set generated by COGA is now ready for release to the general scientific community. The COGA databases contain extensive clinical, diagnostic, psychological, neurophysiological, pedigree, and genetic data on thousands of individuals, who comprise hundreds of families of alcoholics under study. The neurophysiological data will be distributed by SUNY Downstate Health Sciences Center (New York, NY); all other data will be distributed by Washington University (St. Louis, MO). The companion collection of cell lines and DNA samples from individuals studied will be distributed by Rutgers University (Piscataway, NJ). The Institute plans to encourage intensive analysis of the substantial COGA data set by the broadest possible spectrum of investigators.
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Hepatitis C - Alcohol consumption by patients infected with Hepatitis C virus markedly increases liver damage and worsens the prognosis of the disease. Nearly 4 million Americans are infected with Hepatitis C virus, which causes an estimated 8,000 to 10,000 deaths per year. The Committee commends NIAAA for working with other NIH Institutes to cosponsor a symposium and is pleased by the new Request for Applications that focuses specifically on alcohol and Hepatitis C. The Committee urges further research and collaboration on this significant topic. (p. 102)
Action taken or to be taken
The NIAAA is an active and integral component of the research initiatives and collaborations among the NIH Institutes regarding hepatitis C virus (HCV). Heavy drinking increases the severity of hepatitis C and complicates its treatment. Recognizing the substantial increased risk for infected individuals to advance to end-stage liver disease and liver failure, the NIAAA has released a Request for Applications (RFA) in FY 2000. This solicitation specifically focuses on the role of alcohol in promoting end-stage liver disease and subsequent death in HCV patients. Principal goals of this research include elucidating alcohol's impact on the course of hepatitis C, as well as exploring potential mechanisms and their exploitation in the development of successful treatment options.
In FY 1999, the NIAAA also cosponsored other HCV initiatives. For example, the NIAAA participated in the requests for Hepatitis C Research Centers, sponsored by the National Institute of Allergy and Infectious Diseases (NIAID), that will provide a national research network blending basic research and clinical investigations to promote translational research in HCV research -- that is, bring the basic research findings into the clinic. In addition, the NIAAA co-sponsored a request for Small Business Innovation Research (SBIR) applications to establish new animal models to advance the field of alcohol and hepatitis C research. An underlying premise is that multi-disciplinary basic laboratory, animal model and clinical research is needed to advance our understanding of HCV and the liver disease and cancer it can cause. The Institute also has established a new collaboration with the American Liver Foundation's (ALF's) "Hepatitis C Initiative" and is working closely with the ALF in advancing patient-related information and activities.
Item
Medications Development - The Committee commends NIAAA's new initiative to develop medications based on the developing understanding of the neuroscience of alcohol. The development of medications and their testing in clinical trials are important for expanding treatment options in combating this disease. The Committee encourages NIAAA to continue research on methods for delivering drugs across the blood-brain barrier and on medications that target specific receptor subunits in the brain. (p. 102)
Action taken or to be taken
NIAAA-supported scientists are making rapid progress in understanding the neurobiologic mechanisms that underlie alcohol's effects. With this understanding comes the potential to design compounds that therapeutically alter these mechanisms. To channel this rapid accumulation of data toward medication development, the NIAAA is encouraging research grant applications that will result in new methods of screening promising compounds with therapeutic potential. This screening initiative also includes a component intended to stimulate research on pharmacotherapy for the sequelae of alcoholism, such as liver disease.
Project COMBINE, a large, multisite, clinical trial of promising alcohol-treatment medications -- naltrexone and acamprosate --
is ongoing. Investigators are testing the effectiveness of these medications alone and in combination. The medications are being evaluated with two behavioral interventions which are applicable to two types of treatment settings. One is applicable to primary care medical practices, and the other is suitable for addiction medicine specialty practices. Preliminary studies evaluating safety of the combination of the medications and the feasibility of the study protocol are in progress, and the main trial will begin early in year 2000.
Item
Moderate Drinking - The Committee is pleased that NIAAA has expanded its studies on the benefits and risks of moderate drinking. In addition to currently funded research on the health effects of alcohol on atherosclerosis, osteoporosis, cerebrovascular diseases, women's health, and those taking medications, the Committee encourages NIAAA to expand its investigations to include research into alcohol's effect on insulin metabolism, as well as the role of organic components in beverages, including antioxidant effects of phenolic compounds, on overall health. (p. 102)
Action taken or to be taken
The NIAAA continues to support research on the benefits and risks of moderate alcohol consumption, devoting more than $4 million to this topic in FY 1999. Staff are encouraging additional grants to study the health effects of moderate drinking to be submitted by alcohol- and non-alcohol researchers. The Institute is supporting research that examines disruption of insulin-mediated glucose transport by ethanol, which is a risk factor for non-insulin-dependent diabetes.
Item
Neuroscience -- Neuroscience research funded by NIAAA continues to play an important role in determining the biological basis of alcohol-related behaviors. The Committee recognizes the Institute's extensive neuroscience portfolio and supports continued research in areas such as neural circuitry, the action of alcohol on cell membranes and receptors, and the mechanism of craving, reward and reinforcement. The Committee anticipates the development of new medications for treatment of alcoholism and related disorders that will follow this research. (p. 102)
Action taken or to be taken
Approximately 25 percent of the NIAAA's resources are committed to neuroscience research. Recent neuroscience findings on the biologic mechanisms that underlie alcohol's effects represent new possibilities for development of medications for alcohol disorders. Most pharmaceuticals target specific protein sites. Scientists have identified at least one protein site on a neuroreceptor implicated in alcohol's neurodepressant actions, opening the potential for design of compounds to block such protein sites and, thus, alcohol's effects. In response to these and other findings, the Institute has solicited research grants for the study of in vivo screening models that will test new compounds for alcoholism pharmacotherapy. Another initiative solicits research that will examine how alcohol affects neurochemical changes that take place during adolescence.
NIAAA-supported scientists are using and expanding powerful new techniques for studying specific protein areas of neuroreceptors. Site-directed mutagenesis and chimeric techniques permit researchers to examine, individually, components of neuroreceptor proteins to determine if they are involved in the brain's response to alcohol. Gene knock-out techniques eliminate the activity of specific genes and the proteins they encode. These genetic techniques thus allow scientists to test whether specific proteins, including components of neuroreceptors, mediate alcohol's effects on nervous system function. The NIAAA will issue a Request for Applications (RFA) to apply these techniques to alcohol studies in FY 2000. In addition, NIAAA-funded investigators are among the pioneers of a microdialysis technique that enables researchers to directly measure -- simultaneously -- neurotransmitter and neurophysiologic response in freely-behaving rats exposed to cognition-altering substances.
Based on these neuroscience findings, NIAAA-supported scientists are developing new pharmacologic compounds. Grants awarded under the pharmacotherapy-screening initiative will enhance the laboratory testing process for evaluating the therapeutic potential and likelihood of risk associated with these substances. Once this screening task has been accomplished, promising compounds will follow the usual route in the medication-development pipeline; namely, testing for efficacy and safety in animal studies, then small-scale human trials, when appropriate. Compounds shown to be safe and effective in small-scale human trials will then become candidates for large-scale human clinical trials.
Item
Research to Practice Forums - The Committee commends NIAAA for cosponsoring the Research to Practice Forum with the Substance Abuse and Mental Health Services Administration, the New York State Office on Alcoholism and Substance Abuse Services, the Association of Alcoholism and Substance Abuse Programs of New York State, and the American Society of Addiction Medicine, which focused on bridging the gap between researchers and practitioners and translating scientific research into clinical applications. The Committee encourages NIAAA to support the implementation and evaluation of research-based services within the alcohol treatment system. (p. 102)
Action taken or to be taken
In 1997, the Director of New York's Office of Substance Abuse Services met with NIAAA Director
Dr. Enoch Gordis to discuss a number of issues affecting prevention and treatment services in the State. Two ideas emerged: (1) directing research dissemination efforts specifically to clinical directors of treatment programs, and (2) developing a rigorous research demonstration project to test recommended science-based clinical practices and measure outcomes in four or six volunteer treatment programs. To fund these efforts, the Institute entered a partnership with the Center for Substance Abuse Treatment (CSAT). The first phase of the collaboration was a "research-to-practice forum" held in Saratoga Springs, NY, in October 1998. The research symposium was designed specifically for clinical supervisors and directors in New York who received the most cutting-edge research findings on issues affecting their work for incorporation into their programs. In turn, researchers also benefited from input and information from the supervisors about real world barriers and difficulties encountered in their clinics.
The NIAAA and CSAT continue work with New York State, the provider's association, and clinical directors of six programs on phase II of this project. Six programs have been selected to participate in the Best Practices/ Researcher in Residence Program. The program's goal is to encourage the adoption in clinical practice of recent treatment research advances by placing nationally recognized scientists in brief periods of residence at participating clinical treatment sites. Information exchange between participating researchers and clinical supervisors and staff will occur through training sessions, research seminars, presentations of recently-developed techniques, case reviews, and clinical problem solving.
This program has been expanded to the State of North Carolina where a forum was held in November 1999. Phase II of the North Carolina project is under discussion and will be implemented in year 2000. If efforts in these two states show sufficient promise, they will be repeated elsewhere throughout the country.
FY 2000 Senate Appropriations Committee Report Language (Senate Report 106-166)
Item
Binge drinking - Alcohol abuse, particularly "binge" drinking and drinking with the intent to get drunk, continues to pose significant problems for college communities. The Committee strongly supports the efforts of NIAAA's Advisory Council Subcommittee on College Drinking and encourages the Subcommittee to identify the context and consequences of college drinking and provide recommendations on the prevention and treatment of the problem. (p. 156)
Action taken or to be taken
In FY 1999, approximately one-fourth of the Institute's budget was devoted to research on children, from infancy to young adulthood, to examine the causes and correlates of alcohol abuse on college campuses and/or design and test interventions to prevent and reduce binge drinking and other alcohol-related problems. The NIAAA collaborated with the U.S. Department of Education (DoED) and the Center for Substance Abuse Prevention (CSAP), Substance Abuse and Mental Health Administration (SAMHSA), in issuing a special Request for Applications (RFA), entitled "Prevention of Alcohol Related Problems Among College Students." Applicants were required to develop and/or test investigator-initiated or naturally occurring prevention strategies as a means of determining which interventions are actually effective. They were also encouraged to focus on so-called environmental interventions that attempt to change campus and community alcohol policies, as well as social norms, regarding the acceptability of alcohol use and abuse.
In 1998, the NIAAA's National Advisory Council formed a Subcommittee on College-Age Drinking, cochaired by the president of the University of Notre Dame and a leading alcohol investigator. The Subcommittee comprises 10 college presidents and 12 eminent alcohol researchers, who will advise the NIAAA about future research needs in this area. Two panels of the Subcommittee met in June 1999 to examine in depth what is currently known about the prevalence, context, and consequences of drinking by college students (Panel 1) and the prevention and treatment of college alcohol problems (Panel 2). Both panels are currently preparing reports, for the Subcommittee, that will include a series of commissioned papers, synthesis of research findings, and recommendations for researchers and for college presidents and administrators. The Subcommittee and Panel reports should be available in early 2001.
Item
Behavioral research on alcoholism - The Committee commends NIAAA's expansion of its behavioral science portfolio to include basic research of the underlying psychological and cognitive processes involved in alcohol related behaviors and encourages the Institute's efforts in this area. (p. 157)
Action taken or to be taken
The NIAAA continues to support numerous studies using behavioral animal models to examine the neurobiological and neurochemical mechanisms of alcohol-related behaviors, including reinforcement, craving, tolerance, dependence and relapse, as well as the interaction among stress, drinking and aggression. In combination with new molecular, genetic, and neuroimaging techniques that are the tools of neuroscience, it will be possible to discover neural pathways and changes at the cellular level that influence drinking behavior. Characterization of the cognitive and psychomotor changes associated with acute and chronic alcohol abuse also are well represented in the NIAAA research portfolio. The institute sponsored a symposium, entitled "The Cerebellum and Alcohol: Roles in Cognitive and Motor Functions," in FY 1999. The NIAAA plans to pursue this line of research in the future.
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Young Behavioral Science Investigators - The Committee commends NIAAA's establishment of its Behavioral Science Track Awards for Rapid Transition (B/START-NIAAA), a program of small grants for young investigators in behavioral science research. The Committee views this as essential for ensuring the supply of scientists needed to examine the numerous behavioral factors that play a central role in alcohol abuse and alcoholism. The Committee would like a report, by next year's hearings, on the progress of this program.
Action taken or to be taken
The NIAAA recognizes the value of behavioral and social science research to its mission. Overall, the proportion of its budget that the NIAAA devotes to behavioral and social science research -- both basic and applied -- is among the largest at NIH. The NIAAA is in the process of preparing the requested report on its B/START (Behavioral Science Track Awards for Rapid Transition) program, which began in 1999 and invites newly independent investigators to submit applications for small-scale, exploratory research projects. B/START features rapid review and funding decisions on applications for grants lasting no more than 2 years. In the short time since its issuance, the B/START program announcement (PA) has met with strong response.
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Alcohol abuse health services research plan - The Committee views health services research as an essential part of alcohol treatment and prevention, and would like the Institute to report on its progress in implementing this plan at next year's appropriations hearings (p. 157)
Action taken or to be taken
Recommendations in " Improving the Delivery of Alcohol Treatment and Prevention Services," an NIAAA report, have served well as the blueprint for the Institute's health services research program. All of the report's recommendations were included in a call for applications that covered the full range of health services research concerns, including the utilization, outcomes, and costs of care, and the effects of managed care and other developments in the organization and financing of services. More focused calls for applications have also been issued for research on the cost of alcoholism treatment and on secondary analysis of existing health services data sets. The Institute has also held symposia to summarize research knowledge on alcoholism treatment and women's health. Additionally, a set of "Research to Practice Forums" have been held in selected States (working in conjunction with State alcohol and drug treatment authorities) to stimulate the adoption of recent research findings into clinical practice.
Item
Fetal Alcohol Syndrome (FAS ) - The Committee urges the NIAAA to develop and support a National Clearinghouse on Alcohol-Related Birth Defects. FAS is caused by maternal alcohol use during pregnancy and is manifested in neurological and motor deficits, mental retardation, learning disabilities, and craniofacial malformations, among other symptoms. The societal cost of FAS is estimated at $3,400,000,000 annually. There is a strong need to fully inform women of child bearing age about alcohol-related birth defects and to get the message to health professionals. The Clearinghouse should serve as a national resource to educate the public about dangers of drinking alcohol during pregnancy and to develop science-based prevention and education strategies to address this major preventable health problem. (p. 157/158)
Action taken or to be taken
Please refer to page NIAAA-29 of this document for NIAAA's response to this significant item regarding fetal alcohol syndrome (FAS).
Item
Genetics - The Committee is excited by the discovery of the NIAAA-funded Collaborative Study on the Genetics of Alcoholism (COGA) on areas of the genome that are potentially related to alcoholism. The Committee is aware that these data will be released to the scientific community this fall and encourages access to, and continuing analyses of these data by the broader scientific community. (p. 158)
Action taken or to be taken
Please refer to page NIAAA-30 of this document for NIAAA's response to this significant item regarding genetics.
Item
Neuroscience - The Committee recognizes NIAAA's extensive neuroscience portfolio and supports continued research in areas such as neural circuitry, the action of alcohol on cell membranes and receptors, and the mechanisms of craving, reward, and reinforcement. (p. 158)
Action taken or to be taken
Please refer to page NIAAA-33 of this document for NIAAA's response to this significant item regarding neuroscience.
Item
Medications Development - The Committee encourages NIAAA to continue research on methods for delivering drugs across the blood-brain barrier and on medications that target specific receptor subunits in the brain. (p. 158)
Action taken or to be taken
Please refer to page NIAAA-32 of this document for NIAAA's response to this significant item regarding medications development.
Item
Alcohol and Hepatitis C - The Committee recognizes that nearly 4 million Americans are infected with hepatitis C, which causes an estimated 8,000-10,000 deaths per year. The Committee commends NIAAA for working with other NIH institutes to cosponsor a successful symposium and Request for Application (RFA) on hepatitis C. The Committee is also pleased by the new RFA that focuses specifically on alcohol and hepatitis C. The Committee urges further research and collaboration on this significant topic. (p. 158)
Action taken or to be taken
Please refer to page NIAAA-31 of this document for NIAAA's response to this significant item regarding alcohol and hepatitis C.
Item
Alcoholic Liver Disease - The Committee recognizes that alcoholic liver disease (ALD) is a major cause of morbidity and mortality in this country. Developing effective interventions for this disease is of paramount importance. The Committee is pleased by the NIAAA-funded research on ALD, such as the role of cytokines in the inflammatory response, and recommends that NIAAA sponsor additional research on treatment. (p. 158)
Action taken or to be taken
Please refer to page NIAAA-28 of this document for NIAAA's response to this significant item regarding alcoholic liver disease.
Item
Research to Practice Forum - The Committee commends NIAAA for cosponsoring the Research to Practice Forum with SAMHSA, the New York State Office of Alcoholism and Substance Abuse Services, the Association of Alcoholism and Substance Abuse Programs of New York State, and the American Society of Addiction Medicine. This event focused on bridging the gap between researchers and practitioners and translating scientific research into clinical applications. The Committee encourages NIAAA to support the implementation and evaluations of research-based services within the alcohol treatment system. Further, the Committee encourages NIAAA to further evaluate this work as a model for use with other states. (p. 158)
Action taken or to be taken
Please refer to page NIAAA-34 of this document for NIAAA's response to this significant item regarding the Institute's research to practice forum project.
Item
Alcoholism in children and adolescents - The Committee remains acutely concerned over the high incidence of alcoholism and alcohol abuse among children and adolescents of Native Alaskan and native Hawaiian descent. The Committee urges the NIAAA to work with existing native American and native Hawaiian organizations to assess and increase their effectiveness. (p. 159)
Action taken or to be taken
The NIAAA is supporting research on alcoholism and alcohol abuse among children and adolescents and research on the effects of alcoholism and alcohol abuse in minority populations. This research includes native Americans and native Hawaiians. At the request of the State of Hawaii, the NIAAA and the Hawaii Department of Health's Alcohol and Drug Abuse Division cosponsored a forum on treatment implications of alcohol research in March 1999. This forum featured eminent alcohol researchers, who presented a wide range of research-based treatment issues. Service providers from Oahu treatment programs participated in these interactive presentations.
The NIAAA also continues to work with the U.S. Indian Health Service (IHS) to assess the extent of alcoholism and alcohol abuse in native American populations, as well as support a broad range of studies to identify prevention and intervention strategies that would be effective within these communities.
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Youth Violence Prevention Initiative - The Committee encourages NIAAA to examine the relationship of alcohol and youth violence with other mental disorders and to test interventions to prevent alcohol abuse and its consequences. (p. 11)
Action taken or to be taken
Currently, the Institute is participating in an NIH-wide Request for Applications (RFA) on child neglect, which is a major risk factor for both alcohol abuse and subsequent violence. The NIAAA also was an active participant in a recent trans-NIH expert panel meeting on Youth Violence Intervention Research and is participating in a new trans-Institute RFA, Research on the Development of Interventions for Youth Violence, which will fund studies in this fiscal year and is based on recommendations emanating from that meeting. Several of the articles in the special issue of Alcohol and Health cited above also will deal with alcohol and youth violence.
Updated: October 2000