Minutes of the 160th Meeting of the NATIONAL ADVISORY COUNCIL ON ALCOHOL ABUSE AND ALCOHOLISM

DEPARTMENT OF HEALTH AND HUMAN SERVICES

NATIONAL INSTITUTES OF HEALTH

NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM

160th Meeting of the

NATIONAL ADVISORY COUNCIL ON ALCOHOL ABUSE AND ALCOHOLISM

The National Advisory Council on Alcohol Abuse and Alcoholism (NIAAA) convened for its 160th meeting at 12:32 p.m. on Tuesday, May 10, 2022, via Zoom videoconference and NIH Webcast. The Council met in closed session from 11:30 a.m. to 11:59 a.m. to review grant applications and cooperative agreements. Dr. Abraham Bautista, Director, Office of Extramural Activities, presided over the Council’s review session, which, in accordance with the provisions of Sections 552b(C)(6), Title 5, U.S.C., and 10(d) of Public Law 92-463, excluded the public for the review, discussion, and evaluation of individual applications for Federal grant-in-aid funds. The closed session recessed at 11:59 a.m.

Council Members Present:

Nancy Barnett, Ph. D.
Jill B. Becker, Ph.D.
Andrew MacGregor Cameron, M.D., Ph.D.
Christopher S. Carpenter, Ph.D.
Christina Chambers, Ph.D.
H. Westley Clark, M.D., J.D.
Constance M. Horgan, Sc.D.
Beth Kane-Davidson, LCADC, LCPC
Rhonda Jones-Webb, Ph.D.
Charles H. Lang, Ph.D.
Mary E. Larimer, Ph.D.
Laura E. Nagy, Ph.D.
Laura O’Dell, Ph.D.
Scott J. Russo, Ph.D.
Katie Witkiewitz, Ph.D.

Ex-Officio Member

Col. Charles S. Milliken, M.D.

NIAAA Director and Chair: George F. Koob, Ph.D.

NIAAA Deputy Director: Patricia Powell, Ph.D.

Executive Secretary: Abraham P. Bautista, Ph.D.

Senior Staff: Vicki Buckley, M.B.A.; David Goldman, M.D.; Ralph Hingson, Sc.D.; M. Katherine Jung, Ph.D.; Ph.D.; Raye Litten, Ph.D.; David Lovinger, Ph.D.; Antonio Noronha, Ph.D.; and Bridget Williams-Simmons, Ph.D.

Other Attendees at the Open Session

Approximately 168 people viewed the NIH live webcast, including representatives from constituency groups, liaison organizations, NIAAA staff, and members of the general public.

Call to Order

NIAAA Director Dr. George F. Koob, called the open session of the Council meeting to order at 12:32 p.m. on Tuesday, May 10, 2022. Council members and senior staff introduced themselves.

Director’s Report

Dr. Koob highlighted key recent NIAAA activities, referring to the written Director’s Report, which was distributed to Council members.

Fiscal Year (FY) 2022 Budget: On March 15, 2022, the President signed H.R. 2471 - Consolidated Appropriations Act, 2022. NIH received a total of $45.2 billion for FY 2022 (5.4 percent increase), including general increases to NIH Institutes and Centers (ICs); allocations for the Helping to End Addiction Long-term (HEAL) Initiative, the 21^st Century Cures Act, NIH Brain Research Through Advancing Innovative Neurotechnologies (BRAIN) Initiative, and the All of Us research program; and continued support for the Gabriella Miller Kids First Act pediatric research initiative. NIAAA received a total of $573.7 million for FY 2022 (3.4 percent increase). The President’s FY 2023 Budget was released on March 28, 2022 but is not yet approved.

NIAAA Funding Opportunities: Dr. Koob announced the following NIAAA-issued new Notice of Funding Opportunities (NOFOs):

• Specialized Alcohol Research Centers (P50, RFA-AA-22-001): Invites applications to foster and conduct interdisciplinary, collaborative research on alcohol use disorder (AUD), alcohol misuse and alcohol related problems, and other health related consequences across the lifespan and across racial/ethnic groups and other health disparity populations.
• Comprehensive Alcohol Research Centers (P60, RFA-AA-22-002): Invites applications to conduct and foster interdisciplinary, collaborative research on topics relevant to the NIAAA mission across the lifespan and across racial/ethnic groups and other health disparity populations. Applications must include a dissemination core to initiate and expand community education related to the activities of the proposed Center.
• Alcohol Health Services Research (R01, R34, PAR-22-157, PAR-22-157): Encourages research on closing the treatment gap for AUD, including increasing access to AUD treatment and making it more appealing, and reducing health disparities.
• Alcohol Treatment and Recovery Research (R01, R34, PAR-22-158, PAR-22-159): Encourages research on topics relevant to treatment of and recovery from AUD, including behavioral and pharmacotherapy, recovery, precision medicine, translational research, and innovative methods and technologies for AUD treatment and recovery.

Dr. Koob also announced the following Notices of Special Interest issued by NIAAA:

• Research on Alcohol and Coronavirus Disease (COVID-19) within the Mission of NIAAA (R01, R03, R21, K99/R00, NOT-AA-22-012): Invites grant applications that advance understanding of the critical interactions between alcohol use, SARS-CoV-2, and COVID-19. A central focus is research that can improve public health by informing responses to the evolving COVID-19 pandemic and its consequences.

A full list of NOFOs and NOSIs may be found in the NIAAA Director’s Report.

Alcohol and Healthy Aging: Current Research and Future Directions. On May 9, 2022, NIAAA participated in a webinar on alcohol and aging sponsored by the Friends of NIAAA, American Psychological Association, and the Research Society on Alcoholism. Speakers included:

• Robert Huebner, Ph.D., Chair, Friends of NIAAA
• Koob, who presented “Alcohol and Aging: An Overview”
• Katherine Keyes, Ph.D., who discussed “Increased Alcohol Consumption Among Older Adults: Trends, Causes, and Consequences”
• Sara Jo Nixon, Ph.D., who presented on the “Neurobiological and Behavioral Consequences of Moderate Alcohol Consumption in Older Adults”
• Frederick C. Blow, Ph.D., who discussed “Assisting Older Adults Who Misuse Alcohol: Brief Evidence-Based Treatment Approaches”
• Jeff Boissoneault, Ph.D., who presented “Pain and Alcohol Use: Implications for Healthy Aging.”

The Healthcare Professional’s Core Resource on Alcohol: NIAAA’s new Healthcare Professional’s Core Resource on Alcohol launched on May 10, 2022. Designed for busy clinicians with input from practicing physicians and clinical psychologists, the Core consists of 14 interconnected articles covering the basics of what every healthcare professional needs to know about alcohol. The Core articles provide user-friendly, practical overviews of foundational knowledge for understanding alcohol-related problems (4 articles); clinical impacts of alcohol (4 articles); strategies for prevention and treatment of alcohol problems (5 articles); and how to “put it all together” to promote practice change (1 article). The Core articles are living documents that will be updated regularly. Free continuing education credit--0.75 to 1 credit hour for each of the 14 articles (10.75 credit hours total)—is offered for physicians, physician assistants, nurses, pharmacists, and clinical psychologists.

Research Highlights: Dr. Koob presented example highlights of NIAAA-supported research studies that focus on early diagnosis, early treatment, and early changes in the brain related to alcohol use.

"Alcohol-Related Deaths During the COVID-19 Pandemic” was published in JAMA (2022 Mar 18;e224308. doi: 10.1001/jama.2022.4308. Online ahead of print. PMID: 35302593) by A.M. White, I.P. Castle, P.A. Powell, R.W. Hingson, and G.F. Koob. Using death certificate data, this study found that the number and rate of alcohol-related deaths increased approximately 25 percent between 2019 and 2020, the first year of the COVID-19 pandemic. Rates increased for all age groups, with the largest increases occurring for people ages 35 to 44 (39.7 percent) and 25 to 34 (37.0 percent). The number of deaths remained elevated in the first half of 2021.

“Serum Metabolomic Analysis Reveals Several Novel Metabolites in Association with Excessive Alcohol Use - An Exploratory Study” was published in Translational Research (2022 Feb;240:87-98. doi: 10.1016/j.trsl.2021.10.008. Epub 2021 Nov 3.PMID: 34743014) by D. Liu, Z. Yang, K. Chandler, A. Oshodi, T. Zhang, J. Ma, P. Kusumanchi, N. Huda, L. Heathers, K. Perez, K. Tyler, R.A. Ross, Y. Jiang, D. Zhang, M. Zhang, and S. Liangpunsakul. To identify biomarkers of excessive alcohol use, NIAAA-supported researchers profiled metabolites in the serum of research participants with a history of excessive alcohol use, compared to healthy participants. Of the metabolites identified, ten were most significantly associated with quantity and average number of drinks in the last 30 days and had better diagnostic performance for screening than commonly used lab tests.

“Genetic Variants Associated with Acamprosate Treatment Response in Alcohol Use Disorder Patients: A Multiple Omics Study” was published in the British Journal of Pharmacology (2022 Jan 11. doi: 10.1111/bph.15795. Online ahead of print. PMID: 35016259) by MF Ho, C Zhang, L Wei, L Zhang, I Moon, JR Geske, MK Skime, DS Choi, JM Biernacka, TS Oesterle, MA Frye, MD Seppala, VM Karpyak, H Li, and RM Weinshilboum. Acamprosate is an approved U.S. Food and Drug Administration (FDA) medication for the treatment of AUD and is thought to reduce alcohol craving during abstinence. Patients vary in their treatment response to acamprosate and pharmacogenomic variations could partially explain the differences. Researchers conducted a genome-wide association study (GWAS) to identify genetic variants that contribute to variations in plasma metabolomic profiles associated with craving and/or acamprosate treatment outcomes. A series of genes were identified, including a protein-protein interaction network involving the protein tyrosine phosphatase receptor type D (PTPRD) gene. Single nucleotide polymorphisms (SNPs) in PTPRD were associated with acamprosate treatment outcomes.

“Site of Alcohol First-Pass Metabolism Among Women” was published in JAMA Network Open (2022 Mar 1;5(3):e223711) by N. Seyedsadjadi, M.B. Acevedo, R. Alfaro, V.A. Ramchandani, M.H. Plawecki, B. Rowitz, and M.Y. Pepino. Bariatric surgery is associated with higher blood alcohol concentrations (BACs), higher bioavailability of alcohol, and, thus, higher risk of alcohol-related consequences. These effects may be related to deficits in first-pass metabolism of alcohol. To better understand how the stomach contributes to first-pass metabolism, researchers examined alcohol pharmacokinetics after alcohol administration among women with sleeve gastrectomy. Women with the gastrectomy had an approximately 40 percent higher peak BAC after oral alcohol administration compared to women without the procedure. The higher BACs observed indicate that the stomach contributes significantly to the first-pass metabolism of alcohol in this population. These results help explain the link between bariatric surgery and elevated risk of alcohol-related consequences.

“The Amygdala Noradrenergic System is Compromised with Alcohol Use Disorder” was published in Biological Psychiatry (2022 Apr 5:S0006-3223(22)00090-7. doi: 10.1016/j.biopsych.2022.02.006. Online ahead of print. PMID: 35430085) by F.P. Varodayan, R.R. Patel, A. Matzeu, S.A. Wolfe, D.E. Curley, S. Khom, P.J. Gandhi, L. Rodriguez, M. Bajo, S. D'Ambrosio, H. Sun, T.M. Kerr, R.A. Gonzales, L. Leggio, L.A. Natividad, C.L. Haass-Koffler, R. Martin-Fardon, and M. Roberto. The central amygdala (CeA) and the noradrenaline/norepinephrine (NA) system are both involved in the brain’s responses to stress and alcohol. In the current study, researchers investigated how the NA system regulates CeA activity and influences drinking behavior in animal models of alcohol use disorder (AUD). They found that NA receptors, α₁ and β, potentiated CeA GABAergic transmission and drove alcohol intake. In the animal model of alcohol dependence, β receptors disinhibited a subpopulation of CeA neurons and contributed to elevated alcohol intake. Postmortem analyses of human brain tissue revealed increased α_1B receptor mRNA expression in the amygdala of humans with AUD.

“High-risk Drinkers Engage Distinct Stress-Predictive Brain Networks” was published in Biological Psychiatry: Cognitive Neuroscience and Neuroimaging (2022 Mar 7:S2451-9022(22)00049-0. doi: 10.1016/j.bpsc.2022.02.010. Online ahead of print. PMID: 35272096) by E.V. Goldfarb, D. Scheinost, N. Fogelman, D. Seo, and R. Sinha. This study examined whether changes in brain networks that underlie emotional stress responses can serve as an early marker of alcohol misuse. Functional brain imaging and predictive modeling were conducted with people who engaged in binge drinking or “light” drinking and showed differences in stress-related brain networks. Stress was associated with visual and motor networks in the binge drinking group and with the default mode and frontoparietal networks in the light drinking group. The stress networks identified for the binge drinking group predicted future daily stress and loss of control over drinking.

“Age 18-30 Trajectories of Binge Drinking Frequency and Prevalence Across the Past 30 Years for Men and Women: Delineating When and Why Historical Trends Reversed Across Age” was published in Development and Psychopathology (2022 Jan 24:1-15. doi: 10.1017/S0954579421001218. Online ahead of print. PMID: 35068407) by J. Jager, K.M. Keyes, D. Son, M.E. Patrick, J. Platt, and J..E Schulenberg. Binge drinking at age 18 has been decreasing historically but by the mid to late 20s, the reverse is true as reflected in increased binge drinking. The current study analyzed data from the Monitoring the Future study to examine this reversal. Researchers found that the reversal occurred primarily between ages 18-24 for men and 18-22 for women. The historical narrowing in the gap in binge drinking between men and women was more pronounced at the beginning than at end of the transition to adulthood.

Council Discussion: Dr. Katie Witkiewitz inquired in the chat about the status of a name change for NIAAA. Dr. Bridget Williams-Simmons responded that there has been a proposed name change for both NIAAA and the National Institute on Drug Abuse (NIDA) in the President’s budget. Dr. Williams-Simmons stated that the issue is now in the hands of Congress. At present, there is no name change for NIAAA.

Dr. Koob asked Council members to serve as ambassadors for the new Healthcare Professional’s Core Resource of Alcohol (HPCR). He noted that NIAAA is developing a core resource for medical schools based on the HPCR. Beth Kane-Davidson expressed appreciation for the new resource; she noted that providers do not know the right questions to ask in order to refer patients for treatment and the HPCR will provide the necessary guidance. Dr. Koob commented that a poster about alcohol misuse for display in doctor’s offices is needed; he asked Dr. Williams-Simmons to remind him about this idea.

Dr. Koob also noted the many accomplishments of NIAAA during the pandemic, including the Aaron White paper on deaths during the pandemic (see Research Highlights above), a paper on the new NIAAA definition of recovery, and an upcoming article on hyperkatifeia. He encouraged Council members to contribute their ideas for ways to close the alcohol treatment gap.

Dr. Laura O’Dell commented that she was fascinated by the bariatric surgery finding reported in the research highlights of Dr. Koob’s report, noting that nicotine use often precludes a smoker from having surgery. She asked if women are being informed about the risk of getting this surgery and alcohol use. Dr. Koob noted that this was briefly discussed in the paper. He asked Dr. O’Dell to write to Dr Vijay Ramchandani of  NIAAA, co-author of the bariatric surgery article, about nicotine as a risk factor. Dr. Patricia Powell  reported that she attended a symposium on bariatric surgery at the Research Society on Alcoholism (RSA) at least five years ago and people at the symposium asked if the risk of alcohol use for those considering the surgery could be added to “Rethinking Drinking,” suggesting awareness of the issue. Dr. Koob interjected that he believes there is a “one-liner” about the risks in the HPCR. Dr. Powell noted that people often go to a physician for something other than an alcohol problem, and the alcohol issue is detected when the provider looks at the presenting health condition and recognizes that alcohol is either a major contributor or exacerbating the condition. Thus, getting the information into the hands of clinicians and encouraging them to look for an elevated risk from alcohol is important.

Dr. Paule Joseph  commented that a change in taste, smell, or tolerance of food following bariatric surgery is a common phenomenon. There are a few papers looking on how alterations in chemosensation lead to a decrease in desire for sweet tasting foods but an increase in alcohol consumption.

Dr. H. Westley Clark  encouraged NIAAA to share the HCPR with training programs offered by the Health Resources and Services Administration (HRSA) so that screening and brief interventions for alcohol use becomes routine. Dr. Koob noted that NIAAA staff met with staff from the Office of Science and Technology Policy (OSTP) in the White House the previous day where the same suggestion was made. He committed that NIAAA would follow up on Dr. Clark’s suggestion.

Hughes Award Presentation

Dr. Koob presented the Harold Hughes Award for 2022 to Dr. Carlo DiClemente The Hughes Award recognizes those who contribute to the translation of research into practice and builds bridges between the alcohol prevention, treatment, and policy-making communities. Dr. DiClemente, Professor Emeritus of Psychology, University of Maryland, Baltimore County (UMBC) is co-developer of the transtheoretical model of behavior change. His work has helped to reduce stigma around addiction and contributed to the development of compassionate treatment of those in recovery. While at UMBC, he co-chaired the  Friends of NIAAA, a non-profit advocacy group comprising independent organizations working to improve alcohol prevention, treatment, and recovery.  In this role, he helped to educate policymakers and other audiences about the progress and promise of NIAAA-supported research. He was appointed to NIAAA’s National Advisory Council in 2014. Dr. DiClemente accepted the award with humility and appreciation, noting that alcohol has been at the center of his entire career. He expressed pride in the work of the Friends of NIAAA and acknowledged the important contributions of NIAAA.

Council Member Presentation: Earlier Identification of Children Affected by Prenatal Alcohol

Dr. Koob introduced Council member Dr. Christina Chambers a Professor at the University of California, San Diego, who reported that the worldwide prevalence of fetal alcohol spectrum disorders (FASD) was estimated in 2016 to be 2.3 percent. She also summarized findings from an investigation published in JAMA (2018) that estimated the prevalence of FASD in first-grade children in this regional U.S. based general population study is at least 1.1-5.0 percent using the most conservative estimates. Less than 1 percent of 222 children identified in the two years combined across four communities in the study had previously received an FASD diagnosis. Thus, prevention of FASD remains a major public health challenge. As it is unlikely that FASD will be entirely prevented, there is a need for methods to identify who is more likely to have or to be an affected child as early as possible.

Dr. Chambers described the work of the Collaborative Initiative on Fetal Alcohol Spectrum Disorders (CIFASD) to address this need. She began with a description of the Ukraine Cohort Study that she directs in two states in Ukraine as part of CIFASD. In this clinical study with a prospective longitudinal pregnancy and child cohort running from 2007-2022 in collaboration with Omni-Net Centers in Ukraine, 1,200 pregnant participants have been recruited at Rivne Regional Medical Diagnostic Center and the Khmelnytsky Regional Perinatal Center. Medical geneticists at both sites provided local leadership. Study participants were recruited from a screened population with women who were moderately to heavily-exposed to alcohol and low/unexposed women enrolled in a 1:1 ratio. There is high level of alcohol consumption during pregnancy among women in Ukraine: In the screened population, 92.7 percent had consumed alcohol during their lives, 54.8 percent had consumed alcohol around the time of conception, and 46.3 percent had consumed alcohol in the most recent month of their pregnancy.

Study components for the women included two maternal interviews, prenatal ultrasounds, and collection of blood, saliva, and skin swabs on two occasions. Breast milk was also collected after the women gave birth. Data collection among the women’s offspring during infancy/childhood included

dysmorphology examinations to identify FASD; neurobehavioral testing at 6 and 12 months, 2 1/2 – 5 years, and 7 – 10 years; and collection of blood, saliva, and skin swabs. In addition, one site had a camera that allowed for recording of 3D facial images.

The study sought to answer four questions regarding earlier identification of affected children:

Can 2D prenatal ultrasound be used to identify physical features of affected infants before birth with or without knowledge of prenatal alcohol? There were significant differences between children identified with FASD and those who were not based on prenatal ultrasound markers. However, ultrasound variables alone predicted less than 10 percent of the variance in any FASD outcome.

Do trajectories of alcohol use across gestation better characterize exposure with respect to neurobehavioral outcomes? Five prenatal alcohol exposure (PAE) trajectory groups were identified: minimal or no PAE throughout gestation, low-to-moderate PAE with discontinuation early in gestation, low-to-moderate PAE sustained across gestation, moderate-to-high PAE with reduction early in gestation, and high PAE sustained across gestation. The high-sustained PAE trajectory group was associated with deficits in infant weight and length at birth and deficits in psychomotor and mental performance as measured on the Bayley Scale at 6 to 12 months of age. Low-to-moderate sustained use was more strongly associated with most negative infant outcomes than moderate-to-high PAE with early reduction, highlighting the importance of reducing alcohol consumption early in pregnancy.

Can biomarkers in pregnancy be used to identify children who will go on to exhibit developmental deficits associated with prenatal alcohol? One study examined differential expression of miRNAs in maternal plasma in the second and third trimesters of pregnancy looking at compared expression patterns using a nested case-control design among those who were unexposed, moderately to heavily exposed with an apparently unaffected child, and moderately to heavily exposed with an affected child (i.e., characterized by physical features, growth deficiencies, and neurobehavioral impairment). In the initial analysis of several hundred miRNAs, eleven were differentially expressed, particularly in the heavily-exposed/affected group during both the mid- and late-pregnancy phases. The mid-pregnancy samples were the more informative. In a related study, a graduate student used bootstrap techniques to look at sex differences and found a suggestion that maternal co-secretion of miRNAs was different preferentially in mothers carrying female fetuses and that those female fetuses were more likely to be affected.

One proposed mechanism to explain these findings is the effect of alcohol on placental function with miRNAs playing a role. For example, miRNAs might contribute to the pathology of prenatal alcohol by inhibiting trophoblast epithelial-mesenchymal transition (EMT), a pathway critical for placental development. In an experimental study, the 11 miRNAs identified in the earlier study were given to  pregnant mice and compared to a control group that did not receive the miRNAs. Reduced occipital diameter, reduced bi-parietal diameter, and reduced fetal weight were reported in the pups of the mice who received the 11 miRNAs. Importantly, it was found that the 11 miRNAs collectively, but not individually, resulted in these findings. In a separate study, the 11 miRNAs collectively mediated placental EMT inhibition in the mouse model. This suggests a potential mechanism and a potential intervention target.

Another study examined 57 children in the Ukrainian cohort for whom there were plasma samples to investigate miRNA expression in childhood. Of the 9 miRNAs that were dysregulated in the children prenatally exposed to alcohol, all were among the same 11 that predicted dysfunction in the maternal sample, thereby suggesting continuity in the dysregulation of these miRNAs.

A second approach currently under investigation is examining immune networks in pregnancy as a potential biomarker for an affected child. Researchers looked at 152 mother-child pairs from the Ukrainian cohort, organized into four groups: alcohol-unexposed mother with typical development in the child; alcohol-unexposed with neuorodevelopmental delays; alcohol-exposed with typical development; and alcohol-exposed with neuorodevelopmental delays. In the second and third trimesters of pregnancy, the investigators observed differential expression patterns of approximately 40+ cytokines and chemokines. In a subsequent constrained principal component analysis to identify networks of cytokines, three networks were identified: (1) an alcohol-exposed network of cytokines specifically associated with exposure, (2) an exposure-neurodevelopmental delay network associated with both exposure and neurodevelopmental delay in the second trimester, and (3) a vulnerability network. A similar analysis was conducted among 59 preschool-aged children from the cohort and three networks were identified: (1) an alcohol-independent neurodevelopmental delay that is associated with delay independent of alcohol exposure, (2) an alcohol risk resilience network, and (3) an alcohol exposure network. These findings suggest that--much like the miRNA markers--there may be inflammatory biomarkers that will indicate risk of developmental delays in the presence of alcohol or not, and that may also represent intervention targets.

Can an early, scalable screening tool be used identify affected children in infancy? Cardiac orienting responses (COR) index early frontal lobe functioning by evaluating physiological response to novel stimuli (either auditory or visual). The response diverts oxygen to the brain to focus on information processing and causes a deceleration in heart rate. PAE is associated with a diminished COR as indicated by a higher level of heart rate during the trough, i.e., it differentiates between those who were prenatally alcohol-exposed and those who were not. Because testing for COR is simple, inexpensive, and doesn’t require specialized training to conduct, researchers are assessing whether it could be used as a screening tool to identify concerns for developmental delay in infancy rather than more complex neurodevelopmental assessments. In one study, researchers compared COR performed at 6 months with the usual 6-month Bayley assessment to determine how successful each method was in predicting Bayley Scores at 12 months. They concluded that the COR was, in fact, superior to the 6-month Bayley assessment in predicting development at 12 months on the negative predictive value side and fairly comparable on the positive predictive value side. In another study, researchers assessed 120 children from the Ukrainian cohort with COR at 6 and 12 months. Heart rate (HR) responses were aggregated across the first three habituation and dishabituation trials and converted to z-scores relative to the sample's mean response at each second by stimuli. Z-scores greater than 1 were then counted by condition (habituation or dishabituation) to compute a total risk index. Those categorized as partial FAS (pFAS)/FAS at age 5 had significantly higher total deviation scores in response to visual stimuli than those categorized as alcohol-related developmental disorder diagnosis (ARND) with no physical FASD features or as having no alcohol-related diagnosis with or without a history of PAE. These findings suggested that COR could be a useful tool in infancy in predicting a child’s developmental status many years later. Currently, Dr. Chambers and her colleagues are striving to make the COR a clinically-friendly diagnostic tool using an iPad that presents the stimulus, collects data, and provides immediate feedback to help decide if a child needs further evaluation or follow-up.

Next steps in these investigations include further development of a set of tools that identifies children at risk for FASD as early as possible (in infancy) and leads to recommended interventions and subsequent targeted assessments.  Other future directions include understanding the evolution and continuing predictive value of biomarkers for FASD across a lifespan, validating those biomarkers in cross-cultural and diverse population settings, and identifying biological functions of biomarkers which may be amenable to intervention.

Discussion: Dr. Koob commented that he was familiar with the role of miRNA, but not with COR and its link to frontal cortex functioning. Dr. Chambers responded that the visual response seems to be affected by alcohol, whereas the auditory response is affected by tobacco. COR does appear to be promising as an early measure to identify children most at risk for FASD. Dr. Koob asked why Dr. Chambers chose Ukraine as a first site for this research. Dr. Chambers explained that the level and consistency of alcohol exposure in the Ukrainian population is quite high, including during pregnancy at a level that would not be observed in the United States. Further, substance use in Ukraine is almost exclusively alcohol, whereas it often consists of polysubstances in the United States. Dr. Russo asked if Dr. Chambers and her colleagues have followed up on the potential of biological functions as targets for treatment, i.e., miRNA targets or the immune system. Dr. Chambers responded that some animal work is underway to begin identifying what those targets might be. A leading hypothesis is that placental function might be involved and might create an opportunity for intervention. Researchers are also seeking to understand if these miRNAs are involved in growth restriction, irrespective of alcohol exposure. Dr. Russo asked if it is thought that the cells within the placenta are producing these miRNA which are being released and impacting the fetus or are the possibilities open-ended? Dr. Chambers replied that the possibilities are open-ended at this point, as is the issue of sex differences that explain how miRNA secretions are expressed if the woman is carrying a female or a male fetus and how the mother adapts to those as she progresses through pregnancy. Dr. Becker said she was surprised that the ultrasound measurements reported by Dr. Chambers had not yielded much predictive value. She inquired if Dr. Chambers and her colleagues have stratified their findings by sex, as there are sex differences in the rate of fetal growth. Dr. Chambers said they have not done so yet but considered this a great suggestion. She stated that she had not meant to downplay the ultrasound findings, as earlier studies had found some differences. The findings reported in her presentation were important for fetal development but were not a blockbuster in terms of prediction. Dr. Koob commented that it would be interesting to know about the interaction of alcohol with opioids and with tobacco in the trajectories. Dr. Chambers noted that the Healthy Brain and Child Development study will be a unique opportunity to look at 7,500 mother-child pairs overweighted in alcohol exposure and co-exposure to substances. There is evidence of an alcohol-cannabis interaction and some suggestion of an opioid-alcohol interaction as well.

Chemosensory (Taste and Smell) Alterations in Disease

Dr. Koob introduced Dr. Paule Joseph, Chief of the Section on Sensory Science and Metabolism within NIAAA’s intramural program. Her laboratory’s mission is to: 1) understand individual variations in chemosensation (taste, smell and chemesthesis ([chemical sensitivity in the skin and mucous membranes]) in clinical populations; 2) address gaps in neuronal and molecular mechanisms underlying chemosensation; and 3) understand how chemosensation impacts motivational and reward pathways that modulate consummatory behaviors and how they might be different in individuals with obesity and AUD. Dr. Joseph noted that taste and smell are not routinely assessed clinically and are primarily reported when they begin to affect quality of life. Potential factors affecting chemosensation in obesity, AUD, and COVID include genetic, environmental, and acute/chronic disease factors.

Biology of Taste and Smell. Humans’ sense of taste is remarkably sensitive. The tongue contains more than 5,000 onion-shaped taste bud cells found in aggregates of 50-100 taste receptors. Humans taste substances throughout the entire mouth. There are several basic tastes: sweet, sour, umami, salty, bitter and fat. These tastes are sensed when the taste receptors are activated by different stimuli.

The olfactory system is remarkably complex with approximately 400 olfactory receptors stimulated by different odorants. Humans have two mechanisms to detect an odor: orthonasal olfaction (i.e., the smell of food in front of the nose) and retronasal olfaction that occurs in the back of the mouth.

There are many disorders that are associated with deficits in taste and smell, including infectious diseases, neurological diseases, psychiatric conditions, and drug reactions.

COVID’s Impact on Taste and Smell. Dr. Joseph’s laboratory is working as part of the Global Consortium of Chemosensory Researchers (CGCR), a worldwide collaboration founded in 2020, to study how COVID-19 is affecting taste and smell. Some studies have indicated that 85-90 percent of those who tested positive for COVID lost taste and/or smell. A systematic review and meta-analyses were undertaken by Dr. Joseph and her CGCR colleagues to examine the reported loss of taste and smell associated with COVID-19. They included studies with both objective and subjective measures of taste and smell in the meta-analyses and discovered that loss of both senses in COVID patients were accurate, with objective measures revealing a higher prevalence of olfactory loss than subjective measures.

Researchers have made significant progress in elucidating the cellular and molecular processes that explain loss of smell, but less progress on loss of taste. COVID-19 affects all three modalities: taste, smell, and chemesthesis. The SARS-CoV-2 virus enters the respiratory system, moving to the respiratory epithelium, then the olfactory epithelium, and finally the olfactory bulb. Along this pathway are many of the cells that express angiotensin-converting enzyme 2 (ACE2) and transmembrane protease, serine 2 (TMRSS2). Recent reports have concluded that ACE2 is not secreted in the olfactory sensory organs, but in the supporting cells that are impaired, causing the olfactory dysfunction. A recent post-mortem analysis of COVID-19 patients compared to non-COVID patients revealed that ciliated cells are the main cell type most affected by the SARS-CoV-2 virus, with no evidence of infection in the olfactory bulb neurons themselves.

Fewer studies have examined loss of taste in COVID-19 patients. It is known that SARS-COV-2 binds to ACE2 receptors, but it’s not known if ACE2 is expressed on the taste receptor cells. Work by Dr. Josephine Egan at the National Institute of Aging has established that ACE2 is present in the Type 2 cells of taste buds, and this is most likely the mode of entry of the virus into the oral cavity.

CGCR researchers sought to validate COVID patient reports of taste and smell loss by identifying the chemosensory profiles of COVID-19. Their goals were to identify the modalities, qualitative and quantitative changes, and similarities and differences with other respiratory illnesses. Because it was not possible to use objective measures at the beginning of the pandemic, they conducted a patient survey in 36 languages in April 2020 addressing taste, smell, chemesthesis, nasal congestion, and related topics before, during, and after the disease.

In their analysis of the first 4,000 surveyed patients, the researchers determined that loss of taste, smell, and chemesthesis was severely impaired in COVID-19 patients. In a subsequent analysis study of nearly 16,000 surveyed patients, the CGCR investigators set out to answer three questions. Dr. Joseph presented the questions and answers to the audience as follows.

• Can we validate our original observations in a new sample?
  • They were able to validate their original findings about significant taste, smell, and chemesthesis impairment.
• Can we use the differences in self-reported positive or negative results of loss of smell to predict COVID-19 in a PCR test with other symptoms?
  • Centers for Disease Control and Prevention (CDC) indicators of fever, cough, and dyspnea did not efficiently discriminate between COVID-19 and other respiratory illnesses whereas their quantitative questions about loss of smell outperformed the CDC model by about 15 percent.
• How do people with COVID-19 and smell loss recover in a way that is different from other illnesses?
  • The most parsimonious model for predicting the disease was smell during the illness and the number of days since symptom onset. This finding helped the public understand the need to monitor their sense of smell during illness.

The researchers also identified three main clusters of how people recovered their sense of smell after COVID-19 and other respiratory illnesses: Approximately 40 percent of patients recovered their sense of smell within 40 days. Eighty percent recovered their sense of smell within 60 days, while approximately 15-25 percent showed impairments after 90 days. The sense of taste was reported to recover faster than the sense of smell. These findings are raising concerns that there could be about 15 million new people with smell disorders. No similar estimate is available for taste disorders.

Dr. Joseph and her colleagues subsequently did a follow-up study on 4,000 research participants who were now “long haulers” to understand how many experienced parosmia (distorted perception of smell triggered by another common odor) and phantosmia (an olfactory hallucination occurring spontaneously without a trigger). They found that 63 percent experienced parosmia and 33 percent phantosmia. In general, long haulers have more symptoms overall, with more fatigue, headaches, loss of appetite, etc.

In regard to new COVID-19 variants, researchers have found that are fewer reports of loss of taste and smell with omicron.

Chemosensation and Alcohol. There have been few studies that explored smell and taste with AUD. What is known is that alcohol exposure activates the peripheral and central taste and smell pathways and has strong chemesthetic effects. Severe AUD is associated with inability to discriminate taste and smell.

Dr. Joseph reported on a collaborative study being done by her laboratory with Dr. Nancy Diazgranados and Dr. Vijay Ramachandani both in the NIAAA Intramural Research Program. Their goal was to examine self-reports of the chemosensory ability of individuals with different alcohol drinking behaviors and their association with changes in four domains of quality of life (QOL). They began with three hypotheses: (1) there will be a difference in taste and smell abilities of different alcohol drinking groups,  (2) people with persistent heavy drinking would show lower taste and smell scores, and (3)the loss in taste and smell ability of people who engaged in heavy drinking negatively affects their quality of life. Data was collected from 466 individuals between June 2020 and September 2021 from an ongoing longitudinal NIAAA COVID-19 Pandemic Impact on Alcohol Study. Taste/smell data was collected from self-rating questionnaires. Online questionnaires were completed at study enrollment and weeks 4, 8, and 12.

Key findings were that persistent heavy drinking was associated with lower chemosensory ability.

• Heavy drinkers' reduced smell and taste function and association with poorer QOL indicate that early assessment of chemosensory changes may be crucial in identifying poorer well-being outcomes associated with heavy drinking.

New Directions. Dr. Joseph’s laboratory is continuing collaborative studies that address taste and smell in COVID-19, as well as a long hauler study. The laboratory is also pursuing research to examine biological correlates of individual variability in smell and taste sensitivity and preference in obesity, as well as to examine individual variability in smell and taste sensitivity and preference in AUD. One area of interest in both studies is understanding inflammation as a possible mechanism in taste and smell alteration associated with alcohol consumption.

Discussion. Dr. Koob asked if there is a link with affective disorders in individuals experiencing a loss of smell, noting that animal studies have found that removal of the olfactory bulb causes depression. Dr. Joseph responded there are studies in how depression plays a role in response to changes in taste and smell, but not looking specifically at alcohol and depression. Most studies have used very small datasets and more work is needed to understand the mechanisms involved. Little work has been done with taste. Dr. Chambers inquired if a link to infertility has been investigated with alcohol-induced or viral-induced loss of smell. Dr. Joseph responded that there has been little research that addressed this topic. Dr. Clark inquired if there was a difference in outcomes between consumption of high alcohol content found in liquor and lower alcohol content found in beer or wine. Dr. Joseph said she hasn’t seen any papers on this question, but she and her colleagues intend to look at the effects of these types of alcohol drinks on the sensory system. Dr. Koob inquired if there were sex differences in the COVID-19 studies. Dr. Joseph commented that there are more reports of sensory loss from women than from men. Sex differences in taste and smell have been well documented in the literature. Dr. Becker followed up with a question about the impact of menopause, i.e., can the researchers look at differences in women over age 50 as a proxy for menopause. She noted that estrogen impacts taste and smell. Dr. Joseph responded that they have not yet done so but can, because they have a large dataset for analysis.

BRAIN Initiative Update

Dr. Koob introduced Dr. James Eberwine of University of Pennsylvania, Perelman School of Medicine, and Dr. Changhai Cui, a Program Director at NIAAA, who have represented NIAAA on the BRAIN Initiative. Dr. Eberwine reported that the program now has an established administrative structure with Dr. John Ngai, formerly of the University of California, Berkeley, serving as Director for over one year. Dr. Andrea Beckel-Mitchener formerly with the National Institute of Mental Health (NIMH), serves as Deputy Director.  

Funding. The projected funding for the BRAIN Initiative over its 12-year lifespan is $5.8 billion from Congressional funding and the 21^st Century Cures Act. As of 2021, approximately $2.4 billion or 42 percent of the anticipated total has been expended. FY 2023 funding is anticipated to be $900 million.

Brain Census. One of the major accomplishments of the initiative is the brain census, a comprehensive cell atlas of the mammalian motor cortex, which was a massive effort by multiple investigators to identify every cell in the brain to characterize how they’re different from one another and how they work together. Most of the work was focused on the mouse brain. The BRAIN Initiative Cell Census Network (BICCN) published 11 papers about their work in Nature (7 October 2021). All BICCN data is publicly available.

Transformative Projects. Dr. Ngai recently published a commentary in Cell on BRAIN 2.0 in which he reported that “three large new projects--a comprehensive human brain cell atlas, a whole mammalian brain micro-connectivity map, and tools for precision access to brain cell types--promise to transform neuroscience research and the treatment of human brain disorders.” These projects were selected from among a list of transformative projects proposed by NIH BRAIN teams. There are eight project teams within this trans-NIH initiative; every grant application is reviewed and evaluated by one of these teams according to its focus.

The transformative projects described by Dr. Ngai are now moving forward including accelerated launches of the human brain atlas to develop scalable tools and technologies to map larger brains funded at approximately $40 million across 10 awards. Other projects included precision cell access to develop platforms and reagents that provide cell-type specific access across vertebrate species funded at approximately $16 million across 4 awards, and Phase I planning of a 10-year initiative to map brain-connectivity across scales. The latter initiative is expected to result in NOFOs that include large integrated projects and smaller ones targeted to specific approaches and testing of new methods and technologies.

New Funding. New funding opportunities related to the transformative projects but independent of them include:

• Research Resource Grants for Technology Integration and Dissemination (RFA-NS-22-011)
• Translation of Groundbreaking Technologies from Early-stage Development through Early Clinical Study via Blueprint MedTech (NOT-NA-22-052)
• BRAIN Initiative-Related Research Education: Short Courses (R25) (RFA-EY-21-003)
• Administrative Supplements to Embed Ethicists into BRAIN Initiative Supported Research (NOT-MH-22-040)
• BRAIN Initiative Connectivity Across Scales, Comprehensive Center on Human and Non-human Primate Brain (UM1) (NOT-NS-22-045), Comprehensive Centers for Mouse Brain (UM1) (NOT-NS-22-046), and Specialized Projects for Scalable Technologies (U01) (NOT-NS-22-047).

Diversity. Beginning in Spring 2021, the BRAIN Initiative is requiring applications for most NOFOs to include a Plan for Enhancing Diverse Perspectives (PEDP) in their research. The PEDP will be reviewed at peer review and by the IC. This effort reflects the BRAIN Initiative’s experience that diverse teams working together and capitalizing on innovative ideas and distinct perspectives outperform homogeneous teams. To date, PEDPs have been required in eight BRAIN NOFOs, as well as in 10 non-BRAIN NOFOs across NIH. A PEDP policy notice is coming soon, followed by development of a communications framework to ensure consistent messaging across stakeholders and a framework for program analysis for evaluating implementation and impact. Other BRAIN Initiative efforts to advance inclusivity include training awards (approximately $2.3 million across more than 30 new awards in FY 2021); diversity supplements (about $2 million across approximately 20 new awards in FY21), and a U24 program to support capacity development at minority-serving institutions and Institutional Development Award (IDeA)-eligible institutions for precision cell access reagents (RFA-MH-21-180).

Searching for Brain Research. The BRAIN Initiative is currently striving to get a sense of how brain research is advancing across NIH and elsewhere via a literature search using an artificial intelligence web application called BRAINWORKS. This information will help guide development of RFAs in the future and identify areas that need additional support.

BRAIN Initiative Events. Recent events included the Brain Behavior Quantification and Synchronization (BBQS) meeting on March 1-2, 2022, and the Brain Across the Lifespan meeting on April 18-19, 2022.

Neuroethics. The Neuroethics Working Group (NEWG) works with the Multi-Council Working Group that provides ongoing oversight of the long-term scientific vision of the BRAIN Initiative. NEWG continues a wide array of activities, including reviewing funded BRAIN grants for neuroethical considerations, offering neuroethical workshops, providing neuroethical consultations for BRAIN researchers, and overseeing neuroethical grants, among other activities.

BIA Toolmakers Resource. The BRAIN Initiative Alliance (BIA), composed of multiple organizations that are part of the initiative, has put together the BIA Toolmakers Resource that showcases products of BRAIN investigators that are ready for dissemination to the scientific community. These may be found at the BIA website: www.braininitiative.org.

BRAIN Initiative Opportunities and Resources. Dr. Cui demonstrated how to navigate the BRAIN Initiative website in order to stay up-to-date with the program’s activities. She highlighted four resources available to researchers: (1) the BRAIN Initiative collection of plasmid, viral vectors, and recombinant antibodies, (2) curated resources and tools, (3) BRAIN Initiative data, including the BICCN Data Inventory,  and (4) the BRAIN Initiative marmoset resource. Dr. Cui showcased two projects that made use of some of these resources.  One was a secondary analysis of data from the longitudinal Adolescent Brain Cognitive Development (ABCD) study to investigate network-level neural substrates linked to screen media activity, sleep disturbances, and other clinically relevant outcomes.  The other was the coordinating center for collaborative marmoset research at the Oregon, Wisconsin, and Southwest National Primate Research Centers. The common marmoset serves as an ideal model organism for neuroscience and biomedical science due to its small size and ease of handling while at the same time demonstrating physiological, behavioral and cognitive characteristics that are unique to primates, including the core functional architecture and organization of the human nervous system.

Dr. Eberwine concluded the presentation by announcing that the 8^th annual BRAIN investigator meeting on June 21-22, 2022.

Discussion. Dr. Koob noted that research on alcohol and marmosets is wide-open; he was aware of only one project that has never been published. Dr. Cui concurred that there was one study, completed 20-30 years ago. Dr. Koob asked Dr. Powell to comment on PEDP policies. She responded that the BRAIN Initiative has done an outstanding job in implementing diversity efforts into its activities. NIAAA is including a reference to PEDP in its center grants and is evaluating the policy carefully. Dr. Koob asked if there is a link to the BRAIN Initiative on the NIAAA website that is specific enough to be helpful to researchers. Dr. Williams-Simmons responded that she would review the website and make improvements as needed. Dr. Cui agreed to send her presentation slides to Dr. Williams-Simmons to facilitate the transmission of information.

Dr. Koob commented that findings from the BRAIN Initiative may someday influence the work of NIAAA’s Division of Epidemiology and Prevention Research (DEPR). Dr. Eberwine noted that the best way to think about circuit analysis that is receiving significant BRAIN Initiative funding is through some type of perturbation, possibly alcohol. He encouraged alcohol researchers to think about new directions of research in that direction. Dr. Koob concurred.

Dr. Lovinger asked if there were any projects funded by the BRAIN Initiative that address sub-cellular proteomics, specifically what is inside a pre-synaptic brain terminal. Dr. Eberwine responded that that level of analysis has not been funded by the Initiative yet. Currently, the Initiative is focused on the cellular level. However, work is being funded by NIMH and the National Institute of Neurological Disorders and Stroke (NINDS) for sub-cellular analysis of protein localization. He believes this will become an even more important issue as the Initiative moves further into the cell census. He said he would bring Dr. Lovinger’s comment up at the next BRAIN Initiative meeting. Dr. Cui commented that there have been very few cell studies of proteomics and other omics; this is clearly a research gap. Dr. Koob commented that the research paper on metabolomics that he highlighted in his Director’s report addressed protein-protein interactions, indicating that this level of research is happening. Dr. Antonio Noronha commented that Dr. Dayne Mayfield of the University of Texas, has begun experiments on pre-synaptic cells as an adjunct to his work with the Integrative Neuroscience Initiative on Alcoholism-Neuroimmune consortium. Dr. Koob commented that even though NIAAA’s budgetary increase was a lower percentage than that of the overall NIH budget, the Institute benefits from overall NIH funding by mechanisms such as the BRAIN Initiative. He noted that Dr. Ngai meets with him regularly and that Dr. Cui has been invited to join other teams within the Initiative, so that NIAAA’s voice is well-represented.

DEPR Concept Clearance: Advancing mHealth Interventions for Understanding and Preventing Alcohol-Related Domestic Violence 

Dr. Koob introduced Dr. Robert Freeman, Acting Deputy Director of the Division of Epidemiology and Prevention Research (DEPR), NIAAA, who presented a concept clearance about the development of mHealth interventions to combat alcohol-related domestic violence. Dr. Freeman explained that several decades of methodologically rigorous research has demonstrated that alcohol use is an important contributing factor in many instances of domestic violence/intimate partner violence (DV/IPV). Unfortunately, evidence for the effectiveness of preventive interventions for IPV is underwhelming. Development of effective interventions—e.g., traditional batterer intervention programs—has been limited by high dropout rates, treatment resistance, and poor working alliances.

Development of this NOSI at this time reflects a number of recent developments. One of these developments was related to the COVID-19 pandemic, particularly an urgent need for efficacious interventions to reduce alcohol-involved DV in response to evidence of increased rates of heavy drinking and DV during the COVID-19 pandemic lockdown period. Further, the global pandemic has highlighted the utility of mHealth approaches for reaching DV survivors who may remain dangerously sequestered with an abusive partner while likely enduring adverse physical, psychological, social, and economic conditions. Remote intervention delivery possesses a number of attractive features that include enhanced reproducibility and greater engagement, which can be made available 24/7. Another feature is enhanced reach for an increased treatment options for those who live in rural areas. Lastly, there is greater privacy and lower cost.  Wireless and remotely delivered interventions can be delivered in real time, at the critical moment of greatest need. Finally, growing evidence suggests many DV survivors prefer the practicality and confidentiality of technology-enabled interventions and guided online support to in-person face-to-face services such as group counseling and individual therapy.

DEPR intends to issue a notice of special interest (NOSI), based on the documented increases in both alcohol misuse and domestic violence, as a result of the global COVID-19 pandemic and an array of mandated restrictions enacted to mitigate COVID spread. The proposed NOSI addresses the critical need for research related to developing, testing, and intervening proximal to drinking occasions. This may lead to decrease the likelihood of alcohol consumption at levels sufficient to trigger DV and to provide skills shown to reduce risk of DV perpetration and victimization. Specifically, this solicitation seeks to advance the development, feasibility, acceptability, pilot testing, potential efficacy, and implementation of scalable, low resource, and remotely delivered interventions via mobile devices (mHealth) that rely on communication technologies for reducing and preventing alcohol consumption and DV. For this proposed funding opportunity, the term “domestic violence” (DV) will extend to child maltreatment (abuse and neglect) and elder abuse, in addition to intimate partner violence (IPV). 

Thus, NIAAA encourages the submission of basic behavioral etiological grant applications that focus on, but are not limited to the scope listed below.

• Experimental research that informs and tests theoretical models of the association between individual and contextual factors, drinking patterns, and DV perpetration daily and over time.
• Studies that advance ecological momentary assessment (EMA) research methodology that assesses individuals in their own environment in near real-time, providing insights in understanding “in-the-moment” processes.

Establishment of EMA techniques to capture proximal moderator of the alcohol-IPV relationship will enhance the understanding of IPV/DV episodes and provide crucial information for the development of preventive interventions. The contextual and situational factors surrounding DV/IPV episodes (e.g., where and with whom one is drinking; motives for use; feelings of craving, stress) can be probed using EMA methods; 3) studies to assess the feasibility, acceptability, and efficacy of Just-In-Time interventions for alcohol-related IPV/DV that can be deployed before/during drinking episodes with the aim of reducing the amount consumed and/or preventing adverse consequences; and 4) studies that strive to include populations at elevated risk for alcohol-related IPV but which remain relatively understudied (e.g., students with disabilities; sexual and gender minority and community college students).

Dissemination and implementation research is an important next step in moving promising preventive interventions out into the field. Current interventions for IPV tend to be resource intensive, generally requiring in-person sessions facilitated by a trained therapist and often requiring the participation of the partner, making broad dissemination difficult. The NIAAA encourages the development of scalable, sustainable interventions that can be readily integrated into community practice; delivered using existing service platforms, personnel, and resources; and that incorporate features that ease implementation fidelity.

In the review of the concept by Council members prior to the meeting, Dr. Chambers suggested that NIAAA consider the inclusion of pregnant and post-partum individuals under the section on populations at elevated risk for alcohol-related IPV/DV as this is a common time for initiation or escalation of DV.

Discussion: Dr. Koob noted that a remote silver lining to the pandemic is the development of new and useful methods to address the unhealthy use of alcohol. Dr. Witkiewitz stated that she was very excited about this work and encouraged NIAAA to expand beyond community college students to non-residential students at four-year institutions. Dr. Becker noted that African American women are five times more likely to be murdered as a result of DV/IPV. She suggested more attention to minority populations in the announcement.  Dr. Freeman said this is a very important suggestion. Dr. Koob stated that he concurred completely and that this NOSI provided an opportunity to expand into domains that have previously been neglected.

Action: Dr. Witkiewitz endorsed the concept.

Ex Officio Report and Council Discussion:

There was no ex officio report. Dr. Powell commented that diversifying the workforce and addressing health disparities is one of NIAAA’s priorities and will be represented in the next NIAAA strategic plan. Dr. Koob asked Dr. Williams-Simmons to update Council on the status of the plan; she replied that the plan is currently being drafted with a goal of completion by Fall 2022. Dr. Koob inquired of Dr. Bautista about the status of the next Council meeting: remote, face-to-face, or hybrid? Dr. Bautista said it would depend on the number of Council members who wish to attend in person; thus far, only two have definitely committed to physically attending. Dr. Koob concluded that NIAAA will be flexible about the meeting format. Dr. Russo inquired about whether study sections are meeting in person; Dr. Koob responded that there was a recent announcement that one-third of the upcoming study sections will be in person.

Dr. Koob announced a change in policy announced on May 9, 2022, that occurred as part of the 2022 Consolidated Authorization Act. It states that when individuals identified as Principal Investigator or key personnel are removed from their position or disciplined due to harassment, creation of a hostile work environment, etc., this fact must be reported to NIH by the institution. Previously, such individuals could simply move to another institution and continue to receive NIH funding. Now, they will be restricted from receiving grants. NIH will not tolerate any kind of bullying or harassment.

Consideration of February Council Meeting Minutes, Future Meeting Dates

A majority of Council members voted via chat or email to approve the minutes of the NIAAA Advisory Council meeting held on February 10, 2022.

Dr. Bautista announced upcoming meeting dates for 2022-2024. In 2022, Council will meet on May 10 and September 8; the CRAN meeting will be on May 11. In 2023, Council will meet on February 9, May 9, and September 7; the CRAN Council will meet on May 10. In 2024, Council will meet on February 8, May 14, and September 12; the CRAN Council meeting will meet on May 15.

Adjournment

Dr. Koob adjourned the meeting at 4:44 p.m. 

CERTIFICATION

I hereby certify that, to the best of my knowledge, the foregoing minutes are accurate and complete.