BEHAVIORAL THERAPIES DEVELOPMENT PROGRAM NIH GUIDE, Volume 24, Number 29, August 11, 1995 PA NUMBER: PA-94-078 P.T. 34 Keywords: Behavioral/Social Studies/Service Drugs/Drug Abuse Addiction Chemotherapeutic Agents National Institute on Drug Abuse PURPOSE This notice is an addendum to program announcement PA-94-078, which was published in the NIH Guide, Vol. 22, No. 26, July 15, 1994. The purpose of this addendum is to encourage research investigating the most advantageous integration of behavioral and pharmacotherapies to enhance the efficacy of both types of therapeutic interventions. Drug abuse and addiction are complex disorders with biological, cognitive, behavioral and psychosocial dimensions, and frequently co-occur with other mental disorders. While pharmacotherapy and behavioral therapy may both be useful for the treatment of the addictions, each may exert its effects through different mechanisms and influence different symptoms. It may also be that combination therapies are not simply complementary, but could be synergistic. Thus, integrated behavioral therapy-pharmacotherapy combinations may have better efficacy than either treatment alone. The National Institute on Drug Abuse (NIDA) is supporting the study of behavioral therapies (including, but not limited to, psychotherapy, behavior therapy, cognitive therapy, family therapy, skills training, and counseling approaches) that will potentially have a significant impact on reducing drug abuse and addiction and reducing AIDS risk behaviors. For those investigators applying for grants under the Behavioral Therapies Development Program, this notice is meant to supplement Program Announcement PA-94-078, which is still in effect and should be consulted in conjunction with this addendum. RESEARCH OBJECTIVES Behavioral therapies and pharmacotherapies (such as methadone, LAAM, buprenorphine, naltrexone, nicotine preparations, and clonidine) are available for the treatment of addiction to opioids and nicotine. Most treatment research has focused on either pharmacotherapy or behavioral therapy and few studies have explored the potential benefits of carefully specified combined therapies. The maintenance and detoxification of heroin addicts may be optimized by integration of behavioral therapies and pharmacotherapies such as opioid agonists, antagonists, or partial agonists. Differences in behavioral therapies may be required to address the unique needs of particular patient populations and/or the pharmacological differences of the medications. While no medications have as yet proven efficacious for the treatment of cocaine addiction, most studies have been conducted without or with minimal behavioral interventions. Integration of pharmacotherapies and behavioral therapies may enhance compliance with medication regimens, increase retention in treatment and help prevent relapse to drug abuse and addiction. Studies are sought on the integration of behavioral therapies and pharmacotherapies for the treatment of drug abuse and addiction in individuals who abuse and/or are addicted to drugs and in addicts with co-occurring mental and other illnesses, in order to determine when and how behavioral and pharmacological therapies can be integrated for optimal treatment outcome. Applicants are strongly encouraged to develop approaches for distinct drug abusing or addicted patient populations that are sensitive to cultural characteristics or unique needs of specific subgroups. Applications must be submitted on the grant application form PHS 398 (rev. 5/95 ) using the receipt dates in the form. INQUIRIES Direct inquiries regarding programmatic issues to: Dorynne Czechowicz, M.D. Division of Clinical and Services Research National Institute on Drug Abuse 5600 Fishers Lane, Room 10A-12 Rockville, MD 20857 Telephone: (301) 443-0107 .
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