Full Text PA-97-005
 
RESEARCH ON ADOLESCENT DRUG ABUSE
 
NIH GUIDE, Volume 25, Number 37, November 1, 1996
 
PA NUMBER:  PA-97-005
 
P.T. 34, AA

Keywords: 
  Drugs/Drug Abuse 

 
National Institute on Drug Abuse
 
PURPOSE
 
The National Institute on Drug Abuse (NIDA) is firmly committed to
support of research in the area of adolescent drug abuse.  The
purpose of this program announcement (PA) is to  encourage further
investigations in this area, particularly with regard to gaps in
current knowledge.
 
HEALTHY PEOPLE 2000
 
The Public Health Service (PHS) is committed to achieving the health
promotion and disease prevention objectives of "Healthy People 2000,"
a PHS-led national activity for setting priority areas.  This PA,
Research on Adolescent Drug Abuse, is related to the priority area of
alcohol and other drugs.  Potential applicants may obtain a copy of
"Healthy People 2000" (Full Report:  Stock No. 017-001-00474-0 or
Summary Report:  Stock No. 017-001-00473-1) through the
Superintendent of Documents, Government Printing Office, Washington,
DC 20402-9325 (telephone 202-512-1800).
 
ELIGIBILITY REQUIREMENTS
 
Applications may be submitted by foreign and domestic, for-profit and
non-profit organizations, public and private, such as universities,
colleges, hospitals, laboratories, units of State and local
governments, and eligible agencies of the Federal government.
Racial/ethnic minority individuals, women, and persons with
disabilities are encouraged to apply as principal investigators.
Foreign institutions are not eligible for the First Independent
Research Support and Transition (FIRST) (R29) award.
 
MECHANISM OF SUPPORT
 
Mechanisms available for support of this program announcement are the
research project grant (R01), the small grant (R03), and the FIRST
award (R29).  Because the nature and scope of the research proposed
in response to this Program Announcement may vary, it is anticipated
that the size of an award will vary also.
 
RESEARCH OBJECTIVES
 
Background
 
Recently released data from the 1995 Monitoring the Future Study and
the 1995 National Household Survey on Drug Abuse indicate drug use
among youths has increased and the age at which drug use begins has
declined.  Additionally, among those surveyed there was a decrease in
perceived risk-of-harm in using drugs and an increase in the
perception that illicit drugs were easy to obtain.  Although tobacco,
alcohol, and marijuana were the substances most tried, the use of
heroin, cocaine, amphetamine and inhalants was also on the rise, as
was LSD and other hallucinogens (e.g., MDMA/ecstasy) among a growing
number of adolescents who participate in the Rave scene.
 
Studies have examined a wide range of variables,  from  biogenetic
factors to purported macro-environmental influences, to determine
what makes one adolescent and not another more vulnerable to initial
and continued drug use. Research findings suggest that no one factor
accounts for all known causes, consequences, and patterns of  drug
use.  Rather,  interacting biological (e.g., genetic influences),
psychological (e.g., depression; learning problems), social (e.g.,
family instability; sexual/physical abuse; gang membership), and
environmental (e.g., street violence; neighborhood drug trafficking;
poverty) factors appear to put adolescents at risk. Consequently,
multiple factors have been considered when interventions were
developed that aimed at preventing initial exposure or further
escalation of drug use in a teenage population, or at treating
adolescents already affected by drug abuse.
 
In terms of prevention, a number of effective universal-level
programs have been developed that target adolescents sharing a
general risk of drug use. Examples are found in drug-free schools and
the national media.  Effective selective-level programs, by contrast,
have been designed for specific adolescent subgroups demonstrating
one or more of the well defined risks or predispositional factors
associated with later drug use.  Community-sponsored activities such
as the big brother/sister organizations are examples.  At the
indicated-level of prevention intervention, studies have examined
programs that target adolescents identified as currently having
minimal but detectable signs and symptoms that foreshadow drug abuse
and addiction.  Although most of these programs have focused on
school truants and dropouts,  future research is needed to develop
effective interventions for the increasing number of drug-using
adolescents identified in job corps training and juvenile-court
detention programs.
 
Unlike drug prevention efforts, treatment for drug abuse and
addiction traditionally has focused on adult-age clients.  With the
exception of family-based therapy for adolescents, few programs
admitted persons under 18 years of age. When they did, components of
the program (e.g., methadone maintenance; individual counseling) were
based on therapeutic models appropriate for adult addicts.  Rarely
were human developmental differences identified, then examined in
terms of how they might enhance or adversely affect the process or
outcome of treatment.  Recently, however, a number of modified adult
programs (e.g.,  adolescent therapeutic community) and innovative
adolescent-focused behavioral strategies (e.g., life skills training)
have been developed, assessed and found to be effective for reducing,
but not eliminating drug use. Moderate progress has also been made in
developing and assessing behavioral strategies to engage adolescents
and their parents in treatment process.
 
Given the increased number of young persons environmentally exposed
to and/or directly involved in using drugs, there is currently
insufficient scientific knowledge about therapeutic interventions
which are cost-effective in treating drug abusing youths in a variety
of settings (e.g.,  outpatient clinic; residential hospital; primary
care office practice) or efficacious in treating adolescents with
special needs, including those who are runaways or homeless,
incarcerated or on probation, gang members, pregnant or parenting,
gay or lesbian, HIV positive or diagnosed with a comorbid mental
disorder.  In addition, more must be learned about drug treatment
access, availability and utilization, as well as methods to establish
and maintain effective linkages among drug prevention and treatment
programs, other health and social services, public education and
juvenile justice.
 
Based on the many important developmental differences between
adolescents and adults that have been identified in terms of  drug
use patterns, prevention and treatment, considerable progress has
been made over the past decade in developing valid and reliable
screening,  diagnostic, and survey tools appropriate for use with
English speaking youth. Because less attention has been given to
gender-, age-, and cultural specificity or to the multiple
concomitant problems experienced by drug-involved youths,  more
studies are required to provide the field with the necessary
assessment tools for research and practice.
 
Research Areas of Interest
 
This Program Announcement encourages submission of proposals to study
the many remaining issues that relate to adolescent drug abuse.
Research topics of interest include, but are not limited to, the
following:
 
o  Relationship of adolescent drug use initiation, escalation,
dependence, withdrawal and relapse to potential acute, intermediate
and long-term neurotoxicity, neurological disease and cognitive
deficits.
 
o  Relationship among adolescent drug use patterns, high HIV-risk
sexual behaviors and the adolescent's exposure to drug abuse and
violence in the family, peer group and community environment.
 
o  Gender- age-, and culture-related differences in the progression,
initiation to, antecedents and consequences of, and preventive and
therapeutic interventions for drug use, abuse, and dependency.
 
o  Personal,  social, and environmental resiliency- and
protective-factors as they relate to adolescent drug use and
addiction.
 
o  Language-of-origin, acculturation, assimilation, cultural beliefs
and traditional practices, alone or in combination as they affect the
outcome of prevention and treatment.
 
o  Effectiveness  of theory-based, developmentally sensitive, drug
abuse prevention programs designed specifically for younger or for
older adolescents.
 
o  Efficacy of individual, peer group and family behavioral
therapies, or combined behavioral- and pharmacotherapies, when
delivered in more versus least restrictive environments, designed
solely for adolescents or for both youths and adults.
 
o  Efficacy of pre-treatment engagement strategies and orientation
programs to increase retention in treatment, and post-treatment
interventions to prevent relapse to drug use.
 
o  Impact of financing on service utilization and cost-effectiveness
of adolescent drug treatment programs delivered in settings such as a
residential therapeutic community, hospital inpatient ward,
outpatient clinic, or integrated into primary care office practice,
school-based and juvenile court programs, or social service agencies.
 
o  Psychological, familial, social, and environmental factors that
affect adolescents' perception and natural history of drug use,
unsafe sex, and other HIV-risk behaviors.
 
o  Innovative behavioral therapy approaches or multi-component
community-based programs aimed at preventing adolescent drug use and
other HIV-risk behaviors.
 
o  Availability, accessibility, and linkages between drug abuse
treatment
and related services as they may affect the adolescent's compliance
with prescribed psychosocial and pharmacological treatment for
HIV/AIDS.
 
o  Validity, reliability, and normative data on culture-, gender- and
age-specific adolescent subgroups for currently available or newly
developed drug-related survey, screening, diagnostic, and
motivation-for-treatment assessment instruments.
 
Where appropriate, investigators are encouraged to offer HIV testing
and counseling in accordance with current guidelines to subjects
identified during the course of the research as being at risk for HIV
acquisition or transmission. In high risk populations, investigators
are encouraged to assess the effects of new interventions on the
acquisition and transmission of HIV. A focus on the provision,
organization, and management of HIV/AIDS-related services such as
testing and counseling, and services to groups at high risk for
HIV/AIDS is encouraged.
 
Applicants are advised to review the existing literature on
adolescent drug use and abuse. Applications should reflect
appropriate research paradigms, and use most rigorous methodological
and analytic designs that are feasible, given the primary research
question of interest. Timely reporting of findings is emphasized.
Applicants should be willing to participate in research coordination
efforts to maximize the utility of the research, including review and
dissemination activities.
 
For information on other research topics related to adolescent drug
abuse, applicants are encouraged to request copies of program
announcements "School-based Prevention Intervention Research"
(PA-94-061), "Comprehensive Prevention Research in Drug Abuse"
(PA-94-056),  and "Drug Abuse Prevention Through Family Intervention"
(PA-96-013).
 
INCLUSION OF WOMEN AND MINORITIES IN RESEARCH INVOLVING HUMAN
SUBJECTS
 
It is the policy of the NIH that women and members of minority groups
and their subpopulations must be included in all NIH supported
biomedical and behavioral research projects involving human subjects,
unless a clear and compelling rationale and justification is provided
that inclusion is inappropriate with respect to the health of the
subjects or the purpose of the research.  This new policy results
from the NIH Revitalization Act of 1993 (Section 492B of Public Law
103-43) and supersedes and strengthens the previous policies
(Concerning the Inclusion of Women in Study Populations, and
Concerning the Inclusion of Minorities in Study Populations) which
have been in effect since 1990. The new policy contains some new
provisions that are substantially different from the 1990 policies.
 
All investigators proposing research involving human subjects should
read the "NIH Guidelines For Inclusion of Women and Minorities as
Subjects in Clinical Research", which have been published in the
Federal Register of March 28, 1994 (FR 59 14508-14513), and reprinted
in the NIH GUIDE FOR GRANTS AND CONTRACTS, Volume 23, Number 11,
March 18, 1994.
 
Investigators may obtain copies from these sources or from the
program staff or contact person listed below.  Program staff may also
provide additional relevant information concerning the policy.
 
APPLICATION PROCEDURES
 
Applications are to be submitted on the grant application form PHS
398 (rev. 5/95) and will be accepted at the standard application
deadlines as indicated in the application kit. The receipt dates for
applications for AIDS-related research are found in the PHS 398 (rev.
5/95) instructions.  Application kits are available at most
institutional offices of sponsored research and may be obtained from
the Grants Information Office, Office of Extramural Outreach and
Information Resources, National Institutes of Health, 6701 Rockledge
Drive, MSC 7910, Bethesda, MD 20892-7910, telephone 301/710-0267,
email: [email protected].  The title and number of the
program announcement must be typed in Section 2 on the face page of
the application.
 
Applications for the FIRST award (R29) must include at least three
sealed letters of reference attached to the face page of the original
application. FIRST (R29) applications submitted without the required
number of reference letters will be considered incomplete and will be
returned without review.
 
Applicants from institutions that have a General Clinical Research
Center (GCRC) funded by the NIH National Center for Research
Resources may wish to identify the GRC as a resource for conducting
the proposed research.  If so, a letter of agreement from either the
GCRC program director or principal investigator could be included
with the application.
 
The completed original application and five legible copies of the PHS
398 form must be sent or delivered to:
 
DIVISION OF RESEARCH GRANTS
NATIONAL INSTITUTES OF HEALTH
6701 ROCKLEDGE DRIVE, ROOM 1040 - MSC 7710
BETHESDA, MD  20892-7710
BETHESDA, MD  20817 (for courier/overnight service)
 
REVIEW CONSIDERATIONS
 
Applications that are complete will be evaluated for scientific and
technical merit to an appropriate peer review group convened in
accordance with the standard peer review procedures.  As part of the
initial merit review, all applications will receive a written
critique and undergo a process in which only those applications
deemed to have the highest scientific merit, generally the top half
of applications under review, will be discussed, assigned a priority
score, and receive a second level review by the appropriate national
advisory council or board.  R03 applications do not undergo a
second-level review.
 
Review Criteria
 
o  scientific, technical, or clinical significance and originality of
proposed research;
 
o  appropriateness and adequacy of the experimental approach and
methodology proposed to carry out the research;
 
o  qualifications and research experience of the Principal
Investigator and staff, particularly, but not exclusively, in the
area of proposed research;
 
o  availability of the resources necessary to perform the research;
 
o  appropriateness of the proposed budget and duration in relation to
the proposed research;
 
o  adequacy of plans to include both genders and minorities and their
subgroups as appropriate for the scientific goals of the research.
Plans for the recruitment and retention of subjects will also be
evaluated.
 
The initial review group will also examine the provisions for the
protection of human and animal subjects, and the safety of the
research environment.
 
AWARD CRITERIA
 
Applications will compete for available funds with all other approved
applications.  The following will be considered in making funding
decisions: quality of proposed project as determined by peer review,
availability of funds, and program priority.
 
INQUIRIES
 
Inquiries are encouraged.  The opportunity to clarify any issues or
questions from potential applicants is welcome.
 
Direct inquiries regarding programmatic issues to:
 
Elizabeth Rahdert, Ph.D.
Division of Clinical and Services Research
National Institute on Drug Abuse
5600 Fishers Lane, Room 10A-10
Rockville, MD  20857
Telephone:  (301) 443-0107
FAX:  (301) 443-8674
Email:  [email protected]
 
Direct inquires regarding fiscal issues to:
 
Gary Fleming, J.D., M.A.
Grants Management Branch
National Institute on Drug Abuse
5600 Fishers Lane, Room 8A-54
Rockville, MD  20857
Telephone:  (301) 443-6710
Email:  [email protected]
 
AUTHORITY AND REGULATIONS
 
This program is described in the Catalog of Federal Domestic
Assistance No. 93.279.  Awards are made under authorization of
Section 301 of the Public Health Service Act (42 USC 241) and
administered under PHS policies and Federal Regulations at Title 42
CFR 52 "Grants for Research Projects,"  Title 45 CFR Part 74 & 92,
"Administration of Grants" and 45 CFR Part 46, "Protection of Human
Subjects".  This program is not subject to the intergovernmental
review requirements of Executive Order 12372 or Health Systems Agency
review.  Sections of the Code of Federal Regulations are available in
booklet form from the U.S. Government Printing Office. Awards must be
administered in accordance with the PHS Grants Policy Statement,
(revised 4/94), which may be available from your office of sponsored
research.
 
The PHS strongly encourages all grant recipients to provide a
smoke-free workplace and promote the non-use of all tobacco products.
In addition, Public Law 103-227, the Pro-Children Act of 1994,
prohibits smoking in certain facilities (or in some cases, any
portion of a facility) in which regular or routine education,
library, day care, health care or early childhood development
services are provided to children.  This is consistent with the PHS
mission to protect and advance the physical and mental health of the
American people.
 
.

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