NIH GUIDE, Volume 24, Number 29, August 11, 1995

PA NUMBER: PA-94-078

P.T. 34


  Behavioral/Social Studies/Service 

  Drugs/Drug Abuse 


  Chemotherapeutic Agents 

National Institute on Drug Abuse


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



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.


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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