Ten-Year Counterdrug Technology Plan and Development
Roadmap
Demand Reduction Research & Technologies
Scope: Demand Reduction (DR) applies advances in technology to drug abuse
prevention, treatment, research, and policy efforts as shown in the figure above. The
technologies and scientific disciplines associated with DR significantly differ from those
associated with supply reduction discussed in preceding sections. Demand Reduction relies
on the pre-clinical and clinical disciplines of chemistry, neurochemistry, pharmacology,
physiology, medicine, psychology, as well as disciplines for studying broader populations,
such as epidemiology and community issues. The National Institute on Drug Abuse (NIDA)
supports high technology state-of-the-science in all of these areas. The Substance Abuse
and Mental Health Services Administration (SAMHSA) facilitates the adaptation,
dissemination and implementation of technologies in the field. The DR panel addresses
Goals 1 and 3 of the National Drug Control Strategy [1]:
Goal 1: Educate and enable America's youth to reject illegal drugs as well as
alcohol and tobacco, and
Goal 3: Reduce health and social costs to the public of illegal drug use.
Background: Drug abuse is not a single problem, and Demand
Reduction is not a single event. Demand Reduction includes at least three components with
complex antecedents requiring very different preliminary data, processes, and
technologies. There are several global areas of intervention to assure successful DR
[5,6]. These areas include: i) limiting access to and acceptance of drugs, and prevention
of initial use; ii) early intervention for those who have initiated use to prevent
progression to disastrous consequences of drug abuse; and iii) treatment of the direct and
indirect effects of drug abuse, including prevention of secondary or tertiary abuse
resulting from progression to other drugs and drug combinations. These three global
domains must target illegal drugs (e.g., cocaine), legal drugs (e.g., alcohol), and
commonly the combination of the two, from which the most untoward consequences are often a
result.
Objectives: The primary ongoing research areas of DR are
prevention and treatment as shown in Figure 12. NIDA leads diverse entities, interacting
with its sister NIH institutes, medical, biotechnology, and pharmaceutical companies,
academic medicine research institutions, and health care organizations. This leadership
focuses on the technology and science efforts in the crucial major areas of prevention and
treatment. SAMHSA works with prevention and treatment providers, health care and managed
care organizations, and state and local governments to ensure that the technologies
developed by research institutions are disseminated to the field. SAMHSA leads a
departmental initiative on preventing youth substance abuse. The Centers for Disease
Control and Prevention lead another initiative on preventing tobacco use among youth.
These complex interactive programs lead to reduced use of illegal drugs, legal drugs, and
drug combinations. The end users who implement the advanced science and technologies
contributing to DR are experts in Health Care Systems, Education Systems, Criminal Justice
Systems, and the Public Relations (PR) and Communications Systems fields. The critical
technological steps for successful DR are: i) basic research, ii) development to practical
application, and iii) implementation of the technologies and procedures. Each advance
influences long term planning and policy development. These advances directly diminish
costs ranging from immediate individual and social consequences, to the broad costs of
health care, lost income, and accidents. Demand Reduction incorporates the gamut of
scientific research and application. Demand Reduction involves industry, government, and
academic medicine in areas such as imaging hardware and software, neurobiology to human
behavior, and fetal development to drug abuse among the aging population. An example of
this broad community's interaction is demonstrated by the ongoing development and use of
complex technologies such as the Positron Emission Tomography (PET) system shown in Figure
13. These increasingly sophisticated technologies are applied to improving diagnostics and
treatments and to furthering the understandings at the neurochemical substrates of drug
abuse. The interpretation of the brain images suggest medications treatment strategies
which ultimately can lead to advances in medications development. Application of brain
imaging technology has led to the testing of several candidate medications for treatment
of cocaine dependence.
Figure 12: Demand Reduction Components and Functional Relationships
Demand Reduction must identify current and emerging patterns of drug use and abuse, and
determine how and under what conditions drug abuse is initiated or is avoided. Effective
DR research must delineate how drug abuse affects brain and behavior, and how to
ameliorate or reverse drug abuse effects and consequences. Successful DR policy will
educate people to differentiate drug abuse from therapeutic use of medications for the
spectrum of medical disorders. Ultimately, DR depends on the delivery of newly discovered
knowledge and technology to many groups. In education, this requires dissemination of
information to health care professionals, educators, and communities. Most important in
the DR area is the integration of resultant science and technology with the broader health
care delivery systems. The scientific knowledge that is generated through DR research is a
critical element to improving the overall health of the Nation through effective treatment
and prevention programs.
Figure 13: PET System and Drug Application
