I Key Barriers and Critical Strategies in the Research and Public Arenas
RESEARCH ARENA
Facilitating Integration and Collaboration
Barrier: Lack of Integrative and Collaborative Research Within and Across Institutions
Strategies:
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Develop collaborative agreements between deans, chairs, and administrators of institutions to participate in collaborative efforts and to identify individuals and areas for collaboration.
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Develop resource- and facility-sharing plans.
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Convene conferences, forums, and planning sessions to promote collaboration.
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Encourage multi-site clinical and preclinical trials and utilize direct funding to increase cost-effectiveness of research, clinical trials, and training at collaborating institutions.
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Develop mechanisms to involve industry (e.g., consortia, centers without walls, Requests for Applications [RFAs]).
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Expand forums and develop innovative mechanisms to present and share scientific information.
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Convene jointly sponsored workshops, seminars, symposia, and RFAs with different National Institutes of Health institutes.
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Integrate peer-review panels.
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Create "new" interdisciplinary centers of excellence.
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Create new funding mechanism for interdisciplinary research for young and senior investigators.
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Examine and possibly revise federal rules for research protocols (e.g., confidentiality).
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Educate Institutional Review Boards (IRBs) about the risks, benefits, and needs of addiction research.
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Encourage researchers to publish in clinical journals and other publications.
Increasing Skilled Human Resources and Improving Quality
Barrier: Lack of Educational Curricula
Strategies:
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Introduce addiction research at an early stage of education.
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Improve educational curricula in addiction research at all levels, especially among health professionals.
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Provide a progression of educational training opportunities and permit ready access to the study of addiction research issues.
Barrier: Lack of Certification Opportunities
Strategies:
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Clarify definition and requirements for expertise in addiction as it relates to specific specialties.
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Intensify training requirements and ensure that addiction is part of the educational credentialing process for all health care providers.
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Enhance educational curricula to convey understanding of concepts related to genetic, biological, and behavioral aspects of addiction.
Barrier: Inadequate Mentoring
Strategies:
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Enhance effectiveness of existing programs (e.g., K05, K07).
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Develop shorter grant review cycles.
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Ensure mentoring through innovative mechanisms (e.g., satellite programs or a network of mentors for co-mentoring).
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Implement a systematic assessment of the effects of mentoring experiences.
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Provide support for short-term internships in clinical settings.
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Develop joint programs with industry, foundations, universities, and government.
Funding Stability and Adequacy
Barrier: Low Levels and Instability of Funding
Strategies:
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Establish stable funding trajectory for research and training grants.
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Incrementally increase percentage of extramural research funding assigned to training support at National Institute on Drug Abuse and National Institute on Alcohol Abuse and Alcoholism.
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Develop joint programs with other agencies and institutions (e.g., industry, private foundations, academia) to support research training and ease the difficult transition periods for career development of researchers (utilize memorandum of understanding).
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Develop mechanisms to provide bridging support for promising young investigators (particularly at difficult transition periods).
Barrier: Attracting New Investigators
Strategies:
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Develop more effective targeting of specific awards.
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Encourage wider use of B/START (Behavioral Science Track Award for Rapid Transition) mechanism.
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Provide set-aside funds for summer internships.
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Provide travel money for conferences.
Barrier: Special Problems for M.D./Ph.D.s
Strategies:
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Provide a new fellowship that combines research and training.
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Provide mechanisms for longer training intervals.
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Develop a debt forgiveness program.
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Provide support for staggered or short-term clinical internships.
PUBLIC ARENA
Education and Training
Barrier: Lack of Education
Strategies:
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Launch a campaign to educate the public and others in the medical and scientific communities about the commonalities among addictive drugs.
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Emphasize the importance of addiction research and its accomplishments.
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Stress the complex nature of addiction—that it is a chronic, relapsing disease involving fundamental changes in brain circuitry.
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Encourage school- and community-based programs to address issues of addiction at age-appropriate levels.
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Promote the education of science writers through press conferences and public symposia.
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Encourage private and public funding of efforts to develop educational programs for schools, adult education programs, educational computer programs, or other media communications.
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Encourage the development of educational materials for undergraduate-level courses.
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Educate the public and professionals about myths versus scientific clinical facts regarding addiction.
Tackling Stigma and Building Advocacy
Barrier: Lack of Advocacy
Strategies:
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Build advocacy groups from families of nicotine, alcohol, and illegal drug users.
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Emphasize what works and why and link research and treatment to other areas.
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Involve private foundations, industry, universities, and other organizations as well as M.D./Ph.D. scientist leaders to translate research findings and new clinical developments into lay terms.
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Increase communications with media to report timely, accurate, and reliable information about research findings.
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Disseminate scientific information to the public.
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Forge an alliance between local citizens' groups and scientists to conduct symposia.