The agency’s newly released strategic plan for 2022-26 reflects the rapid changes in the addiction and overdose crises
By Jason Langendorf
The newly released National Institute on Drug Abuse (NIDA) strategic plan for fiscal years 2022-26 makes it clear that the agency next half-decade of work will focus heavily on both evidence-based research and practical, harm-reducing solutions based on the lived experiences of people with substance use disorder (SUD) and people who use drugs (PWUD).
Each of the National Institutes of Health (NIH), including NIDA, releases a strategic plan every five years “to take stock of the current state of research and set priorities that are ambitious but achievable,” according to NIDA’s explanation of its latest plan.
The latest plan, which appears to build on the recent explosion of research and innovation within the addiction and treatment field, selects fairly specific targets.
NIDA’s previous plan, encompassing fiscal years 2016-20, featured broad-based, general goals. (Example: “Develop new and improved strategies to prevent drug use and its consequences.”) The latest plan, which appears to build on those goals and the recent explosion of research and innovation within the addiction and treatment field, selects fairly specific targets, describing them as “priority scientific areas.”
A Five-point Plan
Here are the five areas that make up NIDA’s new plan:
- Understand Drugs, the Brain and Behavior
- Develop and Test Novel Prevention, Treatment, Harm Reduction and Recovery Support Strategies
- Accelerate Research on the Intersection of Substance Use, HIV and Related Comorbidities
- Improve the Implementation of Evidence-Based Strategies in Real-World Settings
- Translate Research into Innovative Health Applications
“The strategic plan reflects our commitment to advancing all aspects of addiction science in the service of improving people’s lives,” writes NIDA director Nora Volkow, MD, in her message addressing the plan. “Today’s landscape of substance use poses both unique challenges and unprecedented opportunities to leverage the amazing potential of science toward that goal.”
NIDA’s Evolving Goals
In its latest strategic plan, NIDA outlines its goals within each of its five priority scientific areas—again, with specific approaches and outcomes in mind. (Example: “Goal 3.1: Increase understanding of the etiology, pathogenesis, spread and persistence of HIV/AIDS among people who use drugs.”) But the plan also highlights seven “cross-cutting themes” that can help back NIDA’s five priorities and the goals therein:
- Train the Next Generation of Scientists
- Identify and Develop Approaches to Reduce Stigma
- Understand Sex, Sexual Orientation and Gender Differences
- Identify and Develop Approaches to Reduce Health Disparities
- Understand Interactions Between Substance Use, HIV and other Comorbidities
- Leverage Data Science and Analytics to Understand Real-World Complexity
- Develop Personalized Interventions Informed by People with Lived Experience
The themes from the plan reflect the scope, complexity and changing nature of the addiction crisis. NIDA describes its strategic plan as a “living document,” and emphasizes that it must remain “flexible and responsive to scientific innovations as well as to the rapidly shifting drug use and addiction landscape.”
“The alarming increase in stimulant-involved overdose deaths is a stark illustration that we face an evolving addiction and overdose crisis.”—Nora Volkow, director of NIDA
Over the years, the opioid epidemic gradually changed shape, and eventually was met by a resurgence in stimulant use disorder and stimulant-driven overdoses, and finally was compounded by the rise of synthetic opioids, including fentanyl. Volkow emphasizes the importance of maintaining flexibility in the years ahead to accommodate any new challenges or changes that may require a reshaping of NIDA’s initial plan.
“The alarming increase in stimulant-involved overdose deaths is a stark illustration that we face an evolving addiction and overdose crisis characterized by shifting use of different substances and use of multiple drugs and drug classes together,” Volkow writes.
“While we have made impressive progress, there is more to be done.”