1 00:00:05,280 --> 00:00:10,440 >>WELCOME TO HEAL AND 2 00:00:10,440 --> 00:00:12,160 INTERDISCIPLINARY WORKING GROUP 3 00:00:12,160 --> 00:00:14,560 MEMBERS TO THIS. SECOND MEETING 4 00:00:14,560 --> 00:00:16,720 THIS WEEK AND THIRD IN THE MONTH 5 00:00:16,720 --> 00:00:20,920 OF FEBRUARY, 2023, DISCUSSION OF 6 00:00:20,920 --> 00:00:25,320 HEAL RESEARCH AND PROPOSED NEW 7 00:00:25,320 --> 00:00:27,440 RESEARCH CONCEPTS THAT YOU WILL 8 00:00:27,440 --> 00:00:29,880 HEAR FROM HEAL SCIENTIFIC TEAMS. 9 00:00:29,880 --> 00:00:32,680 WE WILL START WITH A FEW TOPICS 10 00:00:32,680 --> 00:00:34,080 FOCUSED ON TRANSLATION OF 11 00:00:34,080 --> 00:00:37,000 RESEARCH TO PRACTICE FOR ABUSE 12 00:00:37,000 --> 00:00:39,120 DISORDER AND OVERDOSE AND NEW 13 00:00:39,120 --> 00:00:42,080 STRATEGIES TO PREVENT AND TREAT 14 00:00:42,080 --> 00:00:44,280 VARIED MISUSE AND ADDICTION 15 00:00:44,280 --> 00:00:47,560 OVERDOSE AND HAVE A DISCUSSION 16 00:00:47,560 --> 00:00:51,520 LATER IN THE AFTERNOON AROUND 17 00:00:51,520 --> 00:00:53,120 THERAPEUTIC DEVELOPMENT FOR 18 00:00:53,120 --> 00:00:57,200 TREATMENT OF ABUSE DISORDER AND 19 00:00:57,200 --> 00:00:58,760 REVERSAL AND CLOSE AND WE 20 00:00:58,760 --> 00:00:59,960 RESERVED A GOOD AMOUNT OF TIME 21 00:00:59,960 --> 00:01:02,080 AT THE END OF THE AFTERNOON TO 22 00:01:02,080 --> 00:01:04,560 JUST KIND OF LOOK ACROSS ALL OF 23 00:01:04,560 --> 00:01:06,080 THE DIFFERENT HEAL ACTIVITIES 24 00:01:06,080 --> 00:01:07,960 THAT WE HAVE TOLD YOU ABOUT THIS 25 00:01:07,960 --> 00:01:08,760 MONTH. 26 00:01:08,760 --> 00:01:11,680 THEY ARE INCLUDING THE RESEARCH 27 00:01:11,680 --> 00:01:13,520 UNDERWAY THAT WE DISCUSSED ON 28 00:01:13,520 --> 00:01:16,000 FEBRUARY 6TH AS WELL AS SOME OF 29 00:01:16,000 --> 00:01:18,320 THE OVERALL PORTFOLIO 30 00:01:18,320 --> 00:01:20,040 CONSIDERATIONS AND PROPOSALS FOR 31 00:01:20,040 --> 00:01:22,600 NEW RESEARCH TO BE ADDED IN THE 32 00:01:22,600 --> 00:01:22,880 FUTURE. 33 00:01:22,880 --> 00:01:27,000 WE WILL HAVE THAT 90 MINUTES AT 34 00:01:27,000 --> 00:01:28,680 THE END FOR DISCUSSION AND WILL 35 00:01:28,680 --> 00:01:30,400 TRY TO MAKE GOOD USE FOR THAT 36 00:01:30,400 --> 00:01:32,840 AND MIGHT BE ABLE TO END A 37 00:01:32,840 --> 00:01:33,280 LITTLE EARLY. 38 00:01:33,280 --> 00:01:35,280 PLEASE DO STICK WITH US TO GET 39 00:01:35,280 --> 00:01:38,160 TO THAT FINAL SYNTHESIS. WE 40 00:01:38,160 --> 00:01:41,920 WILL HAVE BOTH DOCTORS JOIN US 41 00:01:41,920 --> 00:01:47,960 FOR THAT PORTION. 42 00:01:47,960 --> 00:01:49,320 ERIN, WOULD YOU PLEASE GO 43 00:01:49,320 --> 00:01:52,440 THROUGH THE ROLL FOR 44 00:01:52,440 --> 00:01:53,080 MULTI-DISCIPLINARY WORKING GROUP 45 00:01:53,080 --> 00:01:55,760 MEMBERS AND EXECUTIVE COMMITTEE 46 00:01:55,760 --> 00:01:56,120 MEMBERS? 47 00:01:56,120 --> 00:01:59,000 >>HI. GOOD MORNING, EVERYONE. 48 00:01:59,000 --> 00:02:01,800 I KNOW MULTI-DISCIPLINARY 49 00:02:01,800 --> 00:02:03,120 WORKING GROUP MEMBERS JOINING 50 00:02:03,120 --> 00:02:04,840 THROUGHOUT THE MEETING AND WILL 51 00:02:04,840 --> 00:02:08,680 CALL OUT WHO I SEE NOW. LET'S 52 00:02:08,680 --> 00:02:11,880 START WITH THE REAL DR. GEREAU. 53 00:02:11,880 --> 00:02:15,520 >>HI, EVERYONE. GOOD TO SEE 54 00:02:15,520 --> 00:02:15,720 YOU. 55 00:02:15,720 --> 00:02:17,040 >>DR. BOSS BAUM? 56 00:02:17,040 --> 00:02:17,920 >>GOOD MORNING. 57 00:02:17,920 --> 00:02:19,120 >>GOOD MORNING. 58 00:02:19,120 --> 00:02:20,480 >>DR. JONES? 59 00:02:20,480 --> 00:02:22,960 >>GOOD MORNING. 60 00:02:22,960 --> 00:02:24,760 >>HI, THERE. DR. PACE? 61 00:02:24,760 --> 00:02:25,760 >>GOOD MORNING. 62 00:02:25,760 --> 00:02:27,920 >>GOOD MORNING. LET'S SEE 63 00:02:27,920 --> 00:02:32,280 HERE. I SEE DR. HENRY. 64 00:02:32,280 --> 00:02:34,080 >>THANK YOU, ERIN, GOOD 65 00:02:34,080 --> 00:02:34,760 MORNING, EVERYONE. 66 00:02:34,760 --> 00:02:38,400 >>GOOD MORNING. DR. JERNI 67 00:02:38,400 --> 00:02:39,120 BEGAN? 68 00:02:39,120 --> 00:02:40,000 >>HELLO, EVERYBODY. 69 00:02:40,000 --> 00:02:44,080 >>HELLO. DID I MISS ANYONE 70 00:02:44,080 --> 00:02:47,600 FROM MDWG? 71 00:02:47,600 --> 00:02:51,240 >>HI, EVERYONE. CHRISTIAN. 72 00:02:51,240 --> 00:02:52,640 >>GOOD TO SEE YOU. 73 00:02:52,640 --> 00:02:53,360 >>WELCOME. 74 00:02:53,360 --> 00:02:56,880 >>ALL RIGHT. OF COURSE WE SEE 75 00:02:56,880 --> 00:02:58,720 DR. VOLKOW. HOW ARE YOU? 76 00:02:58,720 --> 00:03:01,360 >>HELLO. GOOD MORNING, 77 00:03:01,360 --> 00:03:01,680 EVERYONE. 78 00:03:01,680 --> 00:03:04,200 >>GOOD MORNING. 79 00:03:04,200 --> 00:03:06,600 >>I SAW DR. KOR SHOTS POP ON 80 00:03:06,600 --> 00:03:10,880 MAYBE NOT. I SEE DR. KRISL 81 00:03:10,880 --> 00:03:11,360 WELL. HELLO. 82 00:03:11,360 --> 00:03:13,440 >>HELLO, EVERYBODY. GOOD 83 00:03:13,440 --> 00:03:13,720 MORNING. 84 00:03:13,720 --> 00:03:18,920 >>GOOD MORNING DR. LANGEVIN. 85 00:03:18,920 --> 00:03:27,240 HELLO. HOW ARE YOU DOING TODAY? 86 00:03:27,240 --> 00:03:29,160 WE CAN'T HEAR YOU YET. YOU 87 00:03:29,160 --> 00:03:31,480 MIGHT BE GETTING READY. 88 00:03:31,480 --> 00:03:35,240 DR. LANGEVIN, CAN YOU HEAR US 89 00:03:35,240 --> 00:03:35,480 OKAY? 90 00:03:35,480 --> 00:03:36,200 >>I CAN. 91 00:03:36,200 --> 00:03:37,680 >>PERFECT. WANTED TO MAKE SURE 92 00:03:37,680 --> 00:03:39,960 YOUR AUDIO IS WORKING GREAT. 93 00:03:39,960 --> 00:03:40,760 >>YES. THANK YOU. 94 00:03:40,760 --> 00:03:43,200 >>ALL RIGHT. DID I MISS ANYONE 95 00:03:43,200 --> 00:03:46,160 FROM THE EXECUTIVE COMMITTEE? 96 00:03:46,160 --> 00:03:48,640 >>JENNIFER WEBSTER IS ON ON 97 00:03:48,640 --> 00:03:51,040 BEHALF OF NIDER. 98 00:03:51,040 --> 00:03:53,680 >>GOOD MORNING. WELCOME. 99 00:03:53,680 --> 00:03:54,880 >>ALL RIGHT. YOU NOTICE WE 100 00:03:54,880 --> 00:03:57,040 HAVE MANY PROGRAM DIRECTORS IN 101 00:03:57,040 --> 00:03:58,720 HEAL AND CO-CHAIR COMMITTEE 102 00:03:58,720 --> 00:04:01,320 MEMBERS THAT WILL PRESENT TODAY. 103 00:04:01,320 --> 00:04:02,680 REBEKAH, I WILL TURN IT BACK 104 00:04:02,680 --> 00:04:04,840 OVER TO YOU. 105 00:04:04,840 --> 00:04:06,000 >>THANK YOU. I ALREADY SAID 106 00:04:06,000 --> 00:04:07,560 WORDS OF WELCOME AND THANKING 107 00:04:07,560 --> 00:04:09,320 THE GROUP FOR GIVING US SO MUCH 108 00:04:09,320 --> 00:04:12,040 TIME AND GOOD INPUT AND ADVICE 109 00:04:12,040 --> 00:04:13,600 OVER THE -- YESTERDAY'S MEETING 110 00:04:13,600 --> 00:04:15,200 AND LOOKING FORWARD TO ANOTHER 111 00:04:15,200 --> 00:04:16,360 GOOD MEETING TODAY. 112 00:04:16,360 --> 00:04:19,160 ON THAT NOTE, I WILL ASK NORA IF 113 00:04:19,160 --> 00:04:22,200 SHE HAS ANY WORDS OF WELCOME OR 114 00:04:22,200 --> 00:04:23,640 AREAS SHE WOULD LIKE THE 115 00:04:23,640 --> 00:04:27,280 PARTICULAR THOUGHTS AND INPUT 116 00:04:27,280 --> 00:04:30,080 FROM MULTIDISCIPLINARY WORKING 117 00:04:30,080 --> 00:04:30,600 GROUP TODAY. 118 00:04:30,600 --> 00:04:33,880 >>I WANTED TO COMMENT JUST 119 00:04:33,880 --> 00:04:35,720 THANKS FOR LETTING ME JUST 120 00:04:35,720 --> 00:04:37,120 HIGHLIGHT WHAT WAS IMPRESSIVE 121 00:04:37,120 --> 00:04:38,880 FOR ME YESTERDAY. IT WAS THE 122 00:04:38,880 --> 00:04:40,600 LEVEL OF DISCUSSION THAT WE HAD. 123 00:04:40,600 --> 00:04:44,240 THIS IS EXACTLY WHAT WE ARE 124 00:04:44,240 --> 00:04:48,280 AIMING TO ACHIEVE WITH THE 125 00:04:48,280 --> 00:04:49,880 PRESENTATION TO GET YOUR INPUT 126 00:04:49,880 --> 00:04:53,080 AND TODAY IS DENSELY PACKED WITH 127 00:04:53,080 --> 00:04:54,040 INFORMATION AND DIFFICULT 128 00:04:54,040 --> 00:04:54,320 DECISIONS. 129 00:04:54,320 --> 00:04:55,840 WE WILL HAVE TIME AT THE END 130 00:04:55,840 --> 00:04:57,520 THAT IS A VERY GOOD OPPORTUNITY 131 00:04:57,520 --> 00:05:03,080 TO GO INTO SPECIFICS. 132 00:05:03,080 --> 00:05:04,320 THANK YOU ALSO FOR YOUR 133 00:05:04,320 --> 00:05:14,880 WILLINGNESS TO BE HERE WITH US. 134 00:05:15,280 --> 00:05:16,840 EXCELLENT. WE CAN MOVE ON. I 135 00:05:16,840 --> 00:05:19,000 HAVE A FEW INTRO SLIDES. THANKS 136 00:05:19,000 --> 00:05:21,600 FOR THAT, NORA. HERE WE ARE AT 137 00:05:21,600 --> 00:05:29,640 DAY 2. NEXT SLIDE, PLEASE. 138 00:05:29,640 --> 00:05:35,160 YOU CAN SEE HOW P MUCH HOU MUCHE 139 00:05:35,160 --> 00:05:37,200 S YOU CAN DIENLEST IT. WE 140 00:05:37,200 --> 00:05:40,000 SHARED WITH YOU THE DETAILED 141 00:05:40,000 --> 00:05:42,600 RESEARCH CONCEPT TREATMENTS THAT 142 00:05:42,600 --> 00:05:44,960 HAVE LOTS OF INFORMATION AND 143 00:05:44,960 --> 00:05:46,800 DIFFERENT PDF DOCUMENTS WE 144 00:05:46,800 --> 00:05:51,200 SHARED. WE WILL GO THROUGH THEM 145 00:05:51,200 --> 00:05:52,840 BRIEFLY. EACH SCIENTIFIC TEAM 146 00:05:52,840 --> 00:05:54,360 WILL END AND THREE ARE 147 00:05:54,360 --> 00:05:55,480 REPRESENTED HERE TODAY AND THEY 148 00:05:55,480 --> 00:05:59,240 WILL SHARE WITH YOU A FEW SLIDES 149 00:05:59,240 --> 00:06:02,320 ABOUT WHAT THEY HAVE PROPOSED 150 00:06:02,320 --> 00:06:05,440 AREAS FOR ALIGNMENT AND GAPS AND 151 00:06:05,440 --> 00:06:09,320 NIH PORTFOLIOS AND SOME 152 00:06:09,320 --> 00:06:11,440 QUESTIONS FOR DISCUSSION. 153 00:06:11,440 --> 00:06:13,440 WE WILL TRY TO MOVE THROUGH AT A 154 00:06:13,440 --> 00:06:17,120 HIGH LEVEL AND LEAVE TIME FOR 155 00:06:17,120 --> 00:06:20,160 QUESTIONS AND DISCUSSION. 156 00:06:20,160 --> 00:06:23,920 NEXT SLIDE, PLEASE. 157 00:06:23,920 --> 00:06:25,600 FIRST TEAM WILL DISCUSS 158 00:06:25,600 --> 00:06:27,880 TRANSLATION OF RESEARCH FOR 159 00:06:27,880 --> 00:06:29,200 PRACTICE AND DISORDER AND 160 00:06:29,200 --> 00:06:31,360 ADDICTION AND PREVENTING 161 00:06:31,360 --> 00:06:35,200 OVERDOSE AND CO-CHAIRS ARE THE 162 00:06:35,200 --> 00:06:39,160 TEAM ARE [INDISCERNIBLE] WIDA 163 00:06:39,160 --> 00:06:41,880 AND MEMBERS OF NIEH. 164 00:06:41,880 --> 00:06:43,320 >>TURNING IT OVER TO YOU AND 165 00:06:43,320 --> 00:06:44,800 HERE IS WHAT WE SAW BEFORE FOR 166 00:06:44,800 --> 00:06:50,120 SOME OF THE OTHER TEAMS VISUAL 167 00:06:50,120 --> 00:06:54,160 DEPICTION OF THE RESEARCH 168 00:06:54,160 --> 00:06:56,560 PROGRAMS LAUNCHED IN THIS AREA 169 00:06:56,560 --> 00:06:57,800 FOR SCIENTIFIC HEAL AND THREE AT 170 00:06:57,800 --> 00:07:00,080 TOP ARE PRESENTED TO YOU 171 00:07:00,080 --> 00:07:01,560 FEBRUARY 6TH THAT THEY LAUNCHED 172 00:07:01,560 --> 00:07:04,360 AND ACCOMPLISHED A LOT AND ARE 173 00:07:04,360 --> 00:07:06,400 NOW IN THE POSITION TO BE 174 00:07:06,400 --> 00:07:07,720 CONTINUED AND IN ALMOST A 175 00:07:07,720 --> 00:07:09,600 DIFFERENT FORMAT OR DEPENDING ON 176 00:07:09,600 --> 00:07:11,880 THE STUDY IN DIFFERENT WAYS 177 00:07:11,880 --> 00:07:13,720 BASED ON CONTINUED SCIENTIFIC 178 00:07:13,720 --> 00:07:18,280 NEED AND PUBLIC HEALTH IMPACT. 179 00:07:18,280 --> 00:07:20,240 OTHER PROGRAMS LAUNCHED LATER 180 00:07:20,240 --> 00:07:21,920 ARE GOING ON. 181 00:07:21,920 --> 00:07:24,280 THOSE THAT ARE A LIGHTER COLOR 182 00:07:24,280 --> 00:07:26,200 IN THE BOTTOM CORNER THERE ARE 183 00:07:26,200 --> 00:07:28,880 THOSE -- THAT THE SCIENTIFIC 184 00:07:28,880 --> 00:07:29,800 TEAM HAS PUT FORWARD FOR 185 00:07:29,800 --> 00:07:32,160 CONSIDERATION FOR ADDING TO THE 186 00:07:32,160 --> 00:07:34,400 PORTFOLIO IN 2024 THAT IS A 187 00:07:34,400 --> 00:07:36,320 TOPIC OF DISCUSSION FOR THIS 188 00:07:36,320 --> 00:07:37,480 MORNING. 189 00:07:37,480 --> 00:07:38,680 NEXT SLIDE, PLEASE. 190 00:07:38,680 --> 00:07:40,920 I THINK THIS IS WHERE I WILL 191 00:07:40,920 --> 00:07:44,280 TURN IT OVER TO YOU, TISHA, AND 192 00:07:44,280 --> 00:07:44,480 WENDY. 193 00:07:44,480 --> 00:07:46,680 THANK YOU VERY MUCH FOR THE 194 00:07:46,680 --> 00:07:47,040 PRESENTATION. 195 00:07:47,040 --> 00:07:49,120 >>THANK YOU, REBEKAH. 196 00:07:49,120 --> 00:07:51,360 SO, THIS IS A SCHEMATIC THAT I 197 00:07:51,360 --> 00:07:52,720 THINK YOU HAVE SEEN THESE 198 00:07:52,720 --> 00:07:54,280 BEFORE. JUST TO THINK ABOUT HOW 199 00:07:54,280 --> 00:07:57,120 THE PORTFOLIO THAT WE FUNDED TO 200 00:07:57,120 --> 00:08:00,400 DATE ALL FITS TOGETHER AND 201 00:08:00,400 --> 00:08:02,600 LARGELY THESE BIG INITIATIVES 202 00:08:02,600 --> 00:08:04,680 FIT INTO SETTINGS AND A NUMBER 203 00:08:04,680 --> 00:08:06,480 OF CROSS-CUTTING THEMES AND 204 00:08:06,480 --> 00:08:08,560 MOSTLY THAT CAME ON BOARD IN 205 00:08:08,560 --> 00:08:10,400 20202 AS WELL AS DATA 206 00:08:10,400 --> 00:08:12,200 INFRASTRUCTURE PIECES AND 207 00:08:12,200 --> 00:08:13,080 HEALING COMMUNITIES THAT IS THE 208 00:08:13,080 --> 00:08:15,760 LARGEST INITIATIVE REALLY CUTS 209 00:08:15,760 --> 00:08:17,240 ACROSS ALL THESE DIFFERENT 210 00:08:17,240 --> 00:08:19,200 SETTINGS AND HOPEFULLY GIVES A 211 00:08:19,200 --> 00:08:21,240 SENSE OF NEXT ONES TO FIT INTO 212 00:08:21,240 --> 00:08:23,560 THE BROADER PORTFOLIO. NEXT 213 00:08:23,560 --> 00:08:24,480 SLIDE, PLEASE. 214 00:08:24,480 --> 00:08:26,240 AGAIN, THESE ARE THE FOUR 215 00:08:26,240 --> 00:08:27,960 CONCEPTS THAT WE WILL DISCUSS 216 00:08:27,960 --> 00:08:28,960 TODAY. WE WILL JUST LAUNCH 217 00:08:28,960 --> 00:08:31,200 RIGHT IN. I THINK THE FIRST ONE 218 00:08:31,200 --> 00:08:35,360 UP, WENDY, IS GOING TO TAKE -- 219 00:08:35,360 --> 00:08:36,920 NEXT SLIDE, PLEASE. 220 00:08:36,920 --> 00:08:39,600 >>YES. THAT IS RIGHT. THANK 221 00:08:39,600 --> 00:08:41,640 YOU, TISHA. GOOD MORNING, 222 00:08:41,640 --> 00:08:43,560 EVERYONE. THANK YOU FOR JOINING 223 00:08:43,560 --> 00:08:45,280 US. FIRST WE WILL TALK ABOUT IS 224 00:08:45,280 --> 00:08:49,640 DEVELOPING AN EVIDENCE BASED FOR 225 00:08:49,640 --> 00:08:53,120 CO-OCCURRING CONDITIONS OF 226 00:08:53,120 --> 00:08:55,200 ALCOHOL ABUSE DISORDER AND 227 00:08:55,200 --> 00:08:57,080 SPECIFICALLY TO INTERVENTION AND 228 00:08:57,080 --> 00:08:59,000 SPEAKING TO THIS GROUP WRU AWARE 229 00:08:59,000 --> 00:09:00,320 OF SIGNIFICANT OVERLAP OF 230 00:09:00,320 --> 00:09:03,080 INDIVIDUALS WISHUS WITH OPIOID 231 00:09:03,080 --> 00:09:04,520 USE AND CO-OCCURRING ALCOHOL USE 232 00:09:04,520 --> 00:09:06,560 THAT IS ESTIMATED TO ME AS MUCH 233 00:09:06,560 --> 00:09:12,160 AS 30% OF THE POPULATION THAT 234 00:09:12,160 --> 00:09:14,160 ARE INDIVIDUALS WITH OPIOID 235 00:09:14,160 --> 00:09:15,400 DISORDER THAT HAVE ALCOHOL USE 236 00:09:15,400 --> 00:09:18,360 IN HIGH AMOUNT THAT CREATES 237 00:09:18,360 --> 00:09:20,000 CHALLENGES FOR TREATMENT. IN 238 00:09:20,000 --> 00:09:22,720 PARTICULAR, THERE MAY BE 239 00:09:22,720 --> 00:09:25,120 INTERACTIONS BETWEEN MEDICATIONS 240 00:09:25,120 --> 00:09:26,720 USED FOR DIFFERENT CONDITIONS. 241 00:09:26,720 --> 00:09:28,800 AND IT MAKES IT QUITE 242 00:09:28,800 --> 00:09:30,280 CHALLENGING TO WORK WITH THIS 243 00:09:30,280 --> 00:09:31,520 POPULATION THEN AND THINK ABOUT 244 00:09:31,520 --> 00:09:33,400 HOW WE NEED TO TAILOR AND 245 00:09:33,400 --> 00:09:35,160 DEVELOP INTERVENTIONS FOR THIS 246 00:09:35,160 --> 00:09:35,800 GROUP. 247 00:09:35,800 --> 00:09:37,600 SO, WE ALSO KNOW THAT ALCOHOL IS 248 00:09:37,600 --> 00:09:40,720 OFTEN A CONTRIBUTING FACTOR TO 249 00:09:40,720 --> 00:09:42,600 OVERDOSES AND IN FACT THOSE WHO 250 00:09:42,600 --> 00:09:48,520 GO INTO GOOD TREATMENT FOR ABUSE 251 00:09:48,520 --> 00:09:50,680 DISORDER COME OUT AND USE 252 00:09:50,680 --> 00:09:52,120 SUBSTANCE ABUSE ALCOHOL PUTTING 253 00:09:52,120 --> 00:09:55,760 THEM AT HIGH RISK IF THEY REDUCE 254 00:09:55,760 --> 00:09:57,880 ELAPSE AND HIGH RISK OF OPIOIDS 255 00:09:57,880 --> 00:09:59,760 AND ALCOHOL AND CONCEPT HERE IS, 256 00:09:59,760 --> 00:10:02,520 YOU KNOW, DESPITE THE FACT THAT 257 00:10:02,520 --> 00:10:04,080 WE KNOW THIS CO-OCCURRENCE 258 00:10:04,080 --> 00:10:06,480 EXISTS, WE NEED MORE RESEARCH TO 259 00:10:06,480 --> 00:10:08,920 REALLY IDENTIFY AN EFFECTIVE 260 00:10:08,920 --> 00:10:10,520 ARSENAL OF TREATMENTS WITH 261 00:10:10,520 --> 00:10:12,240 MEDICATIONS AND PSYCHOSOCIAL 262 00:10:12,240 --> 00:10:13,680 APPROACHES AND COMPLEMENTARY 263 00:10:13,680 --> 00:10:15,760 TYPES OF INTERVENTION TO TARGET 264 00:10:15,760 --> 00:10:17,360 THIS PARTICULAR GROUP THAT HAS 265 00:10:17,360 --> 00:10:20,480 BEEN QUITE MUCH MORE DIFFICULT 266 00:10:20,480 --> 00:10:21,560 TO MANAGE. 267 00:10:21,560 --> 00:10:23,400 THAT IS PROPOSED HERE IS TO 268 00:10:23,400 --> 00:10:25,520 THINK ABOUT HOW TO LEVERAGE THE 269 00:10:25,520 --> 00:10:27,840 ONGOING WORK AND HEAL SO WE CAN 270 00:10:27,840 --> 00:10:31,320 LEARN MORE ABOUT THIS PARTICULAR 271 00:10:31,320 --> 00:10:34,240 SUBGROUP OF INDIVIDUALS BY 272 00:10:34,240 --> 00:10:35,920 EXPANDING SUBJECT RECRUITMENT 273 00:10:35,920 --> 00:10:38,800 ENROLLING INDIVIDUALS WITH A 274 00:10:38,800 --> 00:10:40,640 CO-OCCURRING CONDITION WITH 275 00:10:40,640 --> 00:10:41,920 ADDITIONAL ALCOHOL USE INTO 276 00:10:41,920 --> 00:10:44,000 EXISTING PROJECTS EITHER TO, YOU 277 00:10:44,000 --> 00:10:45,840 KNOW, MAKE SURE WE ARE 278 00:10:45,840 --> 00:10:48,120 COLLECTING COMPREHENSIVE DATA 279 00:10:48,120 --> 00:10:51,040 ABOUT ALCOHOL USE OR INITIATING 280 00:10:51,040 --> 00:10:52,640 ADDITIONAL ANCILLARY STUDIES OR 281 00:10:52,640 --> 00:10:54,720 OTHER THINGS TO ENROLL THAT 282 00:10:54,720 --> 00:10:57,040 PARTICULAR SUBGROUP INTO ONGOING 283 00:10:57,040 --> 00:10:59,920 STUDIES TO LEARN MORE ABOUT HOW 284 00:10:59,920 --> 00:11:00,640 INTERVENTIONS WORK IN THAT 285 00:11:00,640 --> 00:11:01,840 PARTICULAR POPULATION AND WE 286 00:11:01,840 --> 00:11:06,920 KNOW ACROSS HEAL THERE IS 287 00:11:06,920 --> 00:11:08,440 ALREADY IN CASES GREAT 288 00:11:08,440 --> 00:11:09,200 CHARACTERIZATION OF ALCOHOL USE 289 00:11:09,200 --> 00:11:12,760 AND WHAT WE CAN DO TO INCREASE 290 00:11:12,760 --> 00:11:14,960 SECONDARY ANALYSIS DATA TO 291 00:11:14,960 --> 00:11:17,120 BETTER INFORM US HOW TO MANAGE 292 00:11:17,120 --> 00:11:18,120 IN THIS PARTICULAR POPULATION 293 00:11:18,120 --> 00:11:20,320 AND IDEA HERE IS HOW TO LEVERAGE 294 00:11:20,320 --> 00:11:21,680 WHAT WE ARE DOING AND EXPAND 295 00:11:21,680 --> 00:11:24,160 WHAT WE ARE DOING TO LEARN MORE 296 00:11:24,160 --> 00:11:26,880 ABOUT THIS CO-OCCURRING SORT OF 297 00:11:26,880 --> 00:11:27,200 CONDITIONS. 298 00:11:27,200 --> 00:11:32,400 NEXT SLIDE, PLEASE. 299 00:11:32,400 --> 00:11:34,400 SO, HOW DID IT SIT OVERALL WITH 300 00:11:34,400 --> 00:11:36,840 WHAT WE ARE DOING IN HEAL? 301 00:11:36,840 --> 00:11:39,280 AS I MENTIONED, SOME PROGRAMS 302 00:11:39,280 --> 00:11:40,560 ARE COLLECTING DATA IN THIS 303 00:11:40,560 --> 00:11:43,120 SPACE AND HEAL DATA ECOSYSTEM 304 00:11:43,120 --> 00:11:45,120 GIVES US A PLATFORM TO BE ABLE 305 00:11:45,120 --> 00:11:47,920 TO DO ANALYSIS ACROSS DIFFERENT 306 00:11:47,920 --> 00:11:49,920 STUDIES AND BEING ABLE TO HAVE 307 00:11:49,920 --> 00:11:53,360 CONSISTENT DATA COLLECTED AROUND 308 00:11:53,360 --> 00:11:55,560 ALCOHOL USE DISORDER AND THE 309 00:11:55,560 --> 00:11:57,160 AMOUNT OF USE OF ALCOHOL IN 310 00:11:57,160 --> 00:11:59,160 INDIVIDUALS WOULD ALLOW US TO 311 00:11:59,160 --> 00:12:01,800 USE THAT PLATFORM TO CONDUCT 312 00:12:01,800 --> 00:12:02,840 CROSS-STUDY ANALYSIS. 313 00:12:02,840 --> 00:12:05,440 WE HAVE A NUMBER OF PROGRAMS 314 00:12:05,440 --> 00:12:07,720 THAT ARE RIGHT FOR EXPANSION AND 315 00:12:07,720 --> 00:12:09,760 RIGHT FOR DELVING IN AND DOING 316 00:12:09,760 --> 00:12:11,960 MORE SPECIFIC ANCILLARY STUDIES 317 00:12:11,960 --> 00:12:14,960 OR LIKE I SAID ENHANCING THEIR 318 00:12:14,960 --> 00:12:18,160 DATA CLUCKS THAT ENHANCES 319 00:12:18,160 --> 00:12:20,040 POLYUSE SUBSTANCE PROGRAM AS 320 00:12:20,040 --> 00:12:23,120 WELL AS EMPOWER PROGRAM AND 321 00:12:23,120 --> 00:12:25,000 OPTIMIZING SERVICE DELIVERY FOR 322 00:12:25,000 --> 00:12:26,960 THOSE WITH OD CURRENT CONDITIONS 323 00:12:26,960 --> 00:12:29,560 AS WELL AS DATA METHODS PROGRAMS 324 00:12:29,560 --> 00:12:31,320 AND WE THINK THESE WOULD BE SOME 325 00:12:31,320 --> 00:12:34,360 OF NOT LIMITED TO THIS GROUP OF 326 00:12:34,360 --> 00:12:34,800 PROGRAMS. 327 00:12:34,800 --> 00:12:36,840 BUT, CERTAINLY THEY ARE PROGRAMS 328 00:12:36,840 --> 00:12:38,200 THAT WOULD GIVE US THE 329 00:12:38,200 --> 00:12:39,720 OPPORTUNITY TO LEARN MORE IN 330 00:12:39,720 --> 00:12:42,560 THIS SPACE. 331 00:12:42,560 --> 00:12:44,240 SO, NEXT SLIDE. 332 00:12:44,240 --> 00:12:46,680 WE HAVE A SET OF DISCUSSION 333 00:12:46,680 --> 00:12:47,480 QUESTIONS HERE. 334 00:12:47,480 --> 00:12:49,880 CAN I JUST CHECK WITH ERIN OR 335 00:12:49,880 --> 00:12:52,240 REBEKAH AS TO WHETHER YOU WANT 336 00:12:52,240 --> 00:12:54,240 US TO DELVE INTO THESE NOW OR 337 00:12:54,240 --> 00:12:55,840 WHETHER WE SHOULD GO AHEAD AND 338 00:12:55,840 --> 00:12:57,760 NOTE THAT THESE ARE QUESTIONS WE 339 00:12:57,760 --> 00:12:58,840 WILL BRING BACK FOR DISCUSSION 340 00:12:58,840 --> 00:13:01,440 WHEN WE GET TO THE END AND WHAT 341 00:13:01,440 --> 00:13:05,440 WOULD BE THE PREVENS TODAY? 342 00:13:05,440 --> 00:13:10,280 >>WELL, IT IS A LOT TO GET 343 00:13:10,280 --> 00:13:11,480 THROUGH TIMEWISE. 344 00:13:11,480 --> 00:13:13,960 YOU HAVE DONE A GOOD JOB GETTING 345 00:13:13,960 --> 00:13:14,240 STARTED. 346 00:13:14,240 --> 00:13:18,280 I THINK WE CAN TRY TO HAVE A 347 00:13:18,280 --> 00:13:19,040 BRIEF DISCUSSION WITH 348 00:13:19,040 --> 00:13:20,720 RECOGNITION THAT IF WE GO TOO 349 00:13:20,720 --> 00:13:23,280 LONG WE WILL HAVE TO KIND OF 350 00:13:23,280 --> 00:13:24,080 SWITCH GEARS. 351 00:13:24,080 --> 00:13:26,600 >>OKAY. SOUNDS GREAT, 352 00:13:26,600 --> 00:13:29,280 PROFESSOR. I KNOW WE HAD A FEW 353 00:13:29,280 --> 00:13:30,960 DISCUSSIONS ASSIGNED FOR THIS 354 00:13:30,960 --> 00:13:33,160 ONE. WE WILL TAKE QUESTIONS. 355 00:13:33,160 --> 00:13:34,800 YOUR HAND WENT UP VERY QUICKLY. 356 00:13:34,800 --> 00:13:36,960 IT ALSO APPEARED. DID YOU WANT 357 00:13:36,960 --> 00:13:37,400 TO -- 358 00:13:37,400 --> 00:13:40,880 >>I WAS ABOUT TO SAY THAT 359 00:13:40,880 --> 00:13:44,000 DISCUSSANT THING IS TRICKY AND 360 00:13:44,000 --> 00:13:46,960 IF PEOPLE RACED THEIR HAND LET'S 361 00:13:46,960 --> 00:13:48,160 GO AHEAD. 362 00:13:48,160 --> 00:13:51,720 >>LET'S START. I DO HAVE 363 00:13:51,720 --> 00:13:52,000 COMMENTS. 364 00:13:52,000 --> 00:13:52,680 >>OKAY. 365 00:13:52,680 --> 00:13:56,080 >>LET DISCUSSANTS GO. 366 00:13:56,080 --> 00:13:57,840 >>OKAY. GAIL, YOU WERE ONE. 367 00:13:57,840 --> 00:14:01,920 >>I AGREE. I DON'T THINK I'M A 368 00:14:01,920 --> 00:14:02,200 DISCUSSANT. 369 00:14:02,200 --> 00:14:04,080 >>I THINK WE SHOULD GO BY 370 00:14:04,080 --> 00:14:04,320 HANDS. 371 00:14:04,320 --> 00:14:06,440 >>YEAH. I THINK GAIL YOU ARE. 372 00:14:06,440 --> 00:14:10,760 >>OKAY. GOOD. GOOD. THAT IS 373 00:14:10,760 --> 00:14:14,240 GREAT. THIS IS A REALLY 374 00:14:14,240 --> 00:14:15,920 IMPORTANT TOPIC AND WE ARE 375 00:14:15,920 --> 00:14:19,120 SEEING MORE AND MORE OF THIS 376 00:14:19,120 --> 00:14:22,080 EVERY DAY IN AN IS A VERY 377 00:14:22,080 --> 00:14:24,000 DIFFICULT LIFT AND NOT EXACTLY 378 00:14:24,000 --> 00:14:25,480 SURE HOW TO TREAT THESE 379 00:14:25,480 --> 00:14:25,800 INDIVIDUALS. 380 00:14:25,800 --> 00:14:28,480 OF COURSE, FIRST, IT IS 381 00:14:28,480 --> 00:14:29,880 COMPLICATED BECAUSE OF EVEN 382 00:14:29,880 --> 00:14:31,960 FINDING DEGREE OF WITHDRAWAL OF 383 00:14:31,960 --> 00:14:33,600 OUD IF THEY ARE USING LOTS OF 384 00:14:33,600 --> 00:14:36,920 ALCOHOL AS WELL. THAT IS TOUGH. 385 00:14:36,920 --> 00:14:40,360 THEN, OF COURSE, TREATING THEM 386 00:14:40,360 --> 00:14:43,680 WITH SAME NOREP NEF REN IS 387 00:14:43,680 --> 00:14:46,840 DIFFICULT AND WHEN ADDING ON A 388 00:14:46,840 --> 00:14:49,600 BENZO FOR WITHDRAWAL OF ALCOHOL 389 00:14:49,600 --> 00:14:59,320 OR EVEN GABBA PENTON. I'M 390 00:14:59,320 --> 00:15:02,720 EXCITED ABOUT THIS FOR 391 00:15:02,720 --> 00:15:04,840 IN-PATIENT SETTINGS AND WHAT IS 392 00:15:04,840 --> 00:15:09,320 MEDICATION FOR ACUTE WITHDRAWAL 393 00:15:09,320 --> 00:15:11,720 AND THERE IS LOT OF OBVIOUSLY 394 00:15:11,720 --> 00:15:13,840 DATA COLLECTED TO FIGURE OUT 395 00:15:13,840 --> 00:15:17,440 WHAT TO DO LONG TERM AND GETTING 396 00:15:17,440 --> 00:15:20,200 PEOPLE WITHDRAWING FROM ALCOHOL 397 00:15:20,200 --> 00:15:22,600 HOW TO TRAEL THAT ALONG WITH 398 00:15:22,600 --> 00:15:26,280 TREATMENT OF OUD THAT CAN BE 399 00:15:26,280 --> 00:15:28,720 VERY TRICKY. I'M EXCITED ABOUT 400 00:15:28,720 --> 00:15:31,960 FIGURING IT OUT AND THINK MANY 401 00:15:31,960 --> 00:15:34,040 PIS FROM HILL STUDIES WOULD BE 402 00:15:34,040 --> 00:15:35,760 HAPPY TO CONTRIBUTE. WE ARE 403 00:15:35,760 --> 00:15:37,720 SEEING IT A LOT. THEY ARE NOT 404 00:15:37,720 --> 00:15:40,640 PEOPLE WE PUT IN TRADITIONAL 405 00:15:40,640 --> 00:15:42,680 STUDIES OR MY HEAL STUDY. THEY 406 00:15:42,680 --> 00:15:44,240 ARE TOO COMPLICATED AND HAVE TO 407 00:15:44,240 --> 00:15:46,960 BE MORE ADDRESSED IN AN 408 00:15:46,960 --> 00:15:48,040 IN-PATIENT SETTING AND NOT SURE 409 00:15:48,040 --> 00:15:51,880 IT IS TRUE. WE WILL LEARN FROM 410 00:15:51,880 --> 00:15:54,680 YOU. THANK YOU. 411 00:15:54,680 --> 00:15:57,480 >>WELL, I CAN SAY I AGREE WITH 412 00:15:57,480 --> 00:15:59,800 EVERYTHING GAIL JUST SAID AND IT 413 00:15:59,800 --> 00:16:01,960 IS EXTREMELY IMPORTANT AND 414 00:16:01,960 --> 00:16:03,240 ACKNOWLEDGING THE FACT THAT MANY 415 00:16:03,240 --> 00:16:05,440 TIMES PEOPLE -- YOU KNOW, HEALTH 416 00:16:05,440 --> 00:16:10,480 IS DRAGGED DOWN MORE BY WEB OF 417 00:16:10,480 --> 00:16:12,920 COMORBIDITIES THAN ANY 418 00:16:12,920 --> 00:16:13,880 PARTICULAR DISORDER THEY ARE 419 00:16:13,880 --> 00:16:15,520 STRUGGLING WITH. WE TEND TO 420 00:16:15,520 --> 00:16:17,600 STUDY DISORDERS IN A KIND OF 421 00:16:17,600 --> 00:16:19,760 SILOED WAY AND TRYING TO ISOLATE 422 00:16:19,760 --> 00:16:21,520 MECHANISMS AND SO ON. IN THE 423 00:16:21,520 --> 00:16:25,520 REAL WORLD, PEOPLE ARE REALLY 424 00:16:25,520 --> 00:16:27,600 OVERCOME BY THESE COMORBIDITIES 425 00:16:27,600 --> 00:16:29,720 THAT COMPLICATE TREATMENT AND 426 00:16:29,720 --> 00:16:31,840 ILLNESS AND HEALTH AND SO ON AND 427 00:16:31,840 --> 00:16:34,440 IS A REALLY IMPORTANT 428 00:16:34,440 --> 00:16:35,000 INITIATIVE. 429 00:16:35,000 --> 00:16:38,280 >>ANY OTHER DISCUSSANTS? I 430 00:16:38,280 --> 00:16:38,960 COMPLETELY CONCUR WITH 431 00:16:38,960 --> 00:16:41,680 EVERYTHING THAT HAS ALREADY BEEN 432 00:16:41,680 --> 00:16:46,360 SAID AND WOULD LIKE TO ALSO AM 433 00:16:46,360 --> 00:16:51,240 MRIF PI COMPLICATIONS WITH 434 00:16:51,240 --> 00:16:52,800 BENZODIAZEPINES AND -- WHILE 435 00:16:52,800 --> 00:16:56,240 PATIENTS HAVE THESE COMPLICATED 436 00:16:56,240 --> 00:16:59,400 BENZO OR -- AND/OR ALCOHOL-USE 437 00:16:59,400 --> 00:17:01,960 DISORDERS AND NOT NARROWING 438 00:17:01,960 --> 00:17:03,320 OURSELVES TO ONLY THE ANTAGONIST 439 00:17:03,320 --> 00:17:06,240 BUT TO ALSO THINK ABOUT ARE 440 00:17:06,240 --> 00:17:06,920 MEDICATIONS LIKE [INDISCERNIBLE] 441 00:17:06,920 --> 00:17:08,520 OR OTHER THINGS THAT COULD ALSO 442 00:17:08,520 --> 00:17:11,320 BE INCLUDED IN STUDY AND 443 00:17:11,320 --> 00:17:12,880 ADDITIONALLY TO ALSO THINK ABOUT 444 00:17:12,880 --> 00:17:14,920 MINORITY POPULATIONS OR 445 00:17:14,920 --> 00:17:18,080 MARGINALIZED POPULATIONS THAT 446 00:17:18,080 --> 00:17:21,720 MIGHT NOT HAVE BEEN ALWAYS 447 00:17:21,720 --> 00:17:23,640 INCLUDED IN STUDIES AND PREGNANT 448 00:17:23,640 --> 00:17:25,720 INDIVIDUALS ARE DESERVING OF 449 00:17:25,720 --> 00:17:27,560 BEING INCLUDED IN COMPLICATED 450 00:17:27,560 --> 00:17:28,960 PROTOCOLS TO UNDERSTAND HOW BEST 451 00:17:28,960 --> 00:17:32,200 TO TREAT THEM AS WELL AS 452 00:17:32,200 --> 00:17:36,960 INDIVIDUALS THAT ARE LGBTQYA. 453 00:17:36,960 --> 00:17:37,640 THANK YOU. 454 00:17:37,640 --> 00:17:41,200 >>OKAY. THANK YOU. 455 00:17:41,200 --> 00:17:45,000 >>YEAH. GO AHEAD. 456 00:17:45,000 --> 00:17:46,840 >>NED HAS HIS HAND RAISED. 457 00:17:46,840 --> 00:17:47,640 WOULD YOU LIKE TO -- 458 00:17:47,640 --> 00:17:52,320 >>YEAH. I AGREE. SUPER 459 00:17:52,320 --> 00:17:57,200 IMPORTANT TOPIC. I CAN SAY 460 00:17:57,200 --> 00:17:58,160 CLINICALLY TRYING TO TREAT 461 00:17:58,160 --> 00:17:59,600 PATIENTS LONG TERM IS AN 462 00:17:59,600 --> 00:18:01,120 IMPORTANT PROBLEM AND COUPLE 463 00:18:01,120 --> 00:18:04,160 QUICK COMMENTS. 464 00:18:04,160 --> 00:18:11,000 ONE, WRITE-UP SAYS SUBSTANCE USE 465 00:18:11,000 --> 00:18:12,320 DISORDERS AND PEOPLE DRINKING 466 00:18:12,320 --> 00:18:15,720 ALCOHOL AND IF TRUE AND 467 00:18:15,720 --> 00:18:17,520 GUIDELINES OR PRESCRIBING 468 00:18:17,520 --> 00:18:18,960 MEDICINE SAYS THAT WE SHOULD 469 00:18:18,960 --> 00:18:20,400 ABSOLUTELY DO RESEARCH TO 470 00:18:20,400 --> 00:18:22,920 CHALLENGE THAT. I THINK IT IS 471 00:18:22,920 --> 00:18:25,640 WRONG. SOMEONE WITH OPIOID USE 472 00:18:25,640 --> 00:18:27,000 DISORDER HAS TO BE TREATED AND 473 00:18:27,000 --> 00:18:28,520 YOU SHOULD DO SOMETHING ABOUT 474 00:18:28,520 --> 00:18:30,720 THE ALCOHOL BUT YOU HAVE 475 00:18:30,720 --> 00:18:32,520 EFFECTIVE TREATMENT FOR OPIOID 476 00:18:32,520 --> 00:18:34,280 USE DISORDER THAT SHOULD BE 477 00:18:34,280 --> 00:18:36,080 TREATED. AGAIN, THAT IS -- I 478 00:18:36,080 --> 00:18:37,840 CAN IMAGINE IF NOT IN THE 479 00:18:37,840 --> 00:18:39,080 GUIDELINES IT IS A BELIEF THAT 480 00:18:39,080 --> 00:18:44,800 LOTS OF PEOPLE HAVE. THAT 481 00:18:44,800 --> 00:18:46,600 SHOULD BE CHALLENGED WITH DATA 482 00:18:46,600 --> 00:18:49,720 AND PUT IN THE CHAT A EXAMPLE OF 483 00:18:49,720 --> 00:18:51,480 SECONDARY ANALYSIS OF LARGE CTM 484 00:18:51,480 --> 00:18:56,080 STUDY IF PEOPLE ARE INTERESTED. 485 00:18:56,080 --> 00:18:59,120 SUGGESTING DRINKING IS BETTER TO 486 00:18:59,120 --> 00:19:00,040 [INDISCERNIBLE] TREATMENT. 487 00:19:00,040 --> 00:19:03,280 HIDDEN WITHIN THAT, OF COURSE, 488 00:19:03,280 --> 00:19:05,280 PATIENTS THAT KEEP DRINKING AND 489 00:19:05,280 --> 00:19:07,280 RELAPSE AND 50% OF PATIENTS IN 490 00:19:07,280 --> 00:19:11,480 THE STUDY ARE -- HAVE A GOOD 491 00:19:11,480 --> 00:19:21,880 OUTCOME OVER 6 MONTHS. 492 00:19:22,480 --> 00:19:24,240 THOSE REALLY ARE MY COMMENTS. 493 00:19:24,240 --> 00:19:26,680 IS THIS RESTRICTED TO SECONDARY 494 00:19:26,680 --> 00:19:28,680 ANALYSIS AND THINGS LIKE THAT? 495 00:19:28,680 --> 00:19:29,240 IT IS NOT -- 496 00:19:29,240 --> 00:19:31,640 >>WE WILL TAKE A MULTIPRONG 497 00:19:31,640 --> 00:19:35,120 APPROACH HERE AND WE THOUGHT 498 00:19:35,120 --> 00:19:36,840 THERE WOULD BE OPPORTUNITY FOR 499 00:19:36,840 --> 00:19:39,080 SECONDARY ANALYSIS AND EXPANDING 500 00:19:39,080 --> 00:19:41,160 ONGOING WORK AND POTENTIALLY 501 00:19:41,160 --> 00:19:42,760 FUNDING NOVEL WORK AS WELL THAT 502 00:19:42,760 --> 00:19:45,240 WE FELT LIKE TAKING A MULTIPRONG 503 00:19:45,240 --> 00:19:47,640 APPROACH TO LEVERAGE WHAT IS 504 00:19:47,640 --> 00:19:50,440 ONGOING AND WHAT DATA HAS BEEN 505 00:19:50,440 --> 00:19:51,840 COLLECTED DOESN'T MAKE SENSE AND 506 00:19:51,840 --> 00:19:53,760 GETTING A BETTER HANDLE WHAT IS 507 00:19:53,760 --> 00:19:55,400 HAPPENING IN THE SPACE. 508 00:19:55,400 --> 00:19:57,240 >>RIGHT. TWO QUICK COMMENTSES. 509 00:19:57,240 --> 00:19:59,520 ONE IS CONSIDER PTSD WHICH. 510 00:19:59,520 --> 00:20:00,360 >>YEAH. 511 00:20:00,360 --> 00:20:04,560 >>IT IS A COMMON COMORBIDITY. 512 00:20:04,560 --> 00:20:07,920 LET NOT FORGET ABOUT DISUL FOR 513 00:20:07,920 --> 00:20:11,120 AM THAT MOST WRITE OFF AND IS 514 00:20:11,120 --> 00:20:12,200 EXTREMELY HIGHLY EFFECTIVE TO 515 00:20:12,200 --> 00:20:15,400 GET A SIGNIFICANT OTHER TO GIVE 516 00:20:15,400 --> 00:20:17,360 IT TO THE PATIENT EVERY DAY THAT 517 00:20:17,360 --> 00:20:19,440 IS A POWERFUL TREATMENT FOR 518 00:20:19,440 --> 00:20:22,200 STOPPING DRINKING AND WRITE-UP 519 00:20:22,200 --> 00:20:23,360 MENTIONED PSYCHOSOCIAL 520 00:20:23,360 --> 00:20:25,360 INTERVENTIONS THAT ARE ALSO 521 00:20:25,360 --> 00:20:25,880 GOOD. 522 00:20:25,880 --> 00:20:27,800 YOU NEED A PSYCHOSOCIAL 523 00:20:27,800 --> 00:20:33,600 INTERVENTION THAT WILL ENGAGE A 524 00:20:33,600 --> 00:20:35,000 SIGNIFICANT OTHER TO GIVE DISUL 525 00:20:35,000 --> 00:20:36,560 FOR AM THAT WORKS GREAT IF YOU 526 00:20:36,560 --> 00:20:39,120 GET SOMEBODY TO GIVE IT TO THE 527 00:20:39,120 --> 00:20:39,400 PATIENT. 528 00:20:39,400 --> 00:20:41,120 >>GREAT. 529 00:20:41,120 --> 00:20:44,960 >>THOSE ARE MY THOUGHTS. 530 00:20:44,960 --> 00:20:55,160 >>GREAT. 531 00:20:55,640 --> 00:20:57,160 DR. VOLKOW? 532 00:20:57,160 --> 00:20:59,320 >>YES. MY QUESTION IS 533 00:20:59,320 --> 00:21:01,240 OBVIOUSLY GREAT RECEPTION HAVING 534 00:21:01,240 --> 00:21:03,840 A MORE COMPREHENSIVE STUDY OF 535 00:21:03,840 --> 00:21:05,520 PATIENTS WITH COMORBIDITY THAT 536 00:21:05,520 --> 00:21:08,480 IS REALITY THAT WE ARE LOOKING 537 00:21:08,480 --> 00:21:11,360 FOR AND COMBINATION THAT IS AN 538 00:21:11,360 --> 00:21:12,840 OBVIOUS WILL I THIRD ELEMENT 539 00:21:12,840 --> 00:21:15,240 THAT IS VERY RELEVANT THAT IS 540 00:21:15,240 --> 00:21:17,320 THAT OF PAIN. I BRING IT UP AND 541 00:21:17,320 --> 00:21:18,520 THINK THAT THE OPPORTUNITY THAT 542 00:21:18,520 --> 00:21:22,720 WE HAVE, WE NEED OR SHOULD BE 543 00:21:22,720 --> 00:21:26,240 ACTIVELY SEEKING OUT HOW TO 544 00:21:26,240 --> 00:21:27,720 INTEGRATE CONDITIONS. 545 00:21:27,720 --> 00:21:29,440 AND ALCOHOL USE DISORDER 546 00:21:29,440 --> 00:21:31,200 PATIENTS HAVE HIGHER RATES OF 547 00:21:31,200 --> 00:21:34,480 PAIN AS WE KNOW. ALCOHOL ITSELF 548 00:21:34,480 --> 00:21:37,600 MIGHT PROMOTE IT. THIS INTERNAL 549 00:21:37,600 --> 00:21:40,240 USE OF OPIOIDS AND THAT 550 00:21:40,240 --> 00:21:42,000 INTERACTION IS WHAT IS VERY 551 00:21:42,000 --> 00:21:44,040 IMPORTANT THAT I BEHOOF FOR US 552 00:21:44,040 --> 00:21:46,280 TO THINK AS WE ARE LOOKING IN 553 00:21:46,280 --> 00:21:48,920 TERMS HOW WE DO WE ANALYZE DATA 554 00:21:48,920 --> 00:21:50,600 AVAILABLE OR GENERATE NEW 555 00:21:50,600 --> 00:21:52,840 PROJECTS THAT WE THINK ALSO 556 00:21:52,840 --> 00:22:00,120 ABOUT THE COMBINATION WE SEE. 557 00:22:00,120 --> 00:22:02,480 >>PANE CAME UP AS CO-OCCURRENCE 558 00:22:02,480 --> 00:22:05,440 FOR PTSD AND NEGATIVE EMOTIONAL 559 00:22:05,440 --> 00:22:07,240 STATES AND UNDERLYING SEVERAL 560 00:22:07,240 --> 00:22:08,240 ELEMENTS WITH ANOTHER THING THAT 561 00:22:08,240 --> 00:22:10,080 CAME UP THAT WE HAVE BEEN 562 00:22:10,080 --> 00:22:11,360 DISCUSSING THIS AND WILL 563 00:22:11,360 --> 00:22:12,960 DEFINITELY MAKE SURE THAT THE 564 00:22:12,960 --> 00:22:17,480 PAIN ELEMENT IS PART OF THAT. 565 00:22:17,480 --> 00:22:19,520 ALL RIGHT. ONE MORE, GAIL. 566 00:22:19,520 --> 00:22:19,880 YEAH? 567 00:22:19,880 --> 00:22:23,040 >>I WANTED TO ADD I WAS 568 00:22:23,040 --> 00:22:24,200 HEARING, NED. THESE INDIVIDUALS 569 00:22:24,200 --> 00:22:26,960 I SEE IN THE EDR ARE OFTEN 570 00:22:26,960 --> 00:22:28,760 HOMELESS BECAUSE THEY ARE USING 571 00:22:28,760 --> 00:22:31,120 EVERYTHING THEY CAN GET. ALL 572 00:22:31,120 --> 00:22:31,680 RIGHT? 573 00:22:31,680 --> 00:22:33,600 THAT MAKES IT SO DIFFICULT. I 574 00:22:33,600 --> 00:22:35,600 CAN'T GIVE THAT. IF I HAVE A 575 00:22:35,600 --> 00:22:37,240 PATIENT WITH SOMEONE AT HOME OR 576 00:22:37,240 --> 00:22:39,320 WHATEVER I CAN GIVE AND GIVE 577 00:22:39,320 --> 00:22:43,120 THEM TO GIVE CERTAIN AMOUNT OF 578 00:22:43,120 --> 00:22:45,280 BENZOS OR GABBA PENTON OR 579 00:22:45,280 --> 00:22:47,200 WHATEVER THEY DON'T OR DON'T 580 00:22:47,200 --> 00:22:48,640 HAVE OTHER SIGNIFICANT OTHERS 581 00:22:48,640 --> 00:22:50,600 AND WHY THIS IS SO IMPORTANT. 582 00:22:50,600 --> 00:22:52,360 IF I COULD JUST FIGURE OUT EVEN 583 00:22:52,360 --> 00:22:54,480 FOR A COUPLE DAYS TO GET PEOPLE 584 00:22:54,480 --> 00:22:57,200 STARTED ON THE RIGHT MEDS THEN 585 00:22:57,200 --> 00:22:58,560 HOW TO PROGRESS MAYBE AFTER THAT 586 00:22:58,560 --> 00:23:00,840 WOULD BE WONDERFUL. THEY ARE -- 587 00:23:00,840 --> 00:23:04,400 YOU CAN'T OVERESTIMATE HOW MANY 588 00:23:04,400 --> 00:23:08,440 PEOPLE HAVE UNSTABLE HOUSING AND 589 00:23:08,440 --> 00:23:10,680 ALL STUDIES WE ARE FINDING LIKE 590 00:23:10,680 --> 00:23:13,040 OVER 50% THAT IS UNHEARD OF IN 591 00:23:13,040 --> 00:23:15,320 THE PAST. IT IS -- IT IS REALLY 592 00:23:15,320 --> 00:23:20,280 AN EPIDEMIC. 593 00:23:20,280 --> 00:23:24,720 >>A ROLE FOR PETERS IN THAT 594 00:23:24,720 --> 00:23:25,200 POSSIBLY? 595 00:23:25,200 --> 00:23:26,160 >>I DON'T KNOW. 596 00:23:26,160 --> 00:23:26,920 >>YEAH. 597 00:23:26,920 --> 00:23:28,960 >>I DON'T KNOW. 598 00:23:28,960 --> 00:23:29,880 >>MAYBE TRUST -- 599 00:23:29,880 --> 00:23:32,600 >>NAVIGATORS. I LIKE 600 00:23:32,600 --> 00:23:32,920 NAVIGATORS. 601 00:23:32,920 --> 00:23:33,640 >>NAVIGATORS. 602 00:23:33,640 --> 00:23:36,000 >>YOU KNOW, AGAIN, PEERS ARE A 603 00:23:36,000 --> 00:23:37,920 PEER OF 1 WHO HAS ONE 604 00:23:37,920 --> 00:23:38,200 EXPERIENCE. 605 00:23:38,200 --> 00:23:39,280 >>YEAH, YEAH. 606 00:23:39,280 --> 00:23:40,640 >>THESE ARE COMPLICATED 607 00:23:40,640 --> 00:23:41,920 INDIVIDUALS THAT I THINK THAT 608 00:23:41,920 --> 00:23:44,320 PEOPLE WHO ARE USING SUBSTANCE 609 00:23:44,320 --> 00:23:48,840 USE NAVIGATORS WHETHER DR. 610 00:23:48,840 --> 00:23:50,200 HERRING OR WE HAVE RESEARCH AND 611 00:23:50,200 --> 00:23:52,560 COULD BE IN PROJECT RECOVERY BUT 612 00:23:52,560 --> 00:23:56,080 ARE NAVIGATORS UNDER THE 613 00:23:56,080 --> 00:24:00,000 DIRECTION OF US WOULD BE REALLY 614 00:24:00,000 --> 00:24:03,720 HELPFUL. IT IS SO COMPLICATED. 615 00:24:03,720 --> 00:24:04,320 DON'T OVERESTIMATE THINKING 616 00:24:04,320 --> 00:24:05,800 ABOUT THESE TRIALS HOW MANY 617 00:24:05,800 --> 00:24:09,280 PEOPLE ARE HOMELESS. SO -- 618 00:24:09,280 --> 00:24:11,640 >>THANK YOU. WONDERFUL 619 00:24:11,640 --> 00:24:13,080 FEEDBACK AND COMMENTS FROM THE 620 00:24:13,080 --> 00:24:15,960 GROUP AND REALLY HELPFUL AND 621 00:24:15,960 --> 00:24:17,600 50%, GAIL, IS AMAZING THAT YOU 622 00:24:17,600 --> 00:24:20,080 ARE SAYING THAT HIGH RATE. 623 00:24:20,080 --> 00:24:22,640 REBEKAH, SHOULD WE GO TO THE 624 00:24:22,640 --> 00:24:24,960 NEXT ONE? 625 00:24:24,960 --> 00:24:26,040 >>YES, PLEASE. 626 00:24:26,040 --> 00:24:27,640 >>OKAY. NEXT ONE WE WANT TO 627 00:24:27,640 --> 00:24:31,280 TALK WITH ALL OF YOU ABOUT, ONE 628 00:24:31,280 --> 00:24:34,320 MORE SLIDE. 629 00:24:34,320 --> 00:24:35,720 PERFECT. 630 00:24:35,720 --> 00:24:39,520 LEVERAGING IN-PATIENT MEDICAL OR 631 00:24:39,520 --> 00:24:40,240 SURGICAL HOSPITALIZATION TO 632 00:24:40,240 --> 00:24:42,320 IMPROVE OUTCOME FOR PEOPLE WHO 633 00:24:42,320 --> 00:24:44,880 USE DRUGS AND CHALLENGE HERE IS, 634 00:24:44,880 --> 00:24:46,960 YOU KNOW, HOW DO WE MORE 635 00:24:46,960 --> 00:24:48,640 FREQUENTLY OR HOW DO WE TAKE 636 00:24:48,640 --> 00:24:49,800 ADVANTAGE OF OPPORTUNITIES TO 637 00:24:49,800 --> 00:24:55,160 SCREEN FOR AND CONNECT PEOPLE TO 638 00:24:55,160 --> 00:24:56,000 SERVICES? 639 00:24:56,000 --> 00:24:57,600 WHEN WE THINK ABOUT INDIVIDUALS 640 00:24:57,600 --> 00:25:00,080 IN AN IN-PATIENT SETTING, IS IT 641 00:25:00,080 --> 00:25:02,200 AN OPPORTUNITY TO POTENTIALLY 642 00:25:02,200 --> 00:25:03,880 SCREEN FOR INDIVIDUALS 643 00:25:03,880 --> 00:25:06,560 ESPECIALLY GIVEN THE FACT THAT 644 00:25:06,560 --> 00:25:08,120 INDIVIDUALS WHO WHO THEY ARE 645 00:25:08,120 --> 00:25:10,360 HOSPITALIZED FOR MEDICAL OR 646 00:25:10,360 --> 00:25:12,560 SURGICAL CONDITIONS MIGHT HAVE 647 00:25:12,560 --> 00:25:13,320 MORE COMPLICATED TREATMENT 648 00:25:13,320 --> 00:25:15,960 OUTCOMES AND MIGHT BE MORE 649 00:25:15,960 --> 00:25:18,600 CHALLENGING TO FOR EXAMPLE TO 650 00:25:18,600 --> 00:25:21,560 GET VENUS ACCESS OR OTHER THINGS 651 00:25:21,560 --> 00:25:24,280 AND THERE CAN BE STIG 652 00:25:24,280 --> 00:25:25,520 MATIZIZATION FOR INDIVIDUALS 653 00:25:25,520 --> 00:25:27,600 THAT THEY RECEIVE AND MEDICAL 654 00:25:27,600 --> 00:25:29,080 CARE LEADING TO POOR OUTCOMES 655 00:25:29,080 --> 00:25:33,920 AND IDEA IS HOW TO DO WE EXPAND 656 00:25:33,920 --> 00:25:35,640 LINKAGE TO CARE FOR HOSPITALIZED 657 00:25:35,640 --> 00:25:37,600 INDIVIDUALS TO USE DRUGS AND 658 00:25:37,600 --> 00:25:39,200 TESTING MODELS MAYBE THAT HAVE 659 00:25:39,200 --> 00:25:40,880 BEEN STUDIED IN A SINGLE 660 00:25:40,880 --> 00:25:43,000 PARTICULAR SETTING OR IN 661 00:25:43,000 --> 00:25:45,160 SHORT-TERM SETTINGS ACTUALLY 662 00:25:45,160 --> 00:25:46,800 MAKING THIS SUSTAINABLE 663 00:25:46,800 --> 00:25:49,360 TREATMENT SERVICE INFRASTRUCTURE 664 00:25:49,360 --> 00:25:51,840 IN PROGRAMS AND STUDY HOW TO 665 00:25:51,840 --> 00:25:53,840 MAKE IT SUSTAINABLE, I SHOULD 666 00:25:53,840 --> 00:25:54,040 SAY. 667 00:25:54,040 --> 00:25:55,600 THE IDEA HERE WOULD ALSO BE 668 00:25:55,600 --> 00:25:57,680 LOOKING AT HOW TO IDENTIFY 669 00:25:57,680 --> 00:25:59,320 BARRIERS TO TREATMENTS AND 670 00:25:59,320 --> 00:26:00,880 ENGAGEMENT AND RETENTION AND 671 00:26:00,880 --> 00:26:03,200 ADDRESSING ISSUES SUCH AS STIGMA 672 00:26:03,200 --> 00:26:05,720 AND ACCESS AND SOCIAL 673 00:26:05,720 --> 00:26:07,240 DETERMINANTS OF HEALTH TO GET 674 00:26:07,240 --> 00:26:10,280 PEOPLE TO MOVE FROM IN-PATIENT 675 00:26:10,280 --> 00:26:11,360 CARE MOVING INTO COMMUNITY 676 00:26:11,360 --> 00:26:14,920 TRANSITION FOR TREATMENT. 677 00:26:14,920 --> 00:26:17,120 IDEALLY HERE BUILDING UPON AND 678 00:26:17,120 --> 00:26:18,720 CREATING SUSTAINABLE MODELS THAT 679 00:26:18,720 --> 00:26:21,120 WOULD WORK AND LOOKING AT 680 00:26:21,120 --> 00:26:22,280 DIFFERENT SETTINGS WOULD BE 681 00:26:22,280 --> 00:26:24,320 POSSIBILITIES TO LOOK AT HERE 682 00:26:24,320 --> 00:26:26,800 THAT RURAL URBAN AND LARGE 683 00:26:26,800 --> 00:26:28,560 VERSUS SMALL AND BOTH SAFETY NET 684 00:26:28,560 --> 00:26:32,000 SETTINGS AND STRATEGIES TO 685 00:26:32,000 --> 00:26:33,440 SUPPORT REALLY SUCCESSFUL 686 00:26:33,440 --> 00:26:35,160 IMPLEMENTATION AND 687 00:26:35,160 --> 00:26:36,200 SUSTAINABILITY AND CARE AFTER 688 00:26:36,200 --> 00:26:37,560 HOSPITAL DISCHARGE AND HOW WE 689 00:26:37,560 --> 00:26:40,080 MOVE THAT TO THE CASE. SO, 690 00:26:40,080 --> 00:26:43,080 CERTAINLY THIS WOULD ALSO 691 00:26:43,080 --> 00:26:44,160 PROVIDE OPPORTUNITY TO LOOK AT 692 00:26:44,160 --> 00:26:46,360 HOSPITAL REEMISSIONS AND 693 00:26:46,360 --> 00:26:48,800 LONG-TERM OUTCOMES AROUND 694 00:26:48,800 --> 00:26:50,480 MORBIDITY AND MORTALITY OF 695 00:26:50,480 --> 00:26:51,920 SUBSTANCE USE DISORDER 696 00:26:51,920 --> 00:26:53,040 IDENTIFYING AND FINDING PEOPLE 697 00:26:53,040 --> 00:26:57,040 SORT OF IN THIS WAY. 698 00:26:57,040 --> 00:27:01,120 NEXT SLIDE. 699 00:27:01,120 --> 00:27:03,160 HOW DOES IT FIT AND COMPLEMENT 700 00:27:03,160 --> 00:27:04,920 WHAT WE ARE CURRENTLY DOING 701 00:27:04,920 --> 00:27:06,240 WITHIN HEAL? 702 00:27:06,240 --> 00:27:07,840 AS WE EXPAND SOME WORK WE ARE 703 00:27:07,840 --> 00:27:10,520 DOING TO A BROADER SORT OF 704 00:27:10,520 --> 00:27:13,080 SCREENING AREA OF, YOU KNOW, 705 00:27:13,080 --> 00:27:15,840 MORE BROADLY IN-PATIENT AND NOT 706 00:27:15,840 --> 00:27:17,680 INDIVIDUALS WITH SPECIFIC SORT 707 00:27:17,680 --> 00:27:18,960 OF VERY HIGH RISK THAT MIGHT 708 00:27:18,960 --> 00:27:21,240 IDENTIFY THEM AS INDIVIDUALS 709 00:27:21,240 --> 00:27:22,480 WITH SUBSTANCE USE DISORDER AND 710 00:27:22,480 --> 00:27:25,360 WE ARE CERTAINLY AWARE THAT CPN 711 00:27:25,360 --> 00:27:28,640 IS CURRENTLY DOING A STUDY OF A 712 00:27:28,640 --> 00:27:30,040 MULTICOMPONENT PROGRAM ACROSS 713 00:27:30,040 --> 00:27:32,600 MULTIPLE SITES THAT ARE REALLY 714 00:27:32,600 --> 00:27:35,200 TARGETING HOSPITALIZED PATIENTS 715 00:27:35,200 --> 00:27:37,800 WITH INFECTIOUS DISEASES AND 716 00:27:37,800 --> 00:27:42,040 COMPLICATIONS LIKE BACTERIA 717 00:27:42,040 --> 00:27:44,240 CARDITIS AND SCREENING 718 00:27:44,240 --> 00:27:46,000 IMPLEMENTING ACROSS HOSPITAL 719 00:27:46,000 --> 00:27:47,400 IN-PATIENT SETTING AND 720 00:27:47,400 --> 00:27:49,000 IMPLEMENTING BEST PRACTICES AND 721 00:27:49,000 --> 00:27:50,480 THERE IS SOME STUDIES THAT HAVE 722 00:27:50,480 --> 00:27:52,080 BEEN DONE SHOWING YOU CAN DO 723 00:27:52,080 --> 00:27:55,520 THIS. IT LEADS TO FEWER 724 00:27:55,520 --> 00:27:56,280 READMISSIONS THAT HOW DO WE 725 00:27:56,280 --> 00:27:58,440 SCALE IT UP AND GET IT 726 00:27:58,440 --> 00:28:00,040 IMPLEMENTED TO ACTUALLY UTILIZE 727 00:28:00,040 --> 00:28:01,720 IN MORE SETTINGS THAN JUST A 728 00:28:01,720 --> 00:28:03,840 COUPLE PLACES WHERE IT HAS BEEN 729 00:28:03,840 --> 00:28:04,480 STUDIED? 730 00:28:04,480 --> 00:28:06,240 IDENTIFYING AND ADDRESSING 731 00:28:06,240 --> 00:28:08,760 BARRIERS TO TREATMENT, AGAIN, TO 732 00:28:08,760 --> 00:28:10,000 ENGAGEMENT AND RETENTION AND WE 733 00:28:10,000 --> 00:28:12,840 KNOW IT HAS BEEN DONE AND WE 734 00:28:12,840 --> 00:28:14,240 HAVE PROGRAMS ACROSS FIELDS 735 00:28:14,240 --> 00:28:17,040 DOING THIS AND MOSTLY IN OUD 736 00:28:17,040 --> 00:28:18,000 TREATMENT SETTINGS AND MRNL 737 00:28:18,000 --> 00:28:20,080 DEPARTMENTS NO THE ADDRESSING 738 00:28:20,080 --> 00:28:22,680 STIGMA MORE BROADLY ACROSS THE 739 00:28:22,680 --> 00:28:24,440 IN-PATIENT HOSPITAL SETTING THAT 740 00:28:24,440 --> 00:28:25,320 PROVIDES CERTAINLY AN 741 00:28:25,320 --> 00:28:26,920 OPPORTUNITY TO APPLY WHAT WE 742 00:28:26,920 --> 00:28:28,800 HAVE LEARNED IN THE EMERGENCY 743 00:28:28,800 --> 00:28:30,640 DEPARTMENT WOULD IT WORK IN 744 00:28:30,640 --> 00:28:31,920 OTHER PATIENT SETTINGS ACROSS 745 00:28:31,920 --> 00:28:34,160 THE HOSPITAL. INITIATIVE REALLY 746 00:28:34,160 --> 00:28:35,960 SEEKS TO ENCOURAGE RESEARCHERS 747 00:28:35,960 --> 00:28:38,160 TO BUILD ON STUDIES THAT HAVE 748 00:28:38,160 --> 00:28:39,920 BEEN DONE AND BROADEN THEIR 749 00:28:39,920 --> 00:28:41,600 REACH TO UNDERSTAND 750 00:28:41,600 --> 00:28:42,000 IMPLEMENTATION. 751 00:28:42,000 --> 00:28:43,720 NOT DUPLICATING PRIOR WORK AND 752 00:28:43,720 --> 00:28:47,280 HOW DO WE REALLY ENCOURAGE 753 00:28:47,280 --> 00:28:49,440 PROJECTS FROM ACROSS A MORE 754 00:28:49,440 --> 00:28:52,280 VARIETY OF REGIONS ACROSS THE 755 00:28:52,280 --> 00:28:54,280 COUNTRY AND AS WELL AS DIFFERENT 756 00:28:54,280 --> 00:28:55,640 HOSPITAL SYSTEM TYPES THAT WOULD 757 00:28:55,640 --> 00:28:57,160 BE SOMETHING THAT WE WOULD HOPE 758 00:28:57,160 --> 00:28:58,280 TO DO WITH THAT. 759 00:28:58,280 --> 00:28:59,920 SO, I THINK THAT WE ARE ON TO 760 00:28:59,920 --> 00:29:02,000 THE NEXT SLIDE THAT IS THE 761 00:29:02,000 --> 00:29:02,920 DISCUSSION NOTES. 762 00:29:02,920 --> 00:29:04,520 WE HAVE A SET OF QUESTIONS AND 763 00:29:04,520 --> 00:29:07,280 HOW ARE WE DOING FOR TIME, 764 00:29:07,280 --> 00:29:07,800 REBEKAH? 765 00:29:07,800 --> 00:29:09,240 SHOULD WE MOVE ON AND COVER 766 00:29:09,240 --> 00:29:11,960 OTHER ONES OR TAKE A FEW 767 00:29:11,960 --> 00:29:12,360 COMMENTS HERE. 768 00:29:12,360 --> 00:29:14,840 >>I WAS GOING TO SAY I THINK WE 769 00:29:14,840 --> 00:29:17,240 ARE OKAY FOR RIGHT NOW. WE ARE 770 00:29:17,240 --> 00:29:19,040 OKAY. GO RIGHT AHEAD AND WE CAN 771 00:29:19,040 --> 00:29:20,160 HAVE DISCUSSION AND HEAR FROM 772 00:29:20,160 --> 00:29:20,640 THE GROUP. 773 00:29:20,640 --> 00:29:25,160 >>OKAY. YEAH. CURIOUS WHAT 774 00:29:25,160 --> 00:29:27,920 PEOPLE THINK. 775 00:29:27,920 --> 00:29:29,760 YEAH. GO AHEAD. YES? 776 00:29:29,760 --> 00:29:33,600 >>OKAY. I DON'T WANT TO JUMP 777 00:29:33,600 --> 00:29:34,040 THE LINE. 778 00:29:34,040 --> 00:29:37,160 >>IT IS OKAY. IT IS OKAY. 779 00:29:37,160 --> 00:29:42,360 >>SUPER IMPORTANT POPULATION 780 00:29:42,360 --> 00:29:42,720 AL 781 00:29:42,720 --> 00:29:42,920 ALSO. 782 00:29:42,920 --> 00:29:46,720 I'M INVOLVED WITH COLLEAGUES IN 783 00:29:46,720 --> 00:29:50,400 NCATS-FUNDED STUDY LOOKING AT 784 00:29:50,400 --> 00:29:52,720 PATIENTS ADMITTED WITH OPIOID 785 00:29:52,720 --> 00:29:54,000 USE DISORDER AND INFECTIOUS 786 00:29:54,000 --> 00:29:55,840 DISEASE AND STUDIES ARE FINISHED 787 00:29:55,840 --> 00:29:59,280 IN NEXT YEAR AND HAVE RESULTS 788 00:29:59,280 --> 00:30:05,520 AND PUT METHODS PAPER IN THE 789 00:30:05,520 --> 00:30:09,360 CHAT. THESE PATIENTS ARE SUPER 790 00:30:09,360 --> 00:30:11,760 AND SEVERELY ILL WITH ALL KINDS 791 00:30:11,760 --> 00:30:17,160 OF MEDICAL PROBLEMS AND LOTS OF 792 00:30:17,160 --> 00:30:18,360 TIMES HAVE SOCIAL DETERMINANTS 793 00:30:18,360 --> 00:30:22,960 IN HOMELESSNESS AND GAIL THE 794 00:30:22,960 --> 00:30:24,800 MRNL DEPARTMENT POPULATION AND 795 00:30:24,800 --> 00:30:27,880 RESEARCH ASSISTANCE IN THE STUDY 796 00:30:27,880 --> 00:30:30,600 FUNCTION LIKE NAVIGATORS AND 797 00:30:30,600 --> 00:30:31,920 PATIENTS NEED THAT AND WHEN YOU 798 00:30:31,920 --> 00:30:33,920 DON'T WANT RESEARCH STUDY TO DO 799 00:30:33,920 --> 00:30:35,680 THAT BUT YOU WANT THE ACTUAL 800 00:30:35,680 --> 00:30:38,560 TREATMENT DELIVERY SYSTEM TO DO 801 00:30:38,560 --> 00:30:38,880 THAT. 802 00:30:38,880 --> 00:30:40,400 THEY NEED THAT. THIRD THING A 803 00:30:40,400 --> 00:30:43,240 LOT OF TIMES THEY KNOW WHAT THEY 804 00:30:43,240 --> 00:30:48,640 WANT, MENLO DON'T AND NOREP NEF 805 00:30:48,640 --> 00:30:52,720 REN AND INJECTION NOREPINEPHRINE 806 00:30:52,720 --> 00:30:54,960 AND A PROGRAM THAT GIVES 807 00:30:54,960 --> 00:30:57,680 PATIENTS A MENU AND ALLOWS THEM 808 00:30:57,680 --> 00:30:59,040 TO CHOOSE WHAT THEY ARE 809 00:30:59,040 --> 00:31:01,720 INTERESTED IN. OF COURSE, YOU 810 00:31:01,720 --> 00:31:05,720 GET INTO BARRIERS LIKE IS 811 00:31:05,720 --> 00:31:07,880 INJECTION EPINEPHRINE ON FORM 812 00:31:07,880 --> 00:31:09,080 YOU'LLARY AND MENLO DON'T CLINIC 813 00:31:09,080 --> 00:31:13,120 TO BE REFERRED TO. LOTS OF 814 00:31:13,120 --> 00:31:14,640 ISSUES. 815 00:31:14,640 --> 00:31:17,120 RECRUITMENT HAS BEEN AN SIV KIND 816 00:31:17,120 --> 00:31:19,800 OF. SO MANY REASONS THAT 817 00:31:19,800 --> 00:31:20,800 PATIENTS DON'T WANT TO 818 00:31:20,800 --> 00:31:21,560 PARTICIPATE INCLUDING THEY DON'T 819 00:31:21,560 --> 00:31:25,600 WANT TO BE RANDOMIZED AND THEY 820 00:31:25,600 --> 00:31:27,120 KNOW WHAT THEY WANT. 821 00:31:27,120 --> 00:31:28,960 >>THAT IS GREAT FEEDBACK AND 822 00:31:28,960 --> 00:31:30,160 GOOD TO HEAR WHAT YOU ARE 823 00:31:30,160 --> 00:31:34,000 HEARING IN YOUR ONGOING STUDY. 824 00:31:34,000 --> 00:31:38,720 >>YEAH. 825 00:31:38,720 --> 00:31:40,680 >>ONE OF THE DISCUSSANTS ARE 826 00:31:40,680 --> 00:31:42,760 HERE AND THIS IS AN IMPORTANT 827 00:31:42,760 --> 00:31:45,720 PATIENT POPULATION AND THERE IS 828 00:31:45,720 --> 00:31:47,400 A TREMENDOUS NUMBER OF BARRIERS 829 00:31:47,400 --> 00:31:50,320 AND HOSPITAL SETTING I WORK IN, 830 00:31:50,320 --> 00:31:51,920 IN-PATIENT WE LOOKED IN LESS 831 00:31:51,920 --> 00:31:56,720 THAN 1% OF PATIENTS WERE BEING 832 00:31:56,720 --> 00:31:59,200 SCREENED FOR 1%. 833 00:31:59,200 --> 00:32:02,920 I THINK THAT, YOU KNOW SHGS JUST 834 00:32:02,920 --> 00:32:07,760 A VERY BASIC THING AND MEDICAL 835 00:32:07,760 --> 00:32:09,320 RECORD SYSTEM WHAT SCREENING 836 00:32:09,320 --> 00:32:11,920 TOOL IS BEING USED AND FOCUSING 837 00:32:11,920 --> 00:32:16,520 ON VERBAL SCREENING TOOLS NOT 838 00:32:16,520 --> 00:32:20,040 URINE DRUG TESTING AND 839 00:32:20,040 --> 00:32:21,120 LIMITATIONS FOR SCREENINGS TOO. 840 00:32:21,120 --> 00:32:22,760 MAKING SURE YOU HAVE HOSPITAL 841 00:32:22,760 --> 00:32:24,240 ADMINISTRATORS ON BOARD WHEN 842 00:32:24,240 --> 00:32:25,440 ASKING WHO YOU THINK 843 00:32:25,440 --> 00:32:27,320 STAKEHOLDERS SHOULD BE IF YOU 844 00:32:27,320 --> 00:32:28,920 DON'T HAVE HOSPITAL 845 00:32:28,920 --> 00:32:29,760 ADMINISTRATORS ON BOARD THIS 846 00:32:29,760 --> 00:32:31,360 WILL NEVER WORK. YOU NEED TO 847 00:32:31,360 --> 00:32:33,360 HAVE MEDICAL RECORDS FOLKS AND 848 00:32:33,360 --> 00:32:35,520 YOUR BILLING AND HAVE, YOU KNOW, 849 00:32:35,520 --> 00:32:38,120 INFORMATION AND SUPPORT FOR 850 00:32:38,120 --> 00:32:41,240 DOCUMENTATION. IF YOU WANT ANY 851 00:32:41,240 --> 00:32:46,280 OF THESE THINGS IN -- 852 00:32:46,280 --> 00:32:47,640 INTERVENTIONS TO BE SUSTAINED 853 00:32:47,640 --> 00:32:50,880 THEY HAVE TO BE IMBEDDED IN THE 854 00:32:50,880 --> 00:32:53,720 HOSPITAL SYSTEM AND MAKE MONEY 855 00:32:53,720 --> 00:32:58,440 FOR HOSPITALS THINKING 856 00:32:58,440 --> 00:33:00,480 SEQUENTIAL INTERCEPT MAPPING 857 00:33:00,480 --> 00:33:01,960 COULD BE GOOD FOR PATIENT 858 00:33:01,960 --> 00:33:03,160 SETTING AND THROUGHOUT TO 859 00:33:03,160 --> 00:33:03,840 UNDERSTAND REALLY WHERE ALL OF 860 00:33:03,840 --> 00:33:08,000 THE BARRIERS ARE. THEN, TWO, 861 00:33:08,000 --> 00:33:10,800 YOU KNOW, SOMEHOW IT IS 862 00:33:10,800 --> 00:33:13,120 ACCEPTABLE TO SYSTEMATICALLY 863 00:33:13,120 --> 00:33:15,360 DISCRIMINATE AGAINST PATIENTS 864 00:33:15,360 --> 00:33:18,440 THAT HAVE A SUBSTANCE USE 865 00:33:18,440 --> 00:33:18,680 DISORDER. 866 00:33:18,680 --> 00:33:20,440 THERE ARE OTHER DISEASES THAT I 867 00:33:20,440 --> 00:33:23,040 THINK THAT YOU KNOW PLEASE DON'T 868 00:33:23,040 --> 00:33:24,960 UNDERESTIMATE NOT JUST STIGMA 869 00:33:24,960 --> 00:33:29,080 BUT ALSO DISCRIMINATION FOR 870 00:33:29,080 --> 00:33:29,320 PATIENTS. 871 00:33:29,320 --> 00:33:30,400 >>YES. 872 00:33:30,400 --> 00:33:32,080 GREAT. WONDERFUL. WONDERFUL 873 00:33:32,080 --> 00:33:33,760 POINTS P. 874 00:33:33,760 --> 00:33:35,680 DEFINITE WILL IN THE BROADER 875 00:33:35,680 --> 00:33:39,080 CONCEPT I HOPE YOU SAW ELEMENTS 876 00:33:39,080 --> 00:33:41,360 INCLUDED AROUND DISCRIMINATION 877 00:33:41,360 --> 00:33:43,440 AND THOSE BARRIERS. 878 00:33:43,440 --> 00:33:45,880 >>WE ARE HOPING TO ADDRESS THAT 879 00:33:45,880 --> 00:33:49,040 MANY SYSTEMS DON'T SCREEN AT ALL 880 00:33:49,040 --> 00:33:54,680 ROUTINELY. YEAH. WONDERFUL. 881 00:33:54,680 --> 00:33:54,960 >>YEAH. 882 00:33:54,960 --> 00:33:57,040 >>I AGREE WITH ALL THAT. I WAS 883 00:33:57,040 --> 00:33:59,120 GOING TO ADD THAT ONE THING 884 00:33:59,120 --> 00:34:02,600 THROUGH ONE OF OUR STUDIES, CTN 885 00:34:02,600 --> 00:34:04,720 STUDIES WE DID FOCUS GROUPS ON 886 00:34:04,720 --> 00:34:08,600 PATIENTS THAT WE HAD SEEN NEXT 887 00:34:08,600 --> 00:34:12,200 D. SEVERAL OF THEM HAD 888 00:34:12,200 --> 00:34:13,800 MENTIONED HOW THEY EVENTUALLY 889 00:34:13,800 --> 00:34:15,800 GOT INTO TREATMENT WAS BEING IN 890 00:34:15,800 --> 00:34:18,800 THE HOSPITAL WHETHER AORTIC 891 00:34:18,800 --> 00:34:21,480 VALVE REPLACEMENT OR SOMETHING 892 00:34:21,480 --> 00:34:23,120 LESS SERIOUS THAT THE HOSPITAL 893 00:34:23,120 --> 00:34:24,840 -- THEY HAD A LONG TIME IN THE 894 00:34:24,840 --> 00:34:26,640 HOSPITAL TO ACTUALLY ENGAGE AND 895 00:34:26,640 --> 00:34:28,000 START ON TREATMENT THAT THEY 896 00:34:28,000 --> 00:34:31,520 FELT COMFORTABLE WITH. 897 00:34:31,520 --> 00:34:33,400 IT REALLY TURNED THEM AROUND. 898 00:34:33,400 --> 00:34:34,680 THIS IS A GREAT OPPORTUNITY. 899 00:34:34,680 --> 00:34:38,400 THEY ARE THERE. WE HAVE ALL 900 00:34:38,400 --> 00:34:41,040 DIFFERENT MATERIAL OF THINGS WE 901 00:34:41,040 --> 00:34:43,360 CAN USE ON PEOPLE THAT ARE IN 902 00:34:43,360 --> 00:34:44,360 HOSPITALS AND ARE VERY DIFFERENT 903 00:34:44,360 --> 00:34:48,000 THAN WE CAN USE IN AMBULATORY 904 00:34:48,000 --> 00:34:51,040 SETTINGS AND GET PEOPLE FEELING 905 00:34:51,040 --> 00:34:52,640 COMFORTABLE PRETTY SOON. 906 00:34:52,640 --> 00:34:55,080 WE CAN MAKE SURE WE ADDRESS 907 00:34:55,080 --> 00:34:57,320 THEIR ISSUES AND THIS IS 908 00:34:57,320 --> 00:34:59,280 WONDERFUL AND GREAT WE HAVE TO 909 00:34:59,280 --> 00:35:01,880 GET MORE HOSPITALS TO DO THAT 910 00:35:01,880 --> 00:35:04,440 AND SHOW THEM THAT PATIENTS ARE 911 00:35:04,440 --> 00:35:06,160 ALREADY THERE AND REPEATEDLY ARE 912 00:35:06,160 --> 00:35:08,320 COMING BACK. IT IS COSTING THEM 913 00:35:08,320 --> 00:35:11,600 MORE MONEY AND MORE HOSPITAL 914 00:35:11,600 --> 00:35:14,680 BEDS THAN IF THEY WERE TO TAKE 915 00:35:14,680 --> 00:35:16,560 CARE OF THEM INITIALLY AND MORE 916 00:35:16,560 --> 00:35:18,960 HOSPITAL BEDS TO BE USED FOR 917 00:35:18,960 --> 00:35:20,440 OTHERS AND FINANCIAL PIECE IS 918 00:35:20,440 --> 00:35:21,960 WHAT I ALWAYS FIND FLIPS 919 00:35:21,960 --> 00:35:28,280 HOSPITAL ADMINISTRATORS. 920 00:35:28,280 --> 00:35:30,240 THIS IS GREAT. THANK YOU. 921 00:35:30,240 --> 00:35:32,880 >>I HAVE LITTLE TO ADD TO WHAT 922 00:35:32,880 --> 00:35:34,720 DISCUSSANTS SAID AND IT IS 923 00:35:34,720 --> 00:35:35,880 OBVIOUSLY A HUGE MISSED 924 00:35:35,880 --> 00:35:38,560 OPPORTUNITY TO ALLOW IN-PATIENT 925 00:35:38,560 --> 00:35:44,200 VISITS TO GO BY WITHOUT FOCUS ON 926 00:35:44,200 --> 00:35:46,400 SUBSTANCE UDISORDERS THAT SEEMS 927 00:35:46,400 --> 00:35:48,560 OBVIOUS TO ME TO OVERCOME 928 00:35:48,560 --> 00:35:50,440 BARRIERS THAT EXIST THERE. 929 00:35:50,440 --> 00:35:52,360 >>I JUST WANT TO I FORGOT TO 930 00:35:52,360 --> 00:35:54,240 MENTION THERE IS PAIN IN THIS 931 00:35:54,240 --> 00:35:56,040 POPULATION AND PRETTY SEVERE 932 00:35:56,040 --> 00:35:59,320 PAIN AND OSTEOMILITIS AND 933 00:35:59,320 --> 00:36:00,880 PAINFUL SURGERIES AND SO FORTH 934 00:36:00,880 --> 00:36:02,440 AND TO NORA'S POINT ABOUT 935 00:36:02,440 --> 00:36:04,360 CROSS-CUTTING ISSUES AND LOTS OF 936 00:36:04,360 --> 00:36:09,280 PAIN MANAGEMENT ISSUES TO 937 00:36:09,280 --> 00:36:11,000 CONSIDER ALONG WITH ADDICTIONS. 938 00:36:11,000 --> 00:36:14,240 >>RIGHT. WE WILL INCORPORATE 939 00:36:14,240 --> 00:36:14,600 THAT AS WELL. 940 00:36:14,600 --> 00:36:17,240 ALL RIGHT. THANKS FOR WONDERFUL 941 00:36:17,240 --> 00:36:18,960 FEEDBACK AND TURNING THE NEXT 942 00:36:18,960 --> 00:36:25,600 OVER TO YOU, TISHA. TAKE IT 943 00:36:25,600 --> 00:36:25,800 AWAY. 944 00:36:25,800 --> 00:36:27,720 >>GREAT. NEXT SLIDE. THIS 945 00:36:27,720 --> 00:36:29,160 NEXT ONE IS ANOTHER SPECIAL 946 00:36:29,160 --> 00:36:30,160 POPULATION THAT NEEDS ATTENTION 947 00:36:30,160 --> 00:36:32,120 THAT WE TALKED ABOUT THIS AT 948 00:36:32,120 --> 00:36:33,640 DIFFERENT POINTS I THINK WITH 949 00:36:33,640 --> 00:36:36,760 THE GROUP BEFORE. THIS IS ABOUT 950 00:36:36,760 --> 00:36:41,080 CHILD-WELFARE SYSTEM AND HOW IT 951 00:36:41,080 --> 00:36:42,480 RESPONDS SPECIFICALLY TO 952 00:36:42,480 --> 00:36:44,960 POSTPARTUM WOMEN AND WHAT 953 00:36:44,960 --> 00:36:47,480 HAPPENS TO FAMILIES EITHER AFTER 954 00:36:47,480 --> 00:36:50,080 THE CHILD IS BORN IN TERMS HOW 955 00:36:50,080 --> 00:36:51,960 OUD IS DEALT WITH AND THIS IS 956 00:36:51,960 --> 00:36:53,920 ABOUT PROVIDING COMPREHENSIVE 957 00:36:53,920 --> 00:36:56,040 SERVICE MODELS DESIGNED 958 00:36:56,040 --> 00:36:58,840 HOPEFULLY WITH GOAL OF FAMILY 959 00:36:58,840 --> 00:37:00,000 REUNIFICATION OR STABILITY 960 00:37:00,000 --> 00:37:01,200 WHEREVER IT IS POSSIBLE AND 961 00:37:01,200 --> 00:37:03,360 REALLY MAKING SURE THAT THESE 962 00:37:03,360 --> 00:37:06,560 FAMILIES THAT THE PARENT HAS 963 00:37:06,560 --> 00:37:09,720 ACCESS TO APPROPRIATE CARE 964 00:37:09,720 --> 00:37:12,160 INCLUDING MEDICATIONS FOR OPIOID 965 00:37:12,160 --> 00:37:14,240 USE DISORDER AND HEARD SEVERAL 966 00:37:14,240 --> 00:37:15,400 ANECDOTES CHECKING IN WITH 967 00:37:15,400 --> 00:37:17,120 COLLEAGUES AT SAMHSA. IT IS 968 00:37:17,120 --> 00:37:22,640 TRUE IN THE FIELD THERE IS 969 00:37:22,640 --> 00:37:24,640 STIGMA FOR OPIOID USE DISORDER 970 00:37:24,640 --> 00:37:29,720 AT TIMES PARENTS ARE GIVEN 971 00:37:29,720 --> 00:37:31,600 CHOICE FOR -- TO BE REUNIFIED 972 00:37:31,600 --> 00:37:33,960 FOR FAMILIES THAT PUTS THEM AT 973 00:37:33,960 --> 00:37:35,840 RISK FOR FURTHER 974 00:37:35,840 --> 00:37:36,800 DESTABILIZATION. THE GOAL HERE 975 00:37:36,800 --> 00:37:40,360 IS REALLY BRINGING IN 976 00:37:40,360 --> 00:37:42,240 INTERVENTIONS AND EVIDENCE-BASED 977 00:37:42,240 --> 00:37:44,200 SERVICE DELIVERY MODELS TO 978 00:37:44,200 --> 00:37:45,640 SUPPORT APPROPRIATE CARE AND 979 00:37:45,640 --> 00:37:47,200 HOPEFULLY LEAD TO BETTER 980 00:37:47,200 --> 00:37:50,480 OUTCOMES FOR THE FAMILIES 981 00:37:50,480 --> 00:37:50,720 OVERALL. 982 00:37:50,720 --> 00:37:53,440 AND YOU KNOW, THERE IS A LOT OF 983 00:37:53,440 --> 00:37:55,320 PARTNERSHIPS THAT ARE PART OF 984 00:37:55,320 --> 00:37:57,040 HOW THIS GOES AGAINST PUTTING IT 985 00:37:57,040 --> 00:37:58,920 TOGETHER INCLUDING RECOVERY 986 00:37:58,920 --> 00:38:00,320 APPROACHES AND OTHER ELEMENTS 987 00:38:00,320 --> 00:38:03,000 AND WE HAVE HAD CONVERSATIONS 988 00:38:03,000 --> 00:38:06,400 WITH SAMHSA AND ACSF AND VIEW 989 00:38:06,400 --> 00:38:09,280 THEM AS KEY PARTNERS GIVEN THEIR 990 00:38:09,280 --> 00:38:11,640 RELEVANT WORK IN THIS AREA. 991 00:38:11,640 --> 00:38:12,840 NEXT SLIDE, PLEASE. 992 00:38:12,840 --> 00:38:17,040 I THINK THAT I KNOW THAT IS VERY 993 00:38:17,040 --> 00:38:17,280 BRIEF. 994 00:38:17,280 --> 00:38:19,040 I THINK ISSUES ARE SO COMPELLING 995 00:38:19,040 --> 00:38:20,880 FOR THIS POPULATION AND WE KNOW 996 00:38:20,880 --> 00:38:22,960 THAT IS NOT HOW CARE IS GETTING 997 00:38:22,960 --> 00:38:25,480 DELIVERED TO FAMILIES AND YOU 998 00:38:25,480 --> 00:38:27,320 KNOW THIS EFFECTS CHILDREN'S 999 00:38:27,320 --> 00:38:29,560 DEVELOPMENT AND IT EFFECTS THE 1000 00:38:29,560 --> 00:38:31,360 PARENT AND HAS SUCH IMPORTANT 1001 00:38:31,360 --> 00:38:31,720 IMPLICATIONS. 1002 00:38:31,720 --> 00:38:33,840 I THINK IT IS A REALLY IMPORTANT 1003 00:38:33,840 --> 00:38:37,720 TOPIC TO FOCUS ON. I WILL OPEN 1004 00:38:37,720 --> 00:38:42,600 IT UP FOR DISCUSSION. 1005 00:38:42,600 --> 00:38:45,160 >>WELL, I WILL SAY THAT I -- I 1006 00:38:45,160 --> 00:38:47,240 THINK THAT, YOU KNOW, ONE OF THE 1007 00:38:47,240 --> 00:38:48,840 MOST EXCITING THINGS ABOUT THIS 1008 00:38:48,840 --> 00:38:51,080 TO ME IS THIS ATTEMPT TO BREAK 1009 00:38:51,080 --> 00:38:55,080 DOWN THIS -- THESE SILOS. 1010 00:38:55,080 --> 00:38:57,160 THEY ARE KIND OF WORKING AGAINST 1011 00:38:57,160 --> 00:38:59,320 US WITH REGARDS TO HAVING EVER 1012 00:38:59,320 --> 00:39:02,160 VERY INTEGRATED OR REALLY 1013 00:39:02,160 --> 00:39:04,800 INTEGRATED HEALTH CARE SERVICES 1014 00:39:04,800 --> 00:39:06,920 AND TRANSLATIONAL, YOU KNOW, 1015 00:39:06,920 --> 00:39:08,560 PROGRESS OF TRANSLATIONAL 1016 00:39:08,560 --> 00:39:09,760 MEDICINE AND THINK THIS IDEA 1017 00:39:09,760 --> 00:39:12,040 THAT WE CAN WORK TOGETHER ACROSS 1018 00:39:12,040 --> 00:39:13,960 DIFFERENT AGENCIES AND KIND OF 1019 00:39:13,960 --> 00:39:16,000 HARMONIZE AND, YOU KNOW, KIND OF 1020 00:39:16,000 --> 00:39:26,520 SORT OF SIN ERNLIZE IN DIRECTION 1021 00:39:27,520 --> 00:39:29,480 IS EXCITING BREAKING DOWN SILOS 1022 00:39:29,480 --> 00:39:31,720 THAT ARE IMPEDING PROGRESS AND 1023 00:39:31,720 --> 00:39:33,400 KUDOS TO YOU FOR DOING THAT. 1024 00:39:33,400 --> 00:39:35,440 >>THANK YOU. I THINK WE CAN 1025 00:39:35,440 --> 00:39:37,480 BUILD A LOT ON LESSONS WE HAVE 1026 00:39:37,480 --> 00:39:39,320 LEARNED IN WORKING IN THE 1027 00:39:39,320 --> 00:39:40,840 JUSTICE SPACE AND CHALLENGES ARE 1028 00:39:40,840 --> 00:39:43,040 SIMILAR TO WHAT WE HAVE SEEN 1029 00:39:43,040 --> 00:39:44,520 HISTORICALLY AROUND OFFERING 1030 00:39:44,520 --> 00:39:45,160 MEDICATIONS IN THE JUSTICE 1031 00:39:45,160 --> 00:39:47,080 SPACE. YOU ARE SEEING A SIMILAR 1032 00:39:47,080 --> 00:39:49,800 KIND OF DYNAMIC IN THE CHILD 1033 00:39:49,800 --> 00:39:50,360 WELFARE SPACE. 1034 00:39:50,360 --> 00:39:52,320 >>RECORDING STOPPED. 1035 00:39:52,320 --> 00:39:54,000 RECORDING IN PROGRESS. 1036 00:39:54,000 --> 00:39:55,640 >>I SEE NORA'S HAND. 1037 00:39:55,640 --> 00:39:57,920 >>I WANT IT TO BE FIRST SURE 1038 00:39:57,920 --> 00:40:00,480 THERE WAS NOT A PLANNED 1039 00:40:00,480 --> 00:40:01,280 DISCUSSANT BEFOREHAND. 1040 00:40:01,280 --> 00:40:04,280 BEFORE I ACTUALLY BRING FORWARD 1041 00:40:04,280 --> 00:40:05,440 IF THERE IS NOT. 1042 00:40:05,440 --> 00:40:06,920 WHAT I WANTED TO COMMENT IS THIS 1043 00:40:06,920 --> 00:40:09,800 IS AN AREA WITH HORRIFIC NEGLECT 1044 00:40:09,800 --> 00:40:11,320 AND TRYING TO GET INFORMATION 1045 00:40:11,320 --> 00:40:13,960 WHAT RESEARCH HAS BEEN DONE ON 1046 00:40:13,960 --> 00:40:16,280 CHILD WELFARE SYSTEMS AND 1047 00:40:16,280 --> 00:40:17,600 OUTCOMES OF CHILDREN ACTUALLY 1048 00:40:17,600 --> 00:40:19,360 SENT TO FOSTER CARE BECAUSE OF 1049 00:40:19,360 --> 00:40:21,640 USE OF DRUGS. 1050 00:40:21,640 --> 00:40:25,400 TO MY DISMAY, IT IS BASICALLY 1051 00:40:25,400 --> 00:40:25,840 NOTHING. 1052 00:40:25,840 --> 00:40:27,440 SO, WE HAVE GUIDELINES. 1053 00:40:27,440 --> 00:40:32,120 I MEAN THAT ARE BASICALLY NOT 1054 00:40:32,120 --> 00:40:34,480 BASED ON ANY SOLID EVIDENCE 1055 00:40:34,480 --> 00:40:37,280 ABOUT WHAT ARE THE OUTCOMES OF 1056 00:40:37,280 --> 00:40:39,040 THESE CHILDREN THAT ARE SENT OUT 1057 00:40:39,040 --> 00:40:42,560 TO FOSTER CARE. MIND YOU, NO. 1 1058 00:40:42,560 --> 00:40:44,520 REASON WHY CHILDREN ARE SENT TO 1059 00:40:44,520 --> 00:40:46,280 FOSTER CARE IS BECAUSE OF USE OF 1060 00:40:46,280 --> 00:40:47,960 DRUGS BY THE PARENTS. 1061 00:40:47,960 --> 00:40:51,560 SO, THIS IS AN AREA THAT 1062 00:40:51,560 --> 00:40:53,160 DESERVES RESEARCH URNLIENTLY AND 1063 00:40:53,160 --> 00:40:55,600 NOT JUST TO SAY IN TERMS OF 1064 00:40:55,600 --> 00:40:58,000 ACTUALLY WHICH IS VERY IMPORTANT 1065 00:40:58,000 --> 00:41:00,880 WHAT MODELS CAN MINIMIZE 1066 00:41:00,880 --> 00:41:03,200 LIKELIHOOD WHEN A MOTHER HAS AN 1067 00:41:03,200 --> 00:41:04,920 INFANT AND IS TAKING DRUGS THAT 1068 00:41:04,920 --> 00:41:07,120 THEY WILL BASICALLY GET INTO 1069 00:41:07,120 --> 00:41:08,960 TREATMENT AND STAY IN TREATMENT 1070 00:41:08,960 --> 00:41:11,160 AND MINIMIZE LIKELIHOOD THAT 1071 00:41:11,160 --> 00:41:12,600 THEY WILL LOSE THAT CHILD. 1072 00:41:12,600 --> 00:41:15,200 ALSO, IMPORTANTLY, WHAT ARE 1073 00:41:15,200 --> 00:41:16,520 OUTCOMES OF THE DIFFERENT 1074 00:41:16,520 --> 00:41:17,960 OUTCOMES THAT DECISIONS ARE 1075 00:41:17,960 --> 00:41:20,760 BEING MADE BY THE STATES? 1076 00:41:20,760 --> 00:41:22,240 BECAUSE THAT SHOULD BE A 1077 00:41:22,240 --> 00:41:25,160 GUIDELINE IN TERMS OF WHAT MAY 1078 00:41:25,160 --> 00:41:27,080 BE A RECOMMENDATION. 1079 00:41:27,080 --> 00:41:28,640 OTHERWISE, WE ARE IN COMPLETE 1080 00:41:28,640 --> 00:41:29,520 DARKNESS. 1081 00:41:29,520 --> 00:41:32,160 ONES THAT SUFFER, OBVIOUSLY, 1082 00:41:32,160 --> 00:41:35,160 THEY ARE CHILDREN AND MOTHERS. 1083 00:41:35,160 --> 00:41:37,080 THIS BECOMES AN EVEN GREATER 1084 00:41:37,080 --> 00:41:37,840 STRESSOR. 1085 00:41:37,840 --> 00:41:43,280 SO, I WOULD BE VERY INTERESTED 1086 00:41:43,280 --> 00:41:46,720 ON HERE HOW WE TAKE THIS AHEAD. 1087 00:41:46,720 --> 00:41:50,200 HOW DO WE CONSOLIDATE A RESEARCH 1088 00:41:50,200 --> 00:41:55,080 PLAN THAT WILL GIVE YOU OR START 1089 00:41:55,080 --> 00:41:59,720 TO PROVIDE THIS KNOWLEDGE. 1090 00:41:59,720 --> 00:42:03,000 >>I ABSOLUTELY AGREE WITH YOU, 1091 00:42:03,000 --> 00:42:04,520 NORA. 1092 00:42:04,520 --> 00:42:08,040 I SEE ANDREA ALSO HAS HER HAND 1093 00:42:08,040 --> 00:42:08,200 UP. 1094 00:42:08,200 --> 00:42:10,520 >>NO. I APPLAUD NORA. THANK 1095 00:42:10,520 --> 00:42:13,720 YOU SO MUCH FOR SAYING THOSE 1096 00:42:13,720 --> 00:42:15,520 COMMENTS AND ALSO FOR YOUR BLOG 1097 00:42:15,520 --> 00:42:17,880 THAT YOU WROTE ABOUT THIS VERY 1098 00:42:17,880 --> 00:42:21,920 INCREDIBLY TOPIC THAT HAS 1099 00:42:21,920 --> 00:42:23,760 GENERATIONAL IMPACT. I WOULD 1100 00:42:23,760 --> 00:42:25,520 ALSO LIKE TO ADD I KNOW WE FOCUS 1101 00:42:25,520 --> 00:42:28,360 ON THE MOTHER AND ALSO TO CAST A 1102 00:42:28,360 --> 00:42:29,240 WIDE NET. 1103 00:42:29,240 --> 00:42:31,560 THERE IS MANY FATHERS OUT THERE 1104 00:42:31,560 --> 00:42:33,400 THAT WOULD ALSO LIKE TO BRING 1105 00:42:33,400 --> 00:42:34,960 THEIR CHILDREN TO TREATMENT. 1106 00:42:34,960 --> 00:42:36,680 AND THEY WOULD LOSE THEIR 1107 00:42:36,680 --> 00:42:37,640 PARENTAL RIGHTS. 1108 00:42:37,640 --> 00:42:41,840 SO, YOU KNOW, WHERE ARE 1109 00:42:41,840 --> 00:42:44,480 EVIDENCE-BASED MODELS AND DIAD 1110 00:42:44,480 --> 00:42:47,880 THAT IS A PATERNAL CHILD DIAD IN 1111 00:42:47,880 --> 00:42:50,680 ADDITION TO MATERNAL CHILD 1112 00:42:50,680 --> 00:42:51,680 [INDISCERNIBLE]. THAT IS 1113 00:42:51,680 --> 00:42:53,320 INCREDIBLY IMPORTANT THAT I 1114 00:42:53,320 --> 00:42:55,520 CAN'T UNDERSCORE INCREDIBLE 1115 00:42:55,520 --> 00:42:57,760 VARIATION IN THE WAY THAT CHILD 1116 00:42:57,760 --> 00:43:00,920 WELFARE RESPONDS ABOUT I COUNTY. 1117 00:43:00,920 --> 00:43:01,720 IN THE UNITED STATES. 1118 00:43:01,720 --> 00:43:03,880 SO, I KNOW THAT EVERY STATE IS 1119 00:43:03,880 --> 00:43:05,720 DIFFERENT. SOME STATES HAVE 1120 00:43:05,720 --> 00:43:08,200 MORE STATE CONTROL. 1121 00:43:08,200 --> 00:43:09,400 AT LEAST IN MANY STATES 1122 00:43:09,400 --> 00:43:11,120 INCLUDING THE STATE I'M IN IS 1123 00:43:11,120 --> 00:43:13,000 COUNTY DRIVEN AND WE HAVE 100 1124 00:43:13,000 --> 00:43:15,320 COUNTIES AND THINGS ARE DONE 1125 00:43:15,320 --> 00:43:19,200 LITERALLY 100 DIFFERENT WAYS AND 1126 00:43:19,200 --> 00:43:21,080 WE DESPERATELY NEED 1127 00:43:21,080 --> 00:43:22,920 EVIDENCE-BASED GUIDELINES FOR 1128 00:43:22,920 --> 00:43:24,680 SCREENING HOW TO DETERMINE RISKS 1129 00:43:24,680 --> 00:43:25,960 OR SAFETY RISKS FOR CHILDREN AND 1130 00:43:25,960 --> 00:43:29,160 FOR PARENTS AND TO HAVE 1131 00:43:29,160 --> 00:43:31,480 SYSTEMATIC TRAINING WHAT IS A 1132 00:43:31,480 --> 00:43:32,320 SUBSTANCE USE DISORDER WHERE 1133 00:43:32,320 --> 00:43:34,520 TREATMENT IS AVAILABLE FOR OUR 1134 00:43:34,520 --> 00:43:36,120 CHILD WELFARE WORKERS. 1135 00:43:36,120 --> 00:43:38,240 THEY HAVE A TREMENDOUSLY 1136 00:43:38,240 --> 00:43:40,600 DIFFICULT JOB THAT THEY HAVE TO 1137 00:43:40,600 --> 00:43:41,640 DO. THEY OFTEN GET LITTLE 1138 00:43:41,640 --> 00:43:44,880 TRAINING IN, YOU KNOW, ADDICTION 1139 00:43:44,880 --> 00:43:47,040 OR IN SUBSTANCE USE DISORDERS. 1140 00:43:47,040 --> 00:43:49,640 YOU KNOW, JUST USING THIS 1141 00:43:49,640 --> 00:43:50,560 OPPORTUNITY TO STANDARDIZE AND 1142 00:43:50,560 --> 00:43:53,280 LEARN AS MUCH AS WE CAN TO 1143 00:43:53,280 --> 00:43:54,640 STANDARDIZE BASED ON EVIDENCE 1144 00:43:54,640 --> 00:43:56,280 AND ALSO TO NOT FORGET THERE ARE 1145 00:43:56,280 --> 00:43:59,880 MANL STRAIGHTS OUT THERE. 1146 00:43:59,880 --> 00:44:01,920 THERE ARE DIFFERENT COURT 1147 00:44:01,920 --> 00:44:05,240 PROGRAMS SO INTERTWINING OF YOUR 1148 00:44:05,240 --> 00:44:09,720 JUDICIAL SYSTEM AND CHILD 1149 00:44:09,720 --> 00:44:11,320 WELFARE IS INEXTRICABLY LINKED 1150 00:44:11,320 --> 00:44:12,680 AND YOU CAN'T LOOK AT ONE 1151 00:44:12,680 --> 00:44:14,040 WITHOUT THE OTHER AND MAKING 1152 00:44:14,040 --> 00:44:17,000 SURE WE LEARN FROM ALL DIFFERENT 1153 00:44:17,000 --> 00:44:18,240 STAKEHOLDERS ALLOWING 1154 00:44:18,240 --> 00:44:19,400 INTERVENTIONS TO HAPPEN IN ALL 1155 00:44:19,400 --> 00:44:20,720 OF THE DIFFERENT PLACES WHERE, 1156 00:44:20,720 --> 00:44:23,640 YOU KNOW, FAMILIES INTERSECT 1157 00:44:23,640 --> 00:44:25,240 WITH THE CHILD WELFARE SYSTEM. 1158 00:44:25,240 --> 00:44:27,560 THANK YOU FOR GIVING THIS. I'M 1159 00:44:27,560 --> 00:44:29,560 EXCITED ABOUT IT. 1160 00:44:29,560 --> 00:44:33,680 >>THANK YOU, ANDREA. MICHELLE 1161 00:44:33,680 --> 00:44:35,160 REMINDED ME HER GROUP HAS BEEN 1162 00:44:35,160 --> 00:44:37,520 ORGANIZING IN RELATIONSHIP TO 1163 00:44:37,520 --> 00:44:40,160 HBCD AND WORKSHOP ON ENGAGING 1164 00:44:40,160 --> 00:44:41,680 CHILD WELFARE SYSTEMS HAPPENING 1165 00:44:41,680 --> 00:44:43,960 IN MAY AND DEVELOPER OF THIS 1166 00:44:43,960 --> 00:44:46,000 CONCEPT HAS BEEN WORKING WITH 1167 00:44:46,000 --> 00:44:47,320 MICHELLE AND HER TEAM IN DOING 1168 00:44:47,320 --> 00:44:49,000 THAT. THAT IS HEAL SUPPORTED. 1169 00:44:49,000 --> 00:44:50,640 YOU KNOW, ALL OF THE COMPLEXITY 1170 00:44:50,640 --> 00:44:53,400 OF ISSUES YOU ARE HIGHLIGHTING 1171 00:44:53,400 --> 00:44:54,720 ABOUT DIFFERENT STAKEHOLDERS 1172 00:44:54,720 --> 00:44:56,760 THAT NEED TO ENGAGED AND WAY 1173 00:44:56,760 --> 00:44:57,720 THAW THINK ABOUT IT AND 1174 00:44:57,720 --> 00:45:02,840 COMPLEXITY OF, YOU KNOW, FAMILY 1175 00:45:02,840 --> 00:45:04,840 DYNAMICS EXTENDING BEYOND FOCUS 1176 00:45:04,840 --> 00:45:07,120 ON MATERNAL COMPONENTS AND ALSO 1177 00:45:07,120 --> 00:45:09,320 PARENTS AND SORT OF THE WHOLE 1178 00:45:09,320 --> 00:45:12,440 FAMILY. OFTEN THESE ARE 1179 00:45:12,440 --> 00:45:13,040 MULTIGENERATION. YOU KNOW, 1180 00:45:13,040 --> 00:45:14,480 CHILDREN ENTER FOSTER CARE 1181 00:45:14,480 --> 00:45:16,920 SYSTEM TOO AND YOU ARE TALKING 1182 00:45:16,920 --> 00:45:17,680 ABOUT MULTIGENERATIONAL HOMES 1183 00:45:17,680 --> 00:45:20,200 AND LOTS OF COMPLEXITIES THERE 1184 00:45:20,200 --> 00:45:20,920 AS WELL. 1185 00:45:20,920 --> 00:45:23,520 BECAUSE -- ANYWAYS, THANKS FOR 1186 00:45:23,520 --> 00:45:25,400 HIGHLIGHTING ALL THOSE ISSUES 1187 00:45:25,400 --> 00:45:31,720 NEEDING TO BE ATTENDED TO. 1188 00:45:31,720 --> 00:45:33,040 >>ONE MORE THING GLAD MICHELLE 1189 00:45:33,040 --> 00:45:35,080 IS HAVING A MEETING IN MAY. WE 1190 00:45:35,080 --> 00:45:37,680 ARE DOING BIOETHICS AND MAKING 1191 00:45:37,680 --> 00:45:40,280 SURE WE ARE NOT INADVERTENTLY 1192 00:45:40,280 --> 00:45:41,640 CREATING HARM AND MORE PEOPLE 1193 00:45:41,640 --> 00:45:43,280 ARE LOOKING AT FAMILIES AND 1194 00:45:43,280 --> 00:45:45,120 CHILDREN AND MAKING SURE WE ARE 1195 00:45:45,120 --> 00:45:46,960 BALANCING RISK AND BENEFIT FOR 1196 00:45:46,960 --> 00:45:49,720 EVERYBODY. THANK YOU. 1197 00:45:49,720 --> 00:45:50,360 >>THANK YOU. 1198 00:45:50,360 --> 00:45:51,120 >>GAIL? 1199 00:45:51,120 --> 00:45:53,640 >>I WAS JUST GOING TO BRING UP 1200 00:45:53,640 --> 00:45:55,920 THIS IS WONDERFUL. 1201 00:45:55,920 --> 00:45:58,200 IT IS WONDERFUL NEEDED WORK. 1202 00:45:58,200 --> 00:46:00,360 WE ALSO HAVE TO BE CAREFUL ABOUT 1203 00:46:00,360 --> 00:46:02,640 MEDICATIONS WE ARE PRESCRIBING. 1204 00:46:02,640 --> 00:46:06,000 AGAIN, I HAVE SPOKEN WITH WOMEN 1205 00:46:06,000 --> 00:46:07,320 WHO IN DIFFERENT STATES IT IS 1206 00:46:07,320 --> 00:46:09,720 RUN BY THE STATE CAN ONLY USE 1207 00:46:09,720 --> 00:46:11,680 MENLO DON'T AND HAVE TO GET TO 1208 00:46:11,680 --> 00:46:13,920 THE MENLO DON'T CENTER AND THEY 1209 00:46:13,920 --> 00:46:16,560 CAN'T. THERE ARE MANY DESERTS 1210 00:46:16,560 --> 00:46:19,560 WHERE METHO DON'T PLACES ARE. 1211 00:46:19,560 --> 00:46:21,640 THERE WERE SO MANY BARRIERS THAT 1212 00:46:21,640 --> 00:46:23,080 THERE WAS NO WAY THAT MOTHER 1213 00:46:23,080 --> 00:46:25,640 COULD TAKE CARE OF A CHILD AND 1214 00:46:25,640 --> 00:46:27,040 HAD ANOTHER CHILD PARTICULARLY 1215 00:46:27,040 --> 00:46:29,840 AT HOME COULD GET ON A BUS AN 1216 00:46:29,840 --> 00:46:35,040 HOUR A DAY OR BACK AND WEREN'T 1217 00:46:35,040 --> 00:46:36,000 OFFERED NOREPINEPHRINE AND WERE 1218 00:46:36,000 --> 00:46:39,280 OFFERED MENLO DON'T DURING 1219 00:46:39,280 --> 00:46:40,640 PREGNANCY AND WE CAN'T 1220 00:46:40,640 --> 00:46:42,080 TRANSITION THEM WELL DURING 1221 00:46:42,080 --> 00:46:43,760 PREGNANCY. IT IS A MATTER OF 1222 00:46:43,760 --> 00:46:45,960 THAT AND EXPANDING TELEHEALTH 1223 00:46:45,960 --> 00:46:48,520 AND OPTIONS THAT HAPPENED DURING 1224 00:46:48,520 --> 00:46:50,760 COVID THAT EVERYONE THAT IS 1225 00:46:50,760 --> 00:46:52,240 FRIGHTENED WILL GO AWAY. WE 1226 00:46:52,240 --> 00:46:54,560 HAVE TO DO THIS FOR NO. 1 IS 1227 00:46:54,560 --> 00:46:57,960 THEY DON'T HAVE ACCESS TO 1228 00:46:57,960 --> 00:46:59,360 MEDICATIONS VERY EASILY BEING A 1229 00:46:59,360 --> 00:47:01,600 MOM. I WANTED TO JUST MAKE SURE 1230 00:47:01,600 --> 00:47:04,600 THAT WE DIDN'T FORGET THAT. I 1231 00:47:04,600 --> 00:47:06,080 WANTED TO SAY THESE ARE 1232 00:47:06,080 --> 00:47:08,520 MEDICATIONS THAT ARE NOT ONLY 1233 00:47:08,520 --> 00:47:10,480 EFFICACIOUS BUT WILL BE MORE 1234 00:47:10,480 --> 00:47:13,240 LIKELY TO ENGAGE A MOM THAN 1235 00:47:13,240 --> 00:47:15,120 SOMETHING THAT WILL REQUIRE SO 1236 00:47:15,120 --> 00:47:19,480 MUCH REGULATORY PROBLEMS IN 1237 00:47:19,480 --> 00:47:20,320 TRANSPORTATION, ET CETERA. 1238 00:47:20,320 --> 00:47:24,600 >>I THINK THAT IS A SUPER 1239 00:47:24,600 --> 00:47:26,160 IMPORTANT POINT. I THINK TOO 1240 00:47:26,160 --> 00:47:27,200 UNDERSTANDING FROM THE 1241 00:47:27,200 --> 00:47:29,160 PERSPECTIVE OF SYSTEM AND 1242 00:47:29,160 --> 00:47:31,040 AVAILABILITY OF SERVICES IN THE 1243 00:47:31,040 --> 00:47:32,120 COMMUNITY I'M SURE THERE ARE 1244 00:47:32,120 --> 00:47:34,920 MANY CASES AND KNOW FROM WORK I 1245 00:47:34,920 --> 00:47:38,880 DID EARLIER IN MY CAREER THAT 1246 00:47:38,880 --> 00:47:40,920 PEOPLE WERE EFFECTED BY 1247 00:47:40,920 --> 00:47:42,040 NONEFFECTIVE TREATMENTS 1248 00:47:42,040 --> 00:47:43,560 AVAILABLE IN THE COMMUNITY AND 1249 00:47:43,560 --> 00:47:45,400 KEEPING IN MIND PEOPLE ARE BEING 1250 00:47:45,400 --> 00:47:47,120 OFFERED THINGS BOTH EFFECTIVE 1251 00:47:47,120 --> 00:47:48,560 AND ACCESSIBLE. 1252 00:47:48,560 --> 00:47:56,320 SUCH A GREAT POINT. 1253 00:47:56,320 --> 00:47:59,000 >>ALL RIGHT, TISHA. 1254 00:47:59,000 --> 00:48:00,240 WE HAVE ONE MORE. 1255 00:48:00,240 --> 00:48:01,880 >>OKAY. 6TH ONE IS A LITTLE 1256 00:48:01,880 --> 00:48:03,960 BIT IF WE CAN GO TO THE NEXT 1257 00:48:03,960 --> 00:48:05,080 SLIDE. IT IS A LITTLE DIFFERENT 1258 00:48:05,080 --> 00:48:07,680 FROM THE OTHERS AND INSTEAD OF 1259 00:48:07,680 --> 00:48:09,520 FOCUSING ON A POPULATION GAP. 1260 00:48:09,520 --> 00:48:12,000 THIS IS MORE ABOUT SORT OF HOW 1261 00:48:12,000 --> 00:48:14,160 DO WE TRANSLATE OUR FINDINGS 1262 00:48:14,160 --> 00:48:16,120 BACK OUT INTO PRACTICE. 1263 00:48:16,120 --> 00:48:18,440 SO, HERE ARE THE IDEAS THAT ARE 1264 00:48:18,440 --> 00:48:21,680 REALLY ABOUT ENGAGING WITH KEY 1265 00:48:21,680 --> 00:48:24,400 DECISION MAKERS OUT IN THE FIELD 1266 00:48:24,400 --> 00:48:25,640 AND BUILD INFRASTRUCTURE TO 1267 00:48:25,640 --> 00:48:27,760 SUPPORT COLLABORATIONS BETWEEN 1268 00:48:27,760 --> 00:48:29,080 RESEARCHERS AND DECISION MAKERS 1269 00:48:29,080 --> 00:48:32,440 AND SO IN PUBLIC HEALTH LEADERS 1270 00:48:32,440 --> 00:48:34,920 AND WHEN I SAY DECISION MAKERS 1271 00:48:34,920 --> 00:48:37,120 AND PUBLIC HEALTH LEADERS I MEAN 1272 00:48:37,120 --> 00:48:40,920 PUBLIC HEALTH COMMISSIONERS AND 1273 00:48:40,920 --> 00:48:43,200 SINGLE STATE -- OPIOID RESPONSE 1274 00:48:43,200 --> 00:48:46,800 AND HEARING ABOUT ABATEMENT 1275 00:48:46,800 --> 00:48:48,120 COUNCILS. CAN YOU THINK OF 1276 00:48:48,120 --> 00:48:49,840 CLINICAL TREATMENT DIRECTORS AND 1277 00:48:49,840 --> 00:48:52,080 AGENCIES AND PEOPLE THAT END UP 1278 00:48:52,080 --> 00:48:53,760 AND EARLIER YOU MENTIONED 1279 00:48:53,760 --> 00:48:55,480 HOSPITAL ADMINISTRATORS THAT ARE 1280 00:48:55,480 --> 00:48:57,280 PEOPLE THAT ULTIMATELY END UP 1281 00:48:57,280 --> 00:48:59,480 MAKING DECISIONS ABOUT HOW 1282 00:48:59,480 --> 00:49:01,720 VARIOUS RESOURCES GET ALLOCATED 1283 00:49:01,720 --> 00:49:05,160 AND IDEA IS HOW DO WE BRIDGE 1284 00:49:05,160 --> 00:49:06,560 WHAT THEIR NEEDS ARE AROUND 1285 00:49:06,560 --> 00:49:07,880 UNDERSTANDING AND USING RESEARCH 1286 00:49:07,880 --> 00:49:10,600 AND APPLYING RESEARCH IN CONTEXT 1287 00:49:10,600 --> 00:49:12,360 OF THEIR RESPONSIBILITIES AND 1288 00:49:12,360 --> 00:49:13,880 HOW CAN WE BUILD RESEARCH 1289 00:49:13,880 --> 00:49:15,760 INFRASTRUCTURE TO SUPPORT THAT. 1290 00:49:15,760 --> 00:49:17,760 SO, THIS WOULD BE A LITTLE MORE 1291 00:49:17,760 --> 00:49:20,360 OF AN UNUSUAL MECHANISM AND 1292 00:49:20,360 --> 00:49:21,760 REALLY PROOF OF CONCEPT HOW YOU 1293 00:49:21,760 --> 00:49:24,320 DO THIS. WE KNOW IN PORTFOLIOS 1294 00:49:24,320 --> 00:49:26,080 THAT SOMETIMES WE SEE 1295 00:49:26,080 --> 00:49:27,360 APPLICATIONS THAT WILL COME IN, 1296 00:49:27,360 --> 00:49:30,080 IN A FEW PLACES THAT HAVE STRONG 1297 00:49:30,080 --> 00:49:31,480 INFRASTRUCTURE. WE MIGHT SEE 1298 00:49:31,480 --> 00:49:33,400 THIS IS ALSO ABOUT BUILDING 1299 00:49:33,400 --> 00:49:34,880 CONNECTIONS ACROSS JURISDICTIONS 1300 00:49:34,880 --> 00:49:35,000 . 1301 00:49:35,000 --> 00:49:36,400 WE SOMEHOW SEE THINGS COMING IN 1302 00:49:36,400 --> 00:49:39,640 WITH A SINGLE STATE WITH REALLY 1303 00:49:39,640 --> 00:49:41,160 ROBUST INFRASTRUCTURE THAT IS 1304 00:49:41,160 --> 00:49:42,760 HARD TO REPLICATE THAT AND IDEA 1305 00:49:42,760 --> 00:49:44,760 HERE IS TO START TO REALLY 1306 00:49:44,760 --> 00:49:47,120 FIGURE OUT HOW WE SCALE THAT 1307 00:49:47,120 --> 00:49:48,200 INFRASTRUCTURE AND CREATE A 1308 00:49:48,200 --> 00:49:50,000 SYSTEM WHERE WE CAN HAVE LESSONS 1309 00:49:50,000 --> 00:49:51,880 LEARNED FROM ONE SYSTEMS TRANCE 1310 00:49:51,880 --> 00:49:54,640 LAETDED TO ANOTHER. NEXT SLIDE, 1311 00:49:54,640 --> 00:49:55,000 PLEASE 1312 00:49:55,000 --> 00:49:58,120 I THINK THIS IS THE LAST MILD 1313 00:49:58,120 --> 00:49:59,680 GAP IN THE TRANSLATION 1314 00:49:59,680 --> 00:50:00,240 CONTINUUM. 1315 00:50:00,240 --> 00:50:03,480 SO, YOU KNOW, I THINK THIS 1316 00:50:03,480 --> 00:50:04,560 COMPLEMENTS WORK THAT WE HAVE 1317 00:50:04,560 --> 00:50:06,280 DONE WITH HEALING COMMUNITIES 1318 00:50:06,280 --> 00:50:08,160 AND DATA TO ACTION THAT IS 1319 00:50:08,160 --> 00:50:10,040 REALLY ABOUT BUILDING THIS 1320 00:50:10,040 --> 00:50:11,120 INFRASTRUCTURE MORE BROADLY AND 1321 00:50:11,120 --> 00:50:12,720 FIGURING OUT WHAT BARRIERS TO 1322 00:50:12,720 --> 00:50:15,480 DOING THAT WOULD BE. 1323 00:50:15,480 --> 00:50:17,720 AND, YOU KNOW, IT WOULD BE A 1324 00:50:17,720 --> 00:50:20,920 MECHANISM THAT WOULD GIVE US 1325 00:50:20,920 --> 00:50:23,600 SPACE TO FIGURE IT OUT A LITTLE 1326 00:50:23,600 --> 00:50:25,680 MORE. NEXT SLIDE, PLEASE. 1327 00:50:25,680 --> 00:50:27,440 SO, I THINK THAT I COULD OPEN IT 1328 00:50:27,440 --> 00:50:34,440 UP TO QUESTIONS FROM THERE. 1329 00:50:34,440 --> 00:50:36,280 >> JUST A COMMENT. I THINK 1330 00:50:36,280 --> 00:50:38,280 THAT THE IDEA THAT WE WILL BE 1331 00:50:38,280 --> 00:50:41,720 ABLE TO -- TO DO TRANSLATIONAL 1332 00:50:41,720 --> 00:50:45,440 WORK LIKE THIS WITHOUT RESEARCH 1333 00:50:45,440 --> 00:50:46,680 PARTNERSHIPS IS RIDICULOUS. 1334 00:50:46,680 --> 00:50:49,120 THIS IS A REALLY IMPORTANT KIND 1335 00:50:49,120 --> 00:50:51,760 OF RESEARCH PRACTITIONER 1336 00:50:51,760 --> 00:50:53,440 PARTNERSHIP HAVING TO BE PUT IN 1337 00:50:53,440 --> 00:50:56,680 PLACE FOR DECISIONS TO BE MADE 1338 00:50:56,680 --> 00:50:58,400 BASED ON EVIDENCE. 1339 00:50:58,400 --> 00:51:01,040 I THINK, YOU KNOW, IT IS A 1340 00:51:01,040 --> 00:51:02,960 NO-BRAINER. IF WE DON'T HAVE 1341 00:51:02,960 --> 00:51:04,040 INFRASTRUCTURE WE WILL BUILD IT 1342 00:51:04,040 --> 00:51:05,680 SOMEHOW THAT IS A BEGINNING TO 1343 00:51:05,680 --> 00:51:07,400 START TO BUILD THOSE DECISION 1344 00:51:07,400 --> 00:51:08,880 MAKERS THAT ARE PRACTITIONERS 1345 00:51:08,880 --> 00:51:11,000 HERE. YOU HAVE TO REALLY HAVE 1346 00:51:11,000 --> 00:51:12,760 THAT LINK BETWEEN RESEARCHER AND 1347 00:51:12,760 --> 00:51:14,920 PRACTITIONER AND WE DON'T HAVE 1348 00:51:14,920 --> 00:51:16,360 IT NOW A VERY GOOD LINK THERE. 1349 00:51:16,360 --> 00:51:18,160 IT SEEMS OBVIOUS THAT IS A PLACE 1350 00:51:18,160 --> 00:51:22,560 THAT HAS TO BE ADDRESSED. 1351 00:51:22,560 --> 00:51:23,360 SO -- 1352 00:51:23,360 --> 00:51:25,320 >>WE AGREE. 1353 00:51:25,320 --> 00:51:27,040 THE HOW IS THE HARD PART. I 1354 00:51:27,040 --> 00:51:29,160 THINK THAT WE HAVE TO START TO 1355 00:51:29,160 --> 00:51:31,640 TRY THINGS THAT WE HAVEN'T TRIED 1356 00:51:31,640 --> 00:51:33,320 BEFORE. 1357 00:51:33,320 --> 00:51:34,640 >>RIGHT. 1358 00:51:34,640 --> 00:51:41,960 >>NORA? 1359 00:51:41,960 --> 00:51:46,720 >>TO ME SAYING WITH HOW AND I 1360 00:51:46,720 --> 00:51:51,200 SAY THAT THERE ARE MANY HOWS AND 1361 00:51:51,200 --> 00:51:52,960 KEY HOW AND CRUCIAL HIGH AND HOW 1362 00:51:52,960 --> 00:51:54,840 WE CAN BUILD UPON IS DATA AND 1363 00:51:54,840 --> 00:51:58,120 ACCESS TO DATA. 1364 00:51:58,120 --> 00:52:00,800 SO, WE WERE JUST DISCUSSING 1365 00:52:00,800 --> 00:52:03,120 ISSUES OF CHILD WELFARE TO 1366 00:52:03,120 --> 00:52:06,240 EXTENT THAT WE START TO COLLECT 1367 00:52:06,240 --> 00:52:09,320 LARGE DATA BASES INFORMING US 1368 00:52:09,320 --> 00:52:11,280 HOW A PARTICULAR INTERVENTION 1369 00:52:11,280 --> 00:52:12,360 UNDER CERTAIN CONDITIONS 1370 00:52:12,360 --> 00:52:14,280 RESULTED TO AN OUTCOME AND WHAT 1371 00:52:14,280 --> 00:52:16,200 ARE COSTS ASSOCIATED WITH IT. 1372 00:52:16,200 --> 00:52:17,920 WE START TO BUILD THAT 1373 00:52:17,920 --> 00:52:18,520 INFRASTRUCTURE. 1374 00:52:18,520 --> 00:52:20,520 SO, THAT INFRASTRUCTURE IS 1375 00:52:20,520 --> 00:52:22,520 FUNDAMENTAL AND I THINK THAT WE 1376 00:52:22,520 --> 00:52:24,920 SHOULD PULL OUR HEADS TOGETHER. 1377 00:52:24,920 --> 00:52:27,440 WE CAN FIGURE OUT THAT OBVIOUSLY 1378 00:52:27,440 --> 00:52:31,760 ONE OF THE KEY ELEMENTS IS TO 1379 00:52:31,760 --> 00:52:34,000 GENERATE DATA BASES THAT BECOME 1380 00:52:34,000 --> 00:52:35,000 INTEROPERABLE WITH ONE ANOTHER 1381 00:52:35,000 --> 00:52:38,080 AND INTEGRATED SUCH THAT I CAN 1382 00:52:38,080 --> 00:52:39,560 PULL THEM AND GAIN MORE 1383 00:52:39,560 --> 00:52:41,400 INFORMATION THAN WHEN THEY ARE 1384 00:52:41,400 --> 00:52:43,400 IN ISOLATION. 1385 00:52:43,400 --> 00:52:45,400 SO, IF WE SAY WITHIN -- WHAT 1386 00:52:45,400 --> 00:52:47,440 WOULD WE NEED TO DO? 1387 00:52:47,440 --> 00:52:49,360 WITH DATA BASES THAT ARE 1388 00:52:49,360 --> 00:52:53,160 RELEVANT THAT WE ARE COLLECTING 1389 00:52:53,160 --> 00:52:54,160 TO ENSURE THAT THIS INFORMATION 1390 00:52:54,160 --> 00:52:56,480 WILL BE -- WE WILL BE ABLE TO 1391 00:52:56,480 --> 00:52:57,960 PULL IT UP TO GUIDE EXACTLY WHAT 1392 00:52:57,960 --> 00:53:01,000 YOU ARE TRYING TO DO TO 1393 00:53:01,000 --> 00:53:01,560 FACILITATE TRANSLATION OF 1394 00:53:01,560 --> 00:53:03,120 EVIDENCE INTO THE PRACTICE. 1395 00:53:03,120 --> 00:53:06,080 SO, I THINK THAT THIS IS ONE OF 1396 00:53:06,080 --> 00:53:08,240 THE IMPORTANT HOWS THAT I WOULD 1397 00:53:08,240 --> 00:53:10,560 SUGGEST THAT WE TAKE ADVANTAGE 1398 00:53:10,560 --> 00:53:10,720 OF. 1399 00:53:10,720 --> 00:53:14,000 WE ARE ALREADY BUILDING INTO THE 1400 00:53:14,000 --> 00:53:15,640 DATA BASE SPACE. 1401 00:53:15,640 --> 00:53:17,800 >>YEAH. ONE POINT INSPIRATION 1402 00:53:17,800 --> 00:53:20,880 FOR THIS IS JULIE DONAHUE HAS A 1403 00:53:20,880 --> 00:53:23,160 NICE GRANT PULLING TOGETHER 1404 00:53:23,160 --> 00:53:24,840 MEDICAID DIRECTORS FROM MULTIPLE 1405 00:53:24,840 --> 00:53:28,880 STATES USING A DISTRIBUTED 1406 00:53:28,880 --> 00:53:30,760 ANALYSIS APPROACH THAT ALL OF 1407 00:53:30,760 --> 00:53:32,880 THE MEDICAID DATA IS HARD TO PUT 1408 00:53:32,880 --> 00:53:34,880 TOGETHER AND THEY WANT TO 1409 00:53:34,880 --> 00:53:37,360 MAINTAIN CONTROL OF LOCAL DATA 1410 00:53:37,360 --> 00:53:38,520 AND COME UP WITH SHARED 1411 00:53:38,520 --> 00:53:40,720 QUESTIONS AND RUN SIMILAR 1412 00:53:40,720 --> 00:53:43,760 ANALYSES AND COME BACK AND TALK 1413 00:53:43,760 --> 00:53:45,680 ABOUT THE RESULTS. 1414 00:53:45,680 --> 00:53:48,040 OUR HOPE IS TO USE MECHANISM TO 1415 00:53:48,040 --> 00:53:50,560 FIND OUT CREATIVE SOLUTIONS LIKE 1416 00:53:50,560 --> 00:53:53,280 THAT, THAT ARE OF INTEREST AND 1417 00:53:53,280 --> 00:53:54,680 ACCESSIBLE AND WHAT 1418 00:53:54,680 --> 00:53:55,600 INFRASTRUCTURE WE HAVE TO BUILD 1419 00:53:55,600 --> 00:53:58,120 TO RESPOND TO THE SORT OF 1420 00:53:58,120 --> 00:53:59,160 BARRIERS THAT THEY MIGHT 1421 00:53:59,160 --> 00:54:00,840 EXPERIENCE OR WHAT NEEDS ARE AND 1422 00:54:00,840 --> 00:54:02,640 JUST THIS IS REALLY MEANT TO BE 1423 00:54:02,640 --> 00:54:04,920 A FOUNDATIONAL INITIATIVE TO 1424 00:54:04,920 --> 00:54:06,720 JUST FIGURE OUT THE ROADMAP FOR 1425 00:54:06,720 --> 00:54:10,720 THE HOW BY DISCUSSING THOSE 1426 00:54:10,720 --> 00:54:13,800 KINDS OF QUESTIONS. 1427 00:54:13,800 --> 00:54:17,360 >>ANDRÉ? 1428 00:54:17,360 --> 00:54:19,200 >>I HAD A SMALLER COMMENT. 1429 00:54:19,200 --> 00:54:22,320 THAT IS AS I LOOKED THROUGH THE 1430 00:54:22,320 --> 00:54:24,440 DOCUMENTATION THAT YOU SENT ONE 1431 00:54:24,440 --> 00:54:26,080 KEY LEADER GROUP THAT WAS NOT 1432 00:54:26,080 --> 00:54:28,080 MENTIONED THERE IS ANY KIND OF 1433 00:54:28,080 --> 00:54:30,920 PATIENT ADVOCACY OR 1434 00:54:30,920 --> 00:54:32,120 PATIENT-LIVED EXPERIENCE GROUPS 1435 00:54:32,120 --> 00:54:36,320 AND THINKING ABOUT INCLUDING 1436 00:54:36,320 --> 00:54:37,600 THOSE GROUPS AT SOME POINT WHERE 1437 00:54:37,600 --> 00:54:40,200 IT MAKES SENSE. THEY ARE END 1438 00:54:40,200 --> 00:54:41,960 USERS AND FOR IT TO WORK THEY 1439 00:54:41,960 --> 00:54:51,160 HAVE TO REALLY HAVE BUY-IN TOO. 1440 00:54:51,160 --> 00:54:53,400 >>I THINK YOU ARE ABSOLUTELY 1441 00:54:53,400 --> 00:54:55,440 RIGHT WE HAVE THINGS DUE AND 1442 00:54:55,440 --> 00:54:56,640 THINKING ABOUT ALL THAT AND HOW 1443 00:54:56,640 --> 00:55:00,480 IT ENDS UP FITTING TOGETHER AT 1444 00:55:00,480 --> 00:55:09,200 THE END. 1445 00:55:09,200 --> 00:55:11,160 >>ANY OTHER THOUGHTS OR 1446 00:55:11,160 --> 00:55:12,720 COMMENTS ABOUT THIS SPECIFIC 1447 00:55:12,720 --> 00:55:13,920 CONCEPT? 1448 00:55:13,920 --> 00:55:16,800 I THINK IF NOT WE CAN KIND OF 1449 00:55:16,800 --> 00:55:19,040 OPEN IT UP TO ALL OF THE FLOOR 1450 00:55:19,040 --> 00:55:22,200 THAT WE HEARD ABOUT. AND WE CAN 1451 00:55:22,200 --> 00:55:24,520 DISCUSS JUST KIND OF THE GENERAL 1452 00:55:24,520 --> 00:55:27,360 LEVEL OF ENTHUSIASM AND THOUGHTS 1453 00:55:27,360 --> 00:55:30,480 AND FEEDBACK ABOUT THIS GROUP OF 1454 00:55:30,480 --> 00:55:31,840 PROPOSED RESEARCH. 1455 00:55:31,840 --> 00:55:33,360 THERE IS COMMONALITIES 1456 00:55:33,360 --> 00:55:34,520 ESPECIALLY AT THE BEGINNING 1457 00:55:34,520 --> 00:55:37,000 AROUND POPULATIONS AND SOME 1458 00:55:37,000 --> 00:55:38,080 FACTORS THAT WE WANT TO 1459 00:55:38,080 --> 00:55:39,920 CONSIDER. IF YOU HAVE HIGHER 1460 00:55:39,920 --> 00:55:41,640 LEVEL FEEDBACK OR THOUGHTS NOW 1461 00:55:41,640 --> 00:55:52,160 WOULD BE THE TIME TO SHARE. 1462 00:55:58,440 --> 00:56:00,360 I HAD ONE COMMENT THAT I WANT 1463 00:56:00,360 --> 00:56:02,640 BEFORE WE LEFT THAT LAST CONCEPT 1464 00:56:02,640 --> 00:56:04,880 THAT IS ONE CHALLENGE HERE IS TO 1465 00:56:04,880 --> 00:56:09,040 TRY TO QUICKLY FOCUS ON A WAY OF 1466 00:56:09,040 --> 00:56:14,240 GETTING BUY-IN FOR US TO HAVE 1467 00:56:14,240 --> 00:56:16,440 SUSTAINED -- A SUSTAINED LEVEL 1468 00:56:16,440 --> 00:56:18,120 OF INTERACTION BETWEEN DECISION 1469 00:56:18,120 --> 00:56:20,560 MAKERS AND RESEARCHERS AND 1470 00:56:20,560 --> 00:56:22,520 BIGGEST PROBLEM HAPPENING WITH 1471 00:56:22,520 --> 00:56:25,400 RESOURCES IS THERE IS A 1472 00:56:25,400 --> 00:56:26,400 SHORT-TERM THING THAT IS 1473 00:56:26,400 --> 00:56:27,920 INTERESTING TO PEOPLE AND PEOPLE 1474 00:56:27,920 --> 00:56:29,400 HAVE NOT FOUND THEIR STRIDE YET 1475 00:56:29,400 --> 00:56:31,600 THEN IT GOES AWAY. I THINK JUST 1476 00:56:31,600 --> 00:56:38,040 AN EARLY FOCUS ON HOW TO SUSTAIN 1477 00:56:38,040 --> 00:56:39,400 INTERACTIONS BETWEEN RESEARCH 1478 00:56:39,400 --> 00:56:41,120 COMMUNITY AND DECISION MAKERS 1479 00:56:41,120 --> 00:56:43,640 OVER TIME TO -- TO FIND THE 1480 00:56:43,640 --> 00:56:46,040 PARTNERS WHO ARE REALLILE TO 1481 00:56:46,040 --> 00:56:48,520 COMMIT TO A LONGER TERM AND HELP 1482 00:56:48,520 --> 00:56:51,480 TO CREATE, YOU KNOW, RESOURCES 1483 00:56:51,480 --> 00:56:52,960 FOR A LONGER TERM INTERACTION 1484 00:56:52,960 --> 00:56:56,400 WILL BE IMPORTANT IN TERMS OF 1485 00:56:56,400 --> 00:56:59,200 GETTING SUCCESS WOW LIKE TO SEE 1486 00:56:59,200 --> 00:57:02,440 FROM THIS INTERACTION. 1487 00:57:02,440 --> 00:57:07,440 IT WILL TAKE LONGER TERM 1488 00:57:07,440 --> 00:57:11,000 COMMITMENT TO IT. THERE WILL BE 1489 00:57:11,000 --> 00:57:12,800 PARTNERS WHO WILL BE VERY MUCH 1490 00:57:12,800 --> 00:57:16,360 INTERESTED IN CONTRIBUTING TO 1491 00:57:16,360 --> 00:57:17,600 LONGER TERM COMMITMENT. THEY 1492 00:57:17,600 --> 00:57:20,120 HAVE TO BE ENGAGED EARLY ON AND 1493 00:57:20,120 --> 00:57:21,640 LOT OF STRATEGIES FOR DOING 1494 00:57:21,640 --> 00:57:25,120 THAT. I THINK IT WILL BE A 1495 00:57:25,120 --> 00:57:28,880 CRITICAL PART OF MAKING THIS 1496 00:57:28,880 --> 00:57:30,760 SUCCESSFUL IS A LONGER TERM 1497 00:57:30,760 --> 00:57:31,040 COMMITMENT. 1498 00:57:31,040 --> 00:57:33,000 >>THANK YOU. WE WILL 1499 00:57:33,000 --> 00:57:34,000 DEFINITELY GIVE IT THOUGHT ABOUT 1500 00:57:34,000 --> 00:57:39,000 HOW TO MAKE IT HAPPEN. 1501 00:57:39,000 --> 00:57:41,680 >>I HAVE A QUICK COMMENT TO 1502 00:57:41,680 --> 00:57:43,960 JUST APPLAUD ALL OF YOU ON THIS 1503 00:57:43,960 --> 00:57:45,960 WORK AND HAVING COURAGE TO TAKE 1504 00:57:45,960 --> 00:57:47,320 THAT TRANSLATIONAL STEP 1505 00:57:47,320 --> 00:57:49,800 BEGINNING TO TACKLE SOME MAJOR 1506 00:57:49,800 --> 00:57:53,360 SYSTEMIC SYSTEMATIC ISSUES TO BE 1507 00:57:53,360 --> 00:57:54,960 ADDRESSED AND CAN'T WAIT FOR 1508 00:57:54,960 --> 00:57:56,960 PAIN SPACE TO GET HERE AS WELL A 1509 00:57:56,960 --> 00:57:58,520 LITTLE BIT. HOPEFULLY IF YOU 1510 00:57:58,520 --> 00:58:00,040 CAN TACKLE THIS AND KNOCK DOWN 1511 00:58:00,040 --> 00:58:03,560 SOME BARRIERS WE CAN LEARN FROM 1512 00:58:03,560 --> 00:58:05,960 YOU AND THANK YOU SO MUCH FOR 1513 00:58:05,960 --> 00:58:08,360 DOING THIS VERY HARD WORK THAT 1514 00:58:08,360 --> 00:58:10,400 HAS A HEAVY LIFT. 1515 00:58:10,400 --> 00:58:12,200 >>EXACTLY THE SAME THOUGHT AND 1516 00:58:12,200 --> 00:58:13,680 DEFINITELY IN THE PAIN SPACE. 1517 00:58:13,680 --> 00:58:15,240 >>THANK YOU FOR THAT COMMENT. 1518 00:58:15,240 --> 00:58:17,520 WE CAN CERTAINLY LOOK FOR, YOU 1519 00:58:17,520 --> 00:58:19,240 KNOW, THIS IS SOMETHING THAT WE 1520 00:58:19,240 --> 00:58:23,480 CAN LOOK FOR CONNECTION POINTS. 1521 00:58:23,480 --> 00:58:25,520 >>I GUESS I PUT THE QUESTION IN 1522 00:58:25,520 --> 00:58:29,000 THE CHAT. IT MAY SEEM ALMOST 1523 00:58:29,000 --> 00:58:29,320 RHETORICAL. 1524 00:58:29,320 --> 00:58:32,120 BUT, WHAT THE ISSUE OF PAIN 1525 00:58:32,120 --> 00:58:34,360 OBVIOUSLY IS WHAT CAUGHT MY 1526 00:58:34,360 --> 00:58:34,680 ATTENTION. 1527 00:58:34,680 --> 00:58:36,480 SO, I'M WONDERING TO WHAT EXTENT 1528 00:58:36,480 --> 00:58:38,480 THERE IS A CHICKEN AND EGG THING 1529 00:58:38,480 --> 00:58:40,360 HAPPENING HERE. YOU HAVE AN 1530 00:58:40,360 --> 00:58:41,960 INDIVIDUAL WITH A PAIN PROBLEM 1531 00:58:41,960 --> 00:58:44,240 WHO THEN IS EITHER TAKING OP 1532 00:58:44,240 --> 00:58:47,120 OPIATES OR USING ALCOHOL AND 1533 00:58:47,120 --> 00:58:51,240 THEY HAVE ALCOHOL AND BECOME OR 1534 00:58:51,240 --> 00:58:51,960 MISUSE ALCOHOL AND PAIN 1535 00:58:51,960 --> 00:58:53,000 CONDITION DEVELOPS. 1536 00:58:53,000 --> 00:58:56,000 THEN THE FACTOR OF ANL. 1537 00:58:56,000 --> 00:58:58,480 AN ADULT WITH A PAIN PROBLEM 1538 00:58:58,480 --> 00:59:01,040 BECAUSE THEY ARE AN ADULT 1539 00:59:01,040 --> 00:59:02,960 OPPOSED TO A KID. I'M TALKING 1540 00:59:02,960 --> 00:59:06,080 ABOUT A TEENANLER. 1541 00:59:06,080 --> 00:59:12,760 SO, IS -- IS PAIN SECONDARY TO 1542 00:59:12,760 --> 00:59:14,040 USE OF THE DRUG? 1543 00:59:14,040 --> 00:59:18,160 IS IT INDEPENDENT AND TWO 1544 00:59:18,160 --> 00:59:20,840 ENHANCE EACH OTHER OR IS THAT 1545 00:59:20,840 --> 00:59:22,600 KNOWN OR EXAMINED? 1546 00:59:22,600 --> 00:59:24,400 >> YEAH. THAT IS KNOWN. I 1547 00:59:24,400 --> 00:59:26,400 MEAN, I THINK THERE IS A LOT OF 1548 00:59:26,400 --> 00:59:28,040 WORK THAT HAS BEEN PUBLISHED NOW 1549 00:59:28,040 --> 00:59:30,280 FOR MANY YEARS THAT HAVE 1550 00:59:30,280 --> 00:59:33,480 INITIALLY INDICATED MUCH HIGHER 1551 00:59:33,480 --> 00:59:34,680 PREVALENCE OF PAIN AMONG 1552 00:59:34,680 --> 00:59:36,600 INDIVIDUALS WITH VARIOUS CLASSES 1553 00:59:36,600 --> 00:59:38,760 OF SUBSTANCE USE DISORDERS AND 1554 00:59:38,760 --> 00:59:40,560 RESEARCHERS HAVE ACTUALLY BEEN 1555 00:59:40,560 --> 00:59:41,720 LOOKING AT WHETHER IN FACT 1556 00:59:41,720 --> 00:59:44,960 ANIMAL MODELS OF PAIN ADDING FOR 1557 00:59:44,960 --> 00:59:46,360 EXAMPLE ALCOHOL THAT MAYBE HAS 1558 00:59:46,360 --> 00:59:49,320 BEEN ONE THAT IS INVESTIGATED OR 1559 00:59:49,320 --> 00:59:51,480 STIMULANT DRUGS THAT CAN 1560 00:59:51,480 --> 00:59:53,200 EXACERBATE IT. AS YOU KNOW AND 1561 00:59:53,200 --> 00:59:55,120 ARE MENTIONING CERTAINLY WITH 1562 00:59:55,120 --> 00:59:58,840 OPIOIDS THAT YOU HAVE THE 1563 00:59:58,840 --> 01:00:03,480 EMERGENCE OF I PARAGEEZ YA AND 1564 01:00:03,480 --> 01:00:05,960 FROM THE PERSPECTIVE OF NEUROBUY 1565 01:00:05,960 --> 01:00:08,320 OL, THERE IS RESEARCH IT THAT IS 1566 01:00:08,320 --> 01:00:09,800 TRYING TO UNDERSTAND AND HOW IS 1567 01:00:09,800 --> 01:00:12,640 IT THAT DRUGS MAY BE 1568 01:00:12,640 --> 01:00:14,400 ACCELERATING THE PROCESS OF PAIN 1569 01:00:14,400 --> 01:00:17,240 FROM THE PERSPECTIVE OF 1570 01:00:17,240 --> 01:00:18,320 NEUROPLASTICITY IS EXTREMELY 1571 01:00:18,320 --> 01:00:20,360 INTERESTING AS YOU LOOK FOR 1572 01:00:20,360 --> 01:00:22,800 EXAMPLE AT TRANSITION FROM ACUTE 1573 01:00:22,800 --> 01:00:25,720 TO CHRONIC PAIN AND WHERE YOU NO 1574 01:00:25,720 --> 01:00:27,560 LONGER HAVE TRAUMA OF PAIN THAT 1575 01:00:27,560 --> 01:00:29,840 IS ALREADY IN PRESENCE. WE ARE 1576 01:00:29,840 --> 01:00:32,160 FUNTDING RESEARCHERS TO LOOK AT 1577 01:00:32,160 --> 01:00:33,600 WHETHER ONE EFFECT OF DRUGS THAT 1578 01:00:33,600 --> 01:00:37,360 IS TO ACTUALLY ACTIVATE 1579 01:00:37,360 --> 01:00:40,960 NEUROAXIS COULD BE A MECHANISM 1580 01:00:40,960 --> 01:00:42,600 THAT ACCELERATE TRANSITION. 1581 01:00:42,600 --> 01:00:44,800 THAT IS A EXAMPLE OF THE SCIENCE 1582 01:00:44,800 --> 01:00:48,720 FROM THE NEUROSCIENCE 1583 01:00:48,720 --> 01:00:59,160 PERSPECTIVE. BUT, IT -- 1584 01:01:01,040 --> 01:01:02,800 PEOPLE THAT HAVE TAKEN DRUGS END 1585 01:01:02,800 --> 01:01:04,400 UP WITH PAIN BECAUSE OF THE 1586 01:01:04,400 --> 01:01:08,520 EFFECT OF DRUGS OR THE LIFESTYLE 1587 01:01:08,520 --> 01:01:15,160 THAT PUTS YOU -- TO PAIN. SO, 1588 01:01:15,160 --> 01:01:18,120 BUT IT IS A FUNDAMENTAL ONE AND 1589 01:01:18,120 --> 01:01:19,520 INTERESTINGLY ONE THAT IS NOT 1590 01:01:19,520 --> 01:01:23,280 NECESSARILY AT ALL RECOGNIZED BY 1591 01:01:23,280 --> 01:01:25,640 CLINICIANS AND THAT VERY CLOSE 1592 01:01:25,640 --> 01:01:27,160 INTERACTIONS BETWEEN PAIN AND 1593 01:01:27,160 --> 01:01:28,800 SUBSTANCE USE DISORDERS AND BY 1594 01:01:28,800 --> 01:01:31,400 THE WAY ALSO MENTAL ILLNESS THAT 1595 01:01:31,400 --> 01:01:33,120 IS PARTICULARLY MOOD DISORDERS 1596 01:01:33,120 --> 01:01:37,080 AND HIGH, HIGH PREVALENCE OF 1597 01:01:37,080 --> 01:01:37,720 PAIN. 1598 01:01:37,720 --> 01:01:39,040 >>THANK YOU. 1599 01:01:39,040 --> 01:01:42,000 >>GAIL, WOULD YOU ADD TO THAT? 1600 01:01:42,000 --> 01:01:44,040 >>ACTUALLY, NORA JUST SAID TO 1601 01:01:44,040 --> 01:01:47,920 ME THAT PAIN IS THE MENTAL 1602 01:01:47,920 --> 01:01:49,440 HEALTH DISEASE THAT WE SEE MOST 1603 01:01:49,440 --> 01:01:52,000 OFTEN. WE OBVIOUSLY SEE PEOPLE 1604 01:01:52,000 --> 01:01:53,920 WHO HAVE PAIN AND USED 1605 01:01:53,920 --> 01:01:55,680 POPULATION OF HOMELESS 1606 01:01:55,680 --> 01:01:56,760 INDIVIDUALS THAT ARE OUTSIDE OF 1607 01:01:56,760 --> 01:01:59,960 THE -- ALL KINDS OF INJURES, ET 1608 01:01:59,960 --> 01:02:01,880 CETERA, THAT MAKES A MESS, 1609 01:02:01,880 --> 01:02:04,080 ACTUALLY, IN TRYING TO DEAL WITH 1610 01:02:04,080 --> 01:02:05,920 ALL THEIR ISSUES AND MENTAL 1611 01:02:05,920 --> 01:02:08,640 HEALTH ISSUES ARE BY FAR 1612 01:02:08,640 --> 01:02:11,600 OUTWEIGHING THE PHYSICAL PAIN 1613 01:02:11,600 --> 01:02:14,120 THAT WE SEE. 1614 01:02:14,120 --> 01:02:16,120 IT IS NOT JUST THE TYPICAL 1615 01:02:16,120 --> 01:02:18,680 MENTAL HEALTH THAT ONE WOULD 1616 01:02:18,680 --> 01:02:21,720 THINK BUT IS DESPAIR AND 1617 01:02:21,720 --> 01:02:23,520 COGNITIVE DELAYS THAT OFTEN 1618 01:02:23,520 --> 01:02:25,960 CHILDREN HAVE FOR A VARIETY OF 1619 01:02:25,960 --> 01:02:28,960 DIFFERENT REASONS OR ADHD OR 1620 01:02:28,960 --> 01:02:30,880 DELAYS AND THERE IN THE STREET 1621 01:02:30,880 --> 01:02:32,960 AND THEY GET TAKEN OVER BY THE 1622 01:02:32,960 --> 01:02:36,000 -- WHATEVER. 1623 01:02:36,000 --> 01:02:39,960 SO, TO TRULY NEVER SEEN SUCH A 1624 01:02:39,960 --> 01:02:42,600 MESS AND I DON'T MEAN TO BE 1625 01:02:42,600 --> 01:02:45,560 PESSIMISTIC. I HAVE NEVER SEEN 1626 01:02:45,560 --> 01:02:48,400 SO MUCH MENTAL DISEASE OR MANY 1627 01:02:48,400 --> 01:02:51,880 MENTAL HEALTH DISEASE OR DESPAIR 1628 01:02:51,880 --> 01:02:54,360 ACTUALLY IN 30-SOME YEARS IN 1629 01:02:54,360 --> 01:02:56,160 WORKING IN MRNL DEPARTMENTS THAT 1630 01:02:56,160 --> 01:02:57,280 ARE HAPPENING NOW. 1631 01:02:57,280 --> 01:02:59,400 FIXES, YEAH. I CAN GIVE YOU 1632 01:02:59,400 --> 01:03:01,520 MEDICATIONS TO DO IT. I CAN'T 1633 01:03:01,520 --> 01:03:02,640 FIX THE REST. 1634 01:03:02,640 --> 01:03:06,760 THAT IS WHERE WE REALLY -- WE 1635 01:03:06,760 --> 01:03:09,720 ARE REALLY FALLING DOWN ON. 1636 01:03:09,720 --> 01:03:11,680 BECAUSE EVEN WHERE I AM IN NEW 1637 01:03:11,680 --> 01:03:13,480 HAVEN AND YOU THINK I WOULD HAVE 1638 01:03:13,480 --> 01:03:15,560 RESOURCES FOR MENTAL HEALTH, I 1639 01:03:15,560 --> 01:03:16,840 DON'T. I HAVE A [INDISCERNIBLE] 1640 01:03:16,840 --> 01:03:19,080 FULL OF PATIENTS JUST SITTING 1641 01:03:19,080 --> 01:03:20,880 THERE DAY AFTER DAY. ALL WE DO 1642 01:03:20,880 --> 01:03:24,480 IS SAY OKAY. THEY ARE NO LONGER 1643 01:03:24,480 --> 01:03:28,240 SUICIDAL. THIS AIS IT, 1644 01:03:28,240 --> 01:03:28,920 ESSENTIALLY. 1645 01:03:28,920 --> 01:03:31,480 I WAS GOING TO SAY AS WELL 1646 01:03:31,480 --> 01:03:33,800 MENTAL HEALTH ISSUES ASSOCIATED 1647 01:03:33,800 --> 01:03:35,640 WITH THIS HAVE TO BE ADDRESSED 1648 01:03:35,640 --> 01:03:37,960 AND OTHER COMMENT ON THIS IS 1649 01:03:37,960 --> 01:03:39,680 RESOURCE NETWORKS IN ADVANCING 1650 01:03:39,680 --> 01:03:41,600 AND THERE IS LOTS OF MONEY THAT 1651 01:03:41,600 --> 01:03:44,080 SAMHSA GIVES AWAY TO STATES AND 1652 01:03:44,080 --> 01:03:46,360 LOTS OF STATE-FUNDED THINGS BUT 1653 01:03:46,360 --> 01:03:47,320 NONE OF THEM STAY. 1654 01:03:47,320 --> 01:03:50,120 WE REALLY HAVE TO MAKE SURE THAT 1655 01:03:50,120 --> 01:03:51,880 WHOEVER IS GETTING THIS MONEY 1656 01:03:51,880 --> 01:03:53,200 HAS A DIRECT REASON THAT THEY 1657 01:03:53,200 --> 01:03:55,600 WILL BE ABLE TO BE SUSTAINABLE 1658 01:03:55,600 --> 01:03:57,560 AND THEY HAVE TO GET THAT OKAY. 1659 01:03:57,560 --> 01:04:00,520 I DO FIND THOUGH THAT ONCE YOU 1660 01:04:00,520 --> 01:04:02,760 GET THE MONEY, I KEEP A SCRAP 1661 01:04:02,760 --> 01:04:05,000 BOOK OR TELL EVERYBODY TO KEEP 1662 01:04:05,000 --> 01:04:06,600 SCRAP BOOKS. IT IS NOT RESEARCH 1663 01:04:06,600 --> 01:04:09,120 BUT ACTUALLY GOING OUT TO 1664 01:04:09,120 --> 01:04:11,000 ADVOCACY GROUPS AND IT IS 1665 01:04:11,000 --> 01:04:12,560 TEACHING EVERYBODY IN THE 1666 01:04:12,560 --> 01:04:15,200 HOSPITAL AND I ASK CERTAIN MEDIA 1667 01:04:15,200 --> 01:04:16,680 REPRESENTATIVES FOR PEOPLE IN 1668 01:04:16,680 --> 01:04:18,600 NEW HAVEN WOULD YOU RUN AN 1669 01:04:18,600 --> 01:04:19,800 ARTICLE ON THIS SO WE CAN SHOW 1670 01:04:19,800 --> 01:04:23,720 WHAT WE ARE DOING. WE ARE 1671 01:04:23,720 --> 01:04:24,680 CONSTANTLY FROM THE VERY 1672 01:04:24,680 --> 01:04:26,000 BEGINNING REALIZING THAT WE HAVE 1673 01:04:26,000 --> 01:04:28,320 TO KEEP THIS GOING SO NO ONE 1674 01:04:28,320 --> 01:04:30,480 WILL TAKE THESE RESOURCES AWAY. 1675 01:04:30,480 --> 01:04:32,240 TOO OFTEN I HEAR ALL OVER THE 1676 01:04:32,240 --> 01:04:34,160 PLACE THAT THESE SERVICES WILL 1677 01:04:34,160 --> 01:04:36,320 BE SHUT DOWN BECAUSE FUNDING IS 1678 01:04:36,320 --> 01:04:37,120 OVER. 1679 01:04:37,120 --> 01:04:39,400 I THINK THAT WE HAVE TO DO A 1680 01:04:39,400 --> 01:04:41,120 BETTER JOB SAYING NO YOU WON'T 1681 01:04:41,120 --> 01:04:43,520 GET FUNDING TO BEGIN 1LESS YOU 1682 01:04:43,520 --> 01:04:47,920 GIVE ME A PLAN HOW THIS WILL 1683 01:04:47,920 --> 01:04:50,800 MOVE FORWARD. 1684 01:04:50,800 --> 01:04:53,400 >>THOSE ARE VERY GREAT POINTS, 1685 01:04:53,400 --> 01:04:55,760 GAIL. TAKING US TO EARLIER 1686 01:04:55,760 --> 01:04:57,160 POINTS AROUND SUSTAINABILITY AND 1687 01:04:57,160 --> 01:04:59,200 THINK THAT ONE OF THE REASONS 1688 01:04:59,200 --> 01:05:02,840 WHY, YOU KNOW, WE INCLUDED SSD 1689 01:05:02,840 --> 01:05:03,920 LEADERS AND PEOPLE THAT WE 1690 01:05:03,920 --> 01:05:05,160 THOUGHT ABOUT THAT REGARDLESS 1691 01:05:05,160 --> 01:05:06,920 WHAT THEIR RESOURCES ARE 1692 01:05:06,920 --> 01:05:08,520 ULTIMATELY ROLE IS HOW YOU 1693 01:05:08,520 --> 01:05:10,360 ALLOCATE WHAT RESOURCES ARE 1694 01:05:10,360 --> 01:05:11,560 AVAILABLE THAT I THINK WOULD 1695 01:05:11,560 --> 01:05:14,120 HELP THAT APPROACH WOULD HELP 1696 01:05:14,120 --> 01:05:16,280 ADDRESS SUSTAINABILITY EVEN AS 1697 01:05:16,280 --> 01:05:18,720 SOURCE OF THE RESOURCES CHANGES 1698 01:05:18,720 --> 01:05:20,560 OR AS IT GOES UP OR DOWN THESE 1699 01:05:20,560 --> 01:05:22,200 ARE PEOPLE THAT HAVE TO DECIDE 1700 01:05:22,200 --> 01:05:25,320 HOW IT WILL ALLOCATE WHAT IS 1701 01:05:25,320 --> 01:05:27,200 AVAILABLE AND THINK IT IS WHY WE 1702 01:05:27,200 --> 01:05:28,880 THOUGHT IT WAS IMPORTANT TO 1703 01:05:28,880 --> 01:05:31,880 TARGET THAT PARTICULAR KIND OF 1704 01:05:31,880 --> 01:05:37,480 RO 1705 01:05:37,480 --> 01:05:37,680 ROLE. 1706 01:05:37,680 --> 01:05:38,360 >>WELL, TERRIFIC DISCUSSION. 1707 01:05:38,360 --> 01:05:40,880 THANK YOU, TISHA AND WENDY AND 1708 01:05:40,880 --> 01:05:42,760 TO THE DISCUSSANTS AND TO 1709 01:05:42,760 --> 01:05:45,040 EVERYONE WHO JOINED. THIS IS A 1710 01:05:45,040 --> 01:05:46,280 REALLY EXCITING PART. IF YOU 1711 01:05:46,280 --> 01:05:47,600 CAN SEE THE REALLY INTERESTING 1712 01:05:47,600 --> 01:05:50,120 AND IMPORTANT WAYS THAT IT 1713 01:05:50,120 --> 01:05:52,320 CONTINUES TO EVOLVE RELEVANT TO 1714 01:05:52,320 --> 01:05:54,320 THE MENTAL HEALTH ISSUES THAT 1715 01:05:54,320 --> 01:05:56,560 GAIL AND OTHERS JUST RAISED. 1716 01:05:56,560 --> 01:05:58,440 WE CAN MOVE TO THE NEXT SECTION 1717 01:05:58,440 --> 01:06:01,400 OF THE AGENDA AND WE HELD OUR 1718 01:06:01,400 --> 01:06:01,960 DISCUSSION 1719 01:06:01,960 --> 01:06:04,040 ONE MORE SLIDE, PLEASE. 1720 01:06:04,040 --> 01:06:08,280 WE FOCUS ON RESEARCH TO DEVELOP 1721 01:06:08,280 --> 01:06:11,880 NEW STRATEGIES TO PREVENT AND 1722 01:06:11,880 --> 01:06:15,080 TREAT OPIOID ABUSE ADDICTION AND 1723 01:06:15,080 --> 01:06:17,120 DISORDER AND HAVE ON BEHALF OF 1724 01:06:17,120 --> 01:06:20,240 NATIONAL INSTITUTE OF MENTAL 1725 01:06:20,240 --> 01:06:23,000 HEALTH DR. ALEX WHO WILL WALK US 1726 01:06:23,000 --> 01:06:25,280 THROUGH CONCEPTS PROPOSED BY THE 1727 01:06:25,280 --> 01:06:27,000 TEAM AND JUST MAKE A QUICK 1728 01:06:27,000 --> 01:06:28,800 STATEMENT THAT SOME OF THESE ARE 1729 01:06:28,800 --> 01:06:31,840 TRIALS TO BE RUN THROUGH THE 1730 01:06:31,840 --> 01:06:33,920 NIDA CLINICAL TRIALS NETWORK. I 1731 01:06:33,920 --> 01:06:36,360 ASK THOSE ON THE 1732 01:06:36,360 --> 01:06:37,960 MULTI-DISCIPLINARY WORKING GROUP 1733 01:06:37,960 --> 01:06:39,360 ASSOCIATED WITH THAT NETWORK TO 1734 01:06:39,360 --> 01:06:42,280 BE AWARE OF THAT AS YOU 1735 01:06:42,280 --> 01:06:43,280 PARTICIPATE IN THE DISCUSSION 1736 01:06:43,280 --> 01:06:45,480 AND ANY POTENTIAL CONFLICTS 1737 01:06:45,480 --> 01:06:48,640 THERE. NEXT SLIDE, PLEASE. 1738 01:06:48,640 --> 01:06:50,720 HERE, WE HAVE, AGAIN, THIS 1739 01:06:50,720 --> 01:06:53,280 VISUAL DEPICTION OF RESEARCH 1740 01:06:53,280 --> 01:06:55,360 UNDERWAY THROUGH THIS ASPECT OF 1741 01:06:55,360 --> 01:06:58,720 HEAL. THE MANY, MANY, MANY 1742 01:06:58,720 --> 01:07:01,040 TRIALS BEING RUN THROUGH NIDA 1743 01:07:01,040 --> 01:07:03,120 CLINICAL TRIALS NETWORK AND 1744 01:07:03,120 --> 01:07:04,840 FOCUS ON MENTAL HEALTH STARTING 1745 01:07:04,840 --> 01:07:07,680 AT THE VERY BEGINNING IN TERMS 1746 01:07:07,680 --> 01:07:09,960 OF MODELS OF CARE. 1747 01:07:09,960 --> 01:07:11,640 ALSO, INVOLVEMENT OF OTHER 1748 01:07:11,640 --> 01:07:14,040 ASPECTS OF PERSON'S HEALTH 1749 01:07:14,040 --> 01:07:15,520 INCLUDING SLEEP AND SOCIAL 1750 01:07:15,520 --> 01:07:17,000 DETERMINANTS AND AT VERY BOTTOM 1751 01:07:17,000 --> 01:07:19,240 HERE, YOU CAN SEE WHAT HAS BEEN 1752 01:07:19,240 --> 01:07:21,680 PUT FORWARD OR PROPOSED BY THE 1753 01:07:21,680 --> 01:07:23,760 TEAM FOR FUTURE RESEARCH 1754 01:07:23,760 --> 01:07:28,120 STARTING IN FISCAL YEAR 2024. 1755 01:07:28,120 --> 01:07:32,200 THERE IS FOUR DIFFERENT STUDIES 1756 01:07:32,200 --> 01:07:33,720 THAT WILL BE DISCUSSED. WITH 1757 01:07:33,720 --> 01:07:36,200 THAT, TURNING IT TO YOU, ALEX. 1758 01:07:36,200 --> 01:07:38,400 THANKS FOR BEING OUR LEADER 1759 01:07:38,400 --> 01:07:38,600 TODAY. 1760 01:07:38,600 --> 01:07:41,320 >>THANK YOU, REBEKAH. 1761 01:07:41,320 --> 01:07:44,760 >>REBEKAH, I'M ACTUALLY AN 1762 01:07:44,760 --> 01:07:46,240 INVESTIGATOR ON TWO OF THESE. 1763 01:07:46,240 --> 01:07:49,040 PUTTING ME IN A WAITING ROOM OR 1764 01:07:49,040 --> 01:07:49,360 SOMETHING? 1765 01:07:49,360 --> 01:07:51,360 >>NO. THANKS FOR DISCLOSING 1766 01:07:51,360 --> 01:07:53,960 THAT. I THINK WITH HAVING 1767 01:07:53,960 --> 01:07:55,880 DISCLOSURE POTENTIAL CONFLICT I 1768 01:07:55,880 --> 01:07:57,080 THINK AS LONG AS THE GROUP IS 1769 01:07:57,080 --> 01:07:58,920 AWARE OF THAT YOU ARE ALLOWED TO 1770 01:07:58,920 --> 01:08:00,520 PARTICIPATE IN THE DISCUSSION. 1771 01:08:00,520 --> 01:08:02,360 IT IS ALL OPEN SO EVERYONE 1772 01:08:02,360 --> 01:08:02,920 HEARS. 1773 01:08:02,920 --> 01:08:04,600 >>OKAY. JUST FOR THE GROUP, 1774 01:08:04,600 --> 01:08:08,600 I'M AN INVESTIGATOR ON THE FIRST 1775 01:08:08,600 --> 01:08:13,120 TWO BEING OPPOSED JUST SO 1776 01:08:13,120 --> 01:08:13,880 EVERYBODY KNOWS. 1777 01:08:13,880 --> 01:08:15,640 >>GREAT. I DON'T KNOW IF I'M 1778 01:08:15,640 --> 01:08:18,360 ONE AND THIS IS ONE WE HAVE 1779 01:08:18,360 --> 01:08:20,840 WORKED WITH KRISTEN ON EMS AND 1780 01:08:20,840 --> 01:08:22,480 WE HAVEN'T OFFICIALLY SUBMITTED 1781 01:08:22,480 --> 01:08:25,600 IT YET AND IF IT IS I AM WORKING 1782 01:08:25,600 --> 01:08:29,320 WITH EMS PROPOSAL WITH NIDA AND 1783 01:08:29,320 --> 01:08:30,760 ALSO WITH PRIOR MAYBE ONES THAT 1784 01:08:30,760 --> 01:08:34,760 WILL BE DONE BY 2023 IF WE 1785 01:08:34,760 --> 01:08:36,960 DISCUSS THAT. 1786 01:08:36,960 --> 01:08:40,720 >>THANK YOU FOR YOUR 1787 01:08:40,720 --> 01:08:41,320 TRANSPARENCY. 1788 01:08:41,320 --> 01:08:44,080 >>I WOULDN'T HAVE SAID IT 1789 01:08:44,080 --> 01:08:46,240 BETTER MYSELF, REBEKAH. THANKS 1790 01:08:46,240 --> 01:08:48,520 FOR BEING HERE AND LISTENING AND 1791 01:08:48,520 --> 01:08:49,840 WALKING YOU THROUGH FOUR 1792 01:08:49,840 --> 01:08:51,160 CONCEPTS TODAY. 1793 01:08:51,160 --> 01:08:52,600 AUTHORS OF THE CONCEPTS ARE ALSO 1794 01:08:52,600 --> 01:08:55,080 IN ATTENDANCE HERE TODAY. 1795 01:08:55,080 --> 01:08:57,680 THEY ARE USUAL CT EXPERT AND 1796 01:08:57,680 --> 01:09:00,680 COLEADER IS NOT AVAILABLE TODAY. 1797 01:09:00,680 --> 01:09:04,400 I HAVE A PINCH HITTING AND I'M 1798 01:09:04,400 --> 01:09:05,280 GRATEFUL TO EXTRA EXPERTISE WE 1799 01:09:05,280 --> 01:09:08,440 HAVE HERE AVAILABLE FOR THIS 1800 01:09:08,440 --> 01:09:09,040 MEETING. 1801 01:09:09,040 --> 01:09:13,040 ON THIS SLIDE ARE CTM STUDIES WE 1802 01:09:13,040 --> 01:09:15,080 HAVE THROUGH HEAL AND TOO MANY 1803 01:09:15,080 --> 01:09:17,200 TO RUN DOWN AND TELLING YOU ONES 1804 01:09:17,200 --> 01:09:19,320 WITH GREEN DOTS ARE ACTIVELY 1805 01:09:19,320 --> 01:09:21,920 COLLECTING DATA NOW. ORANGE 1806 01:09:21,920 --> 01:09:24,040 DOTS REPRESENT PREIMPLEMENTATION 1807 01:09:24,040 --> 01:09:26,640 AND BLACK DOTS MEAN DATA 1808 01:09:26,640 --> 01:09:28,080 COLLECTION IS COMPLETE AND THAT 1809 01:09:28,080 --> 01:09:32,320 DATA ANALYSIS IS CURRENTLY 1810 01:09:32,320 --> 01:09:34,040 UNDERWAY. NEXT SLIDE, PLEASE. 1811 01:09:34,040 --> 01:09:36,120 I WILL WALK YOU THROUGH WAY THAT 1812 01:09:36,120 --> 01:09:38,800 TEAM RANKED THROUGH CONCEPT AND 1813 01:09:38,800 --> 01:09:41,040 SCORES REPRESENT CO-CHAIR 1814 01:09:41,040 --> 01:09:43,160 PRIORITY RANKINGS AND ONE BEING 1815 01:09:43,160 --> 01:09:46,200 HIGHEST TWO MEDIUM AND 3 LOW 1816 01:09:46,200 --> 01:09:48,000 WITH LOWEST SCORE REPRESENTING 1817 01:09:48,000 --> 01:09:50,000 HIGHER PRIORITY AND MANY A** 1818 01:09:50,000 --> 01:09:51,520 SPEBLTHS OF STUDIES WILL BE 1819 01:09:51,520 --> 01:09:54,200 DISCUSSED AND WORKED OUT DURING 1820 01:09:54,200 --> 01:09:55,320 PROTOCOL DEVELOPMENT PROCESS AND 1821 01:09:55,320 --> 01:09:57,720 ONCE DEVELOPED IT WILL HAVE 1822 01:09:57,720 --> 01:10:00,440 INDEPENDENT REVIEW BY PROTOCOL 1823 01:10:00,440 --> 01:10:02,640 REVIEW BOARD AND WILL INCLUDE 1824 01:10:02,640 --> 01:10:04,280 DISCUSSIONS FOR GROUP MEMBERS 1825 01:10:04,280 --> 01:10:06,080 AFTER EACH CONCEPT AND WE WILL 1826 01:10:06,080 --> 01:10:08,480 HAVE TIME TO TAKE A SIMILAR 1827 01:10:08,480 --> 01:10:10,960 APPROACH THAT TISHA AND WENDY 1828 01:10:10,960 --> 01:10:13,560 DID AND IF NOT I WILL BE HAPPY 1829 01:10:13,560 --> 01:10:15,840 TO WALK THROUGH THEM AND FULL 1830 01:10:15,840 --> 01:10:18,240 SLIDE DECK AND CONCEPTS ARE HERE 1831 01:10:18,240 --> 01:10:20,920 TO HELP ME FIELD QUESTIONS TOO. 1832 01:10:20,920 --> 01:10:22,800 NEXT SLIDE, PLEASE. 1833 01:10:22,800 --> 01:10:24,800 TO START WITH IMPLEMENTATION TO 1834 01:10:24,800 --> 01:10:28,120 FAS ILL ENGAGEMENT IN DETOX 1835 01:10:28,120 --> 01:10:30,320 SETTINGS. HEAL INITIATIVE IS 1836 01:10:30,320 --> 01:10:32,480 IMPROVING MOUD IN VARIETY OF 1837 01:10:32,480 --> 01:10:34,000 SETTINGS SUCH AS PRIMARY CARE 1838 01:10:34,000 --> 01:10:39,240 AND ED AND JUSTICE SYSTEM AND 1839 01:10:39,240 --> 01:10:45,720 MAIN STAYS ODEM CONTRIB TUM -- 1840 01:10:45,720 --> 01:10:47,360 LINKAGE AND ASSOCIATION TO 1841 01:10:47,360 --> 01:10:50,400 TREATMENT AND BARELY OCCURS LESS 1842 01:10:50,400 --> 01:10:53,480 THAN 1 OUT OF 5OUD PATIENTS 1843 01:10:53,480 --> 01:10:57,320 RECEIVE -- THIS IS TO CLOSE GAP 1844 01:10:57,320 --> 01:10:58,600 INCREASING INFORMATION AND LINK 1845 01:10:58,600 --> 01:11:00,280 RAGE TO TREATMENT IN DETOX 1846 01:11:00,280 --> 01:11:02,360 SETTINGS AND PROPOSED CONCEPT 1847 01:11:02,360 --> 01:11:04,280 BUILDS ON EXPERIENCE OF 1848 01:11:04,280 --> 01:11:08,800 MATERIALS IN SCTNWDF TRIAL AND 1849 01:11:08,800 --> 01:11:11,240 ADAPTING SHARED DECISION MAKING 1850 01:11:11,240 --> 01:11:13,680 TOOLKIT AND EMPLOY STANDARD 1851 01:11:13,680 --> 01:11:15,880 IMPLEMENTATION STRATEGY SUCH AS 1852 01:11:15,880 --> 01:11:19,280 LOCAL SITE NEEDS ASSESSMENTS TO 1853 01:11:19,280 --> 01:11:21,600 INCREASE LINKAGE TO DETOX 1854 01:11:21,600 --> 01:11:23,360 SETTINGS AND STUDIES CONSISTING 1855 01:11:23,360 --> 01:11:25,880 OF TWO PHASES FIRST PLANNING AND 1856 01:11:25,880 --> 01:11:28,640 INTERVENTION REFINEMENT PHASE 1857 01:11:28,640 --> 01:11:30,320 FOLLOWED BY SECOND MULTI-SITE 1858 01:11:30,320 --> 01:11:32,720 TRIAL AND IF SHOWN TO BE 1859 01:11:32,720 --> 01:11:33,680 EFFECTIVE INTERVENTION WOULD 1860 01:11:33,680 --> 01:11:36,880 EXIST AS ATTC PRODUCT WITH 1861 01:11:36,880 --> 01:11:39,040 FUTURE DISSEMINATION AND 1862 01:11:39,040 --> 01:11:40,880 POTENTIAL ACROSS DETOX SETTINGS 1863 01:11:40,880 --> 01:11:46,200 BY NATIONAL ATTC NETWORK. 1864 01:11:46,200 --> 01:11:47,200 NEXT SLIDE, PLEASE. 1865 01:11:47,200 --> 01:11:50,320 I HAVE A FEW POTENTIAL 1866 01:11:50,320 --> 01:11:52,120 DISCUSSION QUESTIONS UP HERE KEY 1867 01:11:52,120 --> 01:11:54,240 THEMES INCLUDE FACTORS 1868 01:11:54,240 --> 01:11:56,520 FACILITATING OR SLOWING 1869 01:11:56,520 --> 01:11:58,080 IMPLEMENTATION AND FOLLOWING UP 1870 01:11:58,080 --> 01:12:00,560 RETENTION AND COMMON THEME I 1871 01:12:00,560 --> 01:12:02,200 WILL WEAVE THROUGHOUT DISCUSSION 1872 01:12:02,200 --> 01:12:04,600 QUESTIONS HERE TODAY IS 1873 01:12:04,600 --> 01:12:05,840 STAKEHOLDER ENGAGEMENT AND DATA 1874 01:12:05,840 --> 01:12:07,680 SHARING AND REBEKAH IF WE HAVE 1875 01:12:07,680 --> 01:12:09,720 TIME HERE WE CAN JUMP INTO 1876 01:12:09,720 --> 01:12:11,080 DISCUSSION NOW RATHER THAN 1877 01:12:11,080 --> 01:12:13,600 WAITING FOR THE END. 1878 01:12:13,600 --> 01:12:16,320 >>YOU KNOW, I WONDER, ALEX, 1879 01:12:16,320 --> 01:12:17,880 WHAT YOUR PREFERENCE IS. I 1880 01:12:17,880 --> 01:12:19,480 THINK THAT IN SOME WAYS THESE 1881 01:12:19,480 --> 01:12:22,200 ARE PRETTY SIMILAR IN THAT THERE 1882 01:12:22,200 --> 01:12:24,720 IS SOME -- THERE ARE MORE 1883 01:12:24,720 --> 01:12:26,120 SIMILARITIES AMONG CONCEPTS THAN 1884 01:12:26,120 --> 01:12:28,240 IN THOSE PRESENTED BY THE LAST 1885 01:12:28,240 --> 01:12:28,680 TEAM. 1886 01:12:28,680 --> 01:12:31,360 IF IT WOULD BE EASIER FOR YOU, I 1887 01:12:31,360 --> 01:12:33,160 THINK YOU CAN KIND OF GO THROUGH 1888 01:12:33,160 --> 01:12:34,920 AND DISCUSS AS A WHOLE. I WOULD 1889 01:12:34,920 --> 01:12:37,440 JUST POINT OUT THAT WE HAD SOME 1890 01:12:37,440 --> 01:12:41,640 KIND OF LAST-MINUTE ATTENDANCE 1891 01:12:41,640 --> 01:12:42,400 ISSUES. 1892 01:12:42,400 --> 01:12:44,640 OUR ASSIGNED DISCUSSANTS MIGHT 1893 01:12:44,640 --> 01:12:46,360 NOT BE ON THE CALL AND IS A FREE 1894 01:12:46,360 --> 01:12:48,120 FOR ALL GETTING TO DISCUSSION 1895 01:12:48,120 --> 01:12:49,680 AND SINCE THEY ARE PRETTY 1896 01:12:49,680 --> 01:12:51,400 SIMILAR AND ARE ALL TRIALS AND 1897 01:12:51,400 --> 01:12:53,000 EVERYTHING I THINK IT IS FINE TO 1898 01:12:53,000 --> 01:12:55,320 JUST CONTINUE. WE WILL ISSUE BY 1899 01:12:55,320 --> 01:12:57,400 ISSUE WHEN WE GET TO THE 1900 01:12:57,400 --> 01:12:58,120 DISCUSSION SECTION. 1901 01:12:58,120 --> 01:13:00,720 >>SURE. I WILL MENTION THEMES 1902 01:13:00,720 --> 01:13:02,440 OR CORE THEMES AND QUESTIONS AND 1903 01:13:02,440 --> 01:13:04,760 WHEN I PUT SLIDES UP. LIKE YOU 1904 01:13:04,760 --> 01:13:06,520 SAID, WE CAN WAIT UNTIL THE END 1905 01:13:06,520 --> 01:13:08,000 TO REALLY DIVE INTO THE 1906 01:13:08,000 --> 01:13:10,160 DISCUSSION. I WOULD BE HAPPY TO 1907 01:13:10,160 --> 01:13:11,640 REVISIT ANY SLIDES THAT PEOPLE 1908 01:13:11,640 --> 01:13:13,600 LIKE IF THEY WANT TO JUMP BACK 1909 01:13:13,600 --> 01:13:15,480 AND FORTH AND LET'S GO TO THE 1910 01:13:15,480 --> 01:13:18,040 NEXT SLIDE, PLEASE. 1911 01:13:18,040 --> 01:13:20,720 ONSITE -- THIS PROJECT SEEKS TO 1912 01:13:20,720 --> 01:13:23,720 OVERCOME STRUCTURAL BARRIERS OUD 1913 01:13:23,720 --> 01:13:25,480 TREATMENT AND FRAGMENTATION 1914 01:13:25,480 --> 01:13:28,960 STIGMA EXPERIENCING IN MEDICAL 1915 01:13:28,960 --> 01:13:30,400 -- USING DRUGS ET CETERA 1916 01:13:30,400 --> 01:13:33,120 INTEGRATING PROGRAMS OR SSPS AND 1917 01:13:33,120 --> 01:13:35,520 PEOPLE USE OPIOIDS REPORTING 1918 01:13:35,520 --> 01:13:37,760 SSPS IN LOW STIGMA ENVIRONMENTS 1919 01:13:37,760 --> 01:13:39,480 AND WILLING TO RECEIVE SERVICES 1920 01:13:39,480 --> 01:13:41,720 THERE THAN IN OTHER SETTINGS AND 1921 01:13:41,720 --> 01:13:45,200 MODEL CONCEPT BUILDS ON SSPS AND 1922 01:13:45,200 --> 01:13:46,960 HIV PREVENTION TREATMENT 1923 01:13:46,960 --> 01:13:47,960 STRATEGIES BECAUSE RESEARCH 1924 01:13:47,960 --> 01:13:50,200 SHOWS SERVICES PROVIEDING SSPS 1925 01:13:50,200 --> 01:13:51,960 CAN IMPROVE HEALTH OF PEOPLE 1926 01:13:51,960 --> 01:13:54,240 USING DRUGS AND THAT HAVE PUBLIC 1927 01:13:54,240 --> 01:13:57,120 HEALTH BENEFITS AND COALATE 1928 01:13:57,120 --> 01:13:59,240 LOCATED IN FORMS OF 1929 01:13:59,240 --> 01:14:00,680 COMPREHENSIVE SERVICES IMPORTANT 1930 01:14:00,680 --> 01:14:04,840 TO ASSESS SSP AND ADDRESS HIV 1931 01:14:04,840 --> 01:14:06,200 AND CONCEPT TO TRANSLATE THOSE 1932 01:14:06,200 --> 01:14:10,280 INTO OUD AND OBSERVATIONAL 1933 01:14:10,280 --> 01:14:12,280 STUDIES OFFER PRELIMINARY 1934 01:14:12,280 --> 01:14:13,600 INFORMATION FOR THAT AND STRONG 1935 01:14:13,600 --> 01:14:18,600 MEDIAN DAYS COVERED BY NORBU 1936 01:14:18,600 --> 01:14:21,200 PREN EF RIN -- DECREASES IN 1937 01:14:21,200 --> 01:14:23,640 POSITIVE URINE ANALYSIS FOR 1938 01:14:23,640 --> 01:14:27,240 OTHER OPIOIDS AND THIS 1939 01:14:27,240 --> 01:14:29,080 EFFECTIVENESS TRIAL ONSITE LOW 1940 01:14:29,080 --> 01:14:30,920 THRESHOLD TREATMENT FOR SSPS 1941 01:14:30,920 --> 01:14:33,200 CONDUCTED IN THE CTN. 1942 01:14:33,200 --> 01:14:35,320 PREPARATION PHASE ORE YEAR 1 1943 01:14:35,320 --> 01:14:36,280 INVESTIGATORS WILL IDENTIFY 1944 01:14:36,280 --> 01:14:41,720 PARTNER SSPS AND ACCESS 1945 01:14:41,720 --> 01:14:42,720 ACCEPTABILITY AND FEASIBILITY 1946 01:14:42,720 --> 01:14:45,520 AND READINESS FOR ONSIGN 1947 01:14:45,520 --> 01:14:46,720 TREATMENT. NTVENTION PHASE 1948 01:14:46,720 --> 01:14:50,080 YEARS 2 TO 4 USE SSP RANDOMIZED 1949 01:14:50,080 --> 01:14:51,800 STEP WENL DESIGN TO STAGGER 1950 01:14:51,800 --> 01:14:55,680 TREATMENT IMPLEMENTATION ACROSS 1951 01:14:55,680 --> 01:14:59,680 SSPS WITH READINESS MILESTONES. 1952 01:14:59,680 --> 01:15:01,400 NEXT SLIDE, PLEASE. 1953 01:15:01,400 --> 01:15:03,360 >>LIKE I SAID THERE ARE COMMON 1954 01:15:03,360 --> 01:15:05,520 THEMES ACROSS QUESTIONS AND 1955 01:15:05,520 --> 01:15:07,280 IMPORTANT TOPICS AND 1956 01:15:07,280 --> 01:15:08,280 CONVERSATIONS AROUND THIS 1957 01:15:08,280 --> 01:15:10,240 CONCEPT INCLUDE POPULATIONS AND 1958 01:15:10,240 --> 01:15:13,040 CONTEXT. UTILITY ACROSS THEM. 1959 01:15:13,040 --> 01:15:14,720 AGAIN, STAKEHOLDER ENGAGEMENT 1960 01:15:14,720 --> 01:15:17,720 AND FACILITATION OF ENGAGEMENT 1961 01:15:17,720 --> 01:15:19,160 AMONG UNHOUSED PEOPLE 1962 01:15:19,160 --> 01:15:24,600 ESPECIALLY. NEXT SLIDE, PLEASE. 1963 01:15:24,600 --> 01:15:29,080 THIS STUDY IS FOR MDD AND NORBUP 1964 01:15:29,080 --> 01:15:33,240 NEF RIN AND THIS CONCEPT WOULD 1965 01:15:33,240 --> 01:15:34,760 EVALUATE EFFICACY OF HIGH DOSE 1966 01:15:34,760 --> 01:15:39,320 BU PROEP REON 450 MILLIGRAMS PER 1967 01:15:39,320 --> 01:15:42,520 DAY AMONG PLACEBO AND PATIENTS 1968 01:15:42,520 --> 01:15:46,560 WITH MAJOR DEPRESSIVE DISORDER 1969 01:15:46,560 --> 01:15:49,920 FOR DIAGNOSTIC CRITERIA 1970 01:15:49,920 --> 01:15:52,720 MAINTAINED ON BU PREN OR FRIN 1971 01:15:52,720 --> 01:15:54,760 AND RETENTION AS PRIMARY OUTCOME 1972 01:15:54,760 --> 01:15:58,520 AND DEPRESSIVE DISORDERS ARE 1973 01:15:58,520 --> 01:16:02,960 COMMON DIAGNOSIS FOR ODN AND -- 1974 01:16:02,960 --> 01:16:05,240 WORSE PROGNOSIS AND TREATMENT 1975 01:16:05,240 --> 01:16:06,520 AMONG TREATMENT OUTCOMES 1976 01:16:06,520 --> 01:16:08,720 POINTING TOWARDS NEED FOR 1977 01:16:08,720 --> 01:16:12,680 EFFECTIVE TREATMENT OPTIONS AND 1978 01:16:12,680 --> 01:16:16,440 RESEARCH THAT CAP -- BU PROEP 1979 01:16:16,440 --> 01:16:20,240 REON ANTIDEPRESSANT EFFECTS TO 1980 01:16:20,240 --> 01:16:22,400 HELP CURB STS FOR YA AND 1981 01:16:22,400 --> 01:16:24,360 WITHDRAWAL AND INDUCED CRAVING 1982 01:16:24,360 --> 01:16:25,680 AND PREVIOUS WORK OF 1983 01:16:25,680 --> 01:16:29,720 ACCOMMODATION OF ORAL APPROACH 1984 01:16:29,720 --> 01:16:32,600 REON IS SAFE AND EFFECTIVE FOR 1985 01:16:32,600 --> 01:16:34,920 MODERATE TO -- BETTER EFFECTS ON 1986 01:16:34,920 --> 01:16:39,840 MDD THAN PLACEBO AND THERE IS 1987 01:16:39,840 --> 01:16:40,480 SEQUENTIAL COMPARISON DESIGN 1988 01:16:40,480 --> 01:16:43,600 POTENTIAL ISSUES TO HIGH DESIGN 1989 01:16:43,600 --> 01:16:45,720 PLACEBO RESPONSE RATE AND 1990 01:16:45,720 --> 01:16:46,960 PARTICIPANTS IN TRIAL WOULD 1991 01:16:46,960 --> 01:16:48,880 RECEIVE BU PROEP REON AND 1992 01:16:48,880 --> 01:16:50,320 PARTICIPANTS RANDOMIZE TODAY 1993 01:16:50,320 --> 01:16:52,880 RECEIVE PLACEBO DURING 6 WEEK 1994 01:16:52,880 --> 01:16:55,760 STAGE 1 AND PLACEBO 1995 01:16:55,760 --> 01:16:57,160 NONRESPONDERS ARE RERANDOMIZED 1996 01:16:57,160 --> 01:16:59,480 IN PLACEBO DURING 6 WEEKS STAGE 1997 01:16:59,480 --> 01:17:01,920 2 AND ONE THING WE WONDER ABOUT 1998 01:17:01,920 --> 01:17:05,800 IS IF ELIGIBILITY CRITERIA THAT 1999 01:17:05,800 --> 01:17:08,360 ARE THREE CO-OCCURRING 2000 01:17:08,360 --> 01:17:10,040 CONDITIONS TOO STRINGENT TO 2001 01:17:10,040 --> 01:17:13,240 SUPPORT RECRUITMENT TARGETS AND 2002 01:17:13,240 --> 01:17:14,840 CO-OCCURRING MENTAL HEALTH 2003 01:17:14,840 --> 01:17:17,560 ISSUES ARE EXCLUDED SUCH AS 2004 01:17:17,560 --> 01:17:19,640 ANXIETY AND GOOD SEGUE TO IDEAS 2005 01:17:19,640 --> 01:17:22,920 OF DISCUSSION OF CONCEPTS SO 2006 01:17:22,920 --> 01:17:23,920 NEXT SLIDE, PLEASE. 2007 01:17:23,920 --> 01:17:26,960 A FEW THINGS WE THOUGHT WOULD BE 2008 01:17:26,960 --> 01:17:28,520 WORTHWHILE TO DISCUSS ARE IDEAS 2009 01:17:28,520 --> 01:17:31,200 FOR MEASUREMENT PLANS AND 2010 01:17:31,200 --> 01:17:32,320 CORRECT STAKEHOLDERS TO ENGAGE 2011 01:17:32,320 --> 01:17:36,120 IN THIS RESEARCH. 2012 01:17:36,120 --> 01:17:41,520 NEXT SLIDE, PLEASE. 2013 01:17:41,520 --> 01:17:45,640 EMS INITIATED -- COHORT STUDY OF 2014 01:17:45,640 --> 01:17:49,400 PATIENTS EXPERIENCING OVERDOSE 2015 01:17:49,400 --> 01:17:54,680 RECEIVE EMS CARE BU PREN OR 2016 01:17:54,680 --> 01:17:57,720 FREEN AMBULANCE OR -- EXPOSURE 2017 01:17:57,720 --> 01:18:00,920 TO THE AMBULANCE WAS ASSOCIATED 2018 01:18:00,920 --> 01:18:02,560 WITH DECREASE IN WITHDRAWAL 2019 01:18:02,560 --> 01:18:04,240 SYMPTOMS DPRAETER ODDS OF 2020 01:18:04,240 --> 01:18:06,360 ENGAGING IN OUD TREATMENT WITHIN 2021 01:18:06,360 --> 01:18:11,200 30 DAYS OF EMS ENCOUNTER AND NO 2022 01:18:11,200 --> 01:18:13,960 DIFFERENCE IN OUD -- 36 PATIENTS 2023 01:18:13,960 --> 01:18:17,680 IN CALIFORNIA RECEIVING BU PREN 2024 01:18:17,680 --> 01:18:24,840 OR FRIN IN ENCOUNT ER -- PATIENS 2025 01:18:24,840 --> 01:18:26,920 HAD 50% RATE OF RETENTION 2026 01:18:26,920 --> 01:18:29,480 TREATMENT IN 7 DAYS AND 36% WERE 2027 01:18:29,480 --> 01:18:32,720 IN TREATMENT AT 30 DAYS AND WE 2028 01:18:32,720 --> 01:18:34,280 SEE PROGRAMS AS CALIFORNIA STATE 2029 01:18:34,280 --> 01:18:36,320 MRNL MEDICAL SERVICE COMMISSION 2030 01:18:36,320 --> 01:18:39,080 ADAPTING REGULATION TO 2031 01:18:39,080 --> 01:18:40,720 PARAMEDICS SCOPE OF PRACTICE 2032 01:18:40,720 --> 01:18:44,120 ALLOWING THEM TO ASSESS AND 2033 01:18:44,120 --> 01:18:45,240 ADMINISTER IT WITH FIRST 2034 01:18:45,240 --> 01:18:47,320 RESPONDERS AND PATIENTS WITH OUD 2035 01:18:47,320 --> 01:18:49,520 AND CRITICAL RESEARCH ON 2036 01:18:49,520 --> 01:18:51,040 INNOVATIVE AND PROMISING 2037 01:18:51,040 --> 01:18:53,720 APPROACH AND CONKRECHTS ENTAIL 2038 01:18:53,720 --> 01:18:56,480 MULTI-SITE FOR 3 TO 4 SITE STUDY 2039 01:18:56,480 --> 01:18:59,440 EVALUATING EFFICACY AND 2040 01:18:59,440 --> 01:19:00,400 EFFECTIVENESS OF [INDISCERNIBLE] 2041 01:19:00,400 --> 01:19:02,960 FOR PATIENTS WITH OUD AND 2042 01:19:02,960 --> 01:19:05,160 WITHDRAWAL FOLLOWING OPIOID 2043 01:19:05,160 --> 01:19:08,840 REVERSAL THROUGH CTA AND PHASED 2044 01:19:08,840 --> 01:19:10,640 DURING STAGE OF SCIENCE AND 2045 01:19:10,640 --> 01:19:12,520 EFFICIENCY AND URNL OF RESEARCH 2046 01:19:12,520 --> 01:19:13,480 APPROACH TO STEM RATE OF 2047 01:19:13,480 --> 01:19:15,240 [STANDING OVATION] DOSES WE ARE 2048 01:19:15,240 --> 01:19:20,160 SEEING IN PUBLIC HEALTH CRISIS. 2049 01:19:20,160 --> 01:19:22,240 OUD PRESENTING WITH OVERDOSE 2050 01:19:22,240 --> 01:19:23,800 WOULD BE DEVELOPED INTO 5 AND 2051 01:19:23,800 --> 01:19:26,560 PHASE 2, THEY WOULD CONDUCT 2052 01:19:26,560 --> 01:19:28,280 EFFICACY OR EFFECTIVENESS TRIAL 2053 01:19:28,280 --> 01:19:32,080 COMPARING PATIENTS WITH OUD AND 2054 01:19:32,080 --> 01:19:33,240 WITHDRAWAL FOLLOWING OPIOID 2055 01:19:33,240 --> 01:19:37,720 OVERDOSE REVERSAL RECEIVING -- 2056 01:19:37,720 --> 01:19:39,720 PATIENTS RECEIVING USUAL MEDICAL 2057 01:19:39,720 --> 01:19:42,280 CARE AND WITH PRIMARY OUTCOME OF 2058 01:19:42,280 --> 01:19:45,640 ENGAGEMENT IN MOUD TREATMENT IN 2059 01:19:45,640 --> 01:19:47,640 30 DAYS AND THIS MODEL WOULD 2060 01:19:47,640 --> 01:19:50,680 BUILD OUT SUCCESS OF HIPS AND 2061 01:19:50,680 --> 01:19:52,360 PREVENTION TREATMENT AND I'M 2062 01:19:52,360 --> 01:19:55,240 SORRY I PUT WRONG ONE UP FOR THE 2063 01:19:55,240 --> 01:19:57,280 SLIDES YOU CAN DISREGARD THAT. 2064 01:19:57,280 --> 01:19:58,680 NEXT SLIDE, PLEASE. 2065 01:19:58,680 --> 01:20:01,560 A FEW MORE DISCUSSION QUESTIONS 2066 01:20:01,560 --> 01:20:03,520 THAT PROBABLY LOOK FAMILIAR. IF 2067 01:20:03,520 --> 01:20:05,240 YOU HAVE A FEW THINGS TO TALK 2068 01:20:05,240 --> 01:20:06,680 ABOUT WITH THIS WOULD BE 2069 01:20:06,680 --> 01:20:08,080 APPROPRIATE FOLLOW UP HERE TO 2070 01:20:08,080 --> 01:20:10,400 MEASURE RETENTION AND FRACKING 2071 01:20:10,400 --> 01:20:11,840 ACROSS DIFFERENT DISTRICTS AND 2072 01:20:11,840 --> 01:20:16,080 DUE TO EMS POLICIES AND 2073 01:20:16,080 --> 01:20:18,960 IMPLEMENTATION BARRIERS. 2074 01:20:18,960 --> 01:20:21,800 TRAINING AND STAKEHOLDER 2075 01:20:21,800 --> 01:20:22,800 ENGAGEMENT AGAIN. 2076 01:20:22,800 --> 01:20:25,040 GOING TO NEXT SLIDE IS 2077 01:20:25,040 --> 01:20:26,440 CONCLUSION OF PREPARED COMMENTS 2078 01:20:26,440 --> 01:20:30,240 HAPPY TO WELCOME IN CONCEPT 2079 01:20:30,240 --> 01:20:32,840 AUNLORS AND WG COMMENTERS IT 2080 01:20:32,840 --> 01:20:33,440 INITIATE THE DISCUSSION. 2081 01:20:33,440 --> 01:20:35,280 >>THANK YOU SO MUCH. ALEX, 2082 01:20:35,280 --> 01:20:38,320 THAT WAS INCREDIBLE. 2083 01:20:38,320 --> 01:20:41,280 BEFORE WE GET STARTED IS NORA 2084 01:20:41,280 --> 01:20:43,360 ON? I INVITE YOU IF THERE IS 2085 01:20:43,360 --> 01:20:45,400 ANYTHING YOU WOULD LIKE TO ADD 2086 01:20:45,400 --> 01:20:49,640 FROM NIDA PERSPECTIVE IF YOU ARE 2087 01:20:49,640 --> 01:20:49,880 THERE. 2088 01:20:49,880 --> 01:20:52,880 >>YES. NO. I AM THERE. 2089 01:20:52,880 --> 01:20:53,560 >>YEAH. 2090 01:20:53,560 --> 01:20:55,960 >>I THINK THERE ARE SEVERAL 2091 01:20:55,960 --> 01:20:56,200 ASPECTS. 2092 01:20:56,200 --> 01:21:00,600 THREE PROJECTS IN A WAY ARE 2093 01:21:00,600 --> 01:21:02,840 BASICALLY USING DIFFERENT 2094 01:21:02,840 --> 01:21:04,040 STRATEGIES TO EXPAND NUMBER OF 2095 01:21:04,040 --> 01:21:09,480 PEOPLE THAT CAN BE INITIATED ON 2096 01:21:09,480 --> 01:21:12,800 BOOU NOR EPINEPHRINE W- 2097 01:21:12,800 --> 01:21:13,920 DETOXIFICATION PROGRAM OR 2098 01:21:13,920 --> 01:21:18,680 WHETHER MRNL MEDICAL SERVICES ON 2099 01:21:18,680 --> 01:21:21,120 EXCHANGED SERVICES ARE OVER -- 2100 01:21:21,120 --> 01:21:22,840 THAT IS UNDERSTANDING IMPACT 2101 01:21:22,840 --> 01:21:29,080 THAT EACH ONE OF THEM HAS AS IT 2102 01:21:29,080 --> 01:21:31,400 RELATES NUMBER OF PEOPLE THAT 2103 01:21:31,400 --> 01:21:33,880 CAN HELP THAT IS IMPORTANT THAT 2104 01:21:33,880 --> 01:21:36,280 CAN DETERMINE WHETHER THREE 2105 01:21:36,280 --> 01:21:39,440 INITIATIVES SHOULD BE IN 2106 01:21:39,440 --> 01:21:42,200 PARALLEL OR SHOULD WE 2107 01:21:42,200 --> 01:21:42,760 PRIORITIZE? 2108 01:21:42,760 --> 01:21:45,160 IT IS AN IMPORTANT QUESTION AND 2109 01:21:45,160 --> 01:21:48,520 REALIZE OF COURSE AS WE MAKE 2110 01:21:48,520 --> 01:21:49,560 DECISIONS THAT PATIENT 2111 01:21:49,560 --> 01:21:51,520 POPULATION IS GOING TO BE VERY, 2112 01:21:51,520 --> 01:21:52,520 VERY DIFFERENT AND QUESTION I 2113 01:21:52,520 --> 01:21:54,720 WAS EMERGING IN MY BRAIN I 2114 01:21:54,720 --> 01:21:57,400 WANTED TO ASK GAIL. SHE IS ONE 2115 01:21:57,400 --> 01:21:58,960 THAT WORKS ON THIS POPULATION IS 2116 01:21:58,960 --> 01:22:01,640 IF YOU ACTIVATE MRNL MEDICAL 2117 01:22:01,640 --> 01:22:04,080 SERVICES AND ARE INITIATING 2118 01:22:04,080 --> 01:22:05,680 SOMEONE ON NOREPINEPHRINE YOU 2119 01:22:05,680 --> 01:22:09,080 ARE VERY LIKELY BRINGING 2120 01:22:09,080 --> 01:22:12,920 DESPERATION INTO MRNL 2121 01:22:12,920 --> 01:22:13,680 DEPARTMENT. WHAT IS THE 2122 01:22:13,680 --> 01:22:16,880 ADVANTAGE OVERALL TO INITIATE IN 2123 01:22:16,880 --> 01:22:19,160 MRNL OR SAY FOR EXAMPLE IN 2124 01:22:19,160 --> 01:22:22,720 AMBULANCE OPPOSED TO EMERGENCY 2125 01:22:22,720 --> 01:22:25,120 DEPARTMENT OR IS IT BECAUSE MRNL 2126 01:22:25,120 --> 01:22:26,920 MEDICAL SERVICES DON'T 2127 01:22:26,920 --> 01:22:28,040 NECESSARILY BRING A SIGNIFICANT 2128 01:22:28,040 --> 01:22:31,440 PORTION OF PATIENTS INTO THE 2129 01:22:31,440 --> 01:22:35,040 MRNL DEPARTMENTS? 2130 01:22:35,040 --> 01:22:36,280 THAT IS SOMETHING I WOULD LIKE 2131 01:22:36,280 --> 01:22:38,160 TO HEAR FROM THOSE OUT THERE IN 2132 01:22:38,160 --> 01:22:40,320 THE TRENCHES AND I'M PUTTING YOU 2133 01:22:40,320 --> 01:22:41,240 ON THE SPOT. 2134 01:22:41,240 --> 01:22:45,440 >>SURE. EMS IS RUN DIFFERENTLY 2135 01:22:45,440 --> 01:22:47,280 IN MY STATE BY COUNTY AND 2136 01:22:47,280 --> 01:22:50,680 CERTAINLY STATE BY STATE AND 2137 01:22:50,680 --> 01:22:54,680 CITY BY CITY. 2138 01:22:54,680 --> 01:22:55,440 MANY PLACES THERE IS NO 2139 01:22:55,440 --> 01:22:56,760 REQUIREMENT TO BRING TO MRNL 2140 01:22:56,760 --> 01:22:59,320 STATEMENT AND IN MY CASE THERE 2141 01:22:59,320 --> 01:23:01,600 IS A REQUIREMENT CALLING US AND 2142 01:23:01,600 --> 01:23:03,000 WHY THEY DON'T WANT TO COME AND 2143 01:23:03,000 --> 01:23:04,960 MANY STATES PATIENTS SAY I DON'T 2144 01:23:04,960 --> 01:23:09,040 WANT TO COME. I'M FINE. I'M 2145 01:23:09,040 --> 01:23:10,200 LEAVING. ADVANTAGE OF THIS IS 2146 01:23:10,200 --> 01:23:13,080 YOU CAN CAPTURE PEOPLE WHO MAYBE 2147 01:23:13,080 --> 01:23:15,480 WE COULD INITIATE AND IN STUDIES 2148 01:23:15,480 --> 01:23:17,000 THERE WERE TWO AND THEY WERE 2149 01:23:17,000 --> 01:23:20,400 DONE VERY DIFFERENTLY AND WHEN 2150 01:23:20,400 --> 01:23:21,680 THEY STARTED OUT IN CALIFORNIA 2151 01:23:21,680 --> 01:23:25,120 BRIDGE THERE WERE PEOPLE WITH 2152 01:23:25,120 --> 01:23:27,960 OVERDOSE WHO THOUGHT THEY COULD 2153 01:23:27,960 --> 01:23:30,920 GIVE RIGHT AWAY AND THEY WERE 2154 01:23:30,920 --> 01:23:33,000 CALLING WITHDRAWAL AND CALLING 2155 01:23:33,000 --> 01:23:35,880 CMS AND IN THOSE CASES INITIATED 2156 01:23:35,880 --> 01:23:37,720 IT THEN AND PEOPLE WERE LIKELY 2157 01:23:37,720 --> 01:23:39,680 TO FOLLOW UP AND SAY OKAY WE 2158 01:23:39,680 --> 01:23:42,800 WILL START YOU HERE AND WILL YOU 2159 01:23:42,800 --> 01:23:43,360 GO HERE TOMORROW. 2160 01:23:43,360 --> 01:23:47,200 THAT SEEMS TO HAVE SIGNAL THAT 2161 01:23:47,200 --> 01:23:49,040 WORKS AND IS LATTER YOU ARE 2162 01:23:49,040 --> 01:23:50,800 SAYING IF COMING TO ED WOULDN'T 2163 01:23:50,800 --> 01:23:56,160 BE A PROBLEM AND MANY PEOPLE ARE 2164 01:23:56,160 --> 01:24:00,400 REVOLVING DOORS WITH EMS. 2165 01:24:00,400 --> 01:24:03,320 WE TRIED TOO SENDING OUT 2166 01:24:03,320 --> 01:24:04,760 RECOVERY PEOPLE TO SEE AFTER 2167 01:24:04,760 --> 01:24:07,160 THEY HAD BEEN NEXT D LATER THAT 2168 01:24:07,160 --> 01:24:11,680 DOESN'T SEEM TO WORK. WE TRIED 2169 01:24:11,680 --> 01:24:12,440 THAT. 2170 01:24:12,440 --> 01:24:13,520 THIS IS AN OPPORTUNITY. 2171 01:24:13,520 --> 01:24:15,600 >>I GUESS WHAT YOU ARE SAYING 2172 01:24:15,600 --> 01:24:17,720 GAIL IF I READ YOU CORRECTLY 2173 01:24:17,720 --> 01:24:19,200 THERE MIGHT BE STATES YOU ARE 2174 01:24:19,200 --> 01:24:21,120 NOT OBLIGED BUT IN GENERAL 2175 01:24:21,120 --> 01:24:23,120 SEEING ACROSS THE STATE 2176 01:24:23,120 --> 01:24:25,680 REGARDLESS IT WOULD BE VALUABLE 2177 01:24:25,680 --> 01:24:27,280 FOR THOSE CALLING MRNL SYSTEM 2178 01:24:27,280 --> 01:24:29,280 FOR THOSE THAT ARE WITHDRAWAL 2179 01:24:29,280 --> 01:24:32,040 AND WANT SOMETHING TO HELP THEM 2180 01:24:32,040 --> 01:24:33,040 OVERCOME WITHDRAWAL. 2181 01:24:33,040 --> 01:24:34,440 >>WHY HE. 2182 01:24:34,440 --> 01:24:36,040 >>NOREPINEPHRINE AND THAT WILL 2183 01:24:36,040 --> 01:24:38,280 BE IMPORTANT BASICALLY THAT WE 2184 01:24:38,280 --> 01:24:39,720 PERHAPS TARGET THAT POPULATION 2185 01:24:39,720 --> 01:24:41,880 AND SECOND POINT I WANTED TO 2186 01:24:41,880 --> 01:24:43,720 MAKE ARE THESE ARE THREE STUDIES 2187 01:24:43,720 --> 01:24:46,640 THAT HAVE SIMILAR GOALS TO 2188 01:24:46,640 --> 01:24:49,280 EXPAND ACCESSIBLE NOREPINEPHRINE 2189 01:24:49,280 --> 01:24:52,480 AND SEKTD ONE IS DIFFERENT AND 2190 01:24:52,480 --> 01:24:55,040 THAT IS USE OF [INDISCERNIBLE] 2191 01:24:55,040 --> 01:24:58,560 AN ANTIDEPRESSANT THAT HAS 2192 01:24:58,560 --> 01:25:00,520 INTERESTINGLY STRONG 2193 01:25:00,520 --> 01:25:02,280 [INDISCERNIBLE] URNLIC EFFECTS 2194 01:25:02,280 --> 01:25:06,400 AND RILT OF TENDS TO LEAD TO 2195 01:25:06,400 --> 01:25:08,480 BETTER OUTCOMES WITH PATIENTS 2196 01:25:08,480 --> 01:25:13,200 WITH SUBSTANCE USE DISORDERS IN 2197 01:25:13,200 --> 01:25:13,480 GENERAL. 2198 01:25:13,480 --> 01:25:16,200 >>ABOUT THIS PARTICULAR 2199 01:25:16,200 --> 01:25:16,960 PROPOSAL COMING BACK TO NOTION 2200 01:25:16,960 --> 01:25:20,440 ABOUT ISSUES OF COMORBIDITIES IS 2201 01:25:20,440 --> 01:25:24,200 DEPRESSION IS EXTRAORDINARILY 2202 01:25:24,200 --> 01:25:27,240 PREVALENT WITH PEOPLE WITH 2203 01:25:27,240 --> 01:25:29,720 OPIOID DISORDER IF YOU LOOK AT 2204 01:25:29,720 --> 01:25:30,960 ELECTRONIC RECORDS AND USE THEM 2205 01:25:30,960 --> 01:25:34,840 TO MONITOR OUTCOMES OF LARGE 2206 01:25:34,840 --> 01:25:38,240 PATIENT GROUPS WHAT ONE STUDY 2207 01:25:38,240 --> 01:25:42,800 HAS SHOWN IS INDIVIDUALS WITH 2208 01:25:42,800 --> 01:25:45,040 OPIOID USE DISORDER THAT WERE 2209 01:25:45,040 --> 01:25:46,640 GIVEN [INDISCERNIBLE] ALL THOSE 2210 01:25:46,640 --> 01:25:48,560 SUBJECTED THAT WERE GIVEN 2211 01:25:48,560 --> 01:25:50,880 ANTIDEPRESSANTS WHEN INITIATED 2212 01:25:50,880 --> 01:25:54,280 ON NOREPINEPHRINE OR HAD 2213 01:25:54,280 --> 01:25:56,240 ANTIDEPRESSANTS AND SUSTAINED 2214 01:25:56,240 --> 01:25:59,240 THROUGHOUT HAVE MUCH LOWER RISK 2215 01:25:59,240 --> 01:26:09,160 OF OVERDOSED DA DAENLS. IT IS 2216 01:26:09,160 --> 01:26:11,280 THE EFFECT ANTIDEPRESSANTS 2217 01:26:11,280 --> 01:26:13,680 WHETHER YOU DO OR DON'T HAVE 2218 01:26:13,680 --> 01:26:15,200 DIAGNOSIS OF DEPRESSION AND MAY 2219 01:26:15,200 --> 01:26:16,960 BE BENEFICIAL. FOR ONCE, IT 2220 01:26:16,960 --> 01:26:20,120 MIGHT BE VALUABLE TO OVERCOME 2221 01:26:20,120 --> 01:26:23,400 SOME LONG-LASTING WITHDRAWAL 2222 01:26:23,400 --> 01:26:26,160 SYMPTOMS LEADING PASHENS TO 2223 01:26:26,160 --> 01:26:27,280 RELAPSE WHEN THEY ARE IN 2224 01:26:27,280 --> 01:26:30,800 TREATMENT AND I'M EXTREMELY 2225 01:26:30,800 --> 01:26:35,600 SUPPORTIVE OF THIS TRIAL. 2226 01:26:35,600 --> 01:26:39,280 IT BEGS A QUESTION THAT WE NEED 2227 01:26:39,280 --> 01:26:48,080 TO ADDRESS PATIENTS WITH 2228 01:26:48,080 --> 01:26:51,360 ANTIDEPRESSANTS ARE DOING BETTER 2229 01:26:51,360 --> 01:26:52,840 AND WE HAVE OPPORTUNITY TO 2230 01:26:52,840 --> 01:26:54,960 UNDERSTAND HOW TO ADMINISTER IT 2231 01:26:54,960 --> 01:26:56,920 AND WHAT EFFECT SIZES ARE AND 2232 01:26:56,920 --> 01:26:59,520 REPLICATING IN RANDOMIZED 2233 01:26:59,520 --> 01:27:03,200 CLINICAL TRIAL FINDINGS FROM 2234 01:27:03,200 --> 01:27:08,600 ELECTRONIC HEALTH RECORDS. 2235 01:27:08,600 --> 01:27:11,640 TURNING IT BACK TO YOU REBEKAH 2236 01:27:11,640 --> 01:27:13,640 AND DISCUSSANTS BECAUSE THESE 2237 01:27:13,640 --> 01:27:19,000 ARE POINTS I WANTED TO SAY. 2238 01:27:19,000 --> 01:27:21,880 >>I MAY GO BACK TO ALEX WHO HAD 2239 01:27:21,880 --> 01:27:23,960 DISCUSSIONS OR QUESTIONS AROUND 2240 01:27:23,960 --> 01:27:25,120 STAKEHOLDERS AND WHICH 2241 01:27:25,120 --> 01:27:28,320 STAKEHOLDER WHO IS KIND OF 2242 01:27:28,320 --> 01:27:32,280 EXPANDING BEYOND OUR TRADITIONAL 2243 01:27:32,280 --> 01:27:34,240 HEALTH CARE SYSTEMS IN CERTAIN 2244 01:27:34,240 --> 01:27:34,440 WAYS. 2245 01:27:34,440 --> 01:27:38,000 WE WANT TO APPROACH THAT WITH 2246 01:27:38,000 --> 01:27:40,000 LOTS OF THOUGHTFULNESS. 2247 01:27:40,000 --> 01:27:42,160 I'M INTERESTED IN ALEX'S 2248 01:27:42,160 --> 01:27:46,200 THOUGHTS ON THAT AS WELL AND SEE 2249 01:27:46,200 --> 01:27:50,360 NED'S HAND IS RAISED. 2250 01:27:50,360 --> 01:27:52,120 GO RIGHT AHEAD, NED. 2251 01:27:52,120 --> 01:27:56,440 >>THANK YOU. DISCLOSURE I'M IN 2252 01:27:56,440 --> 01:27:57,320 CTM AND DIDN'T HAVE ANYTHING TO 2253 01:27:57,320 --> 01:28:00,120 DO WITH THIS CONCEPT. I AGREE 2254 01:28:00,120 --> 01:28:02,480 WITH YOUR POINT, NORA. IF I 2255 01:28:02,480 --> 01:28:05,880 UNDERSTAND YOU CORRECTLY I THINK 2256 01:28:05,880 --> 01:28:07,600 WHAT YOU ARE SUGGESTING IS IT 2257 01:28:07,600 --> 01:28:09,600 MIGHT BE HELPFUL TO PATIENTS 2258 01:28:09,600 --> 01:28:13,040 WITH COMBINATION OF OPIOID USE 2259 01:28:13,040 --> 01:28:15,600 DISORDER AND METHAMPHETAMINE USE 2260 01:28:15,600 --> 01:28:17,520 DISORDER WHETHER OR NOT THERE IS 2261 01:28:17,520 --> 01:28:20,440 REALLY DEPRESSION THERE YOU CAN 2262 01:28:20,440 --> 01:28:21,640 DIAGNOSE AND AGREE WITH YOU AND 2263 01:28:21,640 --> 01:28:25,160 WHAT I RECOMMEND FOR THIS 2264 01:28:25,160 --> 01:28:29,520 CONCEPT IS TO NOT MAKE 2265 01:28:29,520 --> 01:28:32,680 DEPRESSION AN ELIGIBILITY 2266 01:28:32,680 --> 01:28:33,920 CRITERION. IT WILL MAKE IT 2267 01:28:33,920 --> 01:28:35,520 HARDER TO RECRUIT AND HAVE TO 2268 01:28:35,520 --> 01:28:37,360 FIGURE OUT WHERE TO MEASURE 2269 01:28:37,360 --> 01:28:39,040 DEPRESSION AND WHERE TO DRAW THE 2270 01:28:39,040 --> 01:28:41,120 LINE. LOTS OF DEPRESSION IS IN 2271 01:28:41,120 --> 01:28:44,680 THESE POPULATIONS AND MOST IS 2272 01:28:44,680 --> 01:28:46,200 SUBSTANCE ABUSE AND GETS BETTER 2273 01:28:46,200 --> 01:28:49,240 IF YOU CAN EFFECTIVELY TREAT 2274 01:28:49,240 --> 01:28:52,240 SUBSTANCE USE DISORDER. 2275 01:28:52,240 --> 01:28:59,320 I WOULD SIMPLIFY THIS DOING A 2276 01:28:59,320 --> 01:29:03,200 TRIAL OF IT VERSUS PLACEBO IN 2277 01:29:03,200 --> 01:29:05,720 PATIENTS WITH SUBSTANCE USE 2278 01:29:05,720 --> 01:29:08,400 DISORDERS AND BU PROPREON 2279 01:29:08,400 --> 01:29:10,240 ADDRESSING THIS QUESTION DOES IT 2280 01:29:10,240 --> 01:29:12,840 HELP PEOPLE WITH OPIOID USE 2281 01:29:12,840 --> 01:29:15,480 DISORDER WITH CO-OCCURRING 2282 01:29:15,480 --> 01:29:16,480 METHAMPHETAMINE USE DISORDER AND 2283 01:29:16,480 --> 01:29:19,320 DEPRESSION AND LOOKING AT 2284 01:29:19,320 --> 01:29:19,960 SECONDARY ANALYSIS WHETHER 2285 01:29:19,960 --> 01:29:28,640 DEPRESSION IS A MODERATOR. I 2286 01:29:28,640 --> 01:29:29,560 WOULDN'T SELECT PEOPLE FOR 2287 01:29:29,560 --> 01:29:31,240 DEPRESSION. IT WILL MAKE IT 2288 01:29:31,240 --> 01:29:36,240 HARDER TO RECRUIT AND REDUCE 2289 01:29:36,240 --> 01:29:36,640 GENERALIZABILITY. 2290 01:29:36,640 --> 01:29:40,320 I WILL BET IT HELPS AS MUCH IN 2291 01:29:40,320 --> 01:29:42,320 PEOPLE WHO DON'T HAVE DIAGNOSED 2292 01:29:42,320 --> 01:29:45,440 DEPRESSION AND THEY ARE 2293 01:29:45,440 --> 01:29:47,480 SUFFERING FROM NEGATIVE EFFECT 2294 01:29:47,480 --> 01:29:49,600 AND SO FORTH PART OF. 2295 01:29:49,600 --> 01:29:50,240 >>VICE CHAIR MIKE ETHERIDGE: 2296 01:29:50,240 --> 01:29:53,680 AMPHETAMINE WITHDRAWAL AND IS MY 2297 01:29:53,680 --> 01:29:55,240 MAIN. I THINK IT IS GREAT TO 2298 01:29:55,240 --> 01:29:57,360 SEE THIS AND HAPPY TO SEE FOCUS 2299 01:29:57,360 --> 01:29:58,840 ON DEPRESSION AND WOULD EVALUATE 2300 01:29:58,840 --> 01:30:02,680 IT AND LOOK AT IT AS A MODERATOR 2301 01:30:02,680 --> 01:30:04,600 BUT NOT SELECT FOR IT. 2302 01:30:04,600 --> 01:30:07,080 >>NED, I COMPLETELY AGREE WITH 2303 01:30:07,080 --> 01:30:10,080 YOU AND BRING IT UP THAT IT AND 2304 01:30:10,080 --> 01:30:13,400 ELECTRONIC HEALTH RECORDS NOT 2305 01:30:13,400 --> 01:30:18,560 JUST ANTIDEPRESSIENTS IN GENERAL 2306 01:30:18,560 --> 01:30:22,800 BUT DOING LONG LASTING ONES AS 2307 01:30:22,800 --> 01:30:26,720 WELL. THESE ARE FOR PATIENTS 2308 01:30:26,720 --> 01:30:28,360 MAINTAINING NORBU PREN OR FRIN 2309 01:30:28,360 --> 01:30:31,640 WE KNOW IT WORKS WELL AND CAN WE 2310 01:30:31,640 --> 01:30:34,240 IMPROVE RETENTION IN TREEM 2311 01:30:34,240 --> 01:30:37,120 GIVING THEM BRO PROEP REON AND 2312 01:30:37,120 --> 01:30:39,920 IMPROVE LIKELIHOOD THEY ACHIEVE 2313 01:30:39,920 --> 01:30:48,440 RECOVERY AND TO BETTER OUTCOMES? 2314 01:30:48,440 --> 01:30:50,960 IN THIS POINT AND MY PERSPECTIVE 2315 01:30:50,960 --> 01:30:53,160 LET'S LOOK AGAIN IN TERMS OF 2316 01:30:53,160 --> 01:30:54,160 FLEXIBILITY THAT ARE NOT 2317 01:30:54,160 --> 01:30:57,120 NECESSARILY LIMITED TO PATIENTS 2318 01:30:57,120 --> 01:31:00,400 WITH OUD PLUS METHAMPHETAMINE 2319 01:31:00,400 --> 01:31:02,120 USE DISORDER THAT IN AND OF 2320 01:31:02,120 --> 01:31:04,040 ITSELF INCLUDING PATIENTS WITH 2321 01:31:04,040 --> 01:31:06,640 AN OPIOID USE DISORDERS THAT MAY 2322 01:31:06,640 --> 01:31:10,680 BE CO-USING OTHER SUBSTANCES OR 2323 01:31:10,680 --> 01:31:17,320 NOT WHETHER USE OF -- ALONGSIDE 2324 01:31:17,320 --> 01:31:19,480 A PLACEBO WHETHER IMPROVE 2325 01:31:19,480 --> 01:31:22,080 OUTCOMES IS WAY I VIEW IT AND 2326 01:31:22,080 --> 01:31:25,200 WILL ALLOW US TO HAVE GREATER 2327 01:31:25,200 --> 01:31:27,160 CLARITY AND ABSOLUTELY YOU ARE 2328 01:31:27,160 --> 01:31:28,480 RIGHT ON TARGET AND DON'T THINK 2329 01:31:28,480 --> 01:31:31,880 WE SHOULD LIMIT IT TO PATIENTS 2330 01:31:31,880 --> 01:31:32,800 WITH DIAGNOSIS OF DEPRESSION. 2331 01:31:32,800 --> 01:31:34,480 >>YOU ARE RIGHT. THERE IS A 2332 01:31:34,480 --> 01:31:36,720 NUMBER OF CLINICAL TRIALS IN 2333 01:31:36,720 --> 01:31:39,640 LITERATURE OF ANTIDEPRESSANTS 2334 01:31:39,640 --> 01:31:43,760 TREATING DEPRESSED SUBSTANCE USE 2335 01:31:43,760 --> 01:31:46,000 DISORDERS OF TYPES AND 2336 01:31:46,000 --> 01:31:48,200 DEPRESSANTS TEND TO DO BETTER 2337 01:31:48,200 --> 01:31:51,720 AND IN OLD DAYS TRICYCLICS AND 2338 01:31:51,720 --> 01:31:53,920 [STANDING OVATION] ALL 2339 01:31:53,920 --> 01:31:56,160 ANTIDEPRESSANTS SEEM TO WORK 2340 01:31:56,160 --> 01:31:58,400 BETTER THAN SERO-10 URNLIC ONES 2341 01:31:58,400 --> 01:32:00,880 SHOWN IN NICOTINE DEPENDENCE FOR 2342 01:32:00,880 --> 01:32:07,400 EXAMPLE AND I LIKE THE IDEA OF 2343 01:32:07,400 --> 01:32:15,800 GIVING BU PROEP REON TO PATI 2344 01:32:15,800 --> 01:32:16,080 PATIENTS. 2345 01:32:16,080 --> 01:32:17,800 LET METHAMPHETAMINE BE SOMETHING 2346 01:32:17,800 --> 01:32:20,760 TO TEST AND MEASURE AS A 2347 01:32:20,760 --> 01:32:21,080 MODERATOR. 2348 01:32:21,080 --> 01:32:23,840 >>OR COCAINE. 2349 01:32:23,840 --> 01:32:25,120 >>YEAH. 2350 01:32:25,120 --> 01:32:26,800 >>HI. THANK YOU VERY MUCH FOR 2351 01:32:26,800 --> 01:32:29,480 COMMENTS ON THIS CONCEPT. I 2352 01:32:29,480 --> 01:32:31,200 AGREE THEY ARE VALID POINTS THAT 2353 01:32:31,200 --> 01:32:35,200 I WILL MODIFY CONCEPTS 2354 01:32:35,200 --> 01:32:37,200 ACCORDI 2355 01:32:37,200 --> 01:32:37,560 ACCORDINGLY. 2356 01:32:37,560 --> 01:32:39,200 >>ANYWAY, THOSE WERE POINTS I 2357 01:32:39,200 --> 01:32:42,600 WANTED TO SAY. I ACTUALLY GIVE 2358 01:32:42,600 --> 01:32:44,800 CUEDOS TO WHAT OTHERS WANT TO 2359 01:32:44,800 --> 01:32:46,120 BRING UP FOR THE DISCUSSION. 2360 01:32:46,120 --> 01:32:49,800 >>YES. THANK YOU, NORA. 2361 01:32:49,800 --> 01:32:56,400 AND IN TERMS OF BOTH THE 2362 01:32:56,400 --> 01:32:57,880 CO-OCCURRING MENTAL HEALTH AND 2363 01:32:57,880 --> 01:32:59,040 SUBSTANCE USE DISORDER CONCEPTS 2364 01:32:59,040 --> 01:33:02,040 AND IN TERMS OF CONCEPTS THAT 2365 01:33:02,040 --> 01:33:03,520 INTRODUCE MEDICATION FOR 2366 01:33:03,520 --> 01:33:05,920 TREATMENT OF OPIOID USE DISORDER 2367 01:33:05,920 --> 01:33:09,320 INTO DIFFERENT SETTINGS OR 2368 01:33:09,320 --> 01:33:10,960 INSTANCES THERE WERE SOME 2369 01:33:10,960 --> 01:33:11,960 THOUGHTFUL DISCUSSION QUESTIONS 2370 01:33:11,960 --> 01:33:12,440 PUT FORWARD. 2371 01:33:12,440 --> 01:33:14,560 I WOULD OPEN IT UP TO THE GROUP 2372 01:33:14,560 --> 01:33:16,680 AND ASK FOR YOUR INPUT OR 2373 01:33:16,680 --> 01:33:18,200 ADDITIONAL THOUGHTS. 2374 01:33:18,200 --> 01:33:20,440 CHRISTIAN I SEE YOUR HAND IS 2375 01:33:20,440 --> 01:33:22,240 RAISED. PLEASE GO RIGHT AHEAD. 2376 01:33:22,240 --> 01:33:26,760 >>COMMENT ON RAPID INDUCTION OF 2377 01:33:26,760 --> 01:33:30,320 NORBU PREN OR FREN WE HAVE TO 2378 01:33:30,320 --> 01:33:31,680 CONSIDER SIGNIFICANT EVIDENCE 2379 01:33:31,680 --> 01:33:35,400 HOW YOU DO THAT ESPECIALLY IN 2380 01:33:35,400 --> 01:33:38,120 FENTANYL EXPOSED PATIENTS THAT 2381 01:33:38,120 --> 01:33:38,840 [INDISCERNIBLE]. 2382 01:33:38,840 --> 01:33:41,720 SO, THERE ARE DIFFERENT SCHOOLS 2383 01:33:41,720 --> 01:33:43,760 OF THOUGHTS THAT I THINK WE HAVE 2384 01:33:43,760 --> 01:33:45,920 TO CONTINUE TO GATHER DATA TO 2385 01:33:45,920 --> 01:33:49,040 REALLY COME UP WITH BEST 2386 01:33:49,040 --> 01:33:50,800 PRACTICES ON [INDISCERNIBLE] IN 2387 01:33:50,800 --> 01:33:54,560 A RAPIDLY EVOLVING LANDSCAPE NOW 2388 01:33:54,560 --> 01:33:56,880 WITH SYNTHETIC OPIOIDS AND THINK 2389 01:33:56,880 --> 01:34:01,160 WE HAVE TO REALLY TAKE IT INTO 2390 01:34:01,160 --> 01:34:08,920 CONSIDERATION. 2391 01:34:08,920 --> 01:34:10,800 >>THANK YOU. 2392 01:34:10,800 --> 01:34:12,240 NAT, YOUR HAND IS RAISED. 2393 01:34:12,240 --> 01:34:14,640 >>SO, I MEAN, GAIL, I WOULD BE 2394 01:34:14,640 --> 01:34:16,200 INTERESTED IN YOUR THOUGHTS ON 2395 01:34:16,200 --> 01:34:19,600 THIS AND SENSES NEXT MS SETTING 2396 01:34:19,600 --> 01:34:21,680 THAT EVERY MINUTE YOU DELAY 2397 01:34:21,680 --> 01:34:24,000 GETTING PATIENTS ON BOOU PREN OR 2398 01:34:24,000 --> 01:34:27,960 FREN IS ANOTHER MINUTE THEY WILL 2399 01:34:27,960 --> 01:34:31,560 DROP OUT OF TREATMENT AND WALK 2400 01:34:31,560 --> 01:34:33,200 OUT AND GET INTO WORSE 2401 01:34:33,200 --> 01:34:34,480 WITHDRAWAL FOR WHATEVER REASON. 2402 01:34:34,480 --> 01:34:36,120 SO, THIS SEEMS VERY ATTRACTIVE 2403 01:34:36,120 --> 01:34:40,400 TO ME THE IDEA OF GETTING -- IF 2404 01:34:40,400 --> 01:34:43,480 YOU CAN GET BU PREN EF RIN IN 2405 01:34:43,480 --> 01:34:45,080 ORDER RIGHT AWAY AND I WONDER 2406 01:34:45,080 --> 01:34:48,080 WHAT YOU THINK ABOUT IT. 2407 01:34:48,080 --> 01:34:52,520 I AGREE. FASTER WE CAN GET IT 2408 01:34:52,520 --> 01:34:55,400 IN AFTER REVERSAL THE BETTER. 2409 01:34:55,400 --> 01:35:01,640 AND THIS IS A LITTLE BIT OF A -- 2410 01:35:01,640 --> 01:35:02,440 I'M TELLING YOU SOMETHING A 2411 01:35:02,440 --> 01:35:04,280 LITTLE EARLY AND HOPING WE HAVE 2412 01:35:04,280 --> 01:35:06,680 A PAPER THAT WILL BE PUBLISHED 2413 01:35:06,680 --> 01:35:09,560 VERY SHORTLY BACK AND FORTH A 2414 01:35:09,560 --> 01:35:14,120 ZILLION TIMES TO JAMA NETWORK 2415 01:35:14,120 --> 01:35:17,640 PLACES AND IN OUR CURRENT STUDY 2416 01:35:17,640 --> 01:35:21,680 OF BU PREN OR FRIN THERE IS 2417 01:35:21,680 --> 01:35:24,720 STANDARD DOSING VERSUS CAM28 2418 01:35:24,720 --> 01:35:26,920 THAT IS A 7-DAY INJECTABLE THAT 2419 01:35:26,920 --> 01:35:31,640 WE HAVE ENROLLED IN THIS MOMENT 2420 01:35:31,640 --> 01:35:35,160 MORE THAN 1350 PATIENTS 2421 01:35:35,160 --> 01:35:36,800 NATIONWIDE AND 28 SITES OVERALL 2422 01:35:36,800 --> 01:35:39,640 THAT HAVE ENROLLED PATIENTS. WE 2423 01:35:39,640 --> 01:35:43,040 ONLY HAVE 9 EPISODES OF 2424 01:35:43,040 --> 01:35:43,440 [INDISCERNIBLE]. 2425 01:35:43,440 --> 01:35:46,760 THOSE ARE, YOU KNOW, CONSISTENT 2426 01:35:46,760 --> 01:35:49,280 SURVEILLANCE ADJUDICATED ABOUT I 2427 01:35:49,280 --> 01:35:52,640 DR. WAL SHALL AND LOCK WALL IN 2428 01:35:52,640 --> 01:35:53,600 KENTUCKY WITH ANY SITUATION 2429 01:35:53,600 --> 01:35:55,560 BROUGHT UP THAT WANTED TO REVIEW 2430 01:35:55,560 --> 01:35:57,720 AND WE DON'T HAVE CONFLICTS 2431 01:35:57,720 --> 01:36:00,800 BETWEEN TREATING TEAM AND 2432 01:36:00,800 --> 01:36:02,360 ADJUDICATORS AND WE ONLY HAVE 9. 2433 01:36:02,360 --> 01:36:03,880 WHILE IT CAN HAPPEN AND IF YOU 2434 01:36:03,880 --> 01:36:07,040 LOOK HISTORICALLY WITH PEOPLE 2435 01:36:07,040 --> 01:36:09,400 WITH PRECIPITATED WITHDRAWAL AND 2436 01:36:09,400 --> 01:36:11,800 IN LITERATURE IT IS MUCH HIGHER 2437 01:36:11,800 --> 01:36:13,400 THAN THAT. I DON'T KNOW. IT IS 2438 01:36:13,400 --> 01:36:15,240 PART OF A TRIAL. CAN YOU ALWAYS 2439 01:36:15,240 --> 01:36:21,520 HAVE THINGS PART OF A TRIAL THAT 2440 01:36:21,520 --> 01:36:22,720 ARE DIFFERENT FOR EVERYONE. 2441 01:36:22,720 --> 01:36:25,800 ALMOST 76% OF THE ENTIRE SAMPLE 2442 01:36:25,800 --> 01:36:28,120 USES FENTANYL THAT IS DRAWN FROM 2443 01:36:28,120 --> 01:36:32,000 MANY AREAS THAT USE FENTANYL AND 2444 01:36:32,000 --> 01:36:35,320 ALL NINE PATIENTS HAVE FENTANYL 2445 01:36:35,320 --> 01:36:36,960 WITH OTHER THINGS, ET CETERA. 2446 01:36:36,960 --> 01:36:38,840 THERE WAS NO PHENOTYPE THAT I 2447 01:36:38,840 --> 01:36:40,720 COULD TELL YOU OF ANY ONE. SOME 2448 01:36:40,720 --> 01:36:43,240 USED A LOT AND SOME DIDN'T. 2449 01:36:43,240 --> 01:36:45,800 SOME WERE A DAY OR SO MORE OUT 2450 01:36:45,800 --> 01:36:48,000 OF AND SOME WERE 6 HOURS AND 2451 01:36:48,000 --> 01:36:50,640 THERE WAS NO RHYME AND REASON IN 2452 01:36:50,640 --> 01:36:53,120 THE 9 PATIENTS AND WE TALK ABOUT 2453 01:36:53,120 --> 01:36:55,160 IT A LOT IN CASE SERIES AND THAT 2454 01:36:55,160 --> 01:36:57,560 IS ABOUT IT. I THINK WE ARE 2455 01:36:57,560 --> 01:36:59,960 USING A LOT MORE BU PREN OR FRIN 2456 01:36:59,960 --> 01:37:01,760 THAN WE DID IN THE PAST AND HAVE 2457 01:37:01,760 --> 01:37:03,920 A BIGGER CRISIS USING MORE 2458 01:37:03,920 --> 01:37:06,200 MEDICATIONS AND ARE SEEING 2459 01:37:06,200 --> 01:37:07,200 PRECIPITANT WHICH WE KNOW WE 2460 01:37:07,200 --> 01:37:09,640 WILL SEE AND WE WERE IN AN ED 2461 01:37:09,640 --> 01:37:12,200 AND WE TREAT IT VERY FAST. 2462 01:37:12,200 --> 01:37:14,640 IF SOMEBODY HAS A ROCKY ROAD 2463 01:37:14,640 --> 01:37:15,800 THEY START TO FEEL DIFFERENTLY 2464 01:37:15,800 --> 01:37:17,880 WE GIVE THEM MORE. WE HAVE NO 2465 01:37:17,880 --> 01:37:20,720 ISSUES WITH THAT REALLY. WE 2466 01:37:20,720 --> 01:37:22,600 KEEP GIVING THEM MORE AND MORE 2467 01:37:22,600 --> 01:37:25,440 BUPE AND THEY DO WELL AND LEAVE 2468 01:37:25,440 --> 01:37:27,760 AND MAYBE THERE IS WHAT THIS 2469 01:37:27,760 --> 01:37:28,720 MEDICATIONS THAT WE HAVE AND 2470 01:37:28,720 --> 01:37:31,480 FEEL COMFORTABLE GIVING EDS THAT 2471 01:37:31,480 --> 01:37:33,840 ARE NOT IN ANY AMBLATTORY 2472 01:37:33,840 --> 01:37:36,040 SETTINGS AND PRECIPITATED 2473 01:37:36,040 --> 01:37:37,200 WITHDRAWAL I'M NOT WORRIED ABOUT 2474 01:37:37,200 --> 01:37:41,280 IT HONEST WILL I GETTING IT IN 2475 01:37:41,280 --> 01:37:42,920 QUICKLY AND IF PERSON IS IN 2476 01:37:42,920 --> 01:37:44,840 WITHDRAWAL OF AT LEAST 8 WE CAN 2477 01:37:44,840 --> 01:37:46,920 GIVE THIS AGAIN AND IF THERE 2478 01:37:46,920 --> 01:37:48,840 WERE ANY ISSUES WE CAN STILL 2479 01:37:48,840 --> 01:37:50,400 CONTINUE TO TREAT THEM AND THEY 2480 01:37:50,400 --> 01:37:52,640 CAN BE TRANSPORTED TO ED AND WE 2481 01:37:52,640 --> 01:37:56,560 HAVE AN OPEN POLICY IN THOSE OF 2482 01:37:56,560 --> 01:37:59,080 US DOING THIS THAT THEY CAN COME 2483 01:37:59,080 --> 01:38:01,320 BACK AND PROBABLY IS NOT TRUE 2484 01:38:01,320 --> 01:38:02,320 EVERYWHERE IN THE WORLD BUT 2485 01:38:02,320 --> 01:38:04,480 ANYONE DOING STUDIES WOULD BE 2486 01:38:04,480 --> 01:38:06,720 ABLE TO COME TO ED AT ANY 2487 01:38:06,720 --> 01:38:06,960 MOMENT. 2488 01:38:06,960 --> 01:38:08,760 >>MY QUESTION TO YOU, GAIL. I 2489 01:38:08,760 --> 01:38:11,200 THINK OBVIOUSLY YOU HAVE BROUGHT 2490 01:38:11,200 --> 01:38:14,360 THIS IN OUR LAST MEETING THAT 2491 01:38:14,360 --> 01:38:15,800 THERE IS THE NOTION YOU ARE 2492 01:38:15,800 --> 01:38:17,440 BEING ABLE TO PUBLISH IN 2493 01:38:17,440 --> 01:38:19,760 EMERGENCY DEPARTMENT THAT YOU 2494 01:38:19,760 --> 01:38:23,440 CAN INITIATE HIGH DOSES OF 2495 01:38:23,440 --> 01:38:24,360 NOREPINEPHRINE WITH LITTLE 2496 01:38:24,360 --> 01:38:27,000 EVIDENCE OF PATIENTS GOING INTO 2497 01:38:27,000 --> 01:38:29,680 WITHDRAWAL AND ASK YOU QUESTION 2498 01:38:29,680 --> 01:38:32,080 BECAUSE IT IS FROM 2499 01:38:32,080 --> 01:38:32,720 PHARMACOLOGICAL PERSPECTIVE THAT 2500 01:38:32,720 --> 01:38:35,160 IS A VERY RELEVANT ONE AND I 2501 01:38:35,160 --> 01:38:38,040 REALIZE YOU HAVE 1,350 PATIENTS 2502 01:38:38,040 --> 01:38:40,880 YOU RECRUITED AND FROM THESE 2503 01:38:40,880 --> 01:38:43,640 PATIENTS WHAT PERCENTAGE OF THEM 2504 01:38:43,640 --> 01:38:46,520 HAD BEEN OR RECEIVED NAL OX YOEN 2505 01:38:46,520 --> 01:38:51,400 PRIOR TO ASSOCIATION OF NORBU 2506 01:38:51,400 --> 01:38:54,120 PREN EF FRIN AND INTERVENTION 2507 01:38:54,120 --> 01:38:55,840 FROM PHARMACOLOGY THAT REVERSES 2508 01:38:55,840 --> 01:38:57,360 PHYSICAL DEPENDENCE AND TO 2509 01:38:57,360 --> 01:38:59,160 EXTENT YOU CAN GIVE NAL OX YOEN 2510 01:38:59,160 --> 01:39:01,280 YOU HAVE REVERTED THE SYSTEM AND 2511 01:39:01,280 --> 01:39:03,800 ARE MUCH LESS LIKELY TO TRIGGER 2512 01:39:03,800 --> 01:39:05,520 WITHDRAWAL. DO YOU KNOW NUMBERS 2513 01:39:05,520 --> 01:39:05,960 BECAUSE -- 2514 01:39:05,960 --> 01:39:09,360 >>I DON'T KNOW THAT NUMBER. IT 2515 01:39:09,360 --> 01:39:13,360 IS NOT A HUGE AMOUNT THOUGH. 2516 01:39:13,360 --> 01:39:16,640 >>MAJORITY OF PARTICIPANTS 2517 01:39:16,640 --> 01:39:19,360 ENDED UP IN MRNL DEPARTMENT. 2518 01:39:19,360 --> 01:39:22,200 THEY DID NOT REQUIRE REVERSAL 2519 01:39:22,200 --> 01:39:25,320 FOR THEIR OVERDOSES AND WERE 2520 01:39:25,320 --> 01:39:26,640 PATIENTS THERE FOR OTHER CAUSES. 2521 01:39:26,640 --> 01:39:27,240 >>YES. 2522 01:39:27,240 --> 01:39:29,080 >>WHAT ARE CHARACTERISTICS? 2523 01:39:29,080 --> 01:39:31,040 >>THEY ARE THERE FOR EITHER 2524 01:39:31,040 --> 01:39:32,880 SEEKING TREATMENT OR THEY ARE 2525 01:39:32,880 --> 01:39:34,840 THERE FOR SOME OTHER ASPECTS 2526 01:39:34,840 --> 01:39:38,400 THAT HAVE NOTHING TO DO WITH 2527 01:39:38,400 --> 01:39:42,960 OPIATE ADDICTION OR THEY COULD 2528 01:39:42,960 --> 01:39:43,760 HAVE OVERDOSED. 2529 01:39:43,760 --> 01:39:45,720 THERE IS A PROPORTION BUT IT IS 2530 01:39:45,720 --> 01:39:47,880 NOT A HUGE PROPORTION THAT CAME 2531 01:39:47,880 --> 01:39:52,960 IN AFTER AN OVERDOSE AND SOME 2532 01:39:52,960 --> 01:39:54,160 PRECIPITATED OWN WITHDRAWAL IN 2533 01:39:54,160 --> 01:39:58,680 THE COMMUNITY TAKING BU PREN OR 2534 01:39:58,680 --> 01:40:01,680 FRIN WITHOUT BEING IN WITHDRAWAL 2535 01:40:01,680 --> 01:40:03,800 AND ARE NOT HUGE AMOUNTS OF 2536 01:40:03,800 --> 01:40:05,880 THOSE THEY ARE ALL DIFFERENT 2537 01:40:05,880 --> 01:40:06,080 REALLY. 2538 01:40:06,080 --> 01:40:08,200 >>IT COULD BE VERY IMPORTANT TO 2539 01:40:08,200 --> 01:40:09,720 LOOK AT DETAILS. 2540 01:40:09,720 --> 01:40:10,520 >>YES. 2541 01:40:10,520 --> 01:40:12,600 >>ACTUALLY, ONE ISSUE I 2542 01:40:12,600 --> 01:40:14,240 BASICALLY IN SPEAKING WITH 2543 01:40:14,240 --> 01:40:16,600 PATIENTS THAT IS A MAJOR CONCERN 2544 01:40:16,600 --> 01:40:19,200 IS WHEN GIVEN BU PREN OR FRIN 2545 01:40:19,200 --> 01:40:20,840 THAT TRIGGERS WITHDRAWAL THEY 2546 01:40:20,840 --> 01:40:23,000 GET BASICALLY NEGATIVELY 2547 01:40:23,000 --> 01:40:23,360 CONDITIONED. 2548 01:40:23,360 --> 01:40:23,640 >>RIGHT. 2549 01:40:23,640 --> 01:40:26,840 >>TO PUT IT INTO THE FUTURE. 2550 01:40:26,840 --> 01:40:29,840 SO, WE DON'T IN ORDER TO BE ABLE 2551 01:40:29,840 --> 01:40:31,640 TO MAXIMIZE LIKELIHOOD WE DON'T 2552 01:40:31,640 --> 01:40:35,040 HAVE NEGATIVE OUTCOMES 2553 01:40:35,040 --> 01:40:36,400 UNDERSTANDING WHO CAN BE AT 2554 01:40:36,400 --> 01:40:40,040 RIFSHG AND BRING IT UP ALSO 2555 01:40:40,040 --> 01:40:42,800 FASCINATES ME FROM PHARMACOLOGY 2556 01:40:42,800 --> 01:40:45,720 PERSPECTIVE YOU KNOW SEVERAL 2557 01:40:45,720 --> 01:40:48,720 CLINICIANS PROPOSE BU PREN OR 2558 01:40:48,720 --> 01:40:51,280 FRIN TO OVERDOSE AND YOU ARE 2559 01:40:51,280 --> 01:40:54,960 PUSHING OUT FENTANYL AND THAT 2560 01:40:54,960 --> 01:40:56,600 ELEMENT AND WE KNOW THESE ARE 2561 01:40:56,600 --> 01:40:59,720 VERY -- I MEAN, IT MAY BE 2562 01:40:59,720 --> 01:41:03,800 ACTUALLY ACT LIKE ANTAGONIST AND 2563 01:41:03,800 --> 01:41:06,040 UNDERSTANDING WHAT GOES ON WILL 2564 01:41:06,040 --> 01:41:08,440 BE CRUCIAL. IF YOU CAN SHOW 2565 01:41:08,440 --> 01:41:10,800 EXACTLY THAT YOU CAN INITIATE 2566 01:41:10,800 --> 01:41:12,720 HIGH DOSES IT MAKES IT SO MUCH 2567 01:41:12,720 --> 01:41:18,520 MORE PRACTICAL AND SOMETHING WE 2568 01:41:18,520 --> 01:41:20,960 CAN GIVE A GUIDELINE CHANGING 2569 01:41:20,960 --> 01:41:22,240 PRACTICES THAT EXIST CURRENTLY. 2570 01:41:22,240 --> 01:41:24,960 >>WE STILL NEED MORE. WITH 2571 01:41:24,960 --> 01:41:26,800 HIGH DOSE INITIATION WE 2572 01:41:26,800 --> 01:41:30,400 PUBLISHED WITH ANDREW HERRING A 2573 01:41:30,400 --> 01:41:31,120 RETROSPECTIVE REVIEW AND 2574 01:41:31,120 --> 01:41:32,480 ALTHOUGH SOME ARE DOING IT, 2575 01:41:32,480 --> 01:41:34,560 THERE IS NOT ENOUGH DATA AND ONE 2576 01:41:34,560 --> 01:41:36,360 REASON WE NEED TO STUDY IT. 2577 01:41:36,360 --> 01:41:38,560 THERE ISN'T. WE HAVE TO GET 2578 01:41:38,560 --> 01:41:39,800 PEOPLE COMFORTABLE WITH IT AND 2579 01:41:39,800 --> 01:41:43,960 SEE IF IT WORKS AND DOES SUSTAIN 2580 01:41:43,960 --> 01:41:47,280 PEOPLE IN TREATMENT. 2581 01:41:47,280 --> 01:41:49,080 IN THIS RECENT STUDY I WILL SEE 2582 01:41:49,080 --> 01:41:51,360 IF I CAN GO BACK AND SOME DATA I 2583 01:41:51,360 --> 01:41:54,680 CAN'T GET NOT AS NIMBLE TO DO 2584 01:41:54,680 --> 01:41:56,840 WITH MS AND AS LONG AS IT IS 2585 01:41:56,840 --> 01:41:58,640 BASELINE DATA I WILL LOOK AT IT 2586 01:41:58,640 --> 01:42:01,960 SEEING HOW MANY FOR YOU AND HOW 2587 01:42:01,960 --> 01:42:06,040 MANY PEOPLE HAD A NAL OX YOEN 2588 01:42:06,040 --> 01:42:08,640 RESCUE PRIOR TO US INITIATING. 2589 01:42:08,640 --> 01:42:10,560 >>WHILE YOU DO THAT QUESTION IS 2590 01:42:10,560 --> 01:42:12,600 NEXT MS PROJECT SPECIFICALLY. 2591 01:42:12,600 --> 01:42:13,440 >>ALL RIGHT. 2592 01:42:13,440 --> 01:42:15,200 >>IS IT BEING ORGANIZED IN SUCH 2593 01:42:15,200 --> 01:42:17,600 A WAY THAT IS GIVING US THIS 2594 01:42:17,600 --> 01:42:18,960 INFORMATION THAT IS NECESSARY IN 2595 01:42:18,960 --> 01:42:23,320 TERMS OF THE DOSES TO INITIATE? 2596 01:42:23,320 --> 01:42:25,400 >>OH, YES. YES. 2597 01:42:25,400 --> 01:42:29,120 >>WELL, THAT ANSWERS MY 2598 01:42:29,120 --> 01:42:33,720 QUESTION. THANK YOU. 2599 01:42:33,720 --> 01:42:36,200 >>I THINK WE HAVE HAD A VERY 2600 01:42:36,200 --> 01:42:37,800 GREAT DISCUSSION AND I WILL TURN 2601 01:42:37,800 --> 01:42:39,720 IT BACK TO YOU, ALEX. WERE 2602 01:42:39,720 --> 01:42:41,600 THERE QUESTIONS YOU WANTED TO BE 2603 01:42:41,600 --> 01:42:45,720 SURE THAT WE GOT FEEDBACK FROM 2604 01:42:45,720 --> 01:42:46,600 MULTI-DISCIPLINARY WORKING GROUP 2605 01:42:46,600 --> 01:42:50,760 MEMBERS ON -- WE HAVE LOTS OF 2606 01:42:50,760 --> 01:42:51,440 FARM COLDISCUSSIONS. 2607 01:42:51,440 --> 01:42:56,040 >>WELL, ONE THING THAT WE HAD 2608 01:42:56,040 --> 01:42:58,040 WOVEN THROUGHOUT WAS WHICH 2609 01:42:58,040 --> 01:42:59,200 STAKEHOLDERS WE SHOULD BE 2610 01:42:59,200 --> 01:43:00,240 ADDRESSING AND LIKE YOU SAID 2611 01:43:00,240 --> 01:43:02,120 THEY ARE PROBABLY A BIT 2612 01:43:02,120 --> 01:43:03,320 DIFFERENT IN WAY THAT THEY WOULD 2613 01:43:03,320 --> 01:43:06,560 BE IMPLEMENTED AND MAYBE SOME 2614 01:43:06,560 --> 01:43:08,560 UNCOMMON SETTINGS FOR US. 2615 01:43:08,560 --> 01:43:10,120 I WOULD APPRECIATE HEARING 2616 01:43:10,120 --> 01:43:12,280 THOUGHTS ON WHO WE SHOULD ENGAGE 2617 01:43:12,280 --> 01:43:20,040 IN TO BEST DO THIS RESEARCH. 2618 01:43:20,040 --> 01:43:23,960 >>THOUGHTS ON STAKEHOLDERS AND 2619 01:43:23,960 --> 01:43:25,680 PLACES THEY WILL STRENGTHEN 2620 01:43:25,680 --> 01:43:27,280 SCIENCE AND OVERCOME BARRIERS TO 2621 01:43:27,280 --> 01:43:33,440 BE IN PLACE THOUGHTS FROM 2622 01:43:33,440 --> 01:43:34,800 MULTI-DISCIPLINARY WORKING 2623 01:43:34,800 --> 01:43:38,800 GROUP? 2624 01:43:38,800 --> 01:43:41,640 >>I WOULD START SAYING WE HAVE 2625 01:43:41,640 --> 01:43:45,360 TO OBVIOUSLY INVOLVE SAMHSA. 2626 01:43:45,360 --> 01:43:49,800 ALSO, HRSA. IN TERMS OF HAVING 2627 01:43:49,800 --> 01:43:57,880 THEM BE ON BOARD THEY ARE 2628 01:43:57,880 --> 01:44:01,680 PROVIDERS OF SUPPORT AND 2629 01:44:01,680 --> 01:44:06,440 RESOURCES AND TO EXTENT THEY ARE 2630 01:44:06,440 --> 01:44:08,520 ACTUALLY ON BOARD WE WOULD BE 2631 01:44:08,520 --> 01:44:10,960 MUCH BETTER TO DEPLOY IT. THOSE 2632 01:44:10,960 --> 01:44:12,840 ARE FOR STARTERS. 2633 01:44:12,840 --> 01:44:15,760 >>YEAH. THANK YOU. THAT WILL 2634 01:44:15,760 --> 01:44:18,320 HELP TOWARDS SUSTAINABILITY AS 2635 01:44:18,320 --> 01:44:20,920 WELL. NED? 2636 01:44:20,920 --> 01:44:27,840 >>YEAH. SO, I AGREE ABOUT 2637 01:44:27,840 --> 01:44:31,880 SAMHSA AND ACTUALLY THE STUDY OF 2638 01:44:31,880 --> 01:44:34,680 INITIATE OF BUR PEN EF RIN ON 2639 01:44:34,680 --> 01:44:37,560 UNITS IN COLLABORATION WITH 2640 01:44:37,560 --> 01:44:41,680 ATTCS FUNDED BY SAMHSA. I WAS 2641 01:44:41,680 --> 01:44:43,760 GOING TO SAY ABOUT STAKEHOLDERS 2642 01:44:43,760 --> 01:44:46,920 IS, YOU KNOW, PART OF WHAT ALL 2643 01:44:46,920 --> 01:44:50,720 IS THAT I THINK ABOUT THAT 80% 2644 01:44:50,720 --> 01:44:51,840 WITH OPIOID USE DISORDER ARE NOT 2645 01:44:51,840 --> 01:44:55,000 ON MEDICATION. I THINK THOSE 2646 01:44:55,000 --> 01:44:58,400 ARE IMPORTANT STAKEHOLDERS AND 2647 01:44:58,400 --> 01:45:01,320 THOSE PEOPLE AND PEOPLE IN, YOU 2648 01:45:01,320 --> 01:45:03,680 KNOW, THE -- THE STAFF IN HARM 2649 01:45:03,680 --> 01:45:05,520 REDUCTION PROGRAMS TAKING CARE 2650 01:45:05,520 --> 01:45:09,880 OF THEM. YOU KNOW, WE NEED TO 2651 01:45:09,880 --> 01:45:16,440 UNDERSTAND THEIR PERSPECTIVE. 2652 01:45:16,440 --> 01:45:18,160 I JUST THINK THAT IS VERY 2653 01:45:18,160 --> 01:45:19,760 IMPORTANT AND DON'T KNOW HOW 2654 01:45:19,760 --> 01:45:21,480 MANY PEOPLE SAW THE ARTICLE BY 2655 01:45:21,480 --> 01:45:23,240 TRACY IN THE NEW YORK TIMES 2656 01:45:23,240 --> 01:45:25,240 ABOUT THE BOSTON DOCTOR WHO IS 2657 01:45:25,240 --> 01:45:27,440 TAKING CARE OF HOMELESS PEOPLE. 2658 01:45:27,440 --> 01:45:28,200 IT -- 2659 01:45:28,200 --> 01:45:31,400 >>IT WAS AMAZING AND IS A BOOK 2660 01:45:31,400 --> 01:45:31,960 EXCERPT. 2661 01:45:31,960 --> 01:45:33,360 >>NOW IT IS A BOOK. 2662 01:45:33,360 --> 01:45:33,640 >>YEAH. 2663 01:45:33,640 --> 01:45:35,840 >>AMAZING. IT GIVES YOU -- YOU 2664 01:45:35,840 --> 01:45:40,080 KNOW, THERE IS A REALLY HIGHLY 2665 01:45:40,080 --> 01:45:41,920 TRAINED INTERNIST ON WAY TO 2666 01:45:41,920 --> 01:45:44,440 FANCY ACADEMIC CAREER THAT 2667 01:45:44,440 --> 01:45:46,560 REALLY WENT THROUGH THE LOOKING 2668 01:45:46,560 --> 01:45:48,240 GLASS WHEN CAME TIME TO ACTUALLY 2669 01:45:48,240 --> 01:45:53,920 FOCUS ON THIS POPULATION OF IN 2670 01:45:53,920 --> 01:45:56,560 THAT CASE HOMELESS PEOPLE AND 2671 01:45:56,560 --> 01:45:57,400 MANY WITH SUBSTANCE USE DISORDER 2672 01:45:57,400 --> 01:45:59,680 AND FEEL WE HAVE TO GO THROUGH 2673 01:45:59,680 --> 01:46:02,920 THE LOOKING GLASS ALSO AND TRY 2674 01:46:02,920 --> 01:46:05,360 TO UNDERSTAND MORE ABOUT THE 2675 01:46:05,360 --> 01:46:08,040 PERSPECTIVE FROM THOSE FOLKS. 2676 01:46:08,040 --> 01:46:11,080 >>SO, I THINK THE OTHER 2677 01:46:11,080 --> 01:46:13,600 STAKEHOLDER IS HOUSING 2678 01:46:13,600 --> 01:46:13,920 AUTHORITIES. 2679 01:46:13,920 --> 01:46:16,880 AND HOW TO ENGAGE THEM IN A 2680 01:46:16,880 --> 01:46:18,280 MEANINGFUL WAY AND GAIL SAID 2681 01:46:18,280 --> 01:46:20,120 THERE IS 50% OF CLIENTS OR 2682 01:46:20,120 --> 01:46:21,560 SOMEONE SAID THIS MORNING THAT 2683 01:46:21,560 --> 01:46:22,760 ARE HOMELESS. 2684 01:46:22,760 --> 01:46:25,640 SO, YEAH. I MEAN, HOUSING IS 2685 01:46:25,640 --> 01:46:27,360 HEALTH CARE. 2686 01:46:27,360 --> 01:46:31,480 >>YEAH. YEAH. ABSOLUTELY. 2687 01:46:31,480 --> 01:46:35,280 >>SO, ADDING TO THAT, DE ACHLT 2688 01:46:35,280 --> 01:46:37,640 AND PHARMACIES AND FARMLY 2689 01:46:37,640 --> 01:46:38,000 ASSOCIATIONS. 2690 01:46:38,000 --> 01:46:40,920 IF YOU RELEASE PEOPLE AND GET 2691 01:46:40,920 --> 01:46:46,600 THEM PRESCRIPTIONS OF HIGH DOSE 2692 01:46:46,600 --> 01:46:49,040 BU PREN EF RIN WILL YOU HAVE A 2693 01:46:49,040 --> 01:46:51,000 HUGE ROAD BLOCK WITH PEOPLE NOT 2694 01:46:51,000 --> 01:46:52,920 WANTING TO GIVE THAT AMOUNT AND 2695 01:46:52,920 --> 01:46:55,440 PHARMACISTS NO THE WANTING TO DO 2696 01:46:55,440 --> 01:46:58,760 THAT AND PERHAPS I WOULD SAY THE 2697 01:46:58,760 --> 01:47:00,760 RECOVERY COMMUNITIES AT LARGE 2698 01:47:00,760 --> 01:47:03,360 STILL A MASSIVE STIGMA AND 2699 01:47:03,360 --> 01:47:05,600 DISCRIMINATION FOR PATIENTS WITH 2700 01:47:05,600 --> 01:47:06,560 THESE [INDISCERNIBLE] AND 2701 01:47:06,560 --> 01:47:10,440 DISCLOSE THAT TO RECOVERY 2702 01:47:10,440 --> 01:47:10,800 COMMUNITIES. 2703 01:47:10,800 --> 01:47:14,440 >>GREAT. THANK YOU, ANDREA AND 2704 01:47:14,440 --> 01:47:17,280 WALTER HAS ADDED INTO THE CHAT 2705 01:47:17,280 --> 01:47:18,920 THAT SOME ADDITIONAL LICHGS FOR 2706 01:47:18,920 --> 01:47:22,240 THOSE THAT ARE FOLLOWING. 2707 01:47:22,240 --> 01:47:24,800 THE ROUGH SLEEPERS BOOK. 2708 01:47:24,800 --> 01:47:27,320 AND COVERAGE WHAT IS HAPPENING 2709 01:47:27,320 --> 01:47:28,320 IN BOSTON. 2710 01:47:28,320 --> 01:47:30,840 SO, I THINK WE ARE AT A NATURAL 2711 01:47:30,840 --> 01:47:33,640 BREAKING POINT. I WOULD LIKE TO 2712 01:47:33,640 --> 01:47:37,320 THANK ALL DISCUSSANTS AND ALEX 2713 01:47:37,320 --> 01:47:39,400 AND WENDY AND TISHA FOR SHARING 2714 01:47:39,400 --> 01:47:41,720 PRESENTATIONS AND CONCEPT LEADS 2715 01:47:41,720 --> 01:47:44,120 WHO HELPED TO DEVELOP THEM AND 2716 01:47:44,120 --> 01:47:47,040 WERE LISTENING IN AND HEARING 2717 01:47:47,040 --> 01:47:49,360 YOUR IMPACT AND INPUT AND 2718 01:47:49,360 --> 01:47:50,440 INCORPORATING THOSE IN REAL TIME 2719 01:47:50,440 --> 01:47:53,080 AND WOULD LIKE TO GIVE US TIME 2720 01:47:53,080 --> 01:47:56,120 FOR A QUICK BREAK. WE ARE 2721 01:47:56,120 --> 01:47:57,920 AMAZINGLY A LITTLE AHEAD OF 2722 01:47:57,920 --> 01:47:58,360 SCHEDULE. 2723 01:47:58,360 --> 01:48:01,160 SO, I THINK THAT WE CAN GIVE 2724 01:48:01,160 --> 01:48:04,080 OURSELVES 10 MINUTES OR 11 2725 01:48:04,080 --> 01:48:04,360 MINUTES. 2726 01:48:04,360 --> 01:48:09,640 WE CAN BE BACK AT 1 P.M. MY 2727 01:48:09,640 --> 01:48:11,000 TIME. 2728 01:48:11,000 --> 01:48:13,000 THANK YOU, AGAIN. WITH WE COME 2729 01:48:13,000 --> 01:48:14,960 BACK WE WILL TALK ABOUT 2730 01:48:14,960 --> 01:48:16,120 THERAPEUTIC DEVELOPMENT AND WILL 2731 01:48:16,120 --> 01:48:19,040 SWITCH GEARS AND LOOK ACROSS 2732 01:48:19,040 --> 01:48:21,200 BOTH PAIN AND ADDICTION AND LOOK 2733 01:48:21,200 --> 01:48:23,080 AT HEAL INVESTMENT PORTFOLIO AND 2734 01:48:23,080 --> 01:48:26,640 ALL OF THE ONGOING AND PROPOSED 2735 01:48:26,640 --> 01:48:28,080 RESEARCH TOGETHER. NORA, YOU 2736 01:48:28,080 --> 01:48:30,440 HAVE YOUR HAND RAISED. MAKING 2737 01:48:30,440 --> 01:48:31,360 SURE YOU DON'T HAVE FINAL 2738 01:48:31,360 --> 01:48:33,200 COMMENTS BEFORE WE GO OFF TO 2739 01:48:33,200 --> 01:48:33,520 BREAK? 2740 01:48:33,520 --> 01:48:35,160 >>NO. JUST THAT I NEED TO 2741 01:48:35,160 --> 01:48:38,040 LOWER IT. BREAK IS PERFECT. 2742 01:48:38,040 --> 01:48:38,280 THANKS. 2743 01:48:38,280 --> 01:48:39,840 >>THANKS, EVERYONE. 2744 01:48:39,840 --> 01:48:46,200 SEE YOU IN 10 MINUTES. 2745 01:48:46,200 --> 01:48:48,120 HUGE FOCUS SINCE BEGINNING IS 2746 01:48:48,120 --> 01:48:51,400 DEVELOPMENT OF NOL ELAND USER 2747 01:48:51,400 --> 01:48:54,360 FRIENDLY TREATMENT OPTIONS AND 2748 01:48:54,360 --> 01:48:56,840 REVERSAL OF OVERDOSE AND WE ARE 2749 01:48:56,840 --> 01:48:58,080 FORTUNATE TO HAVE TWO DEDICATED 2750 01:48:58,080 --> 01:49:02,240 AND AMAZING RESEARCHERS CO-C 2751 01:49:02,240 --> 01:49:05,480 CO-CHAIRING THE SCIENTIFIC TEAM 2752 01:49:05,480 --> 01:49:10,120 DRIVING FORWARD RESEARCH FOR 2753 01:49:10,120 --> 01:49:19,120 AREA OF HEAL AND NIDA I CALL IT 2754 01:49:19,120 --> 01:49:19,640 NIAID. 2755 01:49:19,640 --> 01:49:21,000 KENT NER IS HERE WALKING US 2756 01:49:21,000 --> 01:49:23,120 THROUGH WHAT THE TEAM HAS PUT 2757 01:49:23,120 --> 01:49:25,360 FORWARD FOR CONSIDERATION FOR 2758 01:49:25,360 --> 01:49:28,640 UPCOMING FISCAL YEAR. NEXT 2759 01:49:28,640 --> 01:49:29,360 SLIDE, PLEASE. 2760 01:49:29,360 --> 01:49:31,240 I WILL DO WHAT I DID BEFORE THAT 2761 01:49:31,240 --> 01:49:34,680 IS TO PUT IN CONTEXT PROPOSED 2762 01:49:34,680 --> 01:49:38,200 RESEARCH AT THE BOTTOM HERE 2763 01:49:38,200 --> 01:49:39,720 CLINICAL ASSESSMENTS FOR DRUG 2764 01:49:39,720 --> 01:49:40,680 DEVELOPMENT TO BE SOMETHING 2765 01:49:40,680 --> 01:49:44,240 INCORPORATED INTO WHAT YOU SEE 2766 01:49:44,240 --> 01:49:46,480 AS A VERY BROAD AND DEEP SET OF 2767 01:49:46,480 --> 01:49:50,560 RESEARCH INVESTMENTS FOCUSED ON 2768 01:49:50,560 --> 01:49:52,160 IMMUNOTHERAPIES AND DEVELOPMENT 2769 01:49:52,160 --> 01:49:54,280 FOR OPIOID USE DISORDER AND 2770 01:49:54,280 --> 01:50:00,720 LARGE NUMBER OF MEDICATION AND 2771 01:50:00,720 --> 01:50:01,400 THERAPE 2772 01:50:01,400 --> 01:50:02,120 THERAPE 2773 01:50:02,120 --> 01:50:03,080 THERAPEUTIC-FOCUSED PROGRAMS AND 2774 01:50:03,080 --> 01:50:06,560 RESEARCH FOCUSED IN THE MIDDLE 2775 01:50:06,560 --> 01:50:07,800 FOCUSING ON STIMULANT DISORDERS 2776 01:50:07,800 --> 01:50:09,920 AND FOCUSING ON SPECIFIC 2777 01:50:09,920 --> 01:50:11,280 THERAPEUTICS AND NEW CATEGORIES 2778 01:50:11,280 --> 01:50:13,640 OF THERAPEUTICS FOR TREATMENT OF 2779 01:50:13,640 --> 01:50:16,800 SUBSTANCE USE DISORDER AND THOSE 2780 01:50:16,800 --> 01:50:19,240 ARE NOW IN THE MRANLING PHASE 2781 01:50:19,240 --> 01:50:21,040 INCLUDING MENTAL HEALTH 2782 01:50:21,040 --> 01:50:22,480 CONDITIONS TOGETHER WITH OPIOID 2783 01:50:22,480 --> 01:50:25,040 USE DISORDER AND EMERGING 2784 01:50:25,040 --> 01:50:26,160 THREATS AND ORAL COMPLICATES AND 2785 01:50:26,160 --> 01:50:28,200 OTHER MEDICATIONS FOR THE 2786 01:50:28,200 --> 01:50:29,120 TREATMENT OF OPIOID USE 2787 01:50:29,120 --> 01:50:30,480 DISORDER. SO, I WILL STOP THERE 2788 01:50:30,480 --> 01:50:34,320 AND TURN IT OVER TO YOU, KENT 2789 01:50:34,320 --> 01:50:36,200 NER. NEXT SLIDE, PLEASE. 2790 01:50:36,200 --> 01:50:38,080 >>THANK YOU, DR. BAKER. 2791 01:50:38,080 --> 01:50:42,720 SO, AS A REMINDER AND AS REBEKAH 2792 01:50:42,720 --> 01:50:45,600 SAID, CHARGE FOR OUR TEAM IS TO 2793 01:50:45,600 --> 01:50:47,080 REALLY EXPAND THERAPEUTIC 2794 01:50:47,080 --> 01:50:48,680 OPTIONS FOR TREATMENT OF OPIOID 2795 01:50:48,680 --> 01:50:50,280 AND STIMULANT USE DISORDERS THAT 2796 01:50:50,280 --> 01:50:52,960 OUR GOAL IS TO ACCELERATE 2797 01:50:52,960 --> 01:50:53,760 DEVELOPMENT FOR TREATMENTS FOR 2798 01:50:53,760 --> 01:50:57,480 ALL ASPECTS OF ADDICTION CYCLE 2799 01:50:57,480 --> 01:51:00,120 INCLUDING PROGRESSION OF CHRONIC 2800 01:51:00,120 --> 01:51:04,320 USE AND WITHDRAWAL SYMPTOMS 2801 01:51:04,320 --> 01:51:08,640 CRAVINGS AND OVERDOSE AND THRU 2802 01:51:08,640 --> 01:51:09,960 INITIATIVES LISTED ON PREVIOUS 2803 01:51:09,960 --> 01:51:13,600 SLIDE THAT REBEKAH MENTIONED AND 2804 01:51:13,600 --> 01:51:15,640 KEY POINT IS THAT WHEN WE 2805 01:51:15,640 --> 01:51:19,120 STARTED INITIAL GOAL IS TO HAVE 2806 01:51:19,120 --> 01:51:21,000 15IMDS FILED WITHIN FIRST 5 2807 01:51:21,000 --> 01:51:22,680 YEARS OF HEAL AND CURRENTLY 2808 01:51:22,680 --> 01:51:26,000 SUPPORTED FILING OF 34INDS AND 2809 01:51:26,000 --> 01:51:27,640 23 OF THOSE ARE CURRENTLY ACTIVE 2810 01:51:27,640 --> 01:51:29,760 AND NUMBERS ARE ACTIVELY GROWING 2811 01:51:29,760 --> 01:51:32,000 AND FY24 CONCEPT IS A LITTLE 2812 01:51:32,000 --> 01:51:35,960 DIFFERENT IN THAT IT REALLY IS 2813 01:51:35,960 --> 01:51:39,160 TO SUPPORT ACTIVITIES GETTING 2814 01:51:39,160 --> 01:51:42,080 IND EXPANDING UPON REGULATORY 2815 01:51:42,080 --> 01:51:43,200 RESOURCES AND DRUG DEVELOPMENT 2816 01:51:43,200 --> 01:51:45,760 TOOLS TO BE AVAILABLE FOR 2817 01:51:45,760 --> 01:51:47,040 INVESTIGATORS TO USE. 2818 01:51:47,040 --> 01:51:49,280 SO, CONCEPT OF PROPOSED IS 2819 01:51:49,280 --> 01:51:51,000 TITLED HERE AND SUPPORT OF 2820 01:51:51,000 --> 01:51:53,000 DEVELOPMENT OF CLINICAL OUTCOME 2821 01:51:53,000 --> 01:51:55,080 ASSESSMENTS AS FDA QUALIFIED 2822 01:51:55,080 --> 01:51:57,480 DRUG DEVELOPMENT TOOLS TO 2823 01:51:57,480 --> 01:52:00,320 ACCELERATE DEVELOPMENT OF 2824 01:52:00,320 --> 01:52:02,960 THERAPEUTICS TO TREAT OPIOID 2825 01:52:02,960 --> 01:52:05,360 SIMILAR TO USE DISORDER AND 2826 01:52:05,360 --> 01:52:06,520 CONCEPT INITIATED AND DEVELOPED 2827 01:52:06,520 --> 01:52:09,000 BY DR. RAMI WHO PUT TREMENDOUS 2828 01:52:09,000 --> 01:52:10,280 THOUGHT AND WORK INTO THIS 2829 01:52:10,280 --> 01:52:11,600 CONCEPT AND WE APPRECIATE IT. 2830 01:52:11,600 --> 01:52:13,400 THANK YOU. SHE IS ON THE CALL 2831 01:52:13,400 --> 01:52:14,360 AND WILL ANSWER ANY QUESTIONS 2832 01:52:14,360 --> 01:52:16,080 YOU HAVE ABOUT THE INITIATIVE. 2833 01:52:16,080 --> 01:52:22,440 WITH THAT, GOING TO THE NEXT 2834 01:52:22,440 --> 01:52:23,880 SLIDE. 2835 01:52:23,880 --> 01:52:26,200 >>A CONCERN WE HEARD THROUGH 2836 01:52:26,200 --> 01:52:28,280 COMMUNITY IN WORK WE SUPPORT IS 2837 01:52:28,280 --> 01:52:30,520 A QUALIFIED CLINICAL OUTCOMES 2838 01:52:30,520 --> 01:52:33,760 ASSESSMENTS RECOGNIZED AND 2839 01:52:33,760 --> 01:52:35,560 ACCEPTED BY FDA. 2840 01:52:35,560 --> 01:52:38,120 THAT IS REALLY CRITICAL FOR 2841 01:52:38,120 --> 01:52:40,760 TOOLS TO BE BY USE FOR 2842 01:52:40,760 --> 01:52:42,280 INVESTIGATORS AND FOR EXAMPLE 2843 01:52:42,280 --> 01:52:44,400 HELPFUL FOR INVESTIGATORS TO 2844 01:52:44,400 --> 01:52:47,640 HAVE A TOOLSET AND FDA 2845 01:52:47,640 --> 01:52:51,160 RECOGNIZED OUD SEVERITY CLINICAL 2846 01:52:51,160 --> 01:52:54,000 ASSESSMENT SCALE BASED ON DSM-5 2847 01:52:54,000 --> 01:52:56,920 CRITERIA AND EXAMPLE TO HAVE FDA 2848 01:52:56,920 --> 01:53:00,040 RECOGNIZED EVALUATIVE TOOL FOR 2849 01:53:00,040 --> 01:53:03,080 ASSESSMENT OF OPIOID CRAVINGS 2850 01:53:03,080 --> 01:53:04,840 FOR PATIENT REPORTED OUTCOMES 2851 01:53:04,840 --> 01:53:07,000 AND FDA RECOGNIZING QUALIFIED 2852 01:53:07,000 --> 01:53:09,440 DRUG DEVELOPMENT TOOLS 2853 01:53:09,440 --> 01:53:11,200 INVESTIGATORS CAN RELIABLY USE 2854 01:53:11,200 --> 01:53:12,960 AS TRIAL DESIGN ELEMENTS WOULD 2855 01:53:12,960 --> 01:53:16,720 REMOVE UNCERTAINTY THAT CAN BE 2856 01:53:16,720 --> 01:53:19,000 INVOLVED WITH IND SUBMISSION 2857 01:53:19,000 --> 01:53:22,400 THAT WOULD END UP SPEEDING UP 2858 01:53:22,400 --> 01:53:25,160 THE REGULATORY PROCESS. 2859 01:53:25,160 --> 01:53:27,680 MEETING THE NEED THIS CONCEPT IS 2860 01:53:27,680 --> 01:53:30,360 BUILT AROUND ADVANCING CLINICAL 2861 01:53:30,360 --> 01:53:32,440 ASSESSMENTS OR CLINICAL OUTCOME 2862 01:53:32,440 --> 01:53:35,640 ASSESSMENTS THROUGH FDA DRUG 2863 01:53:35,640 --> 01:53:36,640 DEVELOPMENT TOOL QUALIFICATION 2864 01:53:36,640 --> 01:53:40,160 PATHWAY AND PROPOSING TO USE 2865 01:53:40,160 --> 01:53:41,920 UG3UH3 PHASE MECHANISM WHERE 2866 01:53:41,920 --> 01:53:44,120 THAT TRANSITION MILESTONE IS 2867 01:53:44,120 --> 01:53:45,120 SUBMISSION AND ACCEPTANCE OF 2868 01:53:45,120 --> 01:53:48,160 LETTER OF INTENT TO THE FDA AND 2869 01:53:48,160 --> 01:53:52,600 AT THAT POINT PROPOSED CLINICAL 2870 01:53:52,600 --> 01:53:55,200 ASSESSMENTS QUALIFY THAT PROGRAM 2871 01:53:55,200 --> 01:53:56,960 AND UH3 SECOND PHASE OF THE 2872 01:53:56,960 --> 01:53:58,840 PROJECT IS FOCUSED ON RESPONDING 2873 01:53:58,840 --> 01:54:03,240 TO FDA'S ADVICE LETTER ADVANCING 2874 01:54:03,240 --> 01:54:05,880 CLINICAL ASSESSMENT TOWARDS 2875 01:54:05,880 --> 01:54:08,240 QUALIFICATION OF AN ACCEPTED 2876 01:54:08,240 --> 01:54:11,240 DRUG DEVELOPMENT TOOL. NEXT 2877 01:54:11,240 --> 01:54:11,760 SLIDE. 2878 01:54:11,760 --> 01:54:13,920 LET'S SEE HOW CONCEPT FITS WITH 2879 01:54:13,920 --> 01:54:16,280 HEAL AND ADVANCING PROGRAM AND 2880 01:54:16,280 --> 01:54:18,760 HAVING A SET OF FDA RECOGNIZED 2881 01:54:18,760 --> 01:54:20,880 DRUG DEVELOPMENT TOOLS IS 2882 01:54:20,880 --> 01:54:21,720 SIGNIFICANTLY HELPFUL AND 2883 01:54:21,720 --> 01:54:24,200 INDIVIDUAL INVESTIGATORS ACROSS 2884 01:54:24,200 --> 01:54:27,160 THE PROGRAM THAT WOULD SUPPORT 2885 01:54:27,160 --> 01:54:29,240 ONGOING SOLICITED PROGRAMS 2886 01:54:29,240 --> 01:54:31,240 THROUGH HEAL AND THERE IS A 2887 01:54:31,240 --> 01:54:32,920 SIGNIFICANT NEED HERE AND 2888 01:54:32,920 --> 01:54:34,640 PRODUCTS FROM CONCEPT WILL 2889 01:54:34,640 --> 01:54:41,680 SHORTEN EFFORT NEEDED AT KEY 2890 01:54:41,680 --> 01:54:45,640 STAGES OF CLINICAL DEVELOPMENT 2891 01:54:45,640 --> 01:54:47,080 REDUCING UNCERTAINTY OF THAT 2892 01:54:47,080 --> 01:54:48,880 SUBMISSION AND REGULATORY 2893 01:54:48,880 --> 01:54:50,200 PROCESS AND PROGRAM IS BUILT 2894 01:54:50,200 --> 01:54:52,440 WITH INTERACTIONS AROUND FDA AND 2895 01:54:52,440 --> 01:54:55,320 WE ANTICIPATE THIS CONCEPT HAS A 2896 01:54:55,320 --> 01:54:56,840 SIGNIFICANT IMPACT EXTENDING 2897 01:54:56,840 --> 01:55:00,800 WELL BEYOND THE HEAL PROGRAM. 2898 01:55:00,800 --> 01:55:02,160 NEXT SLIDE, PLEASE. 2899 01:55:02,160 --> 01:55:03,480 FOUR QUESTIONS HERE FOR 2900 01:55:03,480 --> 01:55:04,320 DISCUSSION. 2901 01:55:04,320 --> 01:55:06,480 BASICALLY, WHAT IT COMES DOWN TO 2902 01:55:06,480 --> 01:55:08,280 IS WE ARE LOOKING FOR FEEDBACK 2903 01:55:08,280 --> 01:55:11,000 FROM YOU ON HOW TO BEST FOCUS 2904 01:55:11,000 --> 01:55:13,320 ADVANCES CONCEPT SO WE CAN HAVE 2905 01:55:13,320 --> 01:55:14,880 LARGEST AND GREATEST IMPACT IN 2906 01:55:14,880 --> 01:55:17,080 THE COMMUNITY AND WITH THAT IN 2907 01:55:17,080 --> 01:55:20,920 MIND, THANK YOU. WE WILL OPEN 2908 01:55:20,920 --> 01:55:31,440 IT UP FOR DISCUSSION. 2909 01:55:31,440 --> 01:55:33,600 THANK YOU KENTNER. CHRISTIAN 2910 01:55:33,600 --> 01:55:36,240 HAS HIS HAMMED RAISED. GO RIGHT 2911 01:55:36,240 --> 01:55:36,480 AHEAD. 2912 01:55:36,480 --> 01:55:38,880 >>THANK YOU FORTHAT. THIS IS A 2913 01:55:38,880 --> 01:55:40,080 VERY, VERY IMPORTANT PROJECT AND 2914 01:55:40,080 --> 01:55:42,040 REASON FOR THAT IS IN MY OPINION 2915 01:55:42,040 --> 01:55:44,240 IT IS THAT YOU CANNOT REALLY 2916 01:55:44,240 --> 01:55:47,280 FIND RECOVERY IN TERMS OF 2917 01:55:47,280 --> 01:55:49,840 ABSTINENCE ONLY. 2918 01:55:49,840 --> 01:55:54,000 I THINK THAT IT IS TIME TO MOVE 2919 01:55:54,000 --> 01:55:59,920 FAR BEYOND JUST ABSTINNANCE. I 2920 01:55:59,920 --> 01:56:01,120 WOULD LIKE TO MAKE THREE 2921 01:56:01,120 --> 01:56:02,760 COMMENTS HERE AND FIRST IS ABOUT 2922 01:56:02,760 --> 01:56:04,080 HARM REDUCTION AND THINK THERE 2923 01:56:04,080 --> 01:56:08,040 IS A LOT OF THINGS WE CAN LEARN 2924 01:56:08,040 --> 01:56:11,080 FROM ALCOHOL USE DISORDER. 2925 01:56:11,080 --> 01:56:13,880 AS YOU KNOW THE FDA HAS EVOLVED 2926 01:56:13,880 --> 01:56:17,360 THE FIELD A LITTLE BIT BY ADDING 2927 01:56:17,360 --> 01:56:20,240 NO HEAVY DRINKING DAYS IN 2928 01:56:20,240 --> 01:56:21,560 ALCOHOL USE DISORDER AND WOULD 2929 01:56:21,560 --> 01:56:23,880 ARGUE THIS IS RELATIVELY NARROW 2930 01:56:23,880 --> 01:56:26,320 AND INSENSITIVE SINCE IT IS 2931 01:56:26,320 --> 01:56:28,080 BASICALLY CLASSIFYING PATIENTS 2932 01:56:28,080 --> 01:56:30,560 AS TREATMENT FAILURES AFTER ANY 2933 01:56:30,560 --> 01:56:34,000 HEAVY DRINKING DAYS. 2934 01:56:34,000 --> 01:56:35,920 SO, WHILE WE -- WHILE SOME OF 2935 01:56:35,920 --> 01:56:39,160 THE PATIENTS HAVE SUBSTANTIALLY 2936 01:56:39,160 --> 01:56:40,440 REDUCED THEIR DRINKING AND 2937 01:56:40,440 --> 01:56:42,120 IMPROVE HOW THEY FEEL AND HOW 2938 01:56:42,120 --> 01:56:43,680 THEY FUNCTION IN LIFE IN 2939 01:56:43,680 --> 01:56:44,280 GENERAL. 2940 01:56:44,280 --> 01:56:49,840 SO, AS YOU KNOW, THE EUROPEAN 2941 01:56:49,840 --> 01:56:52,680 MEDICINES AGENCY HAS NOW 2942 01:56:52,680 --> 01:56:55,600 ACCEPTED AS OUTCOME TWO-LEVEL 2943 01:56:55,600 --> 01:56:58,520 REDUCTION IN WHO FOR LEVEL 2944 01:56:58,520 --> 01:57:00,040 CLASSIFICATION OF RISK DRINKING 2945 01:57:00,040 --> 01:57:01,960 LEVELS AND THINK THAT A GROUP 2946 01:57:01,960 --> 01:57:04,760 LIKE ACTIVE GROUP HAS BEEN 2947 01:57:04,760 --> 01:57:08,280 WORKING ON VALIDATION OF THIS 2948 01:57:08,280 --> 01:57:10,920 FOR THE LAST 10 YEARS AND IS A 2949 01:57:10,920 --> 01:57:12,800 GOOD EXAMPLE AND THIS IS FOR 2950 01:57:12,800 --> 01:57:15,600 ALCOHOL USE DISORDER. I SEE IT 2951 01:57:15,600 --> 01:57:18,240 AS VERY VALUED APPROACH AND FOR 2952 01:57:18,240 --> 01:57:20,440 EXAMPLE FOR CANNABIS USE 2953 01:57:20,440 --> 01:57:22,960 DISORDER AND FORMS OF SUBSTANCE 2954 01:57:22,960 --> 01:57:24,480 USE DISORDER AND SECOND POINT TO 2955 01:57:24,480 --> 01:57:27,240 MAKE IS ABOUT CRAVING THAT IS A 2956 01:57:27,240 --> 01:57:30,680 VERY INTERESTING SITUATION WHERE 2957 01:57:30,680 --> 01:57:36,120 THERE HAS BEEN AN INCENTIVE FOR 2958 01:57:36,120 --> 01:57:38,280 US TO DEVELOP CREATING 2959 01:57:38,280 --> 01:57:39,520 MEDICATIONS WHILE CREATING IS 2960 01:57:39,520 --> 01:57:41,360 NOT RECOGNIZED VALUE TO 2961 01:57:41,360 --> 01:57:44,600 RECOGNIZE THE ENDPOINT IN OUR 2962 01:57:44,600 --> 01:57:45,680 REGULATORY TRIALS. 2963 01:57:45,680 --> 01:57:47,560 SO, I THINK THAT ANYTHING WE CAN 2964 01:57:47,560 --> 01:57:50,920 DO, IN ORDER TO VALIDATE NEW 2965 01:57:50,920 --> 01:57:53,320 CRAVING TOOLS THAT WOULD BE 2966 01:57:53,320 --> 01:57:57,040 ACTUALLY ACCEPTED BY FDA NOT 2967 01:57:57,040 --> 01:58:00,480 ONLY AS NICE TO HAVE ENDPOINT 2968 01:58:00,480 --> 01:58:02,920 BUT PRIMARY ENDPOINT MAKING SURE 2969 01:58:02,920 --> 01:58:05,840 WE ACTUALLY LINK ANTI-CRAVING 2970 01:58:05,840 --> 01:58:07,840 EFFECTS TO DRUG USE PATTERNS IS 2971 01:58:07,840 --> 01:58:10,800 GOING TO BE REALLY CRITICAL. 2972 01:58:10,800 --> 01:58:12,320 THIRD POINT THAT I WANTED TO 2973 01:58:12,320 --> 01:58:15,440 MAKE IS REALLY RELATED TO 2974 01:58:15,440 --> 01:58:17,000 QUALITY OF LIFE THAT TODAY STILL 2975 01:58:17,000 --> 01:58:19,400 SEEMS AS NICE TO HAVE AS PART OF 2976 01:58:19,400 --> 01:58:21,880 THE CLINICAL TRIALS THAT IN MY 2977 01:58:21,880 --> 01:58:23,400 OPINION REALLY NEEDS TO CHANGE. 2978 01:58:23,400 --> 01:58:27,840 WE NEED TO MAKE SURE THAT 2979 01:58:27,840 --> 01:58:30,040 QUALITY OF IS PRIMARY ENDPOINTS 2980 01:58:30,040 --> 01:58:32,280 AND REASON FOR THAT IS RECOVERY 2981 01:58:32,280 --> 01:58:36,720 AS I SAID IS NOT ONLY ABOUT 2982 01:58:36,720 --> 01:58:39,360 ABSTINENCE BUT MENTAL HEALTH, 2983 01:58:39,360 --> 01:58:42,440 PHYSICAL HEALTH, EMPLOYMENT 2984 01:58:42,440 --> 01:58:43,840 RATES AND SIGNIFICANTLY 2985 01:58:43,840 --> 01:58:45,800 DECREASING HEALTH RESOURCE 2986 01:58:45,800 --> 01:58:48,280 UTILIZATION AND IN OTHER WORDS 2987 01:58:48,280 --> 01:58:49,680 CONSTELLATION OF FACTORS 2988 01:58:49,680 --> 01:58:50,920 CURRENTLY NOT BEING CONSIDERED 2989 01:58:50,920 --> 01:58:54,880 IN CLINICAL TRIALS OR NOT AS 2990 01:58:54,880 --> 01:59:01,560 PRIMARY ENDPOINTS THREE MAIN 2991 01:59:01,560 --> 01:59:02,600 POINTS FROM ME HARM REDUCTION 2992 01:59:02,600 --> 01:59:04,840 CRAVING AND QUALITY OF LIFE IS A 2993 01:59:04,840 --> 01:59:09,080 MUCH BROADER DEFINITION WHAT 2994 01:59:09,080 --> 01:59:15,320 RECOVERY IS ALL ABOUT. 2995 01:59:15,320 --> 01:59:19,400 >>THANK YOU CHRISTIAN AND THANK 2996 01:59:19,400 --> 01:59:22,360 YOU KENT NER. 2997 01:59:22,360 --> 01:59:25,600 NORA WOULD YOU LIKE TO GO FOR OR 2998 01:59:25,600 --> 01:59:27,600 GO THROUGH DISSENTS AND WEIGH 2999 01:59:27,600 --> 01:59:27,760 IN. 3000 01:59:27,760 --> 01:59:30,240 >>LET ME GO FIRST. IT IS 3001 01:59:30,240 --> 01:59:32,680 SPECIFIC POINT AND FEEDBACK TO 3002 01:59:32,680 --> 01:59:33,960 CHRISTIAN WE HAD TWO MEETINGS 3003 01:59:33,960 --> 01:59:37,000 WITH FDA TO SPECIFICALLY DISCUSS 3004 01:59:37,000 --> 01:59:38,960 EXPLICIT WILL I CRAVING. YOU 3005 01:59:38,960 --> 01:59:42,960 SAW METAANALYSIS CRAVING PAPER 3006 01:59:42,960 --> 01:59:44,320 ON [INDISCERNIBLE] SHOWING HOW 3007 01:59:44,320 --> 01:59:47,120 REGARDLESS HOW CRAVING IS 3008 01:59:47,120 --> 01:59:49,480 ACTUALLY MEASURED OR RELEASED IT 3009 01:59:49,480 --> 01:59:53,160 IS A RELIABLE AND SIGNIFICANT 3010 01:59:53,160 --> 01:59:55,080 PREDICTOR OF RELAPSE AND DRUG 3011 01:59:55,080 --> 01:59:57,520 TAKING AND SENT PAPER TO FDA 3012 01:59:57,520 --> 01:59:59,560 SAYING TO ME THAT METAANALYSIS 3013 01:59:59,560 --> 02:00:04,320 SHOWS EVIDENCE IT IS A VALID 3014 02:00:04,320 --> 02:00:05,480 BIOMARKER. WE MET TWICE TO TRY 3015 02:00:05,480 --> 02:00:07,160 TO FIGURE OUT IF THIS WAS GOING 3016 02:00:07,160 --> 02:00:10,040 TO BE ACCEPTABLE FOR THEM. 3017 02:00:10,040 --> 02:00:13,400 STATUS RIGHT NOW IS THEY ASK US 3018 02:00:13,400 --> 02:00:16,560 TO ORGANIZE A MEETING WITH -- 3019 02:00:16,560 --> 02:00:19,320 THEY WILL BE PARTICIPATING TO BE 3020 02:00:19,320 --> 02:00:21,320 ABLE TO VERY EXPLICITLY IDENTIFY 3021 02:00:21,320 --> 02:00:24,560 WHAT IT IS THAT THEY WILL 3022 02:00:24,560 --> 02:00:26,480 CONSIDER SUFFICIENT EVIDENCE. 3023 02:00:26,480 --> 02:00:28,160 SO, THIS IS THE FIRST 3024 02:00:28,160 --> 02:00:31,680 ALTERNATIVE OUTCOME THAT WE ARE 3025 02:00:31,680 --> 02:00:38,240 TRYING TO PUSH FORWARD BECAUSE 3026 02:00:38,240 --> 02:00:39,960 OF TREMENDOUS RELEVANCE AND WE 3027 02:00:39,960 --> 02:00:41,120 WILL INFORM YOU WHEN WE KNOW 3028 02:00:41,120 --> 02:00:42,920 THAT MEETING WILL HAPPEN. ALSO, 3029 02:00:42,920 --> 02:00:46,200 AS YOU KNOW THEY COME UP WITH 3030 02:00:46,200 --> 02:00:47,280 GUIDELINES FOR PEOPLE THAT -- 3031 02:00:47,280 --> 02:00:50,040 FOR THOSE TRYING TO DEVELOP 3032 02:00:50,040 --> 02:00:53,480 MEDICATIONS FOR OPIOID USE 3033 02:00:53,480 --> 02:00:54,440 DISORDER. 3034 02:00:54,440 --> 02:00:56,040 BASICALLY ALTERNATIVE OUTCOMES 3035 02:00:56,040 --> 02:01:00,080 ARE LISTED. IT IS VERY UNCLEAR 3036 02:01:00,080 --> 02:01:02,680 TO ME THAT THEY ARE SEEING IT AS 3037 02:01:02,680 --> 02:01:05,160 SECONDARY OUTCOMES NOT AS MAIN 3038 02:01:05,160 --> 02:01:09,000 OUTCOMES AND WE -- WHAT WE NEED 3039 02:01:09,000 --> 02:01:11,800 TO TRY TO GAIN IS AN 3040 02:01:11,800 --> 02:01:12,440 ALTERNATIVELY MAIN OUTD COME 3041 02:01:12,440 --> 02:01:15,400 THAT FDA WANTS TO MOVE THAT WILL 3042 02:01:15,400 --> 02:01:17,000 FACILITATE ENORMOUSLY 3043 02:01:17,000 --> 02:01:18,640 DEVELOPMENT OF MEDICATIONS. 3044 02:01:18,640 --> 02:01:20,800 SO, IN THAT RESPECT I'M OF 3045 02:01:20,800 --> 02:01:23,160 COURSE VERY SUPPORTIVE OF THESE 3046 02:01:23,160 --> 02:01:24,600 PROPOSAL FROM TANYA AND WE HAVE 3047 02:01:24,600 --> 02:01:26,960 BEEN SUPPORTING IT BEFORE HAND 3048 02:01:26,960 --> 02:01:29,320 AND FOR SEVERAL YEARS NOW 3049 02:01:29,320 --> 02:01:31,240 ACTUALLY. 3050 02:01:31,240 --> 02:01:33,720 SO, YES. INDEED, THIS HAS BEEN 3051 02:01:33,720 --> 02:01:36,160 A MAJOR CHALLENGE AND ROAD 3052 02:01:36,160 --> 02:01:36,480 BLOCK. 3053 02:01:36,480 --> 02:01:40,840 IT IS AN AREA THAT IF WE CAN 3054 02:01:40,840 --> 02:01:42,920 SOLVE, WE ARE FACILITATING NOT 3055 02:01:42,920 --> 02:01:45,040 JUST DEVELOPMENT IN GENERAL BUT 3056 02:01:45,040 --> 02:01:47,080 FOR US TO SUCCEED GETTING 3057 02:01:47,080 --> 02:01:50,240 MEDICATIONS THAT ARE VALUABLE IF 3058 02:01:50,240 --> 02:01:55,080 THEY DON'T PRODUCE COMPLETE 3059 02:01:55,080 --> 02:01:55,440 ABSTINNANCE. 3060 02:01:55,440 --> 02:01:59,480 >>THANK YOU, NORA. NED, YOUR 3061 02:01:59,480 --> 02:02:04,920 HAND IS RAISED. 3062 02:02:04,920 --> 02:02:06,560 >>SURE. CHRISTIAN LIKE YOUR 3063 02:02:06,560 --> 02:02:10,680 WAY OF LOOKING AT IT HARM 3064 02:02:10,680 --> 02:02:13,200 REDUCTION AND CRAVE IING AND 3065 02:02:13,200 --> 02:02:15,800 QUALITY OF LIFE AND MEASURES OF 3066 02:02:15,800 --> 02:02:18,160 FUNCTIONING AND MAKE A COUPLE 3067 02:02:18,160 --> 02:02:19,240 POINTS ABOUT IT. 3068 02:02:19,240 --> 02:02:22,040 ONE, THE -- I DON'T SEE IT 3069 02:02:22,040 --> 02:02:26,640 TALKED ABOUT MUCH. THE OUTCOME 3070 02:02:26,640 --> 02:02:29,640 AND RIGHT OUTCOME DEPENDS TO AN 3071 02:02:29,640 --> 02:02:32,040 EXTENT WHAT THE TREATMENT DOES. 3072 02:02:32,040 --> 02:02:34,400 SO, THOSE THAT GAVE NAL TRAVEL 3073 02:02:34,400 --> 02:02:36,560 YOENS TO PATIENTS WITHOUT 3074 02:02:36,560 --> 02:02:38,760 ALCOHOL USE DISORDER REDUCING 3075 02:02:38,760 --> 02:02:41,920 HEAVY DRINKING IS WHAT NAL 3076 02:02:41,920 --> 02:02:43,720 TRECHL YOEN DOES AND DOESN'T 3077 02:02:43,720 --> 02:02:46,760 PROMOTE ABSTINNANCE. IF YOU USE 3078 02:02:46,760 --> 02:02:48,560 ABSTINNANCE OUTCOME ON NAL 3079 02:02:48,560 --> 02:02:50,200 TRECHL YOEN TRIAL YOU ARE LESS 3080 02:02:50,200 --> 02:02:51,440 LIKELY TO SEE THE EFFECT. THAT 3081 02:02:51,440 --> 02:02:55,240 IS NO THE WHAT IT REALLY DOES. 3082 02:02:55,240 --> 02:02:59,680 IT MAKES IT SO ALCOHOL IS NOT 3083 02:02:59,680 --> 02:03:03,280 REWARDING ANYMORE AND PATIENTS 3084 02:03:03,280 --> 02:03:08,360 STILL DRINK BUT NOT HEAVILY AND 3085 02:03:08,360 --> 02:03:11,440 [INDISCERNIBLE] AND IN OPIOID 3086 02:03:11,440 --> 02:03:13,200 USE DISORDER FIELD PATIENTS 3087 02:03:13,200 --> 02:03:15,520 DON'T USE OPIOIDS MUCH RECEPTORS 3088 02:03:15,520 --> 02:03:17,920 ARE BLOCKED AND DON'T USE 3089 02:03:17,920 --> 02:03:20,800 OPIOIDS AND SAME MIGHT BE TRUE 3090 02:03:20,800 --> 02:03:23,600 OF BU PREN OR FRIN IF YOU GET 3091 02:03:23,600 --> 02:03:25,040 DOSE HIGH ENOUGH AND SHOULD 3092 02:03:25,040 --> 02:03:27,960 THINK ABOUT WHAT IS NOT JUST THE 3093 02:03:27,960 --> 02:03:29,480 BEST OUTCOME FOR EVERY TREATMENT 3094 02:03:29,480 --> 02:03:30,960 BUT BEST OUTCOME GIVEN WHAT WE 3095 02:03:30,960 --> 02:03:32,440 KNOW ABOUT MECHANISM OF 3096 02:03:32,440 --> 02:03:33,880 TREATMENT AND WHAT WE THINK IT 3097 02:03:33,880 --> 02:03:37,880 DOES CLINICALLY. I GUESS MY 3098 02:03:37,880 --> 02:03:45,000 SECOND POINT WOULD BE THAT IN 3099 02:03:45,000 --> 02:03:48,040 OTHER FIELDS THINKING OF 3100 02:03:48,040 --> 02:03:51,120 PROXIMAL AND DISTAL OUTCOMES AND 3101 02:03:51,120 --> 02:03:53,280 REDUCING CHOLESTEROL PROXIMAL 3102 02:03:53,280 --> 02:03:56,000 OUTCOME AND DISTAL OUTCOME IS 3103 02:03:56,000 --> 02:03:57,280 HEART ATTACKS AND STROKE AND 3104 02:03:57,280 --> 02:04:00,080 WONDER IF THERE IS ANALOGY HERE 3105 02:04:00,080 --> 02:04:03,960 WHERE YOU PROBABLY HAVE TO 3106 02:04:03,960 --> 02:04:07,880 REDUCE DRUG USE TO GET 3107 02:04:07,880 --> 02:04:09,200 IMPROVEMENTS IN QUALITY OF LIFE, 3108 02:04:09,200 --> 02:04:10,400 I THINK. 3109 02:04:10,400 --> 02:04:12,000 SO, I WONDER ABOUT THINKING 3110 02:04:12,000 --> 02:04:16,520 ABOUT IT IN THOSE TERMS AND WHAT 3111 02:04:16,520 --> 02:04:19,880 IS A PROXIMAL OUTCOME AND MORE 3112 02:04:19,880 --> 02:04:20,560 DISTAL OUTCOME? 3113 02:04:20,560 --> 02:04:23,080 MY THIRD POINT WOULD BE THAT 3114 02:04:23,080 --> 02:04:25,000 QUALITY OF LIFE IS HARDER TO 3115 02:04:25,000 --> 02:04:27,280 MEASURE AND TYPICAL MEASURE 3116 02:04:27,280 --> 02:04:30,240 THAT, YOU KNOW, WE USE IS EDQ. 3117 02:04:30,240 --> 02:04:33,800 YOU KNOW, THE -- THE EDQ5 WHICH 3118 02:04:33,800 --> 02:04:35,640 IS A TERRIBLE MEASURE FOR 3119 02:04:35,640 --> 02:04:37,320 ADDICTION OR MENTAL HEALTH AND 3120 02:04:37,320 --> 02:04:38,960 DOESN'T REALLY CAPTURE AND 3121 02:04:38,960 --> 02:04:40,200 CAPTURES WHETHER YOU CAN WALK 3122 02:04:40,200 --> 02:04:44,920 AND FEED YOURSELF AND DOESN'T 3123 02:04:44,920 --> 02:04:47,160 CAPTURE THE FUNCTIONING THAT WE 3124 02:04:47,160 --> 02:04:49,960 CARE ABOUT. 3125 02:04:49,960 --> 02:04:53,160 WALTER LING DEVELOPED SIMPLE 3126 02:04:53,160 --> 02:04:54,160 TREATMENT EFFECTIVENESS 3127 02:04:54,160 --> 02:04:55,880 EVALUATION ASSESSMENT THAT I 3128 02:04:55,880 --> 02:04:57,760 LIKE THAT IS VERY SIMPLE AND 3129 02:04:57,760 --> 02:04:59,120 GETS MORE AT FUNCTIONING THAT WE 3130 02:04:59,120 --> 02:05:01,280 ARE TALKING ABOUT WITH PEOPLE 3131 02:05:01,280 --> 02:05:02,960 WITH MENTAL HEALTH AND SUBSTANCE 3132 02:05:02,960 --> 02:05:04,640 USE. ARE YOU FUNCTIONING AS A 3133 02:05:04,640 --> 02:05:06,280 FAMILY MEMBER AND DOING THINGS 3134 02:05:06,280 --> 02:05:08,440 IN YOUR COMMUNITY AND ENGAGED IN 3135 02:05:08,440 --> 02:05:11,280 POSITIVE ACTIVITIES AND SO 3136 02:05:11,280 --> 02:05:11,960 FORTH? 3137 02:05:11,960 --> 02:05:22,440 SO, THOSE ARE MY COMMENTS. 3138 02:05:27,120 --> 02:05:29,360 >>THANK YOU, NED. GAIL? 3139 02:05:29,360 --> 02:05:31,600 >>JUST GOING TO SAY I PUT MY 3140 02:05:31,600 --> 02:05:37,280 HEAD UP AS NED SAID THAT. 3141 02:05:37,280 --> 02:05:40,560 I LIKE WALTER LINK'S TEA AND 3142 02:05:40,560 --> 02:05:42,760 QUESTION SUBSTANCE THAT IS 3143 02:05:42,760 --> 02:05:44,160 RELATING TO YOUR FAMILY AND 3144 02:05:44,160 --> 02:05:45,680 COMMUNITY AND ARE YOU BACK AT 3145 02:05:45,680 --> 02:05:46,720 WORK? 3146 02:05:46,720 --> 02:05:48,520 TRYING TO INCORPORATE IT INTO 3147 02:05:48,520 --> 02:05:51,200 SOME STUDIES AND AGREE WITH YOU 3148 02:05:51,200 --> 02:05:53,480 THAT IS WHAT WE NEED TO KNOW; 3149 02:05:53,480 --> 02:05:53,840 RIGHT? 3150 02:05:53,840 --> 02:05:55,720 YOU DRINK LESS, OKAY. RIGHT. 3151 02:05:55,720 --> 02:05:57,440 ARE YOU THEN ABLE TO OR STAYING 3152 02:05:57,440 --> 02:05:59,160 WITH YOUR FAMILY AND DO YOU HAVE 3153 02:05:59,160 --> 02:06:02,480 A SIGNIFICANT OTHER OR FRIENDS 3154 02:06:02,480 --> 02:06:04,240 OR DO YOU GO TO WORK? 3155 02:06:04,240 --> 02:06:08,000 THESE ARE IMPORTANT ISSUES THAT 3156 02:06:08,000 --> 02:06:10,640 FAIRLY IS SIMPLISTIC THE TEA IT 3157 02:06:10,640 --> 02:06:12,440 IS NOT. IT LOOKS LIKE IT. IT 3158 02:06:12,440 --> 02:06:14,520 IS FOUR QUESTIONS AND AGREE WITH 3159 02:06:14,520 --> 02:06:17,680 YOU THAT EQ OR WHATEVER WE USE 3160 02:06:17,680 --> 02:06:18,800 THAT IS WORTHLESS. 3161 02:06:18,800 --> 02:06:25,240 I THINK THAT TEA, YOU SHOULD 3162 02:06:25,240 --> 02:06:31,760 LOOK TOWARDS THAT. IT IS GREAT. 3163 02:06:31,760 --> 02:06:33,760 NOW, ROB, ARE YOU IDENTIFIED AS 3164 02:06:33,760 --> 02:06:35,560 A DISCUSSANT AND I DON'T AND 3165 02:06:35,560 --> 02:06:38,080 THOUGHT HAND WAS RAISED BUT 3166 02:06:38,080 --> 02:06:38,320 MAYBE. 3167 02:06:38,320 --> 02:06:38,800 >>[INDISCERNIBLE]. 3168 02:06:38,800 --> 02:06:40,280 >>NORA ADDRESSED QUESTIONS I 3169 02:06:40,280 --> 02:06:44,640 HAVE HAD. I THINK THAT THIS 3170 02:06:44,640 --> 02:06:46,280 SEEMS LIKE AN OBVIOUSLY 3171 02:06:46,280 --> 02:06:48,840 IMPORTANT THING TO DO OUTSIDE OF 3172 02:06:48,840 --> 02:06:51,480 MY AREA OF EXPERTISE AND MEETING 3173 02:06:51,480 --> 02:06:52,760 RIGHT [INDISCERNIBLE] FOR TRIALS 3174 02:06:52,760 --> 02:06:54,320 AND POINT ABOUT WHAT IS GOAL OF 3175 02:06:54,320 --> 02:06:58,000 THE MEDICATION THAT IS SUPER 3176 02:06:58,000 --> 02:06:59,120 IMPORTANT. 3177 02:06:59,120 --> 02:07:01,960 >>THANK YOU. NED? 3178 02:07:01,960 --> 02:07:04,120 >>I WAS GOING TO ASK. WHAT 3179 02:07:04,120 --> 02:07:06,360 KINDS OF STUDIES ARE YOU 3180 02:07:06,360 --> 02:07:07,760 ENVISIONING AND WHAT KINDS OF 3181 02:07:07,760 --> 02:07:09,960 DATA ARE YOU ENVISIONING 3182 02:07:09,960 --> 02:07:15,120 COLLECTING OR LOOKING AT OR 3183 02:07:15,120 --> 02:07:18,920 MAINLY SECONDARY ANALYSIS OR 3184 02:07:18,920 --> 02:07:20,240 INFLUENCING MEASUREMENT PLANS 3185 02:07:20,240 --> 02:07:22,840 FOR TRIALS THAT WILL GET 3186 02:07:22,840 --> 02:07:23,960 INITIATED SOON OR WHAT -- WHAT 3187 02:07:23,960 --> 02:07:26,080 ARE YOU THINKING THERE? 3188 02:07:26,080 --> 02:07:31,040 >>WELL, FIRST ONE, NED, TO ME, 3189 02:07:31,040 --> 02:07:33,160 IT WAS TO DO OR LOOK AT TATE AH 3190 02:07:33,160 --> 02:07:35,240 WE HAVE IN REPOSITORY FOR 3191 02:07:35,240 --> 02:07:37,480 CLINICAL TRIALS FROM CTN AND 3192 02:07:37,480 --> 02:07:41,200 FROM MEDICATION DEVELOPMENT. 3193 02:07:41,200 --> 02:07:43,680 TO ACTUALLY UNDERSTAND IF A 3194 02:07:43,680 --> 02:07:46,760 PARTICULAR MEDICATION THAT WAS 3195 02:07:46,760 --> 02:07:49,320 BEING TESTED. EFFECTED CRAVING 3196 02:07:49,320 --> 02:07:52,600 AND NOW WE ARE FOCUSING ON 3197 02:07:52,600 --> 02:07:55,880 CRAVING AND WHETHER IT IN TURN 3198 02:07:55,880 --> 02:07:58,680 IS ASSOCIATED IN LONG-TERM TO 3199 02:07:58,680 --> 02:08:01,080 POSITIVE OUTCOME. I HEARD FROM 3200 02:08:01,080 --> 02:08:03,480 FDA THAT YES. THIS PAPER DOES 3201 02:08:03,480 --> 02:08:06,840 SHOW IT. IT IS PRETTY STRONG 3202 02:08:06,840 --> 02:08:09,680 EVIDENCE THAT CRAVING IS 3203 02:08:09,680 --> 02:08:09,960 PREDICTOR. 3204 02:08:09,960 --> 02:08:13,880 IT IS NOT PRESENTING IT IN 3205 02:08:13,880 --> 02:08:17,200 CONTEXT OF A CLINICAL TRIAL. 3206 02:08:17,200 --> 02:08:17,440 UH-HUH. 3207 02:08:17,440 --> 02:08:20,440 >>I THINK WE CAN CONSOLIDATE 3208 02:08:20,440 --> 02:08:22,360 IT. THEN WHAT I WOULD LIKE 3209 02:08:22,360 --> 02:08:25,840 ABOUT IT AND I -- AS YOU WERE 3210 02:08:25,840 --> 02:08:28,440 SPEAKING ABOUT PROXIMAL VERSUS 3211 02:08:28,440 --> 02:08:29,440 DISTANT INDICATOR AND ELEMENT 3212 02:08:29,440 --> 02:08:32,200 THAT IS VALUABLE IS HAVING AN 3213 02:08:32,200 --> 02:08:35,880 EARLY INDICATOR THAT A 3214 02:08:35,880 --> 02:08:39,520 PARTICULAR THERAPEUTIC PROMISED 3215 02:08:39,520 --> 02:08:41,760 LOOKING AT IT IN MOLECULES AND 3216 02:08:41,760 --> 02:08:43,400 COMING FROM CLINICAL WORLD AND 3217 02:08:43,400 --> 02:08:45,840 HAVING A PROXIMAL INDICATOR WITH 3218 02:08:45,840 --> 02:08:47,840 A STRONG PREDICTION ON LONG TERM 3219 02:08:47,840 --> 02:08:50,040 THAT WOULD BE VERY VALUABLE FOR 3220 02:08:50,040 --> 02:08:51,240 ALL OF US. 3221 02:08:51,240 --> 02:08:51,800 >>UH-HUH. 3222 02:08:51,800 --> 02:08:54,200 >>I THINK THAT IS -- THAT IS 3223 02:08:54,200 --> 02:08:57,240 ONE ELEMENT AND OTHER IS IN 3224 02:08:57,240 --> 02:08:59,040 TERMS OF DISCUSSION IS WELL SORT 3225 02:08:59,040 --> 02:09:02,400 OF WE CAN COME UP WITH VERY 3226 02:09:02,400 --> 02:09:05,040 DESIRABLE OUTCOMES AND JUST 3227 02:09:05,040 --> 02:09:08,120 IMPROVEMENT ON QUALITY OF LIFE 3228 02:09:08,120 --> 02:09:10,080 OR WELLBEING OF INDIVIDUAL OR 3229 02:09:10,080 --> 02:09:11,520 ONE THAT TANYA IS PUTTING 3230 02:09:11,520 --> 02:09:13,720 FORWARD IN TERMS OF IMPROVEMENT 3231 02:09:13,720 --> 02:09:17,080 ACROSS VARIOUS DOMAINS THAT 3232 02:09:17,080 --> 02:09:20,360 WOULD BE VALUABLE. 3233 02:09:20,360 --> 02:09:22,360 FDA AS YOU IS CHAL EFRNGSING AND 3234 02:09:22,360 --> 02:09:25,840 THEY ARE REGULATIONS AND WE ARE 3235 02:09:25,840 --> 02:09:28,680 FOLLOWING ELECTRONIC RECORDS AND 3236 02:09:28,680 --> 02:09:30,920 LOOKING AT ALSO WHETHER WE CAN 3237 02:09:30,920 --> 02:09:33,000 INFORM FROM THEM AND FROM 3238 02:09:33,000 --> 02:09:34,760 DATABASES IN MEANTIME WE ARE 3239 02:09:34,760 --> 02:09:36,560 FUNDING RESEARCHERS NOW FOR MANY 3240 02:09:36,560 --> 02:09:39,200 YEARS TO ACTUALLY DOCUMENT TO US 3241 02:09:39,200 --> 02:09:41,440 THAT IF YOU HAVE AN INTERVENTION 3242 02:09:41,440 --> 02:09:44,920 THAT REDUCES AMOUNT OF DRUG 3243 02:09:44,920 --> 02:09:47,520 CONSUMED THIS IS A HEALTH 3244 02:09:47,520 --> 02:09:49,240 BENEFIT FOR THE INDIVIDUAL THAT 3245 02:09:49,240 --> 02:09:52,560 IS, FOR EXAMPLE, THE CASE FOR 3246 02:09:52,560 --> 02:09:54,160 COCAINE USE DISORDER WHERE YOU 3247 02:09:54,160 --> 02:09:57,080 ARE ABLE TO SHOW THAT AMOUNT OF 3248 02:09:57,080 --> 02:10:00,120 COCAINE THEY TAKE GOES DOWN 3249 02:10:00,120 --> 02:10:01,080 CARDIOVASCULAR PHYSIOLOGY 3250 02:10:01,080 --> 02:10:02,840 SIGNIFICANTLY IMPROVES AND WE 3251 02:10:02,840 --> 02:10:06,560 ARE FUNDING RESEARCHERS WITH 3252 02:10:06,560 --> 02:10:12,240 DIFFERENT STRATEGIES TRYING TO 3253 02:10:12,240 --> 02:10:15,280 GET FDA TO BE OPEN ANDLE TO BE 3254 02:10:15,280 --> 02:10:17,440 AN ALTERNATIVE OUTCOME AND WE 3255 02:10:17,440 --> 02:10:19,040 HAVE CURRENTLY NOTHING THAT FDA 3256 02:10:19,040 --> 02:10:21,680 HAS APPROVED YET AND DOING 3257 02:10:21,680 --> 02:10:23,960 STUDIES TO SEE IMPROVING SLEEP 3258 02:10:23,960 --> 02:10:26,520 IN PATIENTS WITH OPIOID USE 3259 02:10:26,520 --> 02:10:28,160 DISORDER THAT INCREASES 3260 02:10:28,160 --> 02:10:30,240 LIKELIHOOD THEY ARE ACTUALLY 3261 02:10:30,240 --> 02:10:31,560 ABLE TO FUNCTION PROPERLY THAT 3262 02:10:31,560 --> 02:10:35,640 WON'T BE A MAIN OUTCOME FOR FDA. 3263 02:10:35,640 --> 02:10:38,560 SO, I AM TRYING TO SEE IF WE CAN 3264 02:10:38,560 --> 02:10:46,280 CHANGE THAT SO IT CAN BE A MAIN 3265 02:10:46,280 --> 02:10:49,120 O 3266 02:10:49,120 --> 02:10:49,320 ONE. 3267 02:10:49,320 --> 02:10:51,120 >>OKAY. I THINK WE ARE WITH 3268 02:10:51,120 --> 02:10:54,600 MANY, MANY THINGS WITH ALL OF 3269 02:10:54,600 --> 02:10:56,920 THE DISCUSSION SUGGESTIONS AND 3270 02:10:56,920 --> 02:10:57,160 KENTNER. 3271 02:10:57,160 --> 02:10:59,320 >>ONE OTHER THOUGHT. CTM WE 3272 02:10:59,320 --> 02:11:01,800 HAVE LARGE CLINICAL TRIALS WITH 3273 02:11:01,800 --> 02:11:04,680 LONG-TERM FOLLOW UP IN MEASURE 3274 02:11:04,680 --> 02:11:06,080 CRAVING AND SUBSTANCE USE AND 3275 02:11:06,080 --> 02:11:07,360 STUFF. IT WOULD BE POSSIBLE TO 3276 02:11:07,360 --> 02:11:10,200 LOOK AT SOME OF THESE THINGS IN 3277 02:11:10,200 --> 02:11:11,160 DATA THAT ALREADY EXIST. 3278 02:11:11,160 --> 02:11:12,320 >>EXACTLY. THAT IS WHAT THEY 3279 02:11:12,320 --> 02:11:16,280 ARE DOING AND WE ARE GET 3280 02:11:16,280 --> 02:11:18,960 CONTRACT TO BE ABLE TO DO THAT. 3281 02:11:18,960 --> 02:11:21,080 >>YEAH. 3282 02:11:21,080 --> 02:11:21,600 >>GREAT RESOURCE. 3283 02:11:21,600 --> 02:11:24,400 >>PERFECT. OKAY. WE CAN THEN 3284 02:11:24,400 --> 02:11:30,720 WITH MANY THINGS TO KENT NER AND 3285 02:11:30,720 --> 02:11:33,880 DISCUSSANTS MOVE TO FINAL 3286 02:11:33,880 --> 02:11:35,160 PORTION OF AGENDA. 3287 02:11:35,160 --> 02:11:37,320 I WILL QUICKLY I WILL TRY TO DO 3288 02:11:37,320 --> 02:11:39,000 THIS REALLY QUICKLY AND WE HAVE 3289 02:11:39,000 --> 02:11:42,160 USED UP A LOT OF YOUR TIME. WE 3290 02:11:42,160 --> 02:11:44,440 ARE VERY FWRATFUL FOR IT. 3291 02:11:44,440 --> 02:11:47,720 REVIEW WHAT WE HAVE SHOWN YOU 3292 02:11:47,720 --> 02:11:50,680 OVER THE PAST COUPLE WEEKS 3293 02:11:50,680 --> 02:11:52,120 STARTING WITH LAST WEEK'S AND 3294 02:11:52,120 --> 02:11:52,920 GOING THROUGH YESTERDAY AND 3295 02:11:52,920 --> 02:11:56,280 TODAY AND ENDING WITH A PRETTY 3296 02:11:56,280 --> 02:11:57,160 HIGH-LEVEL DISCUSSION TOGETHER 3297 02:11:57,160 --> 02:12:00,040 WITH NORA AND WALTER ABOUT 3298 02:12:00,040 --> 02:12:01,600 OVERALL HEALED RESEARCH 3299 02:12:01,600 --> 02:12:03,960 DIRECTIONS AND WHERE YOU THINK 3300 02:12:03,960 --> 02:12:06,800 OUR SUSTAINED FOCUS THAT IS MOST 3301 02:12:06,800 --> 02:12:10,120 IMPORTANT. NEXT SLIDE, PLEASE. 3302 02:12:10,120 --> 02:12:12,240 SO, THIS IS WHERE I STARTED WHEN 3303 02:12:12,240 --> 02:12:16,080 I INTRODUCED THE MEETING 3304 02:12:16,080 --> 02:12:16,400 YESTERDAY. 3305 02:12:16,400 --> 02:12:18,600 WE HAVE -- YOU KNOW, THIS IS A 3306 02:12:18,600 --> 02:12:20,120 TERRIFIC GROUP. I HAVE TO SAY 3307 02:12:20,120 --> 02:12:21,840 THAT THE DISCUSSION WE HAVE HAD 3308 02:12:21,840 --> 02:12:24,240 OVER THE PAST FEW DAYS HAS BEEN 3309 02:12:24,240 --> 02:12:27,320 SO WITCH. YOU HAVE REALLY ALL 3310 02:12:27,320 --> 02:12:28,920 HAD A TREMENDOUS UNDERSTANDING 3311 02:12:28,920 --> 02:12:31,080 OF CHALLENGING WE ARE FACING 3312 02:12:31,080 --> 02:12:33,440 TOGETHER AND RESEARCH WE ARE 3313 02:12:33,440 --> 02:12:35,120 CONDUCTING TO DO SO. NOW IS THE 3314 02:12:35,120 --> 02:12:37,520 TIME THAT WE LOOK TO YOU FOR 3315 02:12:37,520 --> 02:12:40,720 HONEST FEEDBACK AROUND HOW ARE 3316 02:12:40,720 --> 02:12:42,760 WE DOING? 3317 02:12:42,760 --> 02:12:46,280 ARE WE RESPONDING NIMBLY TO 3318 02:12:46,280 --> 02:12:49,320 REVOLVING DRIVERS TO OPIOID 3319 02:12:49,320 --> 02:12:51,560 CRISIS AND IN 2018 SINCE WE 3320 02:12:51,560 --> 02:12:53,920 FIRST LAUNCHED AND DOING THIS 3321 02:12:53,920 --> 02:12:56,320 RIGHT NEW EMPHASIS AND 3322 02:12:56,320 --> 02:12:57,800 POLYSUBSTANCE USE AND DITCH WAYS 3323 02:12:57,800 --> 02:12:59,480 TO CONNECT WITH PEOPLE USING 3324 02:12:59,480 --> 02:13:01,320 DRUGS HITTING THE MARK AND WHAT 3325 02:13:01,320 --> 02:13:03,400 CHANGES MIGHT BE NEEDED WE ARE 3326 02:13:03,400 --> 02:13:05,720 SEEING REGULATORY CHANGES AND 3327 02:13:05,720 --> 02:13:07,680 OPIOID PRESCRIBING SGIED 3328 02:13:07,680 --> 02:13:09,640 GUIDANCES THAT HAVE EVOLVED AND 3329 02:13:09,640 --> 02:13:13,760 THEY HAVE OUR PROGRAMS MET THE 3330 02:13:13,760 --> 02:13:20,440 EVOLVING NATURE OF THESE GOALS 3331 02:13:20,440 --> 02:13:20,760 A 3332 02:13:20,760 --> 02:13:20,960 AND. 3333 02:13:20,960 --> 02:13:22,800 WE ALSO DISCUSSED LAST WEEK SOME 3334 02:13:22,800 --> 02:13:24,800 RESEARCH LAUNCHED IN 2018 AND 19 3335 02:13:24,800 --> 02:13:28,240 AND AT THAT TIME WE HAD A CRISP 3336 02:13:28,240 --> 02:13:30,360 VIEW WHAT WAS NEEDED BASED ON 3337 02:13:30,360 --> 02:13:31,880 STAKEHOLDER ENGAGEMENT AND HAD A 3338 02:13:31,880 --> 02:13:34,160 FEW CORE AIR YAZ OF FOCUS THAT 3339 02:13:34,160 --> 02:13:36,600 SINCE EXPANDED GOING BACK TO 3340 02:13:36,600 --> 02:13:39,920 TIPS OF THE SPHERE AND HOW THEY 3341 02:13:39,920 --> 02:13:42,440 HAVE DONE AND IN WHAT WAY DO 3342 02:13:42,440 --> 02:13:45,520 THEY CONTINUE TO REPRESENT 3343 02:13:45,520 --> 02:13:47,120 IMPORTANT ONGOING NEEDS FOR HEAL 3344 02:13:47,120 --> 02:13:50,360 AND WHAT WAYS THEY HAVE TO 3345 02:13:50,360 --> 02:13:52,320 THEMSELVES BE INVOLVED AND 3346 02:13:52,320 --> 02:13:54,200 LASTLY MANY DIFFERENT RESEARCH 3347 02:13:54,200 --> 02:13:56,400 IDEAS UNDER CONSIDERATION THAT 3348 02:13:56,400 --> 02:13:57,800 WE DISCUSSED OVER PAST TWO DAYS 3349 02:13:57,800 --> 02:13:59,760 HOW THEY FIT IN AND HOW YOU 3350 02:13:59,760 --> 02:14:01,680 WOULD PUT THEM IN PERSPECTIVE OF 3351 02:14:01,680 --> 02:14:03,560 LARGER BODY OF ONGOING RESEARCH 3352 02:14:03,560 --> 02:14:06,280 THAT HEAL SUPPORTS FROM A 3353 02:14:06,280 --> 02:14:07,320 PRIORITIZATION PERSPECTIVE AND 3354 02:14:07,320 --> 02:14:12,200 FROM A KIND OF SCIENTIFIC AND 3355 02:14:12,200 --> 02:14:14,080 ARE THEY MEETING OR CONTINUING 3356 02:14:14,080 --> 02:14:17,920 TO MEET NEEDS PERSPECTIVE AND 3357 02:14:17,920 --> 02:14:28,200 NEXT SLIDE, PLEASE STUDY IT ALL 3358 02:14:28,200 --> 02:14:30,440 OF THE DIFFERENT COLORS AND 2019 3359 02:14:30,440 --> 02:14:32,960 YEAR WAS TWO YEARS THAT IS OFF 3360 02:14:32,960 --> 02:14:38,240 BALANCE AND OVERTIME WE HAVE 3361 02:14:38,240 --> 02:14:41,200 SEEN EVOLUTION IN WAYS WE MADE 3362 02:14:41,200 --> 02:14:43,080 RESEARCH INVESTMENTS FOR 3363 02:14:43,080 --> 02:14:45,400 INSTANCE PRECLINICAL AND 3364 02:14:45,400 --> 02:14:46,720 TRANSLATIONAL SPACE HAS GROWN ON 3365 02:14:46,720 --> 02:14:50,520 PAIN MANAGEMENT SIDE AS WE ADDED 3366 02:14:50,520 --> 02:14:54,160 MORE INVESTIGATIONAL AND 3367 02:14:54,160 --> 02:14:55,960 TARGETED RESEARCH PROGRAMS TO 3368 02:14:55,960 --> 02:14:58,160 CORE SET WE LAUNCHED AND 3369 02:14:58,160 --> 02:14:59,800 SIMILARLY IN CROSS-CUTTING AND 3370 02:14:59,800 --> 02:15:03,200 CAREER DEVELOPMENT SIDE ON OTHER 3371 02:15:03,200 --> 02:15:06,320 SIDE OF THE SPECTRUM WE ADDED 3372 02:15:06,320 --> 02:15:10,160 MORE TRAINING AND FIRST WE WERE 3373 02:15:10,160 --> 02:15:12,160 PUTTING TOGETHER LARGE AND 3374 02:15:12,160 --> 02:15:13,960 AMBITIOUS RESEARCH PROGRAMS AND 3375 02:15:13,960 --> 02:15:16,680 WHEN WE DID THAT WE REALIZED WE 3376 02:15:16,680 --> 02:15:19,720 DEPLETED A LOT OF THE WORKFORCE 3377 02:15:19,720 --> 02:15:20,640 AND THERE WASN'T NECESSARILY A 3378 02:15:20,640 --> 02:15:23,120 NEXT GENERATION TO COME REPLACE 3379 02:15:23,120 --> 02:15:24,960 THEMENTD INVESTMENTS THERE AND 3380 02:15:24,960 --> 02:15:27,880 ON DATA SIDE TAKING FINDINGS 3381 02:15:27,880 --> 02:15:30,600 COMING FROM STUDIES DRIVING 3382 02:15:30,600 --> 02:15:32,240 FORWARD FOR SUBSTRATE FOR NEW 3383 02:15:32,240 --> 02:15:34,800 LINES OF INVESTIGATION AND NEXT 3384 02:15:34,800 --> 02:15:36,600 SLIDE, PLEASE. 3385 02:15:36,600 --> 02:15:38,760 REVIEW OF SPECIFIC PROGRAMS 3386 02:15:38,760 --> 02:15:39,840 DISCUSSED LAST WEEK. NEXT SLIDE 3387 02:15:39,840 --> 02:15:43,960 YOU SEE THEM FOCUSED HERE. 3388 02:15:43,960 --> 02:15:47,880 SIGNIFICANT INVESTMENTS PREV 3389 02:15:47,880 --> 02:15:51,200 PREVENTING USE DISORDER TARRING 3390 02:15:51,200 --> 02:15:53,120 ESSING GROUPS AND PARTNERING 3391 02:15:53,120 --> 02:15:54,160 WITH FEDERAL AGENCIES 3392 02:15:54,160 --> 02:15:56,760 UNDERSTANDING HOW TO MAKE 3393 02:15:56,760 --> 02:15:58,280 PREVENTION EFFORTS SUPSTAINABLE 3394 02:15:58,280 --> 02:15:59,720 AND TREMENDOUS NUMBER OF 3395 02:15:59,720 --> 02:16:02,160 CLINICAL TRIALS AND TOO MUCH TO 3396 02:16:02,160 --> 02:16:05,120 GO INTO INTO TAIL THROUGH NIDA 3397 02:16:05,120 --> 02:16:06,800 CLINICAL TRIALS AND AS YOU 3398 02:16:06,800 --> 02:16:07,640 PROBABLY RECOGNIZE FROM 3399 02:16:07,640 --> 02:16:08,640 DISCUSSION WE HAD TODAY WE 3400 02:16:08,640 --> 02:16:10,440 CONTINUE TO ADD THEM THAT IS ON 3401 02:16:10,440 --> 02:16:13,320 A CASE BY CASE BASIS AND 3402 02:16:13,320 --> 02:16:17,080 INFRASTRUCTURE WAS EXPANDED IN 3403 02:16:17,080 --> 02:16:20,320 2019 TO SUPPORT NEW STUDIES AND 3404 02:16:20,320 --> 02:16:23,080 HAVE TO BE EXPANDED AS WELL AND 3405 02:16:23,080 --> 02:16:25,720 TRANSLATION TO RESEARCH PRACTICE 3406 02:16:25,720 --> 02:16:29,840 SIDE WE HAVE INNOVATIVE JUSTICE 3407 02:16:29,840 --> 02:16:30,920 COMMUNITY OPIOID NETWORK WITH 3408 02:16:30,920 --> 02:16:33,400 COMPONENT PARTS SEEKING TO BUILD 3409 02:16:33,400 --> 02:16:35,040 PARTNERSHIPS WITH JUSTICE 3410 02:16:35,040 --> 02:16:38,200 COMMUNITY AND PROVIDE HEAD 3411 02:16:38,200 --> 02:16:42,880 QUALITY CARE TO PEOPLE WHO HAVE 3412 02:16:42,880 --> 02:16:45,200 SUBSTANCE USE DISORDER MOVING IN 3413 02:16:45,200 --> 02:16:47,520 AND OUT OF JUSTICE COMMUNITY AND 3414 02:16:47,520 --> 02:16:50,680 67 COMMUNITIES ACROSS THE 3415 02:16:50,680 --> 02:16:53,480 COUNTRY LOOKING TO OVERDOSE AND 3416 02:16:53,480 --> 02:16:56,080 WORK ON COMMUNITIES IDENTIFYING 3417 02:16:56,080 --> 02:16:58,280 NEEDS PUTTING INTO PLACE FROM 3418 02:16:58,280 --> 02:17:01,880 MENU OF EVIDENCE-BASED OPTIONS 3419 02:17:01,880 --> 02:17:03,720 AND TARGETED STRATEGIES MEETING 3420 02:17:03,720 --> 02:17:06,280 LOCAL NEEDS TO REDUCE OVERDOSE 3421 02:17:06,280 --> 02:17:09,680 DAENL AND LASTLY IN BOTTOM OF 3422 02:17:09,680 --> 02:17:11,800 SLIDE PRECLINICAL TRANSLATIONAL 3423 02:17:11,800 --> 02:17:15,840 SIDE CONTRACTS TO TEST CANDIDATE 3424 02:17:15,840 --> 02:17:18,720 THERAPEUTICS AND SUITE OF 3425 02:17:18,720 --> 02:17:20,800 PROGRAMS TO ADVANCE INDIVIDUAL 3426 02:17:20,800 --> 02:17:22,960 THERAPEUTIC CANDIDATES IN 3427 02:17:22,960 --> 02:17:26,520 PIPELINE AND USING RESOURCES AND 3428 02:17:26,520 --> 02:17:29,160 NKATS INTRAMURAL PROGRAM AND 3429 02:17:29,160 --> 02:17:33,000 THROUGH EXTRAMURAL COMMUNITY WE 3430 02:17:33,000 --> 02:17:34,600 BROUGHT TO YOU BEFORE NEXT 3431 02:17:34,600 --> 02:17:37,040 SLIDE, PLEASE. 3432 02:17:37,040 --> 02:17:40,960 I DON'T THINK I WILL GO THROUGH 3433 02:17:40,960 --> 02:17:44,960 ALL OF THEM. GROUP WAS HERE AND 3434 02:17:44,960 --> 02:17:46,720 THEY PRETTY MUCH REMEMBER AREA 3435 02:17:46,720 --> 02:17:48,720 OF DISCUSSION AND IF YOU WANT TO 3436 02:17:48,720 --> 02:17:50,840 GO BACK REVISITING NOTES WE HAVE 3437 02:17:50,840 --> 02:17:52,520 FROM THE DISCUSSION LAST WEEK WE 3438 02:17:52,520 --> 02:17:55,920 CAN DO SO. FOR 2024 RESEARCH 3439 02:17:55,920 --> 02:17:59,440 CONCEPTS THAT IS A TOPIC OF 3440 02:17:59,440 --> 02:18:05,000 DISCUSSION YESTERDAY AND TODAY 3441 02:18:05,000 --> 02:18:07,600 LOOK AT THIS BEAUTIFUL COLOR 3442 02:18:07,600 --> 02:18:08,280 BREAKDOWN AND THANKS FOR HAVING 3443 02:18:08,280 --> 02:18:10,480 ME AND TALKED ABOUT ON 3444 02:18:10,480 --> 02:18:12,160 PRECLINICAL AND PAIN MANLAGEMENT 3445 02:18:12,160 --> 02:18:14,160 SIDE THAT IS IN BLUE AND THIS IS 3446 02:18:14,160 --> 02:18:16,200 YESTERDAY'S AGENDA LOOKING AT 3447 02:18:16,200 --> 02:18:17,920 INDIVIDUAL DIFFERENCES IN HUMAN 3448 02:18:17,920 --> 02:18:23,280 PAIN CONDITIONS AS WELL AS 3449 02:18:23,280 --> 02:18:27,800 EFFECTS OF EXPOSOME ON ACUTE 3450 02:18:27,800 --> 02:18:30,040 PAIN AND LONGITUDINAL OR 3451 02:18:30,040 --> 02:18:31,880 MECHANISTIC STUDIES AND 3452 02:18:31,880 --> 02:18:34,720 WORKFORCE AND DEVICE-BASED SLEEP 3453 02:18:34,720 --> 02:18:37,120 AND MIOFACIAL PROJECTS FOCUSING 3454 02:18:37,120 --> 02:18:40,400 ON ASPECTS OF PAIN AND WHAT WE 3455 02:18:40,400 --> 02:18:42,920 CAN LEARN CONSIDERING ADDITIONAL 3456 02:18:42,920 --> 02:18:45,920 ELEMENTS OF PAIN EXPERIENCE. 3457 02:18:45,920 --> 02:18:47,760 WE THEN SWITCH GEARS THIS 3458 02:18:47,760 --> 02:18:50,000 MORNING TALKING ABOUT IMPORTANCE 3459 02:18:50,000 --> 02:18:52,040 OF OPIOID USE DISORDER AND 3460 02:18:52,040 --> 02:18:53,040 ALCOHOL USE DISORDER 3461 02:18:53,040 --> 02:18:54,160 CO-OCCURRENCE AND POPULATIONS WE 3462 02:18:54,160 --> 02:18:58,200 SERVE AND WE LOOKED AT A COUPLE 3463 02:18:58,200 --> 02:19:03,680 OF DIFFERENT APPROACHES TO 3464 02:19:03,680 --> 02:19:05,240 TRANSLATE RESEARCH TREATING 3465 02:19:05,240 --> 02:19:07,440 OPIOID REQUEST USE DISORDER INTO 3466 02:19:07,440 --> 02:19:09,960 PRACTICE LOOKING AT HOSPITAL 3467 02:19:09,960 --> 02:19:12,760 SETTING AND LOOKING AT SPECIFIC 3468 02:19:12,760 --> 02:19:14,200 POPULATIONS LIKE WOMEN POST 3469 02:19:14,200 --> 02:19:17,920 PARTIUM AND IMMEDIATE FAMILY AND 3470 02:19:17,920 --> 02:19:20,520 WE SWITCHED TO THE CLINICAL 3471 02:19:20,520 --> 02:19:23,320 TRIALS WITHIN NIDA CLINICAL 3472 02:19:23,320 --> 02:19:24,760 TRIALS WE DISCUSSED AND ENDED 3473 02:19:24,760 --> 02:19:28,440 WITH A FOCUS ON HOW 3474 02:19:28,440 --> 02:19:29,440 UNDERSTANDING REGULATORY 3475 02:19:29,440 --> 02:19:32,080 FRAMEWORK AND OUTCOMES THERE 3476 02:19:32,080 --> 02:19:36,120 COULD ADVANCE BODY OF MEDICATION 3477 02:19:36,120 --> 02:19:36,720 ANDTHERAPIEUTIC DEVELOPMENT 3478 02:19:36,720 --> 02:19:41,240 PROGRAMS IN HEAL AND NEXT SLIDE, 3479 02:19:41,240 --> 02:19:45,520 PLE 3480 02:19:45,520 --> 02:19:46,040 PLEASE. 3481 02:19:46,040 --> 02:19:47,760 ENHANCING PAIN MANAGEMENT IS 3482 02:19:47,760 --> 02:19:49,960 FIRST ANDALITY THIS POINT I WILL 3483 02:19:49,960 --> 02:19:54,320 ASK WALTER TO JOIN ME IN 3484 02:19:54,320 --> 02:19:56,080 FACILITATING A DISCUSSION AROUND 3485 02:19:56,080 --> 02:19:59,560 ALL DIFFERENT PAIN INVESTMENTS 3486 02:19:59,560 --> 02:20:03,880 WE MADE SO FAR. 3487 02:20:03,880 --> 02:20:05,080 WHAT IS NEXT SLIDE? 3488 02:20:05,080 --> 02:20:07,640 YOU HAVE SEEN THIS ALREADY. IT 3489 02:20:07,640 --> 02:20:11,200 HAS MANY DIFFERENT PAIN 3490 02:20:11,200 --> 02:20:12,920 THERAPEUTIC AND PRECLINICAL 3491 02:20:12,920 --> 02:20:14,560 TRANSLATIONAL RESEARCH PROGRAMS 3492 02:20:14,560 --> 02:20:17,200 AS WELL AS SMALL NUMBER PROPOSED 3493 02:20:17,200 --> 02:20:20,920 AT VERY BOTTOM AND RANGES FROM 3494 02:20:20,920 --> 02:20:24,480 TARGET DISCOVERY INVALIDATION TO 3495 02:20:24,480 --> 02:20:27,080 MORE TEAM BASED ANALGESIC 3496 02:20:27,080 --> 02:20:29,360 DEVELOPMENT PROGRAMS TO DEVICE 3497 02:20:29,360 --> 02:20:31,200 BASED APPROACHES ADDITIONAL 3498 02:20:31,200 --> 02:20:33,280 ANIMAL MODELS FOR PAIN AND 3499 02:20:33,280 --> 02:20:34,600 INTEGRATION OF CLINICAL TEAMS 3500 02:20:34,600 --> 02:20:36,880 AND NEXT SLIDE, PLEASE. 3501 02:20:36,880 --> 02:20:41,080 ON CLINICAL SIDE, FIRST TRAUFRNL 3502 02:20:41,080 --> 02:20:43,400 OF CLINICAL TRIAL NETWORKS AND 3503 02:20:43,400 --> 02:20:44,560 COLLABORATIVES THAT WE CREATED 3504 02:20:44,560 --> 02:20:45,960 AT BEGINNING OF HEAL AND 3505 02:20:45,960 --> 02:20:48,680 ADDITION OF EMPOWER TO ADDRESS 3506 02:20:48,680 --> 02:20:51,480 NEEDS OF PEOPLE WHO HAVE A 3507 02:20:51,480 --> 02:20:52,440 SUBSTANCE USE DISORDER AND ALSO 3508 02:20:52,440 --> 02:20:54,800 PAIN AND BIOMARKERS HEALTH 3509 02:20:54,800 --> 02:20:56,680 EQUITY RELATED RESEARCH AND THEN 3510 02:20:56,680 --> 02:20:58,960 JUST MOST RECENTLY A NEW FOCUS 3511 02:20:58,960 --> 02:21:03,920 ON PAIN ASSOCIATED WITH SICKLE 3512 02:21:03,920 --> 02:21:05,920 CELL AND IN NEURAL POPULATIONS 3513 02:21:05,920 --> 02:21:08,120 AND AT BOTTOM RESEARCH PROPOSED 3514 02:21:08,120 --> 02:21:11,600 TO ADD INTO THIS PORTFOLIO. 3515 02:21:11,600 --> 02:21:15,240 NEXT SLIDE, PLEASE. 3516 02:21:15,240 --> 02:21:18,720 WALTER, I WILL TURN IT OVER TO 3517 02:21:18,720 --> 02:21:23,520 YOU AND ASK FOR POINTED 3518 02:21:23,520 --> 02:21:25,080 QUESTIONS AND AREAS FOR 3519 02:21:25,080 --> 02:21:27,280 DISCUSSION FOR 3520 02:21:27,280 --> 02:21:27,840 MULTI-DISCIPLINARY GROUPS. 3521 02:21:27,840 --> 02:21:31,840 >>THANK YOU, BECCA. THESE ARE 3522 02:21:31,840 --> 02:21:37,560 PROGRAMS WE TALKED ABOUT IN 3523 02:21:37,560 --> 02:21:39,800 THESE TWO SESSIONS AND 3524 02:21:39,800 --> 02:21:41,760 PRECLINICAL SCREENING PLATFORM 3525 02:21:41,760 --> 02:21:43,720 THAT IS OPENED FOR ANYBODY TO 3526 02:21:43,720 --> 02:21:49,080 COME IN TESTING ASSETS HIGHLY 3527 02:21:49,080 --> 02:21:54,920 REPRODUCIBLE ANIMAL MODELS AND 3528 02:21:54,920 --> 02:21:57,920 FEEDBACK IN CONCERT WITH 3529 02:21:57,920 --> 02:22:00,800 DEVELOPMENT ANIMAL MODELS AND 3530 02:22:00,800 --> 02:22:03,200 RFAO FOR THAT PURPOSE AND WENT 3531 02:22:03,200 --> 02:22:10,720 THROUGH NCATS PROGRAM THAT IS OR 3532 02:22:10,720 --> 02:22:13,680 HAS REAL ADVANTAGES IN TERMS OF 3533 02:22:13,680 --> 02:22:17,760 THINGS TO DO WITH INTRAMURAL 3534 02:22:17,760 --> 02:22:20,680 RESOUR 3535 02:22:20,680 --> 02:22:21,000 RESOURCES. 3536 02:22:21,000 --> 02:22:22,440 I WILL GO INTO THAT MORE IN A 3537 02:22:22,440 --> 02:22:25,840 SECOND IN TERMS WHAT THOSE 3538 02:22:25,840 --> 02:22:29,080 DIFFERENT COMPONENTS ARE. 3539 02:22:29,080 --> 02:22:31,640 NEW WITH ONES ARE THINGS THAT 3540 02:22:31,640 --> 02:22:33,800 SEEM TO US TO BE KIND OF 3541 02:22:33,800 --> 02:22:35,640 NO-BRAINERS AND ARE THINGS TO DO 3542 02:22:35,640 --> 02:22:41,360 AND MAYBE WE DIDN'T DO THEM YET. 3543 02:22:41,360 --> 02:22:45,480 SOME ARE HARD AND PARTICULARLY 3544 02:22:45,480 --> 02:22:52,280 HUMAN PAIN CONDITIONS IN C 3545 02:22:52,280 --> 02:22:54,200 COMORBIDITIES AND SO MANY THINGS 3546 02:22:54,200 --> 02:22:57,200 INTO PLAY WITH PERCEPTION OF 3547 02:22:57,200 --> 02:23:00,080 PAIN NOT NECESSARILY SENSATION 3548 02:23:00,080 --> 02:23:08,320 AND MAYBE THERE BUT NEW IT WAS 3549 02:23:08,320 --> 02:23:11,440 IMPORTANT BECAUSE IF YOU LOOK AT 3550 02:23:11,440 --> 02:23:14,280 THIS I MENTIONED BEFORE LOOKING 3551 02:23:14,280 --> 02:23:19,000 AT DATA PEOPLE WITH SEVERE 3552 02:23:19,000 --> 02:23:21,600 CHRONIC PAIN HAVE A LARGE NUMBER 3553 02:23:21,600 --> 02:23:27,840 OF MEDICAL CO-MORBIDITIES AND 3554 02:23:27,840 --> 02:23:28,880 PSYCHIATRIC COMORBIDITIES AND 3555 02:23:28,880 --> 02:23:32,880 TRYING TO TREAT JOINT AND NOT 3556 02:23:32,880 --> 02:23:34,200 PAYING ATTENTION TO OTHER ISSUES 3557 02:23:34,200 --> 02:23:37,680 WE WON'T HAVE IMPACT WE WANT FOR 3558 02:23:37,680 --> 02:23:43,960 PEOPLE WE ARE TRYING TO HELP 3559 02:23:43,960 --> 02:23:47,240 EXPOSOME, WE THERE ARE OPENING 3560 02:23:47,240 --> 02:23:57,800 UP A BOX AND GENOME IN BOX AND 3561 02:23:58,480 --> 02:24:00,640 SELECTIVE WHAT WE STUDY SO WE 3562 02:24:00,640 --> 02:24:02,640 DON'T DO ENTIRE OCEAN AND TRYING 3563 02:24:02,640 --> 02:24:06,320 TO PICK OUT SOME THINGS THAT 3564 02:24:06,320 --> 02:24:10,120 PEOPLE ARE EXPOSED TO 3565 02:24:10,120 --> 02:24:11,120 PREDISPOSING THEM TO REAL 3566 02:24:11,120 --> 02:24:12,760 DISABILITY FUNCTIONAL LOSS DOO 3567 02:24:12,760 --> 02:24:17,920 YOU TO CHRONIC PAIN IN FUTURE 3568 02:24:17,920 --> 02:24:20,160 AND YOU KNOW IMPORTANCE OF THOSE 3569 02:24:20,160 --> 02:24:22,920 ARE THOSE ARE WHAT YOU CAN 3570 02:24:22,920 --> 02:24:24,400 POTENTIALLY INTERVENE ON 3571 02:24:24,400 --> 02:24:27,320 PREVENTING SOMEBODY FROM GOING 3572 02:24:27,320 --> 02:24:29,400 INTO THAT STATE. 3573 02:24:29,400 --> 02:24:32,000 WHAT THEY ARE WHETHER EXPOSURE 3574 02:24:32,000 --> 02:24:34,800 TO CERTAIN PAIN CONDITIONS AS A 3575 02:24:34,800 --> 02:24:40,360 KID AND CERTAIN DRUGS AS A KID 3576 02:24:40,360 --> 02:24:44,160 OR CERTAIN OCCUPATIONAL 3577 02:24:44,160 --> 02:24:47,480 EXPOSURES AND THESE HAVE NOT 3578 02:24:47,480 --> 02:24:50,800 REALLY BEEN LOOKED AT CAREFULLY 3579 02:24:50,800 --> 02:24:52,600 WITH A BIG IMPACT TO FIND 3580 02:24:52,600 --> 02:24:56,520 SOMETHING THAT IS ACTIONABLE. 3581 02:24:56,520 --> 02:24:59,800 WE TALKED YESTERDAY ABOUT FACT 3582 02:24:59,800 --> 02:25:05,280 THERE IS A DIRTH OF KNOWLEDGE OF 3583 02:25:05,280 --> 02:25:07,800 TREATING CHILDREN WITH DIFFERENT 3584 02:25:07,800 --> 02:25:09,440 PAIN CONDITIONS AND HEARD PEOPLE 3585 02:25:09,440 --> 02:25:11,200 OR KIDS WITH CERTAIN CONDITIONS 3586 02:25:11,200 --> 02:25:17,120 HAVE HORRIBLE PAIN EVERY DAY. 3587 02:25:17,120 --> 02:25:21,000 IT DRIVES US TO UNDERSTAND HOW 3588 02:25:21,000 --> 02:25:25,560 TO DO BETTER THERE. 3589 02:25:25,560 --> 02:25:27,000 ISSUES OF WORKFORCE WE TALKED 3590 02:25:27,000 --> 02:25:30,360 ABOUT THAT BEFORE AND WE HAVE TO 3591 02:25:30,360 --> 02:25:33,400 DO THINGS TO CREATE PAIN 3592 02:25:33,400 --> 02:25:35,120 WORKFORCE AND THERE IS NO 3593 02:25:35,120 --> 02:25:37,600 INSTITUTE FOR PAIN LIKE THERE IS 3594 02:25:37,600 --> 02:25:39,160 FOR DRUG ABUSE. 3595 02:25:39,160 --> 02:25:42,000 ACTUALLY, HEAL IS REALLY THE ONE 3596 02:25:42,000 --> 02:25:47,040 SHOP IN TOWN THAT CAN BUILD A 3597 02:25:47,040 --> 02:25:49,280 SIZABLE WORKFORCE TO ATTACK 3598 02:25:49,280 --> 02:25:50,560 PROBLEMS WE KNOW ARE SO 3599 02:25:50,560 --> 02:25:51,960 IMPORTANT AND DEVICES TALKED 3600 02:25:51,960 --> 02:25:54,240 ABOUT FROM THE BEGINNING IN 3601 02:25:54,240 --> 02:25:57,600 TERMS OF BIOMARKERS THAT HAVE 3602 02:25:57,600 --> 02:25:59,560 PAIN THAT CHANGES PEOPLE'S 3603 02:25:59,560 --> 02:26:00,920 BEHAVIORS AND CHANGES IN 3604 02:26:00,920 --> 02:26:02,800 BEHAVIORS ARE LIKE WILL I TO BE 3605 02:26:02,800 --> 02:26:05,360 ABLE TO BE CAPTURED. 3606 02:26:05,360 --> 02:26:07,680 THEY CAN BE WITH CURRENT DEVICES 3607 02:26:07,680 --> 02:26:11,920 OR MAYBE SOME, YOU KNOW, MORE 3608 02:26:11,920 --> 02:26:13,880 NOVEMBEREL DEVICES AND THAT 3609 02:26:13,880 --> 02:26:17,920 COULD SERVE AS A -- YOU KNOW, AS 3610 02:26:17,920 --> 02:26:20,360 SOMETHING THAT COMPLIMENTS THE 3611 02:26:20,360 --> 02:26:22,040 PERSON'S REPORT OF THEIR 3612 02:26:22,040 --> 02:26:24,480 PERCEPTION OF PAIN AND MAYBE 3613 02:26:24,480 --> 02:26:25,400 POTENTIALLY SOMETHING THAT MAY 3614 02:26:25,400 --> 02:26:31,440 BE MORE AMENABLE TO LOOK AT 3615 02:26:31,440 --> 02:26:34,280 CHAIVENGS RELATED TO 3616 02:26:34,280 --> 02:26:39,520 INTERVENTIONS SUCH AS DRUGS OR 3617 02:26:39,520 --> 02:26:40,080 NON-PHARMACOLOGICAL 3618 02:26:40,080 --> 02:26:42,960 INTERVENTIONS AND SLEEP AS AN 3619 02:26:42,960 --> 02:26:45,640 INTERVENTION TARGET IS RISING TO 3620 02:26:45,640 --> 02:26:47,920 THE TOP. ACTUALLY IT ROSE TO 3621 02:26:47,920 --> 02:26:49,840 THE TOP EVENTUALLY WITH OPIOID 3622 02:26:49,840 --> 02:26:52,720 ON THE OPIOID SIDE AND CLEARLY 3623 02:26:52,720 --> 02:26:55,400 SLEEP AND PAIN AND USE OF 3624 02:26:55,400 --> 02:26:58,520 MEDICATIONS FOR SLEEP AND PEOPLE 3625 02:26:58,520 --> 02:27:03,640 HAVE PAIN IS INCREDIBLY COMMON. 3626 02:27:03,640 --> 02:27:10,240 THEN DR. LANGEVIN HAS BEEN A 3627 02:27:10,240 --> 02:27:11,720 CHAMPION FOR OPENING OUR EYES TO 3628 02:27:11,720 --> 02:27:13,960 THIS AREA OF PAIN RESEARCH THAT 3629 02:27:13,960 --> 02:27:18,360 HAS BEEN NEGLECTED THAT IS THE 3630 02:27:18,360 --> 02:27:23,360 MIOFACIAL STRUCTURES AND HOW 3631 02:27:23,360 --> 02:27:25,880 INJURY THERE CREATES PAIN AND 3632 02:27:25,880 --> 02:27:27,880 INTERVENTIONS IN THE SPACE MAY 3633 02:27:27,880 --> 02:27:29,360 LEAD THINGS AND THEY ARE THINGS 3634 02:27:29,360 --> 02:27:33,960 WE TALKED ABOUT. I THINK MY 3635 02:27:33,960 --> 02:27:38,720 BUCKET SLIDE IS NEXT; RIGHT? 3636 02:27:38,720 --> 02:27:44,800 WHAT I TRIED TO DO IS TO 3637 02:27:44,800 --> 02:27:46,240 CERTAINLY WE ARE INTERESTED IN 3638 02:27:46,240 --> 02:27:48,920 COMMENTS WE TALKED ABOUT WITH 3639 02:27:48,920 --> 02:27:53,040 REGARDS TO ACTIONAL ITEMS COMING 3640 02:27:53,040 --> 02:27:55,320 INTO MWGP THIS TIME AND THINKING 3641 02:27:55,320 --> 02:27:58,800 ABOUT SPECTRUM WHAT WE ARE DOING 3642 02:27:58,800 --> 02:28:00,880 IN HEAL. 3643 02:28:00,880 --> 02:28:04,320 WHAT I TRIED TO DO HERE IS 3644 02:28:04,320 --> 02:28:05,920 CREATE THREE BUCKETS 3645 02:28:05,920 --> 02:28:07,360 CHARACTERIZED HERE AND 3646 02:28:07,360 --> 02:28:09,920 DEVELOPMENT OF NONADDICTIVE 3647 02:28:09,920 --> 02:28:14,160 THERAPIES AND NOVEMBEREL 3648 02:28:14,160 --> 02:28:14,440 THERAPIES. 3649 02:28:14,440 --> 02:28:16,280 SECT ONE IS USING WHAT WE KNOW 3650 02:28:16,280 --> 02:28:19,880 AND HAVE AVAILABLE USING 3651 02:28:19,880 --> 02:28:22,520 OPTIMALLY MAXIMIZED FUNCTION 3652 02:28:22,520 --> 02:28:24,280 WITH PEOPLE WITH PAIN OR EXPOSED 3653 02:28:24,280 --> 02:28:25,920 TO PAIN AND THIRD BUCKET IS KIND 3654 02:28:25,920 --> 02:28:32,160 OF THINGS THAT WE ARE DOING TO 3655 02:28:32,160 --> 02:28:36,600 KIND OF GROW ECOSYSTEM OF PAIN 3656 02:28:36,600 --> 02:28:45,000 RESEARCH I MENTIONED. 3657 02:28:45,000 --> 02:28:46,480 HEAL HAS AN OPPORTUNITY TO DO 3658 02:28:46,480 --> 02:28:49,920 THIS AND TAKES PLACE OF 3659 02:28:49,920 --> 02:28:51,600 INSTITUTE FOR PAIN. 3660 02:28:51,600 --> 02:28:55,200 I WOULD BE INTERESTED IN 3661 02:28:55,200 --> 02:28:58,840 PEOPLE'S IDEAS ON THREE BUCKETS 3662 02:28:58,840 --> 02:29:02,280 THAT ARE THINGS WE SHOULD BE 3663 02:29:02,280 --> 02:29:06,600 DOING IN ANY THREE AREAS WE ARE 3664 02:29:06,600 --> 02:29:09,560 NOT DOING. THEN FROM WHAT YOU 3665 02:29:09,560 --> 02:29:13,840 KNOW ARE THINGS WE ARE DOING. 3666 02:29:13,840 --> 02:29:17,720 YOU DON'T THINK THEY ARE HIGH 3667 02:29:17,720 --> 02:29:21,160 PRIORITY AND WE BUILT IT OVER 3668 02:29:21,160 --> 02:29:23,560 TIME AND KIND OF A LONG-TERM 3669 02:29:23,560 --> 02:29:25,600 PLAN WITH PIECES COMING IN AND 3670 02:29:25,600 --> 02:29:27,120 OUT AND THINK THESE THREE 3671 02:29:27,120 --> 02:29:30,680 BUCKETS WILL REMAIN OVER THE 3672 02:29:30,680 --> 02:29:39,280 LONG RUN HAPPY TO CALL ON PEOPLE 3673 02:29:39,280 --> 02:29:43,160 IF NO ONE RAISES THEIR HAND. 3674 02:29:43,160 --> 02:29:46,800 ROB? OH, WELL LINDSAY IS HERE 3675 02:29:46,800 --> 02:29:51,760 AND LINDSEY AND DO YOU HAVE 3676 02:29:51,760 --> 02:29:56,800 ANYTHING TO COMMENT ON? HELEN 3677 02:29:56,800 --> 02:29:57,160 IS HERE AND. 3678 02:29:57,160 --> 02:29:59,120 >>YEAH. THANK YOU FOR GREAT 3679 02:29:59,120 --> 02:30:00,520 SUMMARY AND NICE WAY TO THINK 3680 02:30:00,520 --> 02:30:03,160 ABOUT THESE IN TERMS OF BUCKETS 3681 02:30:03,160 --> 02:30:05,680 THAT WE HEARD A LOT OF EXCITING 3682 02:30:05,680 --> 02:30:06,920 PROPOSALS AND ALL OF WHICH HAVE 3683 02:30:06,920 --> 02:30:09,200 A LOT OF MERIT OF COURSE. I 3684 02:30:09,200 --> 02:30:11,040 HOPE THERE WILL BE ENOUGH 3685 02:30:11,040 --> 02:30:14,160 RESOURCES SO ALL CAN BE LAUNCHED 3686 02:30:14,160 --> 02:30:18,920 WHEN WE WOULD LIKE THEM TO I 3687 02:30:18,920 --> 02:30:20,920 WANT TO HIGHLIGHT AGAIN WHAT WE 3688 02:30:20,920 --> 02:30:23,720 HEARD FROM OTHERS THAT IS A HUGE 3689 02:30:23,720 --> 02:30:25,240 GAP AND OPPORTUNITY TO ADDRESS 3690 02:30:25,240 --> 02:30:27,160 WHAT IS REPRESENTED IN THE SET 3691 02:30:27,160 --> 02:30:28,960 THAT IS CHILDREN IN ADOLESCENCE 3692 02:30:28,960 --> 02:30:30,640 WITH PAIN THAT CRIES OUT TO ME 3693 02:30:30,640 --> 02:30:32,840 SOMETHING WHERE WE HAVE A VERY 3694 02:30:32,840 --> 02:30:36,320 BIG GAP AND ALL HAVE MERIT. 3695 02:30:36,320 --> 02:30:37,160 YOU NO SNE. 3696 02:30:37,160 --> 02:30:38,800 THAT IS ONE POINT I WOULD LIKE 3697 02:30:38,800 --> 02:30:40,680 TO HIGHLIGHT RECOGNIZING THAT 3698 02:30:40,680 --> 02:30:44,080 ALL OF THESE ARE EXCITING AND 3699 02:30:44,080 --> 02:30:49,760 WILL CONTRIBUTE TO THIS FIELD 3700 02:30:49,760 --> 02:31:00,040 MOVING FORWARD. 3701 02:31:01,240 --> 02:31:02,240 >>COMMENTS? 3702 02:31:02,240 --> 02:31:04,280 >>SURE. I LIKE THE DISCUSSION 3703 02:31:04,280 --> 02:31:05,320 TODAY AND YESTERDAY AND SEEMS 3704 02:31:05,320 --> 02:31:07,120 THERE IS A REOCCURRING THEME 3705 02:31:07,120 --> 02:31:09,400 THAT WE ARE MOVING TOWARDS MORE 3706 02:31:09,400 --> 02:31:12,600 INTEGRATION AND IN TERMS OF 3707 02:31:12,600 --> 02:31:15,240 CONNECTING THINGS. 3708 02:31:15,240 --> 02:31:16,160 >>HERE HELEN. 3709 02:31:16,160 --> 02:31:17,760 >>CAN YOU HEAR ME? 3710 02:31:17,760 --> 02:31:18,320 >> WE CAN. 3711 02:31:18,320 --> 02:31:20,240 >> IT IS WORKING NOW. 3712 02:31:20,240 --> 02:31:21,960 >>YEAH. WE ARE LOOKING OR 3713 02:31:21,960 --> 02:31:25,320 CONNECTING THINGS FOR EXAMPLE WE 3714 02:31:25,320 --> 02:31:29,320 ARE STARTING TO ADDRESS A 3715 02:31:29,320 --> 02:31:31,080 DIFFICULT TASK LOOKING AT THINGS 3716 02:31:31,080 --> 02:31:32,880 THAT HAPPEN AT SAME TIME THAT 3717 02:31:32,880 --> 02:31:34,160 SOMEBODY HAS PAIN AND FOR 3718 02:31:34,160 --> 02:31:35,560 EXAMPLE CO-OCCURRING CONDITIONS 3719 02:31:35,560 --> 02:31:38,440 THAT WE TALK ABOUT OR PROBLEMS 3720 02:31:38,440 --> 02:31:40,600 WITH SLEEP OR PROBLEMS 3721 02:31:40,600 --> 02:31:44,120 ADDRESSING MORE THAN ONE DOMAIN 3722 02:31:44,120 --> 02:31:50,240 THAT ARE OUR TENDENCY IS WANTING 3723 02:31:50,240 --> 02:31:52,320 TO CONTROL AND SEPARATE AND 3724 02:31:52,320 --> 02:31:54,120 STUDY THINGS ONE AT A TIME THEY 3725 02:31:54,120 --> 02:31:55,920 ARE SKIENTIVE KALILY RIG RHO US 3726 02:31:55,920 --> 02:31:57,480 AND WE MISS THINGS DOING THAT 3727 02:31:57,480 --> 02:32:00,800 AND CHALLENGES DOING INTEGRATIVE 3728 02:32:00,800 --> 02:32:02,000 RESEARCH WITHOUT SACRIFICING 3729 02:32:02,000 --> 02:32:04,520 RIGOR AND WE ARE GETTING THERE 3730 02:32:04,520 --> 02:32:06,320 METHOD LOGICALLY BUT WE HAVE TO 3731 02:32:06,320 --> 02:32:11,600 NOT BE AFRAID TO DO THAT. 3732 02:32:11,600 --> 02:32:14,880 I'M GLAD TO HEAR ENTHUSIASM 3733 02:32:14,880 --> 02:32:16,440 LOOKING AT CO-OCCURRING 3734 02:32:16,440 --> 02:32:18,680 CONDITIONS BOTH IN PHYSICAL AND 3735 02:32:18,680 --> 02:32:26,120 MENTAL HEALTH DOMAIN THAT IS 3736 02:32:26,120 --> 02:32:29,240 VERY ENCOURAGING? 3737 02:32:29,240 --> 02:32:30,400 >>YOU HAVE YOUR HAND UP? 3738 02:32:30,400 --> 02:32:34,320 >>YEAH. BRINGING UP AGREEING 3739 02:32:34,320 --> 02:32:39,840 WITH YOU HAVING HEAL PAIN 3740 02:32:39,840 --> 02:32:41,640 ENABLED US TO HAVE MORE 3741 02:32:41,640 --> 02:32:43,840 INTEGRATIVE SET OF RESEARCH THAT 3742 02:32:43,840 --> 02:32:45,600 CAN HOPEFULLY ADVANCE 3743 02:32:45,600 --> 02:32:48,840 DEVELOPMENT OF NEW MEDICATIONS 3744 02:32:48,840 --> 02:32:51,440 AND ANALGEEZICS PROVIDING WITH 3745 02:32:51,440 --> 02:32:53,240 EVIDENCE-BASED GUIDANCE TREATING 3746 02:32:53,240 --> 02:32:54,520 PATIENTS WITH COMPLEX 3747 02:32:54,520 --> 02:32:56,640 PRESENTATIONS AND WHAT WAS ONE 3748 02:32:56,640 --> 02:33:00,880 THING I WANTED US ALL TO KEEP IN 3749 02:33:00,880 --> 02:33:05,400 OUR BRAINS IS BIO RELEASED 3750 02:33:05,400 --> 02:33:06,720 RECENTLY LATEST REPORT VIS-À-VIS 3751 02:33:06,720 --> 02:33:10,640 LEVEL OF INVESTMENT BY COMPANIES 3752 02:33:10,640 --> 02:33:12,560 OF DIFFERENT CONDITIONS AND 3753 02:33:12,560 --> 02:33:13,960 CANCER IS ONE WITH HIGH 3754 02:33:13,960 --> 02:33:15,360 INVESTMENT. AS YOU KNOW, THEY 3755 02:33:15,360 --> 02:33:19,360 DO THIS BASICALLY CONTRAST 3756 02:33:19,360 --> 02:33:20,920 BETWEEN WHAT IS MAGNITUDE OF 3757 02:33:20,920 --> 02:33:22,600 PROBLEM AND WHAT IS INVESTMENT 3758 02:33:22,600 --> 02:33:25,520 AND WHAT IS TRAGIC IS BOTH FOR 3759 02:33:25,520 --> 02:33:27,640 ONES WITH LOW INVESTMENT IS IN 3760 02:33:27,640 --> 02:33:29,720 TERMS OF VENTURE CAPITALS AND 3761 02:33:29,720 --> 02:33:32,480 LOWEST LOWEST ARE PAIN AND 3762 02:33:32,480 --> 02:33:34,840 SUBSTANCE USE DISORDER. THIS IS 3763 02:33:34,840 --> 02:33:40,840 BY GIGANTIC IMPACT THEY HAVE I 3764 02:33:40,840 --> 02:33:44,640 WAS THINKING ON IT AND FROM 3765 02:33:44,640 --> 02:33:54,800 BEGINN 3766 02:34:02,880 --> 02:34:03,840 BEGINNING. 3767 02:34:03,840 --> 02:34:06,400 PROCESS AND GET A SENSE HEAL 3768 02:34:06,400 --> 02:34:07,560 PERSPECTIVE CAN MAXIMIZE IMPACT 3769 02:34:07,560 --> 02:34:09,280 THAT IS A POINT I WANTED TO SAY. 3770 02:34:09,280 --> 02:34:14,560 WE ARE ACTUALLY NOT ANY BETTER. 3771 02:34:14,560 --> 02:34:19,760 NEITHER FOR PAIN IN TERMS OF 3772 02:34:19,760 --> 02:34:29,960 INVESTM 3773 02:34:33,560 --> 02:34:33,840 INVESTMENTS. 3774 02:34:33,840 --> 02:34:35,440 IVEN VESTMENTLE CAPITAL COULD BE 3775 02:34:35,440 --> 02:34:38,320 GOOD ONE TO HELP US FIGURE OUT 3776 02:34:38,320 --> 02:34:42,080 IF WE CAN COVER THESE REALLY 3777 02:34:42,080 --> 02:34:43,640 DESERT OF INVESTMENT IN THE 3778 02:34:43,640 --> 02:34:44,040 FIELD. 3779 02:34:44,040 --> 02:34:45,680 >>I WILL THROW OUT A COUPLE OF 3780 02:34:45,680 --> 02:34:48,560 THINGS THAT AMIR TOLD ME ABOUT 3781 02:34:48,560 --> 02:34:51,160 ATTRACTING SBIRS IN PAIN THAT WE 3782 02:34:51,160 --> 02:34:52,960 FUNDED. I THINK THAT WE PUT IN 3783 02:34:52,960 --> 02:34:55,600 50 MILLION. THEY ACTUALLY RAISE 3784 02:34:55,600 --> 02:34:58,960 130 MILLION ON TOP OF OUR 50. 3785 02:34:58,960 --> 02:35:01,000 IT IS COMPARED TO CANCER, YOU 3786 02:35:01,000 --> 02:35:02,800 KNOW, IT IS A DROP IN THE 3787 02:35:02,800 --> 02:35:04,400 BUCKET, I'M SURE. 3788 02:35:04,400 --> 02:35:07,320 THE OTHER THING IS THE SAME LINE 3789 02:35:07,320 --> 02:35:09,640 AND MY MEMORY IS FUZZY AND I 3790 02:35:09,640 --> 02:35:11,680 THINK THAT WE HAVE PLANS TO DO A 3791 02:35:11,680 --> 02:35:16,280 SHOWCASE WITH THE INDUSTRY AND 3792 02:35:16,280 --> 02:35:18,920 BIOTECHS WE ARE FUNDING AND 3793 02:35:18,920 --> 02:35:20,920 INVESTIGATORS WE ARE FUNDING AND 3794 02:35:20,920 --> 02:35:23,560 BRINGING BIG PHARMAPEOPLE IN TO 3795 02:35:23,560 --> 02:35:26,080 BASICALLY KEEP THAT FLOW OF 3796 02:35:26,080 --> 02:35:26,760 INFORMATION GOING. 3797 02:35:26,760 --> 02:35:31,760 WE TALKED OR WE TALKED A BUNCH 3798 02:35:31,760 --> 02:35:33,240 OF BIG PHARMA PEOPLE AND THEY 3799 02:35:33,240 --> 02:35:34,800 SAID THEY ARE NOT GOING NEAR 3800 02:35:34,800 --> 02:35:38,680 PAIN AND ARE INTERESTED TO HEAR 3801 02:35:38,680 --> 02:35:44,040 WHAT WAS OUT THERE. 3802 02:35:44,040 --> 02:35:46,000 WE HAVE TO MAKE IT TANTALIZING 3803 02:35:46,000 --> 02:35:49,040 TO PICK IT UP AND MONEY TO BE 3804 02:35:49,040 --> 02:35:53,160 MADE NO QUESTION ABOUT THAT AND 3805 02:35:53,160 --> 02:35:56,400 DERISKING PROCESS OF APPROVAL 3806 02:35:56,400 --> 02:35:58,440 THAT WE ARE UP TO. 3807 02:35:58,440 --> 02:35:59,720 ANYTHING ELSE ABOUT THE SHOWCASE 3808 02:35:59,720 --> 02:36:01,160 THAT I CAN'T REMEMBER THE 3809 02:36:01,160 --> 02:36:02,080 DETAILS OFF THE BAH THE. 3810 02:36:02,080 --> 02:36:06,000 >>I WANT TO SAY IT IS BEING 3811 02:36:06,000 --> 02:36:09,000 PLANNED FOR FALL OF THIS YEAR. 3812 02:36:09,000 --> 02:36:09,240 >>OKAY. 3813 02:36:09,240 --> 02:36:11,520 >>IDEAS IF I HAD ONE TAKEAWAY 3814 02:36:11,520 --> 02:36:18,080 FROM THE DISCUSSIONS WE HAD WITH 3815 02:36:18,080 --> 02:36:21,080 PRIVATE SECTOR FOLKS THERE IS 3816 02:36:21,080 --> 02:36:22,200 CONSOLIDATION WITH NEUROSCIENCE 3817 02:36:22,200 --> 02:36:23,920 BASED GENERALLY AND NOT 3818 02:36:23,920 --> 02:36:25,720 NECESSARILY PAIN IS UNIQUELY 3819 02:36:25,720 --> 02:36:27,520 TARGETED BUT ARE LIMITING 3820 02:36:27,520 --> 02:36:30,880 INVESTMENTS ACROSS THE BOARD. 3821 02:36:30,880 --> 02:36:34,960 THAT IS ALSO AT SAME TIME NOT 3822 02:36:34,960 --> 02:36:43,720 SPECIFIC TO NEURO SCIESCIENCE 3823 02:36:43,720 --> 02:36:45,920 INVESTMENT FOR BIOTECH IS 3824 02:36:45,920 --> 02:36:48,280 GETTING HARDER AND PICKING UP 3825 02:36:48,280 --> 02:36:50,240 PRODUCTS COMMERCIALIZING THEM 3826 02:36:50,240 --> 02:36:52,040 RIGHT AWAY AND OTHER HAND WHAT 3827 02:36:52,040 --> 02:36:55,480 WE INVESTED IN HEAL BECOMES ALL 3828 02:36:55,480 --> 02:36:56,880 THE MORE IMPORTANT. 3829 02:36:56,880 --> 02:36:58,840 WE DON'T HAVE AS MANY 3830 02:36:58,840 --> 02:37:02,120 ALTERNATIVE OPTIONS FOR SMALL 3831 02:37:02,120 --> 02:37:06,480 COMPANIES AND BEING ABLE TO 3832 02:37:06,480 --> 02:37:08,160 DISPLAY WORK GOING ON AND 3833 02:37:08,160 --> 02:37:09,400 PROGRESS WE ARE MAKING MAKING 3834 02:37:09,400 --> 02:37:11,360 KNOWN TO COMPANIES NOT READY TO 3835 02:37:11,360 --> 02:37:15,160 INVEST AND ARE IN WATCHFUL 3836 02:37:15,160 --> 02:37:17,960 WAITING CATEGORY FITS WITH 3837 02:37:17,960 --> 02:37:19,760 CURRENT CLIMATE AND IS PLAN FOR 3838 02:37:19,760 --> 02:37:22,240 FALL MEETING. 3839 02:37:22,240 --> 02:37:25,640 >>I THINK IT IS VERY GOOD AND 3840 02:37:25,640 --> 02:37:26,440 CERTAINLY PROBABLY YOU HAVE 3841 02:37:26,440 --> 02:37:28,120 THOUGHT OF THIS AND WE HAVE TO 3842 02:37:28,120 --> 02:37:31,960 BRING ALSO DEVICES THAT IS A 3843 02:37:31,960 --> 02:37:34,240 COMPLETELY OTHER SPACE THAT 3844 02:37:34,240 --> 02:37:35,720 OFFERS FOR OPPORTUNITIES FOR 3845 02:37:35,720 --> 02:37:37,240 TREATMENT AND DEVELOPMENT MIGHT 3846 02:37:37,240 --> 02:37:40,760 BE FASTER TO BRINGING IN 3847 02:37:40,760 --> 02:37:45,360 MEDICA 3848 02:37:45,360 --> 02:37:45,720 MEDICATION. 3849 02:37:45,720 --> 02:37:47,600 WE HAVE DEVICE PROGRAM AS WELL. 3850 02:37:47,600 --> 02:37:49,280 >>IN TERMS OF BRINGING. 3851 02:37:49,280 --> 02:37:51,120 >>COMPANY, YES, YES, WHY HE. 3852 02:37:51,120 --> 02:37:55,200 >>COMPANIES AND INVESTORS AND 3853 02:37:55,200 --> 02:37:58,120 TRYING TO GET AND LISTEN TO THEM 3854 02:37:58,120 --> 02:38:01,480 AND THEY WOULD MAKE A DIFFERENCE 3855 02:38:01,480 --> 02:38:12,000 AND DON'T THINK BIG PHARMAFOR. 3856 02:38:16,160 --> 02:38:18,400 THIS IS SPACE TO MAXIMIZE 3857 02:38:18,400 --> 02:38:19,000 INTERACTIONS WITH. 3858 02:38:19,000 --> 02:38:19,800 >>RIGHT. 3859 02:38:19,800 --> 02:38:21,760 >>NORA AND WALTER THIS IS THE 3860 02:38:21,760 --> 02:38:23,880 POINT OF THE CONFERENCE WE ARE 3861 02:38:23,880 --> 02:38:25,880 ORGANIZING BETWEEN SBIR GRANTS 3862 02:38:25,880 --> 02:38:30,960 OR GRANTEES AND OTHER MEMBERS OF 3863 02:38:30,960 --> 02:38:34,280 HEAL ACROSS NIH DOING 3864 02:38:34,280 --> 02:38:35,680 THERAPEUTIC DEVELOPMENT PAIN 3865 02:38:35,680 --> 02:38:40,200 GETTING NOT JUST BIG PHARMABUT 3866 02:38:40,200 --> 02:38:50,240 INVESTORS IN -- WHAT HAPPENS IN 3867 02:38:50,240 --> 02:38:52,840 DEVELOPMENT ANGEL INVESTMENT AND 3868 02:38:52,840 --> 02:38:56,680 VC AND RIGHT NOW I WAS AT 3869 02:38:56,680 --> 02:38:57,880 BIOCONFERENCE WHERE PAPER WAS 3870 02:38:57,880 --> 02:38:59,680 PRESENTED AND AUTHOR MADE IT 3871 02:38:59,680 --> 02:39:05,120 VERY, VERY CLEAR AND EMILY AND 3872 02:39:05,120 --> 02:39:08,080 MYSELF MET WITHES DO JENS OF 3873 02:39:08,080 --> 02:39:10,200 COMPANIES SAYING THEY WANT PHASE 3874 02:39:10,200 --> 02:39:13,080 2 DATA WHERE GC2 WANTS TO JUMP 3875 02:39:13,080 --> 02:39:17,720 IN AND SEE EFFICACY IN PATIENT 3876 02:39:17,720 --> 02:39:18,680 POPULATION NOT JUST 3877 02:39:18,680 --> 02:39:21,040 THEORETICALLY DOES IT WORK AND 3878 02:39:21,040 --> 02:39:22,760 IN ANIMAL MODEL, ET CETERA. 3879 02:39:22,760 --> 02:39:25,000 THIS WE HAVE TO FOCUS ON IN HEAL 3880 02:39:25,000 --> 02:39:27,000 AND NOT JUST HELP ACADEMICS BUT 3881 02:39:27,000 --> 02:39:29,680 ALSO COMPANIES THEMSELVES GET TO 3882 02:39:29,680 --> 02:39:31,680 THAT STATE WHERE THEY CAN GET 3883 02:39:31,680 --> 02:39:34,040 EARLY PHASE 2. THAT IS THE 3884 02:39:34,040 --> 02:39:36,240 FIRST EFFICACY STUDIES. 3885 02:39:36,240 --> 02:39:38,400 >>I KNOW. I'M GLAD TO HEAR 3886 02:39:38,400 --> 02:39:40,400 THIS. I WOULD BE REMISED IF I 3887 02:39:40,400 --> 02:39:43,280 DON'T BRING ANOTHER POINT TO THE 3888 02:39:43,280 --> 02:39:43,520 TABLE. 3889 02:39:43,520 --> 02:39:45,120 WE DON'T GET THE LUXURY OF 3890 02:39:45,120 --> 02:39:47,120 HAVING ALL OF YOU AND GETTING 3891 02:39:47,120 --> 02:39:48,320 INPUT IS OPPORTUNITY THAT WE 3892 02:39:48,320 --> 02:39:51,400 HAVE WITH ACTUALLY PARTNERING 3893 02:39:51,400 --> 02:39:54,280 WITH ARPAH. THAT WILL BE 3894 02:39:54,280 --> 02:39:57,560 BRINGING NOT JUST NEW FONTS BUT 3895 02:39:57,560 --> 02:39:58,600 A COMPLETELY DIFFERENT STRUCTURE 3896 02:39:58,600 --> 02:40:01,840 THAT CAN FACILITATE ADVANCING 3897 02:40:01,840 --> 02:40:03,000 DEVELOPMENT OF ACTUALLY 3898 02:40:03,000 --> 02:40:04,160 MEDICATIONS AND PRODUCTS. 3899 02:40:04,160 --> 02:40:07,240 I THINK THAT IT MAY BE 3900 02:40:07,240 --> 02:40:09,480 WORTHWHILE AND THINKING IN THE 3901 02:40:09,480 --> 02:40:13,160 MORNING THAT WE HAVE RENÉ WHO 3902 02:40:13,160 --> 02:40:18,960 DIRECTS THE ARPA H PROGRAM TO 3903 02:40:18,960 --> 02:40:21,000 GIVE A PRESENTATION AT ONE OF 3904 02:40:21,000 --> 02:40:22,560 OUR HEAL MEETINGS. 3905 02:40:22,560 --> 02:40:24,360 >>GREAT SUGGESTION, NORA. SHE 3906 02:40:24,360 --> 02:40:27,560 GAVE A GREAT PRESENTATION THIS 3907 02:40:27,560 --> 02:40:27,920 MORNING. 3908 02:40:27,920 --> 02:40:29,880 WOULD BE GREAT TO BRING HER TO 3909 02:40:29,880 --> 02:40:31,840 THIS GROUP. 3910 02:40:31,840 --> 02:40:32,800 >>ALLAN? 3911 02:40:32,800 --> 02:40:38,240 >>>>YEAH. TWO THINGS 3912 02:40:38,240 --> 02:40:42,520 IMPRESSIVE PRESENTATION AND ONE 3913 02:40:42,520 --> 02:40:45,160 SUGGESTION AND COMMENT THIS 3914 02:40:45,160 --> 02:40:47,120 DOESN'T INCLUDE ALL OF THE 3915 02:40:47,120 --> 02:40:50,480 PROGRESS MADE THROUGH MORE 3916 02:40:50,480 --> 02:40:53,720 TRADITIONAL FUNDING MECHANISMS 3917 02:40:53,720 --> 02:40:57,440 AND ANY WAY TO INTEGRATE DATA 3918 02:40:57,440 --> 02:41:00,680 AND BEEN A SHAME PROGRESS MADE 3919 02:41:00,680 --> 02:41:01,800 THROUGH MECHANISMS AND NICE TO 3920 02:41:01,800 --> 02:41:04,880 SEE HOW THEY RELATE OR OVERLAP 3921 02:41:04,880 --> 02:41:06,760 OR MAYBE DISAGREE AND WE 3922 02:41:06,760 --> 02:41:09,760 CERTAINLY DON'T WANT TO BE 3923 02:41:09,760 --> 02:41:11,080 REDUNDANT AND KNOW THERE HAS 3924 02:41:11,080 --> 02:41:13,640 BEEN DATA GENERATED IN NORMAL 3925 02:41:13,640 --> 02:41:16,840 MECHANISMS AND THROUGH MANY 3926 02:41:16,840 --> 02:41:19,600 INSTITUTES IS NO. 1 ANOTHER IS 3927 02:41:19,600 --> 02:41:21,240 COMMENT ABOUT DEVICES ISSUE AND 3928 02:41:21,240 --> 02:41:23,960 TURNS OUT ISP IS 50 YENL 3929 02:41:23,960 --> 02:41:25,280 ANNIVERSARY AND I HAVE BEEN 3930 02:41:25,280 --> 02:41:28,600 INVOLVED IN THIS AND I'M WRITING 3931 02:41:28,600 --> 02:41:30,520 REVIEWS. SHORT REVIEWS ON 3932 02:41:30,520 --> 02:41:32,600 PROGRESS AND HIGHLIGHTS, BLAH, 3933 02:41:32,600 --> 02:41:33,320 BLAH, BLAH. 3934 02:41:33,320 --> 02:41:35,960 ONE OF WHICH IS WORKING WITH FOR 3935 02:41:35,960 --> 02:41:42,240 EXAMPLE TROLLS YEN SEN IN 3936 02:41:42,240 --> 02:41:45,400 DENMARK WRITING ON CLINICAL 3937 02:41:45,400 --> 02:41:46,880 PROCESS AND DRAFTED PIECE AND 3938 02:41:46,880 --> 02:41:48,240 INTERESTING AND YOU DIDN'T 3939 02:41:48,240 --> 02:41:51,640 INCLUDE ANYTHING ON DEVICES. 3940 02:41:51,640 --> 02:41:55,240 HE SAID BECAUSE DATA IS NOT 3941 02:41:55,240 --> 02:41:56,520 CONVINCING AND ONE REASON HE 3942 02:41:56,520 --> 02:41:59,200 SAYS IS THERE IS RARELY BLIND 3943 02:41:59,200 --> 02:42:00,280 TRIALS AND THEY ARE VERY 3944 02:42:00,280 --> 02:42:03,520 DIFFICULT TO DO AND NOT PLACEBO 3945 02:42:03,520 --> 02:42:06,640 CONTROLLED TRIALS AND HE HAS 3946 02:42:06,640 --> 02:42:12,720 WRITTEN WITH OTHERS SYSTEMATIC 3947 02:42:12,720 --> 02:42:14,840 TYPES OF REVIEWS ON THINGS AND 3948 02:42:14,840 --> 02:42:17,000 IS NOT CONVINCED AND WE HAVE TO 3949 02:42:17,000 --> 02:42:18,200 TAKE THAT CONCERN SERIOUSLY WHEN 3950 02:42:18,200 --> 02:42:21,040 WE ARE TALKING ABOUT THE DEVICES 3951 02:42:21,040 --> 02:42:24,840 THERE WILL BE ACTUALLY A PROPER 3952 02:42:24,840 --> 02:42:26,960 RANDOMIZED CONTROL TRIAL TO THE 3953 02:42:26,960 --> 02:42:28,480 EXTENT IT IS POSSIBLE BECAUSE 3954 02:42:28,480 --> 02:42:29,480 SOMEONE SAYS IT WORKS DOESN'T 3955 02:42:29,480 --> 02:42:34,120 MEAN IT WILL WORK. WE KNOW 3956 02:42:34,120 --> 02:42:34,280 THAT. 3957 02:42:34,280 --> 02:42:39,920 >>GOOD POINT. I THINK THAT 3958 02:42:39,920 --> 02:42:42,040 ANYTHING CONFUSED AND IN BRAIN 3959 02:42:42,040 --> 02:42:44,640 WE HAVE BUCKLED DOWN ON TRYING 3960 02:42:44,640 --> 02:42:47,560 TO UNDERSTAND WHAT IS GOING ON 3961 02:42:47,560 --> 02:42:52,960 IN THE CIRCUITS WITH ELECTRICAL 3962 02:42:52,960 --> 02:42:53,680 STIMULATION PRIMARILY. 3963 02:42:53,680 --> 02:42:55,440 AND THERE IS A -- THERE IS A -- 3964 02:42:55,440 --> 02:42:56,840 WELL, THERE IS A COUPLE OF 3965 02:42:56,840 --> 02:42:59,240 REALLY AMAZING THINGS THAT CAME 3966 02:42:59,240 --> 02:43:02,920 OUT IN THE LAST MONTH OR 2 AND 3967 02:43:02,920 --> 02:43:04,080 SOMETHING NEXT WEEK AND 3968 02:43:04,080 --> 02:43:07,080 SOMETHING ABOUT A MONTH AGO AND 3969 02:43:07,080 --> 02:43:09,200 SPINAL CORD INJURY AND NO THE IN 3970 02:43:09,200 --> 02:43:10,880 THE PAINT SPACE BUT MOTOR SYSTEM 3971 02:43:10,880 --> 02:43:15,280 THAT YOU CAN REALLY MANIPULATE 3972 02:43:15,280 --> 02:43:16,800 SPINAL CIRCUITS AND REALLY IN A 3973 02:43:16,800 --> 02:43:21,200 UNIQUE WAY. SO, I AGREE THAT -- 3974 02:43:21,200 --> 02:43:25,000 THAT THE MOVEMENT INTO THE 3975 02:43:25,000 --> 02:43:29,640 CIRCUIT MANIPULATION IS GOING TO 3976 02:43:29,640 --> 02:43:32,920 BE BIG BUSINESS DOWN THE ROAD 3977 02:43:32,920 --> 02:43:36,440 AND MORE PRECISE THAN DRUGS, I 3978 02:43:36,440 --> 02:43:39,840 THINK. BRAIN ISSUE IS WHERE ALL 3979 02:43:39,840 --> 02:43:42,560 THAT IS SEATING UP. 3980 02:43:42,560 --> 02:43:45,520 >>THANK YOU. 3981 02:43:45,520 --> 02:43:46,920 >>YEAH. ROB? 3982 02:43:46,920 --> 02:43:51,200 >>I HAVE A FEW THINGS, I GUESS. 3983 02:43:51,200 --> 02:43:54,440 LOTS OF THIS DISCUSSION GETTING 3984 02:43:54,440 --> 02:43:57,040 TO THE POINT OF IT. 3985 02:43:57,040 --> 02:44:00,120 JUST MENTIONING WHAT IS GOING ON 3986 02:44:00,120 --> 02:44:01,280 IN PAIN RESEARCH SPACE. 3987 02:44:01,280 --> 02:44:06,240 WE HAVE A LITTLE OF A PR ISSUE I 3988 02:44:06,240 --> 02:44:08,720 THI 3989 02:44:08,720 --> 02:44:08,960 THINK. 3990 02:44:08,960 --> 02:44:11,440 I HEAR FRUSTRATION FROM PAIN 3991 02:44:11,440 --> 02:44:13,080 RESEARCHERS THAT THERE ARE TYPES 3992 02:44:13,080 --> 02:44:15,400 OF THINGS THAT THERE IS HEAL 3993 02:44:15,400 --> 02:44:16,800 FUNDING DOESN'T FIT WITH KIND OF 3994 02:44:16,800 --> 02:44:17,360 YOU KNOW. 3995 02:44:17,360 --> 02:44:18,880 >>RIGHT. 3996 02:44:18,880 --> 02:44:21,200 >>TYPICAL DISCOVERY TYPE OF 3997 02:44:21,200 --> 02:44:24,760 RESEARCH AND SENSE IS THEY ARE 3998 02:44:24,760 --> 02:44:26,240 MISSING OUT ONL THIS OPPORTUNITY 3999 02:44:26,240 --> 02:44:30,400 AND CONVEYING THERE IS OTHER 4000 02:44:30,400 --> 02:44:31,840 MECHANISMS AVAILABLE. 4001 02:44:31,840 --> 02:44:33,640 IS THERE -- WE HAVE A SENSE 4002 02:44:33,640 --> 02:44:36,760 ABOUT ONGOING INVESTMENT FROM 4003 02:44:36,760 --> 02:44:38,040 INSTITUTES IN PAIN RESEARCH HAS 4004 02:44:38,040 --> 02:44:41,480 IT CHANGED WITH HEAL? HAS IT 4005 02:44:41,480 --> 02:44:44,560 GONE DOWN IN CONTEXT OF NORMAL 4006 02:44:44,560 --> 02:44:47,760 R01 TYPE OF MECHANISMS? 4007 02:44:47,760 --> 02:44:49,640 >>FOR US IT HAS GONE UP. 4008 02:44:49,640 --> 02:44:53,960 >>I THINK THERE IS A MISSING -- 4009 02:44:53,960 --> 02:44:55,960 >>ANALYSIS SHARED WITH THIS 4010 02:44:55,960 --> 02:44:58,080 GROUP A WHILE AGO HOW IT WAS 4011 02:44:58,080 --> 02:45:00,120 GOING UP WITH DIFFERENT VIEWS 4012 02:45:00,120 --> 02:45:02,480 MACHINE LEARNING APPROACH TO DO 4013 02:45:02,480 --> 02:45:04,000 ANALYSIS AND WE COULD SHARE 4014 02:45:04,000 --> 02:45:04,960 SLIDES. 4015 02:45:04,960 --> 02:45:06,760 >>WE HAVE FANTASTIC PAIN 4016 02:45:06,760 --> 02:45:08,760 RESEARCH IN OUR INSTITUTE I 4017 02:45:08,760 --> 02:45:08,960 KNOW. 4018 02:45:08,960 --> 02:45:13,040 >>YEAH. THIS IS A -- ALMOST A 4019 02:45:13,040 --> 02:45:14,440 MARKETING THING I THINK HEAL 4020 02:45:14,440 --> 02:45:18,600 COULD BE DOING IN CONTEXT OF BIG 4021 02:45:18,600 --> 02:45:19,840 CONFERENCES TO HIGHLIGHT AND 4022 02:45:19,840 --> 02:45:21,880 THERE IS LOTS OF THIS GOING ON 4023 02:45:21,880 --> 02:45:24,760 MAKING PROGRESS AND IS ONGOING 4024 02:45:24,760 --> 02:45:25,440 INVESTMENT THAT HASN'T CHANGE 4025 02:45:25,440 --> 02:45:28,640 THE AND THERE IS A SENSE PEOPLE 4026 02:45:28,640 --> 02:45:30,120 ARE MISSING OUT ON OPPORTUNITY 4027 02:45:30,120 --> 02:45:32,320 AND WE ARE KIND OF MESSAGE IT IS 4028 02:45:32,320 --> 02:45:34,480 RAISING BOATS AND ADVANCING MAIN 4029 02:45:34,480 --> 02:45:38,000 GOALS TOWARDS CLINIC WE COULD DO 4030 02:45:38,000 --> 02:45:40,720 BETTER WITH THAT. 4031 02:45:40,720 --> 02:45:42,840 >>WHAT ABOUT IDEA THAT CROSSED 4032 02:45:42,840 --> 02:45:48,600 MY MIND BEFORE ABOUT IS IT TOO 4033 02:45:48,600 --> 02:45:50,280 CRAZY TO THINK WE CAN BRING ALL 4034 02:45:50,280 --> 02:45:54,400 PAIN DATE FRAU NIH INTO A DATA 4035 02:45:54,400 --> 02:45:56,440 BASE THAT WOULD KIND OF SIVENGS 4036 02:45:56,440 --> 02:46:00,120 WITH WHAT HEAL DATA ECOSYSTEM 4037 02:46:00,120 --> 02:46:00,520 DOES? 4038 02:46:00,520 --> 02:46:02,240 IS THAT -- WELL, FIRST QUESTION 4039 02:46:02,240 --> 02:46:05,360 IS WOULD IT BE VALID AND WOULD 4040 02:46:05,360 --> 02:46:05,760 ANYBODY CARE? 4041 02:46:05,760 --> 02:46:07,400 >>I THIS I THAT WOULD BE A LOT 4042 02:46:07,400 --> 02:46:09,640 OF WORK THAT WOULD BE HARD FOR 4043 02:46:09,640 --> 02:46:11,720 PEOPLE TO -- IT WOULD MAYBE NOT 4044 02:46:11,720 --> 02:46:13,560 GET AS MUCH UPTAKE. YOU KNOW? 4045 02:46:13,560 --> 02:46:16,200 IT IS VALUABLE TO UNDERSTAND 4046 02:46:16,200 --> 02:46:19,320 THAT THE QUESTION IS HOW WE 4047 02:46:19,320 --> 02:46:19,840 COMMUNICATE IT. 4048 02:46:19,840 --> 02:46:21,480 >>YOU HAVE TO SHARE DATA 4049 02:46:21,480 --> 02:46:24,960 ANALYSIS THAT WILL BE POSTED 4050 02:46:24,960 --> 02:46:25,280 SOMEWHERE. 4051 02:46:25,280 --> 02:46:25,520 >>YEAH. 4052 02:46:25,520 --> 02:46:27,120 >>AS YOU KNOW, YOU WOULDN'T BE 4053 02:46:27,120 --> 02:46:30,000 ABLE TO FIND IT. YOU CAN BUILD 4054 02:46:30,000 --> 02:46:33,720 SOMETHING WITH STUFF THAT IS 4055 02:46:33,720 --> 02:46:34,120 [INDISCERNIBLE]. 4056 02:46:34,120 --> 02:46:34,440 >>YEAH. 4057 02:46:34,440 --> 02:46:37,040 >>>>JUST AN IDEA THAT IS 4058 02:46:37,040 --> 02:46:39,560 INTERESTING THAT CAME UP WITH 4059 02:46:39,560 --> 02:46:39,760 DATA. 4060 02:46:39,760 --> 02:46:42,000 >>WALTER I DON'T THINK JESS IS 4061 02:46:42,000 --> 02:46:44,480 ON TODAY. PART OF DEVELOPING 4062 02:46:44,480 --> 02:46:47,640 HEAL DATA ECOSYSTEM WE HAVE 4063 02:46:47,640 --> 02:46:48,840 IDENTIFIED REPOSITORIES THAT ARE 4064 02:46:48,840 --> 02:46:50,800 COMPATIBLE WITH DATA PLATFORM TO 4065 02:46:50,800 --> 02:46:54,280 MAKE HEAL DATA FAIR, FINE 4066 02:46:54,280 --> 02:46:55,840 ACCESSIBLE INTEROPERABLE AND 4067 02:46:55,840 --> 02:46:57,280 REUSABLE AND RESOURCES WILL BE 4068 02:46:57,280 --> 02:46:59,760 MADE AVAILABLE TO EVERY 4069 02:46:59,760 --> 02:47:00,920 INVESTIGATOR; RIGHT? 4070 02:47:00,920 --> 02:47:03,280 DOESN'T HAVE TO BE HEAL DATA TO 4071 02:47:03,280 --> 02:47:05,520 ENTER THEM INTO REPOSITORIES 4072 02:47:05,520 --> 02:47:07,320 TAKING ADVANTAGE OF SAME 4073 02:47:07,320 --> 02:47:09,160 METADATA INDEXING AND THINGS TO 4074 02:47:09,160 --> 02:47:12,360 BE ACING CRESSIBLE. IT THAT MAY 4075 02:47:12,360 --> 02:47:14,600 BE A SOURCE OF CONNECTION FOR 4076 02:47:14,600 --> 02:47:17,200 BASIC AND OTHER NONHEAL 4077 02:47:17,200 --> 02:47:20,280 RESEARCHERS IN HEAL AND IS 4078 02:47:20,280 --> 02:47:21,960 FORWARD-LOOKING AT THIS POINT. 4079 02:47:21,960 --> 02:47:24,760 MY GUESS IS MOST TYPES OF 4080 02:47:24,760 --> 02:47:26,640 INVESTIGATORS ROB IS REFERENCING 4081 02:47:26,640 --> 02:47:28,280 HAVE NOT BEEN MAKING FINDINGS 4082 02:47:28,280 --> 02:47:32,360 PUBLICLY AVAILABLE IN SAME WAY 4083 02:47:32,360 --> 02:47:35,560 GOING FORWARD. 4084 02:47:35,560 --> 02:47:37,320 >>YEAH. ANOTHER THING I WOULD 4085 02:47:37,320 --> 02:47:40,760 LIKE TO ONE THING I WAS 4086 02:47:40,760 --> 02:47:45,880 INTERESTED TO HEAR TODAY WAS 4087 02:47:45,880 --> 02:47:47,920 PROPOSALS IN SUBSTITUTE SPACE 4088 02:47:47,920 --> 02:47:51,080 ABOUT UPTAKE AND IMPLEMENTATION 4089 02:47:51,080 --> 02:47:52,840 WHERE BARRIERS AND I FEEL IT 4090 02:47:52,840 --> 02:47:56,560 GETS TO PART OF THE PROBLEM WE 4091 02:47:56,560 --> 02:48:00,040 HAVE WITH BIG PHARMA AND PAIN 4092 02:48:00,040 --> 02:48:02,280 MANAGEMENT IN VERY BEGINNING 4093 02:48:02,280 --> 02:48:05,240 EARLY MEETING WE HAD WALTER YOU 4094 02:48:05,240 --> 02:48:07,520 AND NORA WERE BOTH THERE IN THE 4095 02:48:07,520 --> 02:48:11,480 MEETING TRYING TO PARTNER WITH 4096 02:48:11,480 --> 02:48:13,680 BIG PHARMA. 4097 02:48:13,680 --> 02:48:17,960 ONE THING I RAISED ALET THAT 4098 02:48:17,960 --> 02:48:23,520 MEETING HAD TO DO WITH SAFETY 4099 02:48:23,520 --> 02:48:24,160 BAR. 4100 02:48:24,160 --> 02:48:26,000 FEEDBACK FROM REGULATORS IS A 4101 02:48:26,000 --> 02:48:30,080 HUGE POPULATION SHARING COMPLETE 4102 02:48:30,080 --> 02:48:31,200 SAFETY. 4103 02:48:31,200 --> 02:48:37,520 FDA IS IN CHARGE OF SAFETY. 4104 02:48:37,520 --> 02:48:40,280 WHAT WE ARE PRESCRIBING NOW 4105 02:48:40,280 --> 02:48:43,000 LARGELY CAN DO IMMENSE HARM AND 4106 02:48:43,000 --> 02:48:46,800 WOULDN'T BE APPROVED AND POINT 4107 02:48:46,800 --> 02:48:51,800 OF WORKING WITH REGULATORS ON 4108 02:48:51,800 --> 02:48:54,360 SAFER THAN OPIOIDS AND ANYTHING 4109 02:48:54,360 --> 02:48:56,080 SAFER THAN OPIOIDS WOULD BE A 4110 02:48:56,080 --> 02:48:59,200 WIN FOR PAIN MANAGEMENT. 4111 02:48:59,200 --> 02:48:59,680 >>YEAH. 4112 02:48:59,680 --> 02:49:02,760 >>WHAT CAN WE DO AS FAR AS FDA 4113 02:49:02,760 --> 02:49:04,320 PROCESS AND TALKING ABOUT 4114 02:49:04,320 --> 02:49:06,400 ENDPOINTS FOR CLINICAL TRIALS 4115 02:49:06,400 --> 02:49:07,920 TODAY IS ANOTHER POINT. WHAT DO 4116 02:49:07,920 --> 02:49:09,440 WE HAVE IN PAIN AND ASKING 4117 02:49:09,440 --> 02:49:12,160 PEOPLE ON SCALE OF 0-10 AND 4118 02:49:12,160 --> 02:49:14,120 THERE IS WORK BEING DONE THERE 4119 02:49:14,120 --> 02:49:16,080 AND WE HAVE DONE AN AMAZING JOB 4120 02:49:16,080 --> 02:49:20,320 OF PIPELINE OF OPPORTUNITY TO 4121 02:49:20,320 --> 02:49:26,160 HELP GO FROM IDEA TO MOLECULE TO 4122 02:49:26,160 --> 02:49:28,640 [INDISCERNIBLE] AND RUN INTO A 4123 02:49:28,640 --> 02:49:30,240 BRICK WALL GETTING THROUGH 4124 02:49:30,240 --> 02:49:31,640 APPROVAL PROCESS AND THINK YOU 4125 02:49:31,640 --> 02:49:33,840 ARE -- I'M REALLY INSPIRED BY 4126 02:49:33,840 --> 02:49:37,080 STUFF WE TALKED ABOUT TODAY 4127 02:49:37,080 --> 02:49:39,560 RELATED TO SUBSTANCE USE 4128 02:49:39,560 --> 02:49:42,640 DISORDER AND HEAL COULD BRING 4129 02:49:42,640 --> 02:49:44,400 SIMILAR FOCUS TO PAIN SPACE 4130 02:49:44,400 --> 02:49:46,080 HELPING GET THING AS CROSS THE 4131 02:49:46,080 --> 02:49:47,400 FINISH LINE WILL BE VERY 4132 02:49:47,400 --> 02:49:49,400 IMPORTANT. THAT IS A 4133 02:49:49,400 --> 02:49:52,640 COMPLICATED TASK. SAFETY ISSUE 4134 02:49:52,640 --> 02:49:55,920 IS VERY COMPLICATED. 4135 02:49:55,920 --> 02:49:57,640 THAT PERCEPTION THERE IS FAILED 4136 02:49:57,640 --> 02:49:59,640 TRIALS AND THAT STUFF. WE ARE 4137 02:49:59,640 --> 02:50:01,040 DEALING WITH THOSE THINGS AND 4138 02:50:01,040 --> 02:50:04,600 HAVE DONE A GOOD JOB DEVELOPING 4139 02:50:04,600 --> 02:50:06,880 SCIENCE FOR THAT. 4140 02:50:06,880 --> 02:50:10,760 WHAT CAN WE DO ON OTHER END TO 4141 02:50:10,760 --> 02:50:12,200 FACILITATE THAT WOULD BE USEFUL 4142 02:50:12,200 --> 02:50:17,880 AND ENCOURAGING TO KEEP THIS 4143 02:50:17,880 --> 02:50:22,800 WHOLE DEVELOPMENT PIPELINE 4144 02:50:22,800 --> 02:50:23,920 OPERATING. YOU HAVE DONE THAT. 4145 02:50:23,920 --> 02:50:25,960 I THINK IT IS CHANGE RING AND I 4146 02:50:25,960 --> 02:50:27,640 HAVE DONE IT IN THE COMMUNITY 4147 02:50:27,640 --> 02:50:29,360 AND CHANGED HOW PEOPLE THINK 4148 02:50:29,360 --> 02:50:30,920 ABOUT WHAT THEY WILL DO WITH 4149 02:50:30,920 --> 02:50:32,680 PAIN RESEARCH AND THERE IS A 4150 02:50:32,680 --> 02:50:36,000 PROGRAM AVAILABLE THAT IS THERE. 4151 02:50:36,000 --> 02:50:39,600 AND JUST IT LOWERS THE BAR 4152 02:50:39,600 --> 02:50:41,040 SIGNIFICANTLY AND HEAL HAS DONE 4153 02:50:41,040 --> 02:50:44,200 A FANTASTIC JOB IN TERMS OF 4154 02:50:44,200 --> 02:50:45,000 GENERAL FEEDBACK. 4155 02:50:45,000 --> 02:50:48,720 A LOT OF NEW THINGS WE ARE 4156 02:50:48,720 --> 02:50:51,800 TALKING TODAY ARE REALLY 4157 02:50:51,800 --> 02:50:52,960 IMPACTFUL AND PRACTICAL THINGS 4158 02:50:52,960 --> 02:50:56,920 THAT NEED TO BE DONE AND ARE IN 4159 02:50:56,920 --> 02:50:58,040 THE RIGHT SPOT NOW. 4160 02:50:58,040 --> 02:51:00,520 WE HAVE TO BE SMART WITH HOW WE 4161 02:51:00,520 --> 02:51:02,400 DEPLOY NEW PROGRAMS SO WE ARE 4162 02:51:02,400 --> 02:51:04,280 NOT ROBBING FROM THINGS THAT ARE 4163 02:51:04,280 --> 02:51:10,920 -- THAT WE DEVELOPED SO FAR. 4164 02:51:10,920 --> 02:51:12,040 I TALKED TOO LONG. 4165 02:51:12,040 --> 02:51:17,000 >>IT IS ALL GOOD. HELEN WAS 4166 02:51:17,000 --> 02:51:17,320 NEXT. 4167 02:51:17,320 --> 02:51:18,760 >>QUICK QUESTION FOLLOWING 4168 02:51:18,760 --> 02:51:21,400 DISCUSSION ABOUT GETTING A 4169 02:51:21,400 --> 02:51:23,280 BIGGER VIEW WHAT IS GOING ON IN 4170 02:51:23,280 --> 02:51:24,880 PAIN RESEARCH INSIDE AND OUTSIDE 4171 02:51:24,880 --> 02:51:27,280 OF HEAL. THIS IS A TOPIC COMING 4172 02:51:27,280 --> 02:51:32,680 UP AT LAST IPRCC MEETING INTD 4173 02:51:32,680 --> 02:51:34,240 AGENCY PAIN COMMUNITY AND 4174 02:51:34,240 --> 02:51:35,520 PRESENTATION ABOUT WHAT HEAL IS 4175 02:51:35,520 --> 02:51:37,760 DOING AND COMMITTEE MEMBERS WERE 4176 02:51:37,760 --> 02:51:38,840 TALKING ABOUT WHILE THERE IS 4177 02:51:38,840 --> 02:51:41,000 PAIN RESEARCH GOING ON IN PLACES 4178 02:51:41,000 --> 02:51:43,800 LIKE VA FOR EXAMPLE AND COREY 4179 02:51:43,800 --> 02:51:48,080 AND PLACES TO BE NICE TO HAVE 4180 02:51:48,080 --> 02:51:50,560 OVERVIEW OF THAT TO SEE HOW IS 4181 02:51:50,560 --> 02:51:52,720 ALL THAT HELPING EACH OTHER AND 4182 02:51:52,720 --> 02:51:54,240 MAKING SURE WE ARE NOT 4183 02:51:54,240 --> 02:51:56,920 DUPLICATING THINGS AND HOW WE 4184 02:51:56,920 --> 02:51:58,120 SIN ERNLIZE. 4185 02:51:58,120 --> 02:52:01,520 THERE WILL BE A SUBGROUP OF IPCC 4186 02:52:01,520 --> 02:52:03,240 AND LOOKING AT THAT AND DIDN'T 4187 02:52:03,240 --> 02:52:05,160 TALK ABOUT WHAT IS IS GOING ON 4188 02:52:05,160 --> 02:52:07,080 WITH NIH OUTSIDE OF HA ELTHAT IS 4189 02:52:07,080 --> 02:52:09,160 INTERESTING AND NOT TALKING 4190 02:52:09,160 --> 02:52:10,400 ABOUT GOING DRILLING DOWN TO 4191 02:52:10,400 --> 02:52:12,400 LEVEL OF DATA THAT IS ANOTHER 4192 02:52:12,400 --> 02:52:13,760 THING WE CAN DO. LOOKING AT 4193 02:52:13,760 --> 02:52:16,600 LEVEL OF PROJECTS AND GROUPS OF 4194 02:52:16,600 --> 02:52:19,840 PROJECTS MIGHT BE REALLY 4195 02:52:19,840 --> 02:52:23,320 INTERESTING TO DO IN CONJUNCTION 4196 02:52:23,320 --> 02:52:29,960 WITH EFFORT TO GO ACROSS 4197 02:52:29,960 --> 02:52:34,000 AGENC 4198 02:52:34,000 --> 02:52:34,280 AGENCIES. 4199 02:52:34,280 --> 02:52:37,160 YEAH. GOOD POINT. 4200 02:52:37,160 --> 02:52:40,520 WE HAVE RCDC TO WORK OFF OF. 4201 02:52:40,520 --> 02:52:42,840 >>PORTFOLIO ANALYSIS HELPED US 4202 02:52:42,840 --> 02:52:44,800 IF YOU RECALL WALTER WHEN 4203 02:52:44,800 --> 02:52:47,080 WANTING TO COMPARE HISTORICALLY 4204 02:52:47,080 --> 02:52:49,240 NIH INVESTMENT PAIN RESEARCH AND 4205 02:52:49,240 --> 02:52:52,000 HOW HEAL HAD EXPANDED ABOUT YOU 4206 02:52:52,000 --> 02:52:54,200 IN A NONDIAL LUTED WAY 4207 02:52:54,200 --> 02:52:55,720 INCREASING OVERINVESTMENT THAT 4208 02:52:55,720 --> 02:52:59,960 THEY WERE VERY HELPFUL AND ALSO 4209 02:52:59,960 --> 02:53:03,760 WITH VISUALIZATIONS. 4210 02:53:03,760 --> 02:53:04,600 >>YEAH. GREAT. 4211 02:53:04,600 --> 02:53:06,160 >>YOU CAN DO THAT AGAIN. 4212 02:53:06,160 --> 02:53:07,720 >>NORA? 4213 02:53:07,720 --> 02:53:09,880 >>YEAH. MAKING SAME POINT TO 4214 02:53:09,880 --> 02:53:12,320 SELENA IT WILL BE VERY, VERY 4215 02:53:12,320 --> 02:53:14,480 VALUABLE AND VALUABLE TOO 4216 02:53:14,480 --> 02:53:16,520 BECAUSE DIALOGUES WE ASK 4217 02:53:16,520 --> 02:53:18,040 OURSELVES IS HOW WE DISTINGUISH 4218 02:53:18,040 --> 02:53:22,240 WHEN IT SHOULD BE HEAL PAIN 4219 02:53:22,240 --> 02:53:24,240 PROJECT VERSUS A PAIN PROJECT BY 4220 02:53:24,240 --> 02:53:26,480 INSTITUTES AND HAVING 4221 02:53:26,480 --> 02:53:28,000 UNDERSTANDING OF THAT LANDSCAPE 4222 02:53:28,000 --> 02:53:29,760 WILL GIVE PERSPECTIVE OF CERTAIN 4223 02:53:29,760 --> 02:53:35,240 THINGS THAT ARE MORE TARGETED TO 4224 02:53:35,240 --> 02:53:38,840 AREAS THAT ARE UNIQUE TO WHAT 4225 02:53:38,840 --> 02:53:41,640 THEY ARE DOG OR MAYBE NOT OR 4226 02:53:41,640 --> 02:53:42,920 INCORPORATED INTO MORE 4227 02:53:42,920 --> 02:53:46,040 COORDINATED RESEARCH AGENDA AND 4228 02:53:46,040 --> 02:53:50,760 I THINK IT IS NO-BRAINER LOOKING 4229 02:53:50,760 --> 02:53:52,720 AT HOW LANDSCAPE WORKS IN TYPES 4230 02:53:52,720 --> 02:53:57,760 OF PROJECTS AND HUGE RESEARCH ON 4231 02:53:57,760 --> 02:53:59,800 NEUROSCIENCE OF PAIN OF COURSE. 4232 02:53:59,800 --> 02:54:02,040 >>RIGHT. 4233 02:54:02,040 --> 02:54:03,840 >>AND FARM COL. 4234 02:54:03,840 --> 02:54:05,800 >>YEAH. 4235 02:54:05,800 --> 02:54:09,440 >>INTERESTING TO KNOW, NORA. 4236 02:54:09,440 --> 02:54:13,080 DOING THAT LARGE LOOK ACROSS 4237 02:54:13,080 --> 02:54:17,640 AGENCIES IS THERE ANYONE 4238 02:54:17,640 --> 02:54:18,560 TACKLING DISSEMINATION 4239 02:54:18,560 --> 02:54:21,920 CHALLENGES BROUGHT INTO HEAL AND 4240 02:54:21,920 --> 02:54:23,560 WE HEARD EXCITING THINGS THIS 4241 02:54:23,560 --> 02:54:25,440 MORNING ABOUT OPIOID SPACE ABOUT 4242 02:54:25,440 --> 02:54:28,200 THINGS TO DO DOING TRANSLATIONAL 4243 02:54:28,200 --> 02:54:29,680 WORK IN ATTACKING AND WORKING 4244 02:54:29,680 --> 02:54:31,200 WITH AND TRYING TO BREAK DOWN 4245 02:54:31,200 --> 02:54:35,280 HOSPITAL SYSTEMS ISSUES. 4246 02:54:35,280 --> 02:54:36,960 ANY OTHER POCKETS WHERE PAIN 4247 02:54:36,960 --> 02:54:39,960 RESEARCH IS GOING ON ACROSS 4248 02:54:39,960 --> 02:54:42,120 AGENCIES IS THERE IS GREAT DNI 4249 02:54:42,120 --> 02:54:46,280 WORK GOING ON COULD BE BROUGHT 4250 02:54:46,280 --> 02:54:47,800 INTO HEAL COULD BE GREAT AND 4251 02:54:47,800 --> 02:54:48,760 WONDERFUL TO KNOW. 4252 02:54:48,760 --> 02:54:59,200 >>I AGREE 100%. 4253 02:55:00,200 --> 02:55:04,400 >>THIS IS GREAT INPUT. 4254 02:55:04,400 --> 02:55:06,840 >>WE ARE HAVING A HIGH-LEVEL 4255 02:55:06,840 --> 02:55:09,600 DISCUSSION AND WOULD INVITE THE 4256 02:55:09,600 --> 02:55:11,800 MULTI-DISCIPLINARY WORKING GROUP 4257 02:55:11,800 --> 02:55:12,800 MEMBERS TO REACT TO THE 4258 02:55:12,800 --> 02:55:14,120 INFORMATION THAT IS ON THE SLIDE 4259 02:55:14,120 --> 02:55:16,840 OR WE CAN MOVE FORWARD TO THE 4260 02:55:16,840 --> 02:55:19,080 DISCUSSION QUESTIONS AND JUST 4261 02:55:19,080 --> 02:55:25,360 FROM YOUR PERSPECTIVE WHAT AT 4262 02:55:25,360 --> 02:55:27,840 THIS INFLECTION POINT FOR HEAL 4263 02:55:27,840 --> 02:55:29,560 IS IMPORTANT TO BE SURE WE 4264 02:55:29,560 --> 02:55:34,240 CONTINUE TO FUND OR ADD TO THE 4265 02:55:34,240 --> 02:55:34,640 PORTFOLIO? 4266 02:55:34,640 --> 02:55:36,000 YOU ARE IN THE BEST POSITION TO 4267 02:55:36,000 --> 02:55:41,840 ADVISE US ON THIS. SO, VERY 4268 02:55:41,840 --> 02:55:43,040 OPEN TO INPUT. 4269 02:55:43,040 --> 02:55:45,760 >>I THINK I COVERED THAT 4270 02:55:45,760 --> 02:55:48,600 QUESTION WITH WHAT I WOULD SAY. 4271 02:55:48,600 --> 02:55:49,200 >>YEAH. 4272 02:55:49,200 --> 02:55:49,680 >>[INDISCERNIBLE]. 4273 02:55:49,680 --> 02:55:51,560 >> IN TERMS OF IDEA ABOUT WHAT 4274 02:55:51,560 --> 02:55:53,240 HEAL IS DOING THAT IS SORT OF 4275 02:55:53,240 --> 02:55:54,840 DIFFERENT THAN WHAT IS HAPPENING 4276 02:55:54,840 --> 02:55:57,040 WITH ICS AND WAY TO LOOK AT WHAT 4277 02:55:57,040 --> 02:55:59,600 WE HAVE DONE WITH AT LEAST ON 4278 02:55:59,600 --> 02:56:01,960 PAIN ASPECTS OF HEAL IS TO BUILD 4279 02:56:01,960 --> 02:56:04,280 THIS ENABLING ECOSYSTEM THAT 4280 02:56:04,280 --> 02:56:07,160 ALLOWS PEOPLE TO REALLY PROGRESS 4281 02:56:07,160 --> 02:56:10,160 THEIR IDEAS FROM DISCOVERY TO 4282 02:56:10,160 --> 02:56:10,520 THERAPEUTIC. 4283 02:56:10,520 --> 02:56:14,400 AND THAT IS WHERE WE CAN HIGH 4284 02:56:14,400 --> 02:56:16,440 LIGHT WHAT FOR THAT COMMUNITY IN 4285 02:56:16,440 --> 02:56:18,480 TERMS OF MARKETING ASPECT IS 4286 02:56:18,480 --> 02:56:21,840 WHAT WE ARE TRYING TO DO HERE IS 4287 02:56:21,840 --> 02:56:26,240 GET THINGS FROM ACROSS THAT 4288 02:56:26,240 --> 02:56:26,560 LINE. 4289 02:56:26,560 --> 02:56:29,760 NOT EVERYTHING FITS IN THE 4290 02:56:29,760 --> 02:56:34,840 BUC 4291 02:56:34,840 --> 02:56:35,080 BUCKET. 4292 02:56:35,080 --> 02:56:35,920 >>ENABLE INFRASTRUCTURE AND 4293 02:56:35,920 --> 02:56:39,640 ECOSYSTEM IS ONE AS I SAID IS 4294 02:56:39,640 --> 02:56:42,880 CHANGING THINGS ENCOURAGE YOU TO 4295 02:56:42,880 --> 02:56:43,160 CONTINUE. 4296 02:56:43,160 --> 02:56:47,040 >> PSPP IS AN EXPERIMENT. 4297 02:56:47,040 --> 02:56:49,960 WE ARE DOING ANIMAL MODELS THAT 4298 02:56:49,960 --> 02:56:53,920 WILL BRING A LEVEL OF RIGOR TO A 4299 02:56:53,920 --> 02:56:56,120 FEW ASSETS THAT COME THROUGH. 4300 02:56:56,120 --> 02:56:58,000 MAKING SURE WE GET TO SEE 4301 02:56:58,000 --> 02:56:59,360 OUTCOMES OF THOSE AND WHAT 4302 02:56:59,360 --> 02:57:01,880 HAPPENS WITH CLINICAL TRIALS IS 4303 02:57:01,880 --> 02:57:04,960 A LOT TO BE LEARNED THERE THAT 4304 02:57:04,960 --> 02:57:06,600 CAN ABSOLUTELY CHANGE THEIR WAY 4305 02:57:06,600 --> 02:57:08,760 TO VALIDATE HOW WE ARE DOING 4306 02:57:08,760 --> 02:57:09,920 THINGS AND IS VERY IMPORTANT AND 4307 02:57:09,920 --> 02:57:14,000 TRAINING ASPECTS WHAT WE ARE 4308 02:57:14,000 --> 02:57:14,960 DOING HERE. 4309 02:57:14,960 --> 02:57:17,800 WALTER YOU HIT IT ON THE HEAD 4310 02:57:17,800 --> 02:57:21,440 LACK OF PAIN INSTITUTE MEANS 4311 02:57:21,440 --> 02:57:22,640 TRAINING OPPORTUNITIES ARE RARE 4312 02:57:22,640 --> 02:57:24,840 RELATIVE TO RESEARCH AREAS AND 4313 02:57:24,840 --> 02:57:28,000 HEAL GETTING INTO THAT SPACE IS 4314 02:57:28,000 --> 02:57:28,440 REALLY IMPORTANT. 4315 02:57:28,440 --> 02:57:32,040 NEW AREAS OF RESEARCH THAT I 4316 02:57:32,040 --> 02:57:34,080 THINK I -- THERE IS A LOT COMING 4317 02:57:34,080 --> 02:57:37,760 IN TERMS OF DISCOVERY SCIENCE 4318 02:57:37,760 --> 02:57:41,400 WITH NEW TECHNOLOGY THAT IS IN 4319 02:57:41,400 --> 02:57:43,000 OMICS SPACE THAT WILL CHANGE ON 4320 02:57:43,000 --> 02:57:44,240 THE DISCOVERY SIDE FOR SURE AND 4321 02:57:44,240 --> 02:57:47,800 WE SHOULD BE ABLE TO TAKE 4322 02:57:47,800 --> 02:57:51,000 ADVANTAGE OF THAT. 4323 02:57:51,000 --> 02:57:53,400 THINGS IT THAT WE OR I MENTIONED 4324 02:57:53,400 --> 02:57:56,320 ON WORKING ON BACKEND ON 4325 02:57:56,320 --> 02:57:59,720 TRANSLATION TO PRACTICE AND 4326 02:57:59,720 --> 02:58:04,560 APPROVAL ON THE PAYER SIDE 4327 02:58:04,560 --> 02:58:09,920 GETTING THINGS POORLY COVERED 4328 02:58:09,920 --> 02:58:11,320 ARE OPPORTUNITIES FOR REAL RAPID 4329 02:58:11,320 --> 02:58:15,360 IMPACT WITH PAYERS IF YOU CAN DO 4330 02:58:15,360 --> 02:58:17,880 THINGS THAT CAN INFLUENCE WAY 4331 02:58:17,880 --> 02:58:20,560 THINGS GET OR INFLUENCE UPTAKE 4332 02:58:20,560 --> 02:58:22,600 IN TERMS OF GETTING BILLING 4333 02:58:22,600 --> 02:58:24,840 CODES FOR TREATMENTS THAT APPLY 4334 02:58:24,840 --> 02:58:27,240 PAIN WOULD BE HELPFUL AND ARE 4335 02:58:27,240 --> 02:58:30,040 PRAGMATIC THINGS WE COULD DO 4336 02:58:30,040 --> 02:58:33,080 THAT MIGHT HELP TO GET THINGS 4337 02:58:33,080 --> 02:58:36,880 MORE QUICKLY TO PATIENTS THAN IT 4338 02:58:36,880 --> 02:58:41,920 TAKES WITH DEVELOP MEMENT. 4339 02:58:41,920 --> 02:58:43,320 IT WILL HELP ON BACKEND. 4340 02:58:43,320 --> 02:58:43,960 >>RIGHT. 4341 02:58:43,960 --> 02:58:45,040 >>THANK YOU. 4342 02:58:45,040 --> 02:58:47,320 >>WE DON'T HAVE TIME RIGHT NOW 4343 02:58:47,320 --> 02:58:50,800 BUT ONE OF THE FUTURE MEETINGS 4344 02:58:50,800 --> 02:58:54,040 ALONG WITH SUGGESTIONS MADE THAT 4345 02:58:54,040 --> 02:59:01,160 WE SHOULD HAVE LINDA PORTER 4346 02:59:01,160 --> 02:59:04,960 SPOKE TO US YESTERDAY WITH -- 4347 02:59:04,960 --> 02:59:06,520 MAIN MANAGEMENT BILLING CODE 4348 02:59:06,520 --> 02:59:08,760 WITH DATA MEASURES FOR PAIN THAT 4349 02:59:08,760 --> 02:59:10,280 WERE DEVELOPED BY HEAL TEAM. 4350 02:59:10,280 --> 02:59:12,240 THERE IS A LOT TO SHARE IN THAT 4351 02:59:12,240 --> 02:59:19,880 REGARD AND LO ITS TO DO. 4352 02:59:19,880 --> 02:59:20,200 SHARON? 4353 02:59:20,200 --> 02:59:22,760 >>FOLLOW UP WITH WHAT ROB SAID 4354 02:59:22,760 --> 02:59:25,480 AND REAL OPPORTUNITY TO 4355 02:59:25,480 --> 02:59:29,120 INCENTIVIZE MODELS OF CARE AND 4356 02:59:29,120 --> 02:59:33,640 HAVING WE HEARD THIS MORNING EMS 4357 02:59:33,640 --> 02:59:35,840 TEAM IS DWIFING BU PREN OR FRIN 4358 02:59:35,840 --> 02:59:37,600 NOW AND FOUR YEARS AGO WOULDN'T 4359 02:59:37,600 --> 02:59:39,280 HAVE THOUGHT OF THAT AND 4360 02:59:39,280 --> 02:59:42,880 CHANGING PRACTICE ACT AND ALL 4361 02:59:42,880 --> 02:59:44,640 THINGS GAIL SPOKE ABOUT AND 4362 02:59:44,640 --> 02:59:46,480 THINKING OF WAYS TO DEPLOY 4363 02:59:46,480 --> 02:59:48,360 WORKFORCE WE DO HAVE TO BETTER 4364 02:59:48,360 --> 02:59:50,160 SERVE PATIENTS IS A REAL 4365 02:59:50,160 --> 02:59:51,840 OPPORTUNITY TO LEVERAGE 4366 02:59:51,840 --> 02:59:54,360 RESOURCES AND IMPROVE CARE AND 4367 02:59:54,360 --> 02:59:55,960 DECREASED COSTS FOR PATIENTS AND 4368 02:59:55,960 --> 02:59:58,040 WOULD LOVE TO SEE AGAIN IF THERE 4369 02:59:58,040 --> 03:00:00,360 IS OTHER SPACES IN THE LARGER 4370 03:00:00,360 --> 03:00:02,080 PORTFOLIO WHERE THAT IS GOING 4371 03:00:02,080 --> 03:00:03,760 ON, BRINGING THAT INFORMATION TO 4372 03:00:03,760 --> 03:00:06,560 THE HEAL SPACE WOULD BE VERY 4373 03:00:06,560 --> 03:00:07,240 HELPFUL. 4374 03:00:07,240 --> 03:00:10,640 ANYTHING THAT WE CAN DO TO 4375 03:00:10,640 --> 03:00:13,600 ACCELERATE ADVANCES IN GETTING 4376 03:00:13,600 --> 03:00:20,320 CARE TO PATIENTS WOULD BE 4377 03:00:20,320 --> 03:00:20,600 FABULOUS. 4378 03:00:20,600 --> 03:00:23,080 >>>>RUNNING PRISON NETWORK 4379 03:00:23,080 --> 03:00:27,000 THAT IS HEALTH SYSTEMS AND WE 4380 03:00:27,000 --> 03:00:32,960 HAVE THIS IDEA OF TRYING TO 4381 03:00:32,960 --> 03:00:35,120 RESEARCH INTEGRATED PAIN CARE 4382 03:00:35,120 --> 03:00:37,000 MODELS AND HEALTH CARE SYSTEMS 4383 03:00:37,000 --> 03:00:39,960 THAT I THINK OUR ISSUE HAS BEEN 4384 03:00:39,960 --> 03:00:43,480 ATTRACTING HEALTH CARE SYSTEMS 4385 03:00:43,480 --> 03:00:47,440 INTO THE SPACE OPPOSED TO 4386 03:00:47,440 --> 03:00:50,920 ACADEMIC PEOPLE WHO CAN PUBLISH 4387 03:00:50,920 --> 03:00:52,600 AND SEE WHAT HAPPENS. 4388 03:00:52,600 --> 03:00:54,920 >>IF YOU CAN SHOW DECREASED 4389 03:00:54,920 --> 03:00:56,080 COST IN EMERGENCY DEPARTMENT 4390 03:00:56,080 --> 03:00:59,680 VISITS WILL GET ATTENTION RIGHT 4391 03:00:59,680 --> 03:01:00,760 AWAY. 4392 03:01:00,760 --> 03:01:03,040 BAR IS LOW IN SENSE WHAT GETS 4393 03:01:03,040 --> 03:01:04,640 ATTENTION. IT IS ALL ABOUT 4394 03:01:04,640 --> 03:01:04,880 COST. 4395 03:01:04,880 --> 03:01:05,520 >>YEAH. 4396 03:01:05,520 --> 03:01:07,360 >>DECREASING NUMBER OF STAYS 4397 03:01:07,360 --> 03:01:09,480 AND NUMBER OF VISITS AND LENGTH 4398 03:01:09,480 --> 03:01:11,360 OF STAY AND NUMBER OF VISITS. 4399 03:01:11,360 --> 03:01:13,240 >>RIGHT. PROBABLY LOTS OF WAYS 4400 03:01:13,240 --> 03:01:23,720 TO DO THAT IN PAIN SPACE . 4401 03:01:26,120 --> 03:01:27,880 WE WILL TALK TO HEALTH CARE 4402 03:01:27,880 --> 03:01:30,840 SYSTEMS TRYING TO GET THAT OFF. 4403 03:01:30,840 --> 03:01:32,320 >>PUTTING PHYSICAL THERAPISTS 4404 03:01:32,320 --> 03:01:34,520 IN EMERGENCY DEPARTMENTS AND 4405 03:01:34,520 --> 03:01:36,680 PATIENTS COMING IN WITH FLAIR UP 4406 03:01:36,680 --> 03:01:39,080 AND ACUTE LOW BACK PAIN AND 4407 03:01:39,080 --> 03:01:41,880 CHANGING TRAJECTORY OF PATIENT 4408 03:01:41,880 --> 03:01:44,760 ACROSS EPISODE OF CARE AND EARLY 4409 03:01:44,760 --> 03:01:49,000 DATA VERY PRELIMINARY DATA SHOWS 4410 03:01:49,000 --> 03:01:53,200 INCREASED FUNCTION AND DECREASED 4411 03:01:53,200 --> 03:01:59,840 PAIN AND COST SAVINGS AND LARGE 4412 03:01:59,840 --> 03:02:03,800 DATA SETS AGGREGATING COULD 4413 03:02:03,800 --> 03:02:14,360 REVEAL OPPORTUNITIES TO CHANGE. 4414 03:02:17,320 --> 03:02:19,600 >>LISTENING TO THIS GETTING 4415 03:02:19,600 --> 03:02:22,240 SPECIALTIES INVOLVED AND STRUCK 4416 03:02:22,240 --> 03:02:26,120 BY COMMENT YESTERDAY ORNLO 4417 03:02:26,120 --> 03:02:33,040 PEEDIST STUDY BONE PSYCHIATRISTS 4418 03:02:33,040 --> 03:02:35,120 UPHILL BY AND LARGE AND PAIN 4419 03:02:35,120 --> 03:02:43,000 DON'T DEAL WITH IT AND WORKFORCE 4420 03:02:43,000 --> 03:02:44,600 DEVELOPMENT GETTING SPECIALTIES 4421 03:02:44,600 --> 03:02:50,720 TO SEE IS PART OF MISSION. 4422 03:02:50,720 --> 03:02:53,680 >>THIS IS COMMON AND 4423 03:02:53,680 --> 03:02:54,680 OVENGOLOGISTS DON'T TREAT PAIN 4424 03:02:54,680 --> 03:02:56,240 AND THEY HAVE A LARGE TEAM 4425 03:02:56,240 --> 03:02:58,200 AROUND THEM TAPPING INTO AND 4426 03:02:58,200 --> 03:03:01,280 GETTING ORNLO PEEDISTS AND 4427 03:03:01,280 --> 03:03:03,240 PRACTITIONERS TO ADOPT THAT 4428 03:03:03,240 --> 03:03:06,080 MODEL THAT IS AN 4429 03:03:06,080 --> 03:03:07,680 INTERDISCIPLINARY TEAM NOT JUST 4430 03:03:07,680 --> 03:03:09,520 INTERDISCIPLINARY TEAM SITTING 4431 03:03:09,520 --> 03:03:12,400 DOWN TALKING TO PATIENTS AND 4432 03:03:12,400 --> 03:03:15,600 PROFESSIONS BRING EXPERTISE TO 4433 03:03:15,600 --> 03:03:25,800 THE TABLE. 4434 03:03:28,040 --> 03:03:29,320 >>YEAH? 4435 03:03:29,320 --> 03:03:31,720 >>I'M INTERESTED IN THE 4436 03:03:31,720 --> 03:03:33,280 DISCUSSION. GOING FURTHER AND 4437 03:03:33,280 --> 03:03:35,960 FURTHER AND DEEPER AND DEEPER 4438 03:03:35,960 --> 03:03:36,560 INTO IMPLEMENTATION SCIENCE 4439 03:03:36,560 --> 03:03:37,920 WORLD WE ARE STARTING TO THINK 4440 03:03:37,920 --> 03:03:39,760 ABOUT QUESTIONS WE WOULDN'T HAVE 4441 03:03:39,760 --> 03:03:41,600 WANTED TO THINK ABOUT MAYBE 4 OR 4442 03:03:41,600 --> 03:03:45,760 5 YEARS AGO; RIGHT? 4443 03:03:45,760 --> 03:03:51,680 EARLY STUDY WAS -- DIDN'T GET 4444 03:03:51,680 --> 03:03:54,720 FUNDED BY PRISM WHERE IT WAS 4445 03:03:54,720 --> 03:03:55,840 PROPOSING TO LOOK AT DIFFERENT 4446 03:03:55,840 --> 03:03:58,200 CARE MODELS AND ONE TYPE OF 4447 03:03:58,200 --> 03:03:59,920 PRACTITIONER WAS GOING TO SEE 4448 03:03:59,920 --> 03:04:01,440 THE PATIENT FIRST OPPOSED TO 4449 03:04:01,440 --> 03:04:04,240 SECOND AND WE FUNDED IT AT 4450 03:04:04,240 --> 03:04:05,240 NCCIH. 4451 03:04:05,240 --> 03:04:07,040 THIS IS SOMETHING LIKE JUST FOUR 4452 03:04:07,040 --> 03:04:10,760 YEARS AGO WE DIDN'T WANT TO GO 4453 03:04:10,760 --> 03:04:11,280 THERE. 4454 03:04:11,280 --> 03:04:14,200 NOW, I THINK WE ARE LOOKING 4455 03:04:14,200 --> 03:04:16,320 ATHAT THE FRONT AND CENTER 4456 03:04:16,320 --> 03:04:17,440 LOOKING AT CARE MODELS. 4457 03:04:17,440 --> 03:04:19,880 IT IS INTERESTING TO SEE HOW 4458 03:04:19,880 --> 03:04:23,480 CONVERSATION HAS EVOLVED ABOUT 4459 03:04:23,480 --> 03:04:31,440 -- BECAUSE AS SHARON MENTIONED 4460 03:04:31,440 --> 03:04:34,840 PHYSICAL THERAPIST INSIDE 4461 03:04:34,840 --> 03:04:36,400 DEPARTMENT -- THERE IS HOSPITAL 4462 03:04:36,400 --> 03:04:37,920 AND IS IT OUR BUSINESS TO TELL 4463 03:04:37,920 --> 03:04:38,840 THEM THAT? 4464 03:04:38,840 --> 03:04:42,680 NO. OF COURSE. WE CAN DESIGN A 4465 03:04:42,680 --> 03:04:44,240 PRAGMATIC IMPLEMENTATION TRIAL 4466 03:04:44,240 --> 03:04:48,280 IN A HOSPITAL SETTING LOOKING 4467 03:04:48,280 --> 03:04:50,400 LIKE DIFFERENCE BETWEEN 4468 03:04:50,400 --> 03:04:51,880 EMERGENCY DEPARTMENT WITH 4469 03:04:51,880 --> 03:04:53,000 PHYSICAL THERAPIST AND ONE 4470 03:04:53,000 --> 03:04:54,760 WITHOUT AND QUESTIONS TO GRAPPLE 4471 03:04:54,760 --> 03:04:58,520 WITH AND I THINK IS GREAT AND 4472 03:04:58,520 --> 03:05:05,760 LIKE THAT SUGGESTION, SHARON. 4473 03:05:05,760 --> 03:05:07,160 >>THANK YOU TO YOUR INPUT AND 4474 03:05:07,160 --> 03:05:11,040 STUGSS AND WE CAN BEGIN TO MOVE 4475 03:05:11,040 --> 03:05:17,480 TO THE NEXT SECTION OF THE 4476 03:05:17,480 --> 03:05:19,400 SUMMARY THAT WILL BE BRIEF. 4477 03:05:19,400 --> 03:05:20,880 NEXT SLIDE, PLEASE. YOU HAVE 4478 03:05:20,880 --> 03:05:26,120 SEEN BEFORE ALL OF THE DIFFERENT 4479 03:05:26,120 --> 03:05:30,320 HEAL PROGRAMS LAUNCHED ON 4480 03:05:30,320 --> 03:05:34,840 TRANSLATING OPENOID USE DISORDER 4481 03:05:34,840 --> 03:05:38,240 STARTING WITH LARGE AND 4482 03:05:38,240 --> 03:05:39,000 AMBITIOUS IMPLEMENTATION SCIENCE 4483 03:05:39,000 --> 03:05:41,800 AND COLLABORATIVE STRUCTURES 4484 03:05:41,800 --> 03:05:45,400 THAN ADDING SPECIFIC AREAS OF 4485 03:05:45,400 --> 03:05:47,880 FOCUS THAT ARE INCLUDING 4486 03:05:47,880 --> 03:05:50,880 RESEARCH RECOVERY SUPPORT 4487 03:05:50,880 --> 03:05:57,000 SERVICES AND HARM REDUCTION AND 4488 03:05:57,000 --> 03:05:58,720 POLY SUBSTANCE USE AND TOPICS 4489 03:05:58,720 --> 03:06:00,320 DISCUSSED AT BOTTOM HERE AND 4490 03:06:00,320 --> 03:06:02,440 GOING TO NEXT SLIDE, PLEASE. 4491 03:06:02,440 --> 03:06:04,800 >>ON THE PREVENTION AND 4492 03:06:04,800 --> 03:06:06,240 TREATMENT OF OPIOID USE 4493 03:06:06,240 --> 03:06:07,760 DISORDERS WE HAVE A DIFFERENT 4494 03:06:07,760 --> 03:06:10,360 SIDE INVESTMENTS WITH SIMILAR 4495 03:06:10,360 --> 03:06:12,440 TRAJECTORY STARTING WITH 4496 03:06:12,440 --> 03:06:14,840 RESEARCH AT RISK GROUPS AND 4497 03:06:14,840 --> 03:06:17,920 TRIALS IN NIDA CLINICAL TRIALS 4498 03:06:17,920 --> 03:06:19,560 NETWORK ADDING ON SPECIFIC 4499 03:06:19,560 --> 03:06:21,640 STUDIES FOCUSING ON SPECIFIC 4500 03:06:21,640 --> 03:06:23,160 POPULATIONS AND ALSO EXPANDING 4501 03:06:23,160 --> 03:06:26,200 INTO SOCIAL DETERMINANTS OF 4502 03:06:26,200 --> 03:06:27,360 HEALTH RECOGNIZING HOW IMPORTANT 4503 03:06:27,360 --> 03:06:29,880 IT WILL BE ULTIMATELY FOR 4504 03:06:29,880 --> 03:06:33,480 PREVENTION AND ADDING TRIALS WE 4505 03:06:33,480 --> 03:06:36,520 TALKED ABOUT TODAY AS POTENTIAL 4506 03:06:36,520 --> 03:06:43,800 ADDITIONS TO OVERALL PORT FOLIO. 4507 03:06:43,800 --> 03:06:47,080 NEXT SLIDE, PLEASE. 4508 03:06:47,080 --> 03:06:51,400 >>YOU HEARD FROM KENT NER ABOUT 4509 03:06:51,400 --> 03:06:52,520 PROGRESS BEING MADE AND 4510 03:06:52,520 --> 03:06:53,840 INDIVIDUAL STUDIES AND 4511 03:06:53,840 --> 03:06:57,640 INDIVIDUAL INDS THROUGH THESE 4512 03:06:57,640 --> 03:07:00,400 PROGRAM AND ALSO SOME ADDITIONS 4513 03:07:00,400 --> 03:07:02,960 RELATED TO SPECIFIC TYPES OF 4514 03:07:02,960 --> 03:07:05,200 SUBSTANCE USE DISORDER INCLUDING 4515 03:07:05,200 --> 03:07:06,920 STIMULANTS AND SPECIFIC 4516 03:07:06,920 --> 03:07:08,120 APPROACHES FOR TREATING THESE 4517 03:07:08,120 --> 03:07:10,800 AND ENDING WITH CLINICAL OUTCOME 4518 03:07:10,800 --> 03:07:12,760 ASSESSMENTS WE JUST DISCUSSED. 4519 03:07:12,760 --> 03:07:14,160 NEXT SLIDE, PLEASE. 4520 03:07:14,160 --> 03:07:17,240 WE DIDN'T TALK AT ALL ABOUT 4521 03:07:17,240 --> 03:07:18,600 BABIES TODAY. 4522 03:07:18,600 --> 03:07:22,240 WE HAVE RESEARCH UNDERWAY 4523 03:07:22,240 --> 03:07:27,280 ALREADY FOCUSED ON INTERVENTIONS 4524 03:07:27,280 --> 03:07:30,280 AND EXPOSURE DURING MOTHER'S 4525 03:07:30,280 --> 03:07:31,800 PREGNANCY SCREENING APPROACHES 4526 03:07:31,800 --> 03:07:35,080 AND LONG-TERM ASSESSMENTS 4527 03:07:35,080 --> 03:07:37,120 FOLLOWING BIRTH OF FAMILY AND 4528 03:07:37,120 --> 03:07:39,480 UNDERSTANDING THOSE EXPOSURES IN 4529 03:07:39,480 --> 03:07:41,120 CONTEXT OF ALL OTHER EXPOSURES 4530 03:07:41,120 --> 03:07:42,960 THAT A CHILD HAS AND WE HAVE 4531 03:07:42,960 --> 03:07:46,720 ADDED TO THAT WITH KIND OF WAYS 4532 03:07:46,720 --> 03:07:49,840 TO MAKE SURE RESEARCH IS STRONG 4533 03:07:49,840 --> 03:07:51,120 UNDERSTANDING PLACENTA AND 4534 03:07:51,120 --> 03:07:52,800 UNDERSTANDING ADDITIONAL ASPECTS 4535 03:07:52,800 --> 03:07:55,880 OF BIOL THROUGH BIOSPECIMEN 4536 03:07:55,880 --> 03:07:58,960 COLLECTION AND BEING ABLE TO 4537 03:07:58,960 --> 03:08:01,240 CONTINUE TO SUPPORT FAMILIES 4538 03:08:01,240 --> 03:08:04,080 THROUGH PEER NAVIGATORS AND 4539 03:08:04,080 --> 03:08:05,680 PROMOTE ASSESSMENTS AND NOTHING 4540 03:08:05,680 --> 03:08:07,520 PROPOSED TO BE ADDED THIS TIME 4541 03:08:07,520 --> 03:08:08,800 AROUND AND DON'T HAVE LOTS TO 4542 03:08:08,800 --> 03:08:13,360 DISCUSS THERE IN TERMS OF NEW 4543 03:08:13,360 --> 03:08:13,680 ADDITIONS. 4544 03:08:13,680 --> 03:08:17,320 GOING TO NEXT SLIDE I WILL TURN 4545 03:08:17,320 --> 03:08:18,840 IT OVER TO NORA. 4546 03:08:18,840 --> 03:08:21,040 WE HAVE A QUICK SUMMARY WHAT WAS 4547 03:08:21,040 --> 03:08:21,800 DISCUSSED TODAY. 4548 03:08:21,800 --> 03:08:23,400 AND WHAT WAS DISCUSSED LAST WEEK 4549 03:08:23,400 --> 03:08:27,480 IN TERMS OF PROGRAMS THAT ARE IN 4550 03:08:27,480 --> 03:08:30,840 A SPOT FOR CONTINUATION OR 4551 03:08:30,840 --> 03:08:32,240 DISCONTINUATION AND NEW RESEARCH 4552 03:08:32,240 --> 03:08:35,920 COMES UP PROPOSED TO EYE TO THE 4553 03:08:35,920 --> 03:08:37,520 PORTFOLIO AND THINK NEXT SLIDE 4554 03:08:37,520 --> 03:08:39,760 SHOULD BE DISCUSSION QUESTIONS; 4555 03:08:39,760 --> 03:08:40,840 RIGHT? 4556 03:08:40,840 --> 03:08:41,480 >>YEAH. 4557 03:08:41,480 --> 03:08:42,280 >>THANK YOU. 4558 03:08:42,280 --> 03:08:45,400 >>THANK YOU, NORA. TAKING IT 4559 03:08:45,400 --> 03:08:46,160 AWAY, PLEASE. 4560 03:08:46,160 --> 03:08:49,200 >>THANK YOU TO ALL MEMBERS OF 4561 03:08:49,200 --> 03:08:50,560 MULTI-DISCIPLINARY WORKING 4562 03:08:50,560 --> 03:08:53,960 GROUP. THERE HAVE BEEN SEVERAL 4563 03:08:53,960 --> 03:08:56,880 A** SPEB-- ASPECTS DISCUSSED 4564 03:08:56,880 --> 03:08:58,960 THROUGHOUT THE DAY AND LINGERING 4565 03:08:58,960 --> 03:09:01,360 PROJECTS IS MY PERSPECTIVE GIVES 4566 03:09:01,360 --> 03:09:02,920 A BACKBONE WHERE IT IS AND WHAT 4567 03:09:02,920 --> 03:09:06,960 IT IS THAT WE ARE TRYING TO 4568 03:09:06,960 --> 03:09:10,080 ACHIEVE. 4569 03:09:10,080 --> 03:09:12,880 FOR OVERDOSE CRISIS WE KNOW WE 4570 03:09:12,880 --> 03:09:15,360 HAVE TO EXPAND TREATMENT THAT IS 4571 03:09:15,360 --> 03:09:17,120 FUNDAMENTAL AND CRUCIAL AND 4572 03:09:17,120 --> 03:09:18,240 EXPANDING TREATMENT IS NOT JUST 4573 03:09:18,240 --> 03:09:21,320 EXPANDING MEDICATIONS FOR OPIOID 4574 03:09:21,320 --> 03:09:23,400 USE DISORDER ABOUT YOU EXPANDING 4575 03:09:23,400 --> 03:09:25,320 ACCESS TO NAL OX YOEN THAT IS 4576 03:09:25,320 --> 03:09:27,360 EASIER SAID THAN DONE AND MANY 4577 03:09:27,360 --> 03:09:28,680 PROJECTS YOU HAVE SEEN PRESENTED 4578 03:09:28,680 --> 03:09:33,120 THAT ARE ONGOING ALREADY IN 4579 03:09:33,120 --> 03:09:35,240 DOING CTN AND CLINICAL TRIAL 4580 03:09:35,240 --> 03:09:37,560 NETWORK AND ALSO PART OF OTHER 4581 03:09:37,560 --> 03:09:40,920 PROJECTS THAT WERE INITIATED 4582 03:09:40,920 --> 03:09:46,880 THROUGH J COIN OR HEALTH 4583 03:09:46,880 --> 03:09:49,120 PERSISTENCE AND AIM ACTUALLY 4584 03:09:49,120 --> 03:09:51,320 MAXIMIZING DIFFERENT MODELS THAT 4585 03:09:51,320 --> 03:09:53,000 WE CAN DEVELOP TAKING ADVANTAGE 4586 03:09:53,000 --> 03:09:55,520 OF THE FACT THAT AT LEAST FOR 4587 03:09:55,520 --> 03:09:58,120 TREATMENTS THAT WE HAVE AN 4588 03:09:58,120 --> 03:09:58,960 INFRASTRUCTURE IN OUR COUNTRY 4589 03:09:58,960 --> 03:10:01,560 THAT ALLOWS US TO DEPLOY THEM 4590 03:10:01,560 --> 03:10:03,400 AND WE CAN EXPAND THEM AND YES 4591 03:10:03,400 --> 03:10:06,000 WE HAVE COME FROM VERY MUCH 4592 03:10:06,000 --> 03:10:07,720 FOCUSING EFFORTS OF CLINICAL 4593 03:10:07,720 --> 03:10:09,200 TRIAL NETWORK AND GOING FROM 4594 03:10:09,200 --> 03:10:12,000 SPECIALIZED TREATMENTS GOING 4595 03:10:12,000 --> 03:10:13,120 INTO HEALTH CARE. 4596 03:10:13,120 --> 03:10:16,320 YOU HAVE SEEN HOW SUCCESSFUL 4597 03:10:16,320 --> 03:10:19,080 THAT HAS BEEN WITH RESPECT TO 4598 03:10:19,080 --> 03:10:20,400 ENGAGING IN PRIMARY CARE 4599 03:10:20,400 --> 03:10:22,680 PHYSICIANS AND PROPOSALS BEING 4600 03:10:22,680 --> 03:10:24,440 PRESENTED REGARDING INDIVIDUALS 4601 03:10:24,440 --> 03:10:26,880 THAT GO INTO THE HOSPITAL FOR 4602 03:10:26,880 --> 03:10:28,640 MEDICAL OR SURGICAL PROCEDURES 4603 03:10:28,640 --> 03:10:30,600 THAT IS ANOTHER LOW-HANGING 4604 03:10:30,600 --> 03:10:32,240 FRUIT AND ANOTHER AREA THAT WE 4605 03:10:32,240 --> 03:10:35,400 HAVE BEEN VERY MUCH DEVELOPING 4606 03:10:35,400 --> 03:10:37,040 IS THAT OF INFECTIOUS DISEASE 4607 03:10:37,040 --> 03:10:39,520 AND WE ARE VERY INTERESTED 4608 03:10:39,520 --> 03:10:41,200 ACTUALLY IN BRINGING FORWARD THE 4609 03:10:41,200 --> 03:10:43,800 HEALTH CARE SYSTEM INTO 4610 03:10:43,800 --> 03:10:45,640 PEDIATRICS AND IN PEDIATRICS YOU 4611 03:10:45,640 --> 03:10:47,720 DO A BETTER JOB DOING SCREENING 4612 03:10:47,720 --> 03:10:49,560 AND EARLY IDENTIFICATIONS. 4613 03:10:49,560 --> 03:10:51,120 AND SO FOR TREATMENT WE HAVE 4614 03:10:51,120 --> 03:10:53,160 HEALTH CARE ON ONE HAND AND 4615 03:10:53,160 --> 03:10:55,280 OTHER SYSTEM WE PROBE IS THAT OF 4616 03:10:55,280 --> 03:10:59,960 JUSTICE SETTING THAT ENABLES US. 4617 03:10:59,960 --> 03:11:02,440 THAT HAS CHANGED DRAMATICALLY I 4618 03:11:02,440 --> 03:11:04,960 WOULD SAY OVER THE PAST FIVE 4619 03:11:04,960 --> 03:11:07,760 YEARS AND ON THE WILLINGNESS OF 4620 03:11:07,760 --> 03:11:11,600 JUSTICE SIFT NEM JAILS AND IN 4621 03:11:11,600 --> 03:11:15,800 TRANSITION IN PAIREL. 4622 03:11:15,800 --> 03:11:18,080 THERE IS A LOT OF WORK TO DO AND 4623 03:11:18,080 --> 03:11:21,920 THINK ONE PROPOSAL YOU SAW IS 4624 03:11:21,920 --> 03:11:25,360 THAT TISHA WAS PRESENTING IS HOW 4625 03:11:25,360 --> 03:11:29,040 DO WE EXPAND THOSE ADVANCES WE 4626 03:11:29,040 --> 03:11:32,200 DON'T IN JUSTICE SETTINGS 4627 03:11:32,200 --> 03:11:33,920 BRINGING FORWARD INTERVENTIONS 4628 03:11:33,920 --> 03:11:35,840 IF IN JUSTICE SETTING AND FOR 4629 03:11:35,840 --> 03:11:39,880 EXAMPLE ARE INITIATIVES COULD 4630 03:11:39,880 --> 03:11:41,600 TAKE ADVANTAGE OF POLICE AND 4631 03:11:41,600 --> 03:11:44,640 LOCAL EFFORTS GENERATED IN 4632 03:11:44,640 --> 03:11:46,120 COMMUNITIES FOR POLICE TO BRING 4633 03:11:46,120 --> 03:11:49,640 INTO TREATMENTS AND EXPLORING 4634 03:11:49,640 --> 03:11:52,560 FOR THOSE INNOVATIONS THAT 4635 03:11:52,560 --> 03:11:55,400 RESULTED US DUE TO URGENCY OF 4636 03:11:55,400 --> 03:11:56,920 CRISIS COMMUNITIES ARE DOG TO 4637 03:11:56,920 --> 03:11:59,280 BRING IT FORWARD AS A MORE 4638 03:11:59,280 --> 03:12:01,120 INTEGRATED PLATFORM THAT ALLOWS 4639 03:12:01,120 --> 03:12:04,680 TO WORK NO THE JUST WITH JUSTICE 4640 03:12:04,680 --> 03:12:08,680 BUT WITH OTHER ORGANIZATIONS IN 4641 03:12:08,680 --> 03:12:10,080 THE COMMUNITY AND THAT IS 4642 03:12:10,080 --> 03:12:11,960 HELPING AND WE HAVE FOR 4643 03:12:11,960 --> 03:12:13,280 TREATMENT THAT IS MANY MUCH MORE 4644 03:12:13,280 --> 03:12:15,240 THAN WE HAVE FOR PREVENTION THAT 4645 03:12:15,240 --> 03:12:17,680 IS IN THE SECOND ELEMENT. 4646 03:12:17,680 --> 03:12:20,720 SO, A LOT OF WORK IS GOING INTO 4647 03:12:20,720 --> 03:12:21,960 PREVENTION AND INTO 4648 03:12:21,960 --> 03:12:23,680 IMPLEMENTATION RESEARCH TO 4649 03:12:23,680 --> 03:12:26,040 ENSURE THAT HEALTH CARE SYSTEM 4650 03:12:26,040 --> 03:12:29,840 CAN PARTICIPATE IN SCREENING AND 4651 03:12:29,840 --> 03:12:32,320 IN THERAPEUTICS OF INDIVIDUALS 4652 03:12:32,320 --> 03:12:34,200 WITH OPIOID DISORDER AND THROUGH 4653 03:12:34,200 --> 03:12:38,160 ADDICTIONS AND AREA THAT 4654 03:12:38,160 --> 03:12:39,040 BASICALLY WE ARE DOING 4655 03:12:39,040 --> 03:12:40,640 TREMENDOUSLY THAT IS NO THE NEW 4656 03:12:40,640 --> 03:12:43,400 AND SOMETHING THAT HAS BEEN WITH 4657 03:12:43,400 --> 03:12:45,160 MANY INVESTIGATORS AND MANY 4658 03:12:45,160 --> 03:12:47,760 PEOPLE IN PUBLIC HEALTH IS THAT 4659 03:12:47,760 --> 03:12:49,720 PREVENTION WE SPEAK A LOT ABOUT 4660 03:12:49,720 --> 03:12:52,000 PREVENTION AND WE DON'T HAVE 4661 03:12:52,000 --> 03:12:52,600 INFRASTRUCTURE IN THE UNITED 4662 03:12:52,600 --> 03:12:54,600 STATES OR IN MANY OTHER 4663 03:12:54,600 --> 03:12:56,760 COUNTRIES AND CERTAINLY NOT IN 4664 03:12:56,760 --> 03:12:58,280 THE UNITED STATES TO DEPLOY 4665 03:12:58,280 --> 03:12:59,880 PREVENTION INTERVENTIONS AND 4666 03:12:59,880 --> 03:13:01,640 VERY DIFFERENT FROM HEALTH CARE 4667 03:13:01,640 --> 03:13:03,120 WHERE TREATMENT CAN BE 4668 03:13:03,120 --> 03:13:05,560 IMPLEMENTED TO HEALTH CARE. 4669 03:13:05,560 --> 03:13:07,840 WITH RESPECT TO WAY WE ARE 4670 03:13:07,840 --> 03:13:09,320 DEALING WITH OVERDOSE CRISIS 4671 03:13:09,320 --> 03:13:13,480 WITH PREVENT IS LOOKING AT WHAT 4672 03:13:13,480 --> 03:13:16,160 INFRASTRUCTURE COULD BE BUILT. 4673 03:13:16,160 --> 03:13:18,840 VERY IMPORTANTLY HOW WE CAN TAKE 4674 03:13:18,840 --> 03:13:21,560 ADVANTAGE OF INFRASTRUCTURE OUT 4675 03:13:21,560 --> 03:13:24,000 THERE TO DEPLOY PREVENTION AND 4676 03:13:24,000 --> 03:13:25,960 RESPECT FOR EXAMPLE CLINICAL 4677 03:13:25,960 --> 03:13:29,640 TRIAL NETWORK THAT LAUNCHED 4678 03:13:29,640 --> 03:13:32,200 RANDOMIZED CLINICAL TRIAL FOR 4679 03:13:32,200 --> 03:13:34,840 SUBTHRESHOLD INDIVIDUALS WITH 4680 03:13:34,840 --> 03:13:36,120 OPIOID USE DISORDER AND 4681 03:13:36,120 --> 03:13:38,160 INDIVIDUALS THAT DON'T HAVE 4682 03:13:38,160 --> 03:13:41,720 SUBSTANCE USE DISORDER DIAGNOSIS 4683 03:13:41,720 --> 03:13:45,080 BUT ARE STARTING WITH RISKY 4684 03:13:45,080 --> 03:13:46,920 PATTERNS OF DRUGS HOW TO 4685 03:13:46,920 --> 03:13:48,880 INTERVENE AND COULD BE REFERRED 4686 03:13:48,880 --> 03:13:50,360 TO US SECONDARY PREVENTION THAT 4687 03:13:50,360 --> 03:13:52,000 IS ONE THAT IS EXTREMELY 4688 03:13:52,000 --> 03:13:53,320 IMPORTANT AND WOULD SAY IN MANY 4689 03:13:53,320 --> 03:13:58,720 WAYS IS AKIN TO WHAT DIABETES 4690 03:13:58,720 --> 03:14:01,360 FIELD IN 2000 WHEN CAME UP WITH 4691 03:14:01,360 --> 03:14:03,080 CONCEPT SCREENING AND INTERVENE 4692 03:14:03,080 --> 03:14:06,080 FOG PREADDICTION AND DIABETICS 4693 03:14:06,080 --> 03:14:09,600 AND CAN WE DO SOMETHING SIMILAR 4694 03:14:09,600 --> 03:14:12,280 FOR PREADDICTION AND SUBSTANCE 4695 03:14:12,280 --> 03:14:13,800 USE DISORDER AND THIS IS ONE 4696 03:14:13,800 --> 03:14:16,080 ELEMENT THAT RELATES TO 4697 03:14:16,080 --> 03:14:19,000 DISCUSSES GOING ON AND PROJECTS 4698 03:14:19,000 --> 03:14:20,840 YOU HAVE SEEN DEPLOYED AND 4699 03:14:20,840 --> 03:14:24,560 THROUGH NIDA AND DECADES 4700 03:14:24,560 --> 03:14:27,760 INVESTING ENORMOUS AMOUNT OF 4701 03:14:27,760 --> 03:14:29,360 MONEY ON PREVENTION RESEARCH AND 4702 03:14:29,360 --> 03:14:31,400 PREVENTION THAT WORKS AND IT IS 4703 03:14:31,400 --> 03:14:33,280 NOT IMPLEMENTED. 4704 03:14:33,280 --> 03:14:35,920 THIS IS AGAIN AN ASPECT THAT WAS 4705 03:14:35,920 --> 03:14:37,440 BROUGHT UP BACK AND FORTH. YOU 4706 03:14:37,440 --> 03:14:39,280 CAN HAVE SCIENCE IF THERE IS NOT 4707 03:14:39,280 --> 03:14:42,280 A BUY IN OR SUSTAINABLE WAY OF 4708 03:14:42,280 --> 03:14:43,680 PROVIDING THAT SERVICE IS NOT 4709 03:14:43,680 --> 03:14:47,000 GOING TO HAPPEN. SO, IN GENERAL 4710 03:14:47,000 --> 03:14:50,280 PREVENTION HAS NOT BEEN A 4711 03:14:50,280 --> 03:14:54,120 PRIORITY FOR INVESTMENTS. 4712 03:14:54,120 --> 03:14:56,760 TO ME AT LEAST CERTAINLY FROM 4713 03:14:56,760 --> 03:14:58,280 PERSPECTIVE OF SCIENCE WHAT CAN 4714 03:14:58,280 --> 03:15:01,080 WE DO THAT WILL CHANGE THAT 4715 03:15:01,080 --> 03:15:02,600 DIALOGUE? 4716 03:15:02,600 --> 03:15:04,000 PREVENTION RESEARCH THAT YOU 4717 03:15:04,000 --> 03:15:09,640 HEARD IS ACTUALLY TRYING TO 4718 03:15:09,640 --> 03:15:14,240 PROVIDE DATA FOR HEALTH CHANGE 4719 03:15:14,240 --> 03:15:16,040 POLICIES THAT BASICALLY LINKING 4720 03:15:16,040 --> 03:15:20,600 TO MORE SPECIFIC PROPOSAL OF HOW 4721 03:15:20,600 --> 03:15:23,280 DO YOU USE SCIENCE TO GUIDE 4722 03:15:23,280 --> 03:15:24,760 POLICIES AND APPLY IT AND 4723 03:15:24,760 --> 03:15:27,280 TRANSLATE IT AND AREA OF 4724 03:15:27,280 --> 03:15:29,000 PREVENTION IS CRUCIAL. NOT THAT 4725 03:15:29,000 --> 03:15:30,840 WE DON'T HAVE EVIDENCE-BASED 4726 03:15:30,840 --> 03:15:31,960 PREVENTIONS THAT WORKING BUT 4727 03:15:31,960 --> 03:15:35,360 THAT NO ONE IS PAYING FOR THEM 4728 03:15:35,360 --> 03:15:37,400 OR SUSTAINING THEM. 4729 03:15:37,400 --> 03:15:41,480 WE NEED TO CROSS THAT BRIDGE. 4730 03:15:41,480 --> 03:15:44,520 ALSO IN FIELD OF PREVENTION FOR 4731 03:15:44,520 --> 03:15:46,840 OPIOID DISEASE THAT WE NOTED 4732 03:15:46,840 --> 03:15:49,680 VERY EARLY ON THAT MOST 4733 03:15:49,680 --> 03:15:51,840 PREVENTION PORTFOLIO FOCUSES ON 4734 03:15:51,840 --> 03:15:53,640 CHILDREN AND ADOLESCENCE AND 4735 03:15:53,640 --> 03:15:56,400 [INDISCERNIBLE] IS PERIOD OF 4736 03:15:56,400 --> 03:15:57,720 TREMENDOUS STRESS AND TURMOIL 4737 03:15:57,720 --> 03:16:00,120 THAT IS CHALLENGING SEEING 4738 03:16:00,120 --> 03:16:02,320 OVERDOSE CRISIS PREVENTION 4739 03:16:02,320 --> 03:16:04,360 EFFORTS BEING PUT FORWARD ARE 4740 03:16:04,360 --> 03:16:06,600 TACKLING THIS ANL GROUP AND 4741 03:16:06,600 --> 03:16:10,320 DEMOGRAPHIC THAT ACTUALLY FOR 4742 03:16:10,320 --> 03:16:15,400 WHICH EVIDENCE BASED PREVENTION 4743 03:16:15,400 --> 03:16:17,240 IS MUCH MORE LIMITED AND 4744 03:16:17,240 --> 03:16:20,280 ELEMENTS OF TREATMENT AND 4745 03:16:20,280 --> 03:16:27,800 PREVENTION ONE GREAT TERRITORY 4746 03:16:27,800 --> 03:16:29,760 TEAM COMES AROUND FOR PAIN SIDE 4747 03:16:29,760 --> 03:16:34,120 AND FOR US IS CONCEPT HOW DO WE 4748 03:16:34,120 --> 03:16:35,960 COORDINATE EFFORTS? STARLTING 4749 03:16:35,960 --> 03:16:37,760 TO SEE HOW MANY RESEARCH 4750 03:16:37,760 --> 03:16:41,800 PROPOSALS IN FACT HAVING 4751 03:16:41,800 --> 03:16:45,560 ASSOCIATIONS WITH THE OTHER 4752 03:16:45,560 --> 03:16:49,800 COORDINATING EFFORTS RESEARCH 4753 03:16:49,800 --> 03:16:51,760 DEALING WITH HEALING INSTITUTES 4754 03:16:51,760 --> 03:16:52,560 AND ORGANIZATIONS AND BROUGHT UP 4755 03:16:52,560 --> 03:16:54,920 MANY TIMES AND SEEM TO REPEAT 4756 03:16:54,920 --> 03:16:57,160 MYSELF AND IS CRUCIAL WE LISTEN 4757 03:16:57,160 --> 03:17:00,560 AND DON'T FORGET AND BRINGING UP 4758 03:17:00,560 --> 03:17:04,360 AGENCIES DEPLOYING THIS THAT IS 4759 03:17:04,360 --> 03:17:07,480 HRSA AND CMS FOR MEDICAID AND 4760 03:17:07,480 --> 03:17:10,520 SAMHSA. WE HAVE TO WORK WITH 4761 03:17:10,520 --> 03:17:17,160 THEM THAT PARTNERSHIP HAS 4762 03:17:17,160 --> 03:17:18,840 SUSTAINABILITY AND DEPARTMENT OF 4763 03:17:18,840 --> 03:17:20,320 JUSTICE HAVING THEM BUY IN TO 4764 03:17:20,320 --> 03:17:22,400 THE VALUE OF SCIENCE AND WHAT IT 4765 03:17:22,400 --> 03:17:26,280 MEANS IN TERMS OF PRACTICES I 4766 03:17:26,280 --> 03:17:28,280 THINK HAS BEEN DONE SUCCESSFULLY 4767 03:17:28,280 --> 03:17:30,880 AS OF NOW AND WITHOUT IT IS 4768 03:17:30,880 --> 03:17:32,520 BASICALLY LOT OF WORK WE ARE 4769 03:17:32,520 --> 03:17:34,240 DOING WILL END UP AS AN 4770 03:17:34,240 --> 03:17:36,280 INTERESTING ARTICLE IN A 4771 03:17:36,280 --> 03:17:38,080 JOURNAL. WHEREAS WHAT WE SEE IS 4772 03:17:38,080 --> 03:17:42,240 BEING TRANSLATED INTO PRACTICE 4773 03:17:42,240 --> 03:17:44,760 IN AREA OF IMPLEMENTATION FOR 4774 03:17:44,760 --> 03:17:46,160 TREATMENT AND PREVENTION AND 4775 03:17:46,160 --> 03:17:49,400 CLEARLY BECAUSE THAT IS WHY WE 4776 03:17:49,400 --> 03:17:51,640 ALWAYS PRIORITIZE IT AND ONE 4777 03:17:51,640 --> 03:17:52,840 THING FROM THE BEGINNING WHEN 4778 03:17:52,840 --> 03:17:53,880 FRANCIS SAYS WHEN YOU HAVE MORE 4779 03:17:53,880 --> 03:17:55,720 MONEY WHAT WOULD YOU DO? NEED 4780 03:17:55,720 --> 03:18:01,440 MORE MEDICATIONS AND 4781 03:18:01,440 --> 03:18:03,440 THERAPEUTICS FOR SUBSTANCE 4782 03:18:03,440 --> 03:18:05,040 DISORDER AND WE ARE LUCKY WHAT 4783 03:18:05,040 --> 03:18:08,280 THIS IS AND DO WE STOP WITH CORE 4784 03:18:08,280 --> 03:18:10,680 DIFFERENT TYPES OF FARM LOGICAL 4785 03:18:10,680 --> 03:18:11,040 ENTITIES? 4786 03:18:11,040 --> 03:18:15,240 WE NEED TO PUSH IT FURTHER AND 4787 03:18:15,240 --> 03:18:17,440 PUSH IT FURTHER BECAUSE NOT 4788 03:18:17,440 --> 03:18:19,760 EVERYBODY SHOULD RESPONSE TO IT. 4789 03:18:19,760 --> 03:18:21,960 RELAPSE RATES WE ARE GETTING ARE 4790 03:18:21,960 --> 03:18:24,560 PRETTY HIGH AND LOTS OF WORK CAN 4791 03:18:24,560 --> 03:18:27,200 BE DONE TO IMPROVE WHOLE ASPECT 4792 03:18:27,200 --> 03:18:28,760 OF MEDICATION DEVELOPMENT AND I 4793 03:18:28,760 --> 03:18:30,240 ALSO THINK THERE IS, AGAIN, THAT 4794 03:18:30,240 --> 03:18:32,840 IS WHY YOU HAVE PROPOSALS FOR 4795 03:18:32,840 --> 03:18:34,840 CLINICAL TRIAL NETWORK AND THERE 4796 03:18:34,840 --> 03:18:37,000 IS A LOT OF RESEARCH THAT CAN BE 4797 03:18:37,000 --> 03:18:39,880 DONE AND HELP US ACTUALLY 4798 03:18:39,880 --> 03:18:41,880 IMPROVE THE WAY WE USE THIS 4799 03:18:41,880 --> 03:18:43,120 TREATMENT INTERVENTIONS AND THAT 4800 03:18:43,120 --> 03:18:50,640 IS WHY I BASICALLY SPOKE UP WHEN 4801 03:18:50,640 --> 03:18:53,640 DISCUSSING ISSUE COMBINING BU 4802 03:18:53,640 --> 03:18:55,800 PREN OR FRIN AND [INDISCERNIBLE] 4803 03:18:55,800 --> 03:18:58,160 THAT IS AN ANTIDEPRESSANT THAT 4804 03:18:58,160 --> 03:18:59,680 BASICALLY BASED ON WHAT WE 4805 03:18:59,680 --> 03:19:02,120 ALREADY KNOW IT WILL HELP RETAIN 4806 03:19:02,120 --> 03:19:06,360 PEOPLE IN TREATMENT FOR A LONGER 4807 03:19:06,360 --> 03:19:07,120 TIME PERIOD. 4808 03:19:07,120 --> 03:19:09,560 TO EXTENT WE CAN IDENTIFY WHICH 4809 03:19:09,560 --> 03:19:14,680 ARE AREAS THAT WE CAN DO 4810 03:19:14,680 --> 03:19:17,320 TRACTION RAPIDLY SHOWING THERE 4811 03:19:17,320 --> 03:19:19,400 IS A LARGE BENEFIT THERE IS -- 4812 03:19:19,400 --> 03:19:23,520 THOSE -- THE TYPE OF FINDING CAN 4813 03:19:23,520 --> 03:19:24,760 IMPACT CLINICAL PRACTICE THAT IN 4814 03:19:24,760 --> 03:19:27,320 TURN CAN HELP US AND ENSURE 4815 03:19:27,320 --> 03:19:31,080 THERE IS PROPER REIMBURSEMENT. 4816 03:19:31,080 --> 03:19:33,200 AT END OF ALL THESE I MEAN 4817 03:19:33,200 --> 03:19:36,520 OBVIOUSLY THIS IS THE SPACE THAT 4818 03:19:36,520 --> 03:19:39,040 WE ARE INTERACTING ALL THE TIME 4819 03:19:39,040 --> 03:19:40,720 WITH DIFFERENT AGENCY WHAT WE DO 4820 03:19:40,720 --> 03:19:44,080 AND NIDA DOES IS NOTION OF 4821 03:19:44,080 --> 03:19:45,840 RECOGNIZING THAT KEY ASPECT FOR 4822 03:19:45,840 --> 03:19:48,640 ALL OF US TO BE SUCCESSFUL AND 4823 03:19:48,640 --> 03:19:50,200 RELEVANT TO PAIN IS TRAINING OF 4824 03:19:50,200 --> 03:19:53,680 THE SCIENTISTS THAT WILL 4825 03:19:53,680 --> 03:19:56,000 CONTINUE TO DO THIS WORK. 4826 03:19:56,000 --> 03:19:59,120 ALSO, TRAINING OF INDIVIDUALS 4827 03:19:59,120 --> 03:20:01,640 THAT WILL MAKE POSSIBLE 4828 03:20:01,640 --> 03:20:04,200 IMPLEMENTATION OF INITIATIVES. 4829 03:20:04,200 --> 03:20:07,800 AND SO THIS WAS NOT SPECIFICALLY 4830 03:20:07,800 --> 03:20:11,160 PROPOSED WITHIN THE SPACE BUT 4831 03:20:11,160 --> 03:20:14,400 TRAINING WAS ONE KEY PROPOSAL 4832 03:20:14,400 --> 03:20:15,720 FOR THE PAIN. 4833 03:20:15,720 --> 03:20:18,200 I DO THINK THAT ASPECT IS 4834 03:20:18,200 --> 03:20:21,880 CRUCIAL WHERE WE CAN ASK DO 4835 03:20:21,880 --> 03:20:23,960 REALLY ADVANCE QUALITY OF THE 4836 03:20:23,960 --> 03:20:26,200 EDUCATION MATERIAL THAT IS 4837 03:20:26,200 --> 03:20:30,160 PRESENTED TO PEOPLE ENGAGED WITH 4838 03:20:30,160 --> 03:20:32,360 PATIENTS WITH PAIN. 4839 03:20:32,360 --> 03:20:35,440 ALSO, FACILITATE TYPE OF QUALITY 4840 03:20:35,440 --> 03:20:38,080 EDUCATIONAL MATERIALS ENGAGED 4841 03:20:38,080 --> 03:20:38,800 WITH INDIVIDUALS [INDISCERNIBLE] 4842 03:20:38,800 --> 03:20:42,560 AND SOME OF WHOM HAVE SUBSTANCE 4843 03:20:42,560 --> 03:20:43,600 USE DISORDER. 4844 03:20:43,600 --> 03:20:46,960 MY LAST POINT I HAVE TO SAY I'M 4845 03:20:46,960 --> 03:20:48,600 OBVIOUSLY THINKING ABOUT IT 4846 03:20:48,600 --> 03:20:51,840 CONSTANTLY IS THESE ARE SPACES 4847 03:20:51,840 --> 03:20:56,280 WE ARE COVERING. 4848 03:20:56,280 --> 03:20:58,920 IS THERE ONE OR ANYTHING THERE 4849 03:20:58,920 --> 03:21:00,480 THAT BOTHERS ME I WOULD LIKE US 4850 03:21:00,480 --> 03:21:02,960 TO HAVE BASICALLY A BETTER HOLD? 4851 03:21:02,960 --> 03:21:05,560 YOU HEARD ME SAY IT AGAIN. 4852 03:21:05,560 --> 03:21:08,760 I WILL REPEAT IT AGAIN. IT IS 4853 03:21:08,760 --> 03:21:10,600 STILL A TREMENDOUS NEED THAT IS 4854 03:21:10,600 --> 03:21:14,600 A NEED OF MORE TIMELY DATA. 4855 03:21:14,600 --> 03:21:18,720 I THINK WE ARE ALWAYS IN 4856 03:21:18,720 --> 03:21:19,440 RESPONSIVE MODE AND DON'T 4857 03:21:19,440 --> 03:21:23,200 EXACTLY KNOW WHERE THE SITUATION 4858 03:21:23,200 --> 03:21:23,360 IS. 4859 03:21:23,360 --> 03:21:27,240 LAST WEEK HAD A MEETING WITH 4860 03:21:27,240 --> 03:21:30,480 ONDCP AND WANTED TO DISCUSS RISE 4861 03:21:30,480 --> 03:21:34,000 IN SILO KROOEN YOU SAW IN ALL OF 4862 03:21:34,000 --> 03:21:36,760 THE NEWSPAPERS AND SILO SEEN IS 4863 03:21:36,760 --> 03:21:38,280 STARTING TO EMERGE IN NEWSPAPERS 4864 03:21:38,280 --> 03:21:40,360 BECAUSE OF REALLY ADVERSE 4865 03:21:40,360 --> 03:21:42,760 CONSEQUENCES IT HAS TO PATIENTS 4866 03:21:42,760 --> 03:21:49,960 INJECTING DRUGS WITH SILO SEEN. 4867 03:21:49,960 --> 03:21:52,240 ATTENTION IS BROUGHT THIS IS A 4868 03:21:52,240 --> 03:21:53,960 PROBLEM AND WE SHOULDN'T BE HERE 4869 03:21:53,960 --> 03:21:56,040 WITH TOOLS AND PROCESSES 4870 03:21:56,040 --> 03:21:57,680 ENABLING US TO DOCUMENT IN A 4871 03:21:57,680 --> 03:21:59,840 MUCH MORE TIMELY MANNER WHAT ARE 4872 03:21:59,840 --> 03:22:02,120 DRUGS THAT ARE EMERGING ALLOWING 4873 03:22:02,120 --> 03:22:06,480 US TO RESPOND MORE RAPIDLY AND 4874 03:22:06,480 --> 03:22:09,600 INFRASTRUCTURE WILL HELP US 4875 03:22:09,600 --> 03:22:13,520 DETERMINE EXTENT TO WHICH 4876 03:22:13,520 --> 03:22:17,280 INTERVENTIONS HAVE A IMPN IMPAC 4877 03:22:17,280 --> 03:22:18,600 IT EQUITABLE AND CERTAIN GROUPS 4878 03:22:18,600 --> 03:22:20,600 THAT ARE NEGLECTED? ALL I 4879 03:22:20,600 --> 03:22:22,640 WANTED TO SAY AND LOTS OF 4880 03:22:22,640 --> 03:22:24,280 DISCUSSION AND WONDERFUL 4881 03:22:24,280 --> 03:22:27,440 PRESENTATION AND POINTS BROUGHT 4882 03:22:27,440 --> 03:22:32,080 UP TO ALL OF US. 4883 03:22:32,080 --> 03:22:34,680 WHILE HERE IN OPEN DIALOGUE I 4884 03:22:34,680 --> 03:22:36,760 WOULD WELCOME THAT DIALOGUE TO 4885 03:22:36,760 --> 03:22:38,240 CONTINUE WHEN THIS MEETING IS 4886 03:22:38,240 --> 03:22:41,400 ADJOURNED AND IF YOU HAVE IDEAS, 4887 03:22:41,400 --> 03:22:44,640 PLEASE REACH OUT TO US AND 4888 03:22:44,640 --> 03:22:46,160 THANKS FOR PARTICIPATING. 4889 03:22:46,160 --> 03:22:53,680 >>SAME HERE. GOOD POINT. 4890 03:22:53,680 --> 03:22:54,840 THERE IS A HAND UP. 4891 03:22:54,840 --> 03:22:55,200 >>YES. 4892 03:22:55,200 --> 03:22:57,360 >>THANK YOU SO MUCH. I 4893 03:22:57,360 --> 03:22:58,520 APPRECIATED THAT SUMMARY AND 4894 03:22:58,520 --> 03:23:00,200 FACT YOU POINTED OUT SILO SEEN 4895 03:23:00,200 --> 03:23:02,000 AND WOULD LIKE TO SHARE THAT IS 4896 03:23:02,000 --> 03:23:07,280 THE TIP OF THE ICEBERG; RIGHT? 4897 03:23:07,280 --> 03:23:08,960 THERE IS SO MANY DIFFERENT TYPES 4898 03:23:08,960 --> 03:23:12,000 OF TOXIC ADULTERANTS IN 4899 03:23:12,000 --> 03:23:14,000 SUBSTANCES AND DIFFERENT TYPES 4900 03:23:14,000 --> 03:23:17,160 OF FENTANYL IS OUT THERE AND A 4901 03:23:17,160 --> 03:23:19,160 PAPER WAS PUBLISHED WHERE 4902 03:23:19,160 --> 03:23:21,400 COLLEAGUES SHOWED THAT VERMONT 4903 03:23:21,400 --> 03:23:25,560 AND KENTUCKY SAMPLES FROM DEA 4904 03:23:25,560 --> 03:23:29,320 HAD UP TO 9 DIFFERENT TYPES OF 4905 03:23:29,320 --> 03:23:33,240 SYSTEMS INSIDE THEM NOT JUST 4906 03:23:33,240 --> 03:23:35,440 FENTANYL; RIGHT? PUTTING IN 4907 03:23:35,440 --> 03:23:37,760 BRAIN HOW HEAL INITIATIVE CAN BE 4908 03:23:37,760 --> 03:23:40,880 LEVERAGED TO FIND OUT MORE 4909 03:23:40,880 --> 03:23:42,000 QUICKLY WHAT TOXIC 4910 03:23:42,000 --> 03:23:42,720 [INDISCERNIBLE] ARE AND WHAT 4911 03:23:42,720 --> 03:23:44,520 THEY ARE DOING AND COMBINATIONS 4912 03:23:44,520 --> 03:23:47,480 MAKING THINGS MORE LETHAL FOR 4913 03:23:47,480 --> 03:23:48,720 PEOPLE USING SUBSTANCES. 4914 03:23:48,720 --> 03:23:50,280 >>I AGREE TOTALLY AND BROUGHT 4915 03:23:50,280 --> 03:23:52,840 UP ISSUE OF SILO SEEN IN THE 4916 03:23:52,840 --> 03:23:56,160 NEWSPAPER AND EVERYBODY REACTS 4917 03:23:56,160 --> 03:23:59,000 AND WE HAVE SEEN THIS HAS HAVE 4918 03:23:59,000 --> 03:24:02,720 BEEN APPEARING FOR 6 MONTHS IF 4919 03:24:02,720 --> 03:24:06,640 NOT LONGER AND IS A TREADMILL. 4920 03:24:06,640 --> 03:24:07,040 GAIL? 4921 03:24:07,040 --> 03:24:12,800 >>YES. I WAS GOING TO SAY 4922 03:24:12,800 --> 03:24:14,240 THANK YOU EVERYONE HERE BRINGING 4923 03:24:14,240 --> 03:24:17,320 UP ALL THESE ISSUES AND WE ARE 4924 03:24:17,320 --> 03:24:21,080 TRYING TO DO THAT. 4925 03:24:21,080 --> 03:24:24,800 WE HAVE BANKED URINE SAMPLES AND 4926 03:24:24,800 --> 03:24:28,640 AS FAST AS WE DO IT SOMETHING 4927 03:24:28,640 --> 03:24:31,000 ELSE APPEARS AND NEEDS TO BE 4928 03:24:31,000 --> 03:24:33,600 NIMBLE AND TRYING TO GET THAT OR 4929 03:24:33,600 --> 03:24:35,000 THOSE SUPPLEMENTS THAT ARE 4930 03:24:35,000 --> 03:24:37,040 WHATEVER WE CAN TO MOVE FORWARD. 4931 03:24:37,040 --> 03:24:40,520 ONE GREAT THING I THINK WE HAVE 4932 03:24:40,520 --> 03:24:44,480 BEEN ABLE TO DO IS SCIENCE. 4933 03:24:44,480 --> 03:24:48,000 WHAT HEAL CAN DO IS CONTINUE 4934 03:24:48,000 --> 03:24:49,720 WITH SCIENCE BECAUSE THERE ARE 4935 03:24:49,720 --> 03:24:52,080 MANY ISSUES IMPACTING CARE AND 4936 03:24:52,080 --> 03:24:53,320 WE CAN'T DEAL WITH THEM. 4937 03:24:53,320 --> 03:24:57,760 SCIENCE DOES ALLOW US TO GO TO 4938 03:24:57,760 --> 03:25:00,760 FDA OR OTHER AGENCIES AND DEA 4939 03:25:00,760 --> 03:25:02,480 AND EVERYWHERE ELSE TO SAY YOU 4940 03:25:02,480 --> 03:25:04,240 HAVE TO FIX THIS. 4941 03:25:04,240 --> 03:25:07,440 WE WERE ABLE TO DO THAT. MANY, 4942 03:25:07,440 --> 03:25:10,240 MANY PEOPLE DID IT WITH MATT ACT 4943 03:25:10,240 --> 03:25:12,240 THAT RESCINDED THE AMOUNTS OF 4944 03:25:12,240 --> 03:25:14,400 PEOPLE WHO COULD DWIF OUT AND 4945 03:25:14,400 --> 03:25:16,160 NEEDED X WAIVERS AND WE WERE 4946 03:25:16,160 --> 03:25:18,080 ABLE TO DO THAT. 4947 03:25:18,080 --> 03:25:22,960 EVEN SOMETHING LIKE LONG-ACTING 4948 03:25:22,960 --> 03:25:24,120 [INDISCERNIBLE] PREPARATIONS IN 4949 03:25:24,120 --> 03:25:28,720 ALL DISCLOSURE AND I'M STUDYING 4950 03:25:28,720 --> 03:25:31,200 THEM IN 7 DAYS AND SUPPLICATE 4951 03:25:31,200 --> 03:25:32,760 THAT HAS BEEN AROUND A WHILE I 4952 03:25:32,760 --> 03:25:36,000 HAVE TO LITERALLY GET RIGHT ARM 4953 03:25:36,000 --> 03:25:37,680 AWAY TO GET DOSE IN EMERGENCY 4954 03:25:37,680 --> 03:25:39,200 DEPARTMENT AND AMOUNT OF CRISIS 4955 03:25:39,200 --> 03:25:41,160 I HAVE TO GO THROUGH HAS ALMOST 4956 03:25:41,160 --> 03:25:44,240 -- I HAVE SAVED PEOPLES LIVES 4957 03:25:44,240 --> 03:25:45,640 AND THIS IS WHAT THEY REALLY 4958 03:25:45,640 --> 03:25:47,240 NEED AND I CAN'T GIVE IT TO THEM 4959 03:25:47,240 --> 03:25:48,920 AND WE ACTUALLY HAVE PUT PEOPLE 4960 03:25:48,920 --> 03:25:51,120 IN THE CAR TAKING THEM TO OPIATE 4961 03:25:51,120 --> 03:25:53,560 TREATMENT PROGRAM TO GET 4962 03:25:53,560 --> 03:25:57,840 MEDICATION ORDERED AND MEDICARE 4963 03:25:57,840 --> 03:25:59,360 AND MEDICAID WOULD PAY TO GET IT 4964 03:25:59,360 --> 03:26:00,880 THERE AND DROVE THE PATIENT 4965 03:26:00,880 --> 03:26:04,040 THERE THAT IS AN ESTATE THAT IS 4966 03:26:04,040 --> 03:26:04,680 PRETTY BLUE. 4967 03:26:04,680 --> 03:26:08,200 WE NEED THIS DATA AND WE HAVE TO 4968 03:26:08,200 --> 03:26:08,960 KEEP PRODUCING THIS. 4969 03:26:08,960 --> 03:26:12,920 WE CAN GO TO PEOPLE AND SAY AND 4970 03:26:12,920 --> 03:26:15,000 EVEN FDA AND IN TERMS OF WHAT 4971 03:26:15,000 --> 03:26:18,000 THE LIMITS ARE ON CERTAIN 4972 03:26:18,000 --> 03:26:20,600 MEDICINES GOING OUTSIDE OF THE 4973 03:26:20,600 --> 03:26:23,760 LIMIT OF GABAPENTIN FOR EXAMPLE, 4974 03:26:23,760 --> 03:26:29,400 EVEN. YOU KNOW, WHATEVER. EVEN 4975 03:26:29,400 --> 03:26:33,320 USING THE BU PEN EF RIN PATCH 4976 03:26:33,320 --> 03:26:35,160 USING IT FOR PAIN NOT OPIOIDS IS 4977 03:26:35,160 --> 03:26:38,240 CRAZY AND MORE STUDIES COMING 4978 03:26:38,240 --> 03:26:39,480 OUT THAT SHOW THESE ARE 4979 03:26:39,480 --> 03:26:42,000 EFFECTIVE MORE TOOLS WE HAVE TO 4980 03:26:42,000 --> 03:26:44,400 GO TO OTHER AGENCIES PUSHING FOR 4981 03:26:44,400 --> 03:26:47,600 HELP TO IMPROVE CARE OF OUR 4982 03:26:47,600 --> 03:26:47,840 PATIENTS. 4983 03:26:47,840 --> 03:26:50,640 THAT IS WHAT WE ARE DOING. GO 4984 03:26:50,640 --> 03:26:50,840 AHEAD. 4985 03:26:50,840 --> 03:26:54,280 >>I KNOW, GAIL. ABSOLUTELY. 4986 03:26:54,280 --> 03:26:55,640 COMMENTING YOUR POINT YOU MADE 4987 03:26:55,640 --> 03:26:57,800 EARLIER THAT BASICALLY GOT 4988 03:26:57,800 --> 03:27:00,160 IMPRINTED IN MY BRAIN. THIS IS 4989 03:27:00,160 --> 03:27:01,720 A VERY PRECISE RECOMMENDATION 4990 03:27:01,720 --> 03:27:03,640 AND GUIDELINE ON SOMETHING WE 4991 03:27:03,640 --> 03:27:06,600 CAN DO THAT CAN HELP TO CHANGE 4992 03:27:06,600 --> 03:27:07,920 PRACTICES DON'T MAKE ANY SENSE 4993 03:27:07,920 --> 03:27:10,560 AND NOT USING MEDICATIONS FOR 4994 03:27:10,560 --> 03:27:12,640 OPIOID USE DISORDER AND PATIENT 4995 03:27:12,640 --> 03:27:13,760 WITH ALCOHOL USE DISORDER. 4996 03:27:13,760 --> 03:27:14,080 >>RIGHT. 4997 03:27:14,080 --> 03:27:15,600 >>WHERE IS EVIDENCE THAT IS 4998 03:27:15,600 --> 03:27:17,680 HARMLEFUL TO START WITH? 4999 03:27:17,680 --> 03:27:19,200 THERE IS EVIDENCE THAT NAL 5000 03:27:19,200 --> 03:27:21,480 TRECHL YOEN IS EFFECTIVE IN 5001 03:27:21,480 --> 03:27:22,880 TREATMENT OF ALCOHOL USE 5002 03:27:22,880 --> 03:27:25,440 DISORDER AND EVIDENCE THAT 5003 03:27:25,440 --> 03:27:27,360 NOREPINEPHRINE IS REDUCING 5004 03:27:27,360 --> 03:27:28,840 CONSUMPTION AND THAT DATA IS OUT 5005 03:27:28,840 --> 03:27:29,520 THERE. 5006 03:27:29,520 --> 03:27:32,520 SO, I SORT OF -- BEING ABLE TO 5007 03:27:32,520 --> 03:27:35,480 VERY EXPLICITLY AND SO I -- I 5008 03:27:35,480 --> 03:27:38,640 TOOK AN ONLY ON THAT AND 5009 03:27:38,640 --> 03:27:40,320 REACHING OUT TO FDA TO SAY WHAT 5010 03:27:40,320 --> 03:27:42,120 DO WE HAVE TO GIVE YOU SUCH THAT 5011 03:27:42,120 --> 03:27:44,920 YOU CAN REMOVE CONSTRAINTS? 5012 03:27:44,920 --> 03:27:47,720 BECAUSE I THINK IT IS ACTUALLY 5013 03:27:47,720 --> 03:27:49,200 HARMING PEOPLE AND WORKING WITH 5014 03:27:49,200 --> 03:27:50,920 THEM BRINGING FORWARD CONCEPT 5015 03:27:50,920 --> 03:27:53,720 HOW CRUCIAL WE CAN COORDINATE 5016 03:27:53,720 --> 03:27:55,520 EFFORTS THEY ARE REGULATORY 5017 03:27:55,520 --> 03:27:57,080 AGENTS IS NOT SUFFICIENT FOR ME 5018 03:27:57,080 --> 03:27:59,040 TO SAY YOU HAVE TO CHANGE THIS. 5019 03:27:59,040 --> 03:28:02,400 WE HAVE TO GIVE THEM DATA THAT 5020 03:28:02,400 --> 03:28:04,080 MAKES THEM FEEL COMFORTABLE TO 5021 03:28:04,080 --> 03:28:04,880 DO IT. 5022 03:28:04,880 --> 03:28:08,880 THAT IS -- IN FACT, PROPOSAL 5023 03:28:08,880 --> 03:28:12,200 THAT TISHA PRESENTED EARLIER TO 5024 03:28:12,200 --> 03:28:14,800 GENERATE TRANSLATION AIMS TO DO 5025 03:28:14,800 --> 03:28:17,400 THAT AND ACCELERATING PROCESSES. 5026 03:28:17,400 --> 03:28:23,880 >>EXACTLY. THANK YOU. 5027 03:28:23,880 --> 03:28:32,080 >>CHRISTINE? 5028 03:28:32,080 --> 03:28:34,440 >>GOING BACK TO THIS THAT HAS 5029 03:28:34,440 --> 03:28:36,880 BEEN SIGNED BY BIDEN 5030 03:28:36,880 --> 03:28:40,640 ADMINISTRATION, WE ARE MAKING 5031 03:28:40,640 --> 03:28:43,920 ASSUMPTIONS THAT ELIMINATION OF 5032 03:28:43,920 --> 03:28:47,320 EX-WAIVER FOR PRESCRIBES OF BU 5033 03:28:47,320 --> 03:28:50,280 PREN EF RIN WILL HAVE A MASSIVE 5034 03:28:50,280 --> 03:28:51,680 IMPACT IN PRESCRIPTION PATTERNS. 5035 03:28:51,680 --> 03:28:54,280 I THINK THAT IT IS A UNIQUE 5036 03:28:54,280 --> 03:28:56,680 OPPORTUNITY FOR US TO REALLY 5037 03:28:56,680 --> 03:28:58,800 STUDY THIS MORE FORMALLY. AND 5038 03:28:58,800 --> 03:29:01,280 REALLY LOOKING AT IMPACT OF SUCH 5039 03:29:01,280 --> 03:29:04,280 A RADICAL CHANGE IN LOW ON TO 5040 03:29:04,280 --> 03:29:07,040 PRESCRIPTION PATTERNS AND THINK 5041 03:29:07,040 --> 03:29:11,040 THAT NOW WOULD BE TIME TO REALLY 5042 03:29:11,040 --> 03:29:12,720 SEE IMPACT. 5043 03:29:12,720 --> 03:29:16,600 I BELIEVE THAT THIS WILL TAKE 5044 03:29:16,600 --> 03:29:18,560 TIME. 5045 03:29:18,560 --> 03:29:21,560 LET'S BE VERY HONEST. 5046 03:29:21,560 --> 03:29:32,120 >>I AGREE 100%. IT BEHOOVES. 5047 03:29:33,600 --> 03:29:36,360 UNDERSTANDING WHAT CHANGING 5048 03:29:36,360 --> 03:29:38,640 POLICY WILL BE DOING TO ACCESS 5049 03:29:38,640 --> 03:29:42,880 OF TREATMENTS AND OTHER ASPECT 5050 03:29:42,880 --> 03:29:45,120 ABOUT IT NOT EVERYBODY 5051 03:29:45,120 --> 03:29:48,080 IMMEDIATELY INTEGRATED IS STATES 5052 03:29:48,080 --> 03:29:52,520 WILL BE IMPLEMENTING. 5053 03:29:52,520 --> 03:29:53,920 >> VERY LIKELY SOME STATES 5054 03:29:53,920 --> 03:29:56,560 WON'T ALLOW OPENING AND GIVES US 5055 03:29:56,560 --> 03:29:59,360 OPPORTUNITY TO INVESTIGATE ARE 5056 03:29:59,360 --> 03:30:00,560 DIFFERENCES BETWEEN STATES THAT 5057 03:30:00,560 --> 03:30:02,600 DO IT AND THOSE THAT DON'T AND 5058 03:30:02,600 --> 03:30:04,800 LIKE WHEN THEY WERE EXPANDING 5059 03:30:04,800 --> 03:30:06,760 MEDICAID AND WHEN WE ARE ABLE TO 5060 03:30:06,760 --> 03:30:09,200 DEMONSTRATE OUTCOMES ARE MUCH 5061 03:30:09,200 --> 03:30:10,960 BETTER FOR SUBSTANCE USE 5062 03:30:10,960 --> 03:30:18,000 DISORDER IN STATES EXPANDING 5063 03:30:18,000 --> 03:30:28,120 MEDIC 5064 03:30:29,160 --> 03:30:29,360 MEDICAID. 5065 03:30:29,360 --> 03:30:30,440 >>THIS IS A RECOMMENDATION AND 5066 03:30:30,440 --> 03:30:34,800 BEST PRACTICE IN ADDICTION 5067 03:30:34,800 --> 03:30:35,160 MEDICINE. 5068 03:30:35,160 --> 03:30:37,600 >>YES. YES. I BELIEVE IN DATA 5069 03:30:37,600 --> 03:30:39,600 AND BELIEVE IN THAT DATA WILL 5070 03:30:39,600 --> 03:30:42,720 WIN AT END OF THE DAY. 5071 03:30:42,720 --> 03:30:47,640 OVER HOPEFULLY PREJUDICES AND 5072 03:30:47,640 --> 03:30:51,040 POLITICS. WE WHETHER SEE. 5073 03:30:51,040 --> 03:30:52,720 >>I SAW HANDS NEXT. 5074 03:30:52,720 --> 03:30:56,480 >>YES. TO STAY WITH FOCUS ON 5075 03:30:56,480 --> 03:30:59,640 DATA AND SHIFTING A LITTLE BIT 5076 03:30:59,640 --> 03:30:59,920 EMPHASIS. 5077 03:30:59,920 --> 03:31:02,200 I'M WONDERING IF AT THIS POINT 5078 03:31:02,200 --> 03:31:06,480 WE ARE FAR ENOUGH ALONG IN HEAL 5079 03:31:06,480 --> 03:31:08,240 INITIATIVE WE ARE SEEING USE OF 5080 03:31:08,240 --> 03:31:10,200 DATA WHERE PEOPLE ARE ABLE TO 5081 03:31:10,200 --> 03:31:12,840 GET ACCESS TO AGGREGATE DATA ON 5082 03:31:12,840 --> 03:31:14,920 WHETHER THERE IS RELEVANT DATA 5083 03:31:14,920 --> 03:31:16,800 ACROSS DIFFERENT STUDIES AND 5084 03:31:16,800 --> 03:31:19,560 INITIATIVES AND WHEN THEY ARE 5085 03:31:19,560 --> 03:31:21,760 AGGREGATED AND IN LINE FOR MAYBE 5086 03:31:21,760 --> 03:31:22,840 ADDRESSING POINT -- ANOTHER 5087 03:31:22,840 --> 03:31:24,240 POINT THAT WASN'T NECESSARILY 5088 03:31:24,240 --> 03:31:26,080 FOCUS OF ORIGINAL DATA AND 5089 03:31:26,080 --> 03:31:27,880 WONDERING HOW IT IS GOING AND 5090 03:31:27,880 --> 03:31:29,240 DIDN'T HEAR MUCH ABOUT IT AT 5091 03:31:29,240 --> 03:31:31,440 THIS TIME AND MISSED IT IN FIRST 5092 03:31:31,440 --> 03:31:32,160 MEETING ABOUT YOU. 5093 03:31:32,160 --> 03:31:33,880 >>WE DIDN'T TALK ABOUT IT TOO 5094 03:31:33,880 --> 03:31:35,640 MUCH TODAY. NORA, WOULD YOU 5095 03:31:35,640 --> 03:31:37,560 LIKE ME TO ANSWER THAT ONE? 5096 03:31:37,560 --> 03:31:41,360 >>I THINK I WILL SPEAK FROM 5097 03:31:41,360 --> 03:31:44,160 PERSPECTIVE OF NOOIDA. NOT -- 5098 03:31:44,160 --> 03:31:47,240 WE HAVE NOT YET. I MEAN, WE 5099 03:31:47,240 --> 03:31:49,560 HAVE OBVIOUSLY THROUGH CTN AND 5100 03:31:49,560 --> 03:31:52,120 MEDICATION DEVELOPMENT WE HAVE A 5101 03:31:52,120 --> 03:31:54,640 CLINICAL REPOSITORY THAT IS DATA 5102 03:31:54,640 --> 03:31:57,560 TO USE TO TRY TO VALIDATE 5103 03:31:57,560 --> 03:31:59,560 CRAVING. IT IS VERY SPECIFIC TO 5104 03:31:59,560 --> 03:32:01,880 PROJECTS THAT HAVE BEEN DONE 5105 03:32:01,880 --> 03:32:02,960 THROUGH NIDA. 5106 03:32:02,960 --> 03:32:05,600 ONE SPEAKING ABOUT INTEGRATION 5107 03:32:05,600 --> 03:32:08,880 ABOUT DIFFERENT TYPES OF STUDIES 5108 03:32:08,880 --> 03:32:11,560 FUNDED BY HEAL. RIGHT NOW FROM 5109 03:32:11,560 --> 03:32:13,480 NIDA, WE DON'T HAVE ANYTHING 5110 03:32:13,480 --> 03:32:15,520 THAT EMERGED BUT ARE WORKING 5111 03:32:15,520 --> 03:32:17,200 VERY HARD TO TRY TO TAKE 5112 03:32:17,200 --> 03:32:20,200 ADVANTAGE OF DATABASES THAT ARE 5113 03:32:20,200 --> 03:32:21,400 OBTAINED THROUGH HEALING 5114 03:32:21,400 --> 03:32:24,840 COMMUNITY STUDIES SO WE CAN 5115 03:32:24,840 --> 03:32:27,080 LEARN HOW DIFFERENT PRACTICES IN 5116 03:32:27,080 --> 03:32:29,440 FOUR STATES INFLUENCE OUTCOMES 5117 03:32:29,440 --> 03:32:31,920 AND IT IS ACTUALLY HAS BEEN MORE 5118 03:32:31,920 --> 03:32:36,000 CHALLENGING I WISH I WOULD SAY. 5119 03:32:36,000 --> 03:32:39,720 THIS DATA SHOULD BECOME 5120 03:32:39,720 --> 03:32:42,240 ACCESSIBLE AND CERTAIN DATABASES 5121 03:32:42,240 --> 03:32:43,480 STATES OWN AND SOME DON'T WANT 5122 03:32:43,480 --> 03:32:48,000 TO SHARE THEM. WE ARE WORKING 5123 03:32:48,000 --> 03:32:50,920 ON IT FOR NIDA PERSPECTIVE, NOT 5124 03:32:50,920 --> 03:32:51,120 YET. 5125 03:32:51,120 --> 03:32:58,600 >>YEAH. NIH-WIDE OR NIH HEAL 5126 03:32:58,600 --> 03:32:59,760 INITIATIVEWIDE WOULD SAY WE ARE 5127 03:32:59,760 --> 03:33:02,640 ON THE CUSP OF HAVING LOTS OF 5128 03:33:02,640 --> 03:33:04,960 HEAL FUNDED RESEARCH BE AT 5129 03:33:04,960 --> 03:33:06,360 RESULTS PHASE. 5130 03:33:06,360 --> 03:33:08,240 SO, SOME STUDIES BECAUSE OF 5131 03:33:08,240 --> 03:33:09,840 THEIR NATURE AND SOMETHING LIKE 5132 03:33:09,840 --> 03:33:11,920 A SURVEY OR SOMETHING MIGHT BE 5133 03:33:11,920 --> 03:33:12,960 READY NOW. 5134 03:33:12,960 --> 03:33:15,560 MOST OF OUR TRIALS ARE NOT. 5135 03:33:15,560 --> 03:33:19,240 THEY ARE STILL IN THE FIELD NOT 5136 03:33:19,240 --> 03:33:22,440 YET HAVING COMPLETED DATA 5137 03:33:22,440 --> 03:33:22,960 ACQUISITION. 5138 03:33:22,960 --> 03:33:25,440 SO, WE ARE -- WHAT WE HAVE BEEN 5139 03:33:25,440 --> 03:33:30,240 FOCUSED ON. I THINK THAT NORA 5140 03:33:30,240 --> 03:33:31,960 ELUDED TO THIS AS WELL PUTTING 5141 03:33:31,960 --> 03:33:34,760 INTO PLACE REALLY RESOURCES AND 5142 03:33:34,760 --> 03:33:37,800 INFRASTRUCTURE SO WHEN DATA ARE 5143 03:33:37,800 --> 03:33:39,600 KIND OF READY TO SHARE, WHICH IS 5144 03:33:39,600 --> 03:33:41,760 A FUZZY TARGET. IT IS IN A 5145 03:33:41,760 --> 03:33:42,880 POSITION WHERE IT WOULD BE 5146 03:33:42,880 --> 03:33:44,360 POSSIBLE TO SHARE IF THERE IS A 5147 03:33:44,360 --> 03:33:46,920 PLACE TO PUT THEM AND THERE IS A 5148 03:33:46,920 --> 03:33:50,280 WAY FOR METADATA TO BE 5149 03:33:50,280 --> 03:33:52,160 CATALOGED. THERE IS, YOU KNOW, 5150 03:33:52,160 --> 03:33:54,240 WE HAVE A STEWARDS TEAM THAT 5151 03:33:54,240 --> 03:33:57,400 HELPS THE INVESTIGATORS IDENTIFY 5152 03:33:57,400 --> 03:33:59,440 RIGHT REPOSITORIES AND RIGHT 5153 03:33:59,440 --> 03:34:00,200 INFORMATION TO SHARE. 5154 03:34:00,200 --> 03:34:04,160 NOW THAT THE NIH-WIDE PAIN 5155 03:34:04,160 --> 03:34:05,520 MANAGEMENT AND SHARING POLICY IS 5156 03:34:05,520 --> 03:34:07,400 IN PLACE THAT MEANS THAT GOING 5157 03:34:07,400 --> 03:34:10,080 FORWARD EVERYONE HAS TO DO THIS. 5158 03:34:10,080 --> 03:34:11,480 RESOURCES WILL BECOME EVEN MORE 5159 03:34:11,480 --> 03:34:12,560 USED AND VALUABLE. 5160 03:34:12,560 --> 03:34:15,200 I THINK REALLY -- I HAVE TWO 5161 03:34:15,200 --> 03:34:17,120 QUESTIONS TO YOU AND GROUP ABOUT 5162 03:34:17,120 --> 03:34:17,400 THAT. 5163 03:34:17,400 --> 03:34:19,120 FIRST BEING HOW DO WE GO OR 5164 03:34:19,120 --> 03:34:21,000 RECOGNIZING THAT WE ARE GOING 5165 03:34:21,000 --> 03:34:24,360 INTO THIS PHASE TO MAKE IT AS 5166 03:34:24,360 --> 03:34:26,960 KIND OF WIN/WIN AS POSSIBLE. 5167 03:34:26,960 --> 03:34:30,200 THE MOST HIGH-QUALITY DATA WITH 5168 03:34:30,200 --> 03:34:33,240 -- AND ALL THE MOST KIND OF 5169 03:34:33,240 --> 03:34:35,440 VALUE AND SENSE OF PURPOSE FROM 5170 03:34:35,440 --> 03:34:37,080 INVESTIGATORS NO THE JUST FROM 5171 03:34:37,080 --> 03:34:39,240 COMPLIANCE PERSPECTIVE BUT 5172 03:34:39,240 --> 03:34:40,440 RESEARCH AND SCIENCE PERSPECTIVE 5173 03:34:40,440 --> 03:34:44,640 HOW DO WE MAKE THIS VALUABLE TO 5174 03:34:44,640 --> 03:34:45,160 THEM? 5175 03:34:45,160 --> 03:34:46,680 ALSO, YOU KNOW, HOW WOULD YOU 5176 03:34:46,680 --> 03:34:49,040 LIKE TO HEAR ABOUT IT GOING 5177 03:34:49,040 --> 03:34:49,480 FORWARD? 5178 03:34:49,480 --> 03:34:52,200 WE ARE MOVING INTO A TIME WHERE 5179 03:34:52,200 --> 03:34:53,680 THERE WILL BE MORE DATA AND WILL 5180 03:34:53,680 --> 03:34:56,720 YOU BE IN A POSITION TO GIVE US 5181 03:34:56,720 --> 03:34:58,600 ADVICE ON IT. 5182 03:34:58,600 --> 03:34:59,960 >>WELL, I'M RESPONDING TO THE 5183 03:34:59,960 --> 03:35:02,480 FACT THAT WE HAVE A LARGE DATA 5184 03:35:02,480 --> 03:35:05,320 REPOSITORY YOU KNOW IN ABCD. 5185 03:35:05,320 --> 03:35:07,600 IT IS JUST I THINK SURPRISED 5186 03:35:07,600 --> 03:35:09,160 EVERYONE ASSOCIATED WITH THIS 5187 03:35:09,160 --> 03:35:11,120 HOW MUCH HAS COME OUT OF 5188 03:35:11,120 --> 03:35:13,680 SECONDARY DATA ANALYSIS THAT 5189 03:35:13,680 --> 03:35:15,560 PEOPLE WERE ABLE TO GO FIND 5190 03:35:15,560 --> 03:35:17,680 SOMETHING IN DATA BEING 5191 03:35:17,680 --> 03:35:20,840 COLLECTED THAT WERE VERY 5192 03:35:20,840 --> 03:35:21,880 VALUABLE AND DIFFERENT FROM WHAT 5193 03:35:21,880 --> 03:35:24,480 WE WERE THINKING ABOUT WHEN WE 5194 03:35:24,480 --> 03:35:26,240 DESIGNED THE STUDY THAT I THINK 5195 03:35:26,240 --> 03:35:30,640 IS THAT EXPERIENCE THAT IF DATA 5196 03:35:30,640 --> 03:35:32,520 LIKE MANY OF THE -- LIKE MANY 5197 03:35:32,520 --> 03:35:34,520 THINGS BEING COLLECTED IN THE 5198 03:35:34,520 --> 03:35:36,480 HEAL INITIATIVE ARE ACTUALLY 5199 03:35:36,480 --> 03:35:38,800 JUST MADE AVAILABLE FOR 5200 03:35:38,800 --> 03:35:41,120 SECONDARY ANALYSIS. 5201 03:35:41,120 --> 03:35:42,720 INVESTIGATORS OUT THERE WHO HAVE 5202 03:35:42,720 --> 03:35:45,840 A PARTICULAR BURNING QUESTION 5203 03:35:45,840 --> 03:35:52,560 WILL FIND WAYS TO REALLY EXPLOIT 5204 03:35:52,560 --> 03:35:53,840 THOSE DATA TO ANSWER INTERESTING 5205 03:35:53,840 --> 03:35:56,600 QUESTIONS AND I JUST -- IT HAS 5206 03:35:56,600 --> 03:35:58,480 JUST BEEN VERY MUCH FOR ME I 5207 03:35:58,480 --> 03:36:00,000 THINK I DON'T KNOW NORA HOW YOU 5208 03:36:00,000 --> 03:36:01,640 FEEL ABOUT THIS. THINGS COME 5209 03:36:01,640 --> 03:36:04,000 OUT OF ABC DATE THAW WE ARE 5210 03:36:04,000 --> 03:36:05,360 AMAZED THAT PEOPLE ARE ABLE TO 5211 03:36:05,360 --> 03:36:06,880 DO THESE THINGS THAT MAKES 5212 03:36:06,880 --> 03:36:09,600 SENSE. 5213 03:36:09,600 --> 03:36:11,200 BUT, YOU JUST HAVE TO -- I THINK 5214 03:36:11,200 --> 03:36:15,880 TO SOME EXTENT YOU HAVE TO 5215 03:36:15,880 --> 03:36:16,920 PROVIDE RESOURCES FOR OTHER 5216 03:36:16,920 --> 03:36:19,680 PEOPLE TO BRING OR FIGURE OUT 5217 03:36:19,680 --> 03:36:21,040 HOW TO USE IT. 5218 03:36:21,040 --> 03:36:23,760 NOT SO MUCH YOU HAVE TO USE 5219 03:36:23,760 --> 03:36:25,360 METADATA AND HAVE DATA 5220 03:36:25,360 --> 03:36:27,120 DICTIONARIES AND USE DATA USE 5221 03:36:27,120 --> 03:36:28,480 AGREEMENTS AND WAYS OF 5222 03:36:28,480 --> 03:36:30,320 MONITORING USE OF DATA AND ALL 5223 03:36:30,320 --> 03:36:32,280 THAT. I JUST THINK THAT WITH 5224 03:36:32,280 --> 03:36:35,720 SUCH AN ENORMOUS INVESTMENT 5225 03:36:35,720 --> 03:36:40,240 COLLECTING EXTREMELY VALUABLE 5226 03:36:40,240 --> 03:36:41,360 DATA THERE COULD BE LOTS MORE 5227 03:36:41,360 --> 03:36:44,080 MIND FROM IT IN THE FUTURE. IF, 5228 03:36:44,080 --> 03:36:46,040 YOU KNOW, A LITTLE MORE 5229 03:36:46,040 --> 03:36:54,000 ATTENTION WAS PAID TO MAKING IT 5230 03:36:54,000 --> 03:36:56,400 AVAILABLE FOR SECONDARY USES AND 5231 03:36:56,400 --> 03:36:57,800 PROCESS KNOWING SOMETHING IS 5232 03:36:57,800 --> 03:36:59,000 COLLECTED AND SEEING A QUESTION 5233 03:36:59,000 --> 03:37:01,000 COULD BE ANSWERED BY AGGREGATING 5234 03:37:01,000 --> 03:37:04,040 IT OR COMBINING IT OR SOMETHING 5235 03:37:04,040 --> 03:37:04,520 LIKE THAT. 5236 03:37:04,520 --> 03:37:06,360 >>THAT IS ABSOLUTELY THE 5237 03:37:06,360 --> 03:37:13,520 PURPOSE OF THE RENLTRY OF HEAL 5238 03:37:13,520 --> 03:37:16,360 TO MAKE THAT DATA AVAILABLE AND 5239 03:37:16,360 --> 03:37:18,640 IS MORE COMPLEX THAN ABC. ABC 5240 03:37:18,640 --> 03:37:22,240 IS ONE STUDY AND WE HAVE 5241 03:37:22,240 --> 03:37:23,440 MULTIPLE STUDIES CROSSING 5242 03:37:23,440 --> 03:37:24,480 THROUGH VERY, VERY DIFFERENT 5243 03:37:24,480 --> 03:37:26,600 TYPES OF COMMUNITIES AND 5244 03:37:26,600 --> 03:37:27,280 SCIENCE. 5245 03:37:27,280 --> 03:37:29,960 SO, THAT IS -- ALSO, THE OTHER 5246 03:37:29,960 --> 03:37:32,400 ASPECT THAT MAKES IT CHALLENGING 5247 03:37:32,400 --> 03:37:34,920 IS THAT ACCESS TO DATA AND 5248 03:37:34,920 --> 03:37:36,840 JUSTICE SETTINGS IS NOT THE SAME 5249 03:37:36,840 --> 03:37:39,240 THING AS SUCCESS THROUGH DATA TO 5250 03:37:39,240 --> 03:37:42,480 HEALTH CARE AND IS WHY WE ARE 5251 03:37:42,480 --> 03:37:46,240 WORKING VERY PROACTIVELY TO MAKE 5252 03:37:46,240 --> 03:37:46,960 THIS POSSIBLE. 5253 03:37:46,960 --> 03:37:49,160 YOU ARE ABSOLUTELY RIGHT. IT IS 5254 03:37:49,160 --> 03:37:51,520 NOT JUST COLLECTING DATA BUT 5255 03:37:51,520 --> 03:37:56,520 CREATING A FORMAT FOR DATA THAT 5256 03:37:56,520 --> 03:37:58,280 IS ALONGSIDE STRUCTURE AND 5257 03:37:58,280 --> 03:38:01,200 SUPPORT ALLOWING RESEARCHERS TO 5258 03:38:01,200 --> 03:38:04,280 ACCESS IT AND HAVE AN ANALYTICAL 5259 03:38:04,280 --> 03:38:06,040 METHOD TO DEPLOY IT IF THEY 5260 03:38:06,040 --> 03:38:08,480 DON'T HAVE THEM IN THEIR 5261 03:38:08,480 --> 03:38:11,720 INSTITUTION WHAT ABC HAS BEEN SO 5262 03:38:11,720 --> 03:38:14,480 SUCCESSFUL. AS COMPLEX AS CDC 5263 03:38:14,480 --> 03:38:16,000 IS THIS IS ANOTHER LEVEL. 5264 03:38:16,000 --> 03:38:19,720 >>I AGREE. I MUST SAY FROM OUR 5265 03:38:19,720 --> 03:38:22,360 EXPERIENCE WE HAVE TO THINK IN 5266 03:38:22,360 --> 03:38:24,680 TERMS OF DIFFERENT MODELS FOR 5267 03:38:24,680 --> 03:38:26,840 ACCESS AND SOME ARE MUCH MORE 5268 03:38:26,840 --> 03:38:28,440 RESTRICTED WHERE THERE IS HIGH 5269 03:38:28,440 --> 03:38:30,440 PRIORITY PULLING IT TOGETHER AND 5270 03:38:30,440 --> 03:38:32,840 MUCH MORE RESTRICTED ACCESS 5271 03:38:32,840 --> 03:38:34,680 POLICY AND VERY HIGH PRIORITY 5272 03:38:34,680 --> 03:38:36,480 THINGS DATA HAS TO REALLY BE 5273 03:38:36,480 --> 03:38:38,520 PULLED AND OTHERS THAT ARE MORE 5274 03:38:38,520 --> 03:38:40,280 FREE AND OPEN AND PEOPLE CAN 5275 03:38:40,280 --> 03:38:42,600 KIND OF HAVE MORE EASY ACCESS 5276 03:38:42,600 --> 03:38:45,320 AND MAYBE DATA SETS ARE BETTER 5277 03:38:45,320 --> 03:38:46,800 ANONYMIZED AND SOMETHING LIKE 5278 03:38:46,800 --> 03:38:48,320 THAT AND DON'T THINK ONE SHARING 5279 03:38:48,320 --> 03:38:50,120 MODEL WILL WORK AND FIRST TO SAY 5280 03:38:50,120 --> 03:38:52,400 I THINK IT DEPENDS WHAT KIND OF 5281 03:38:52,400 --> 03:38:55,720 DATA THEY ARE. AND WHAT THE 5282 03:38:55,720 --> 03:38:57,920 LEVEL OF PRIORITY OF THE 5283 03:38:57,920 --> 03:38:58,520 QUESTION IS. 5284 03:38:58,520 --> 03:39:00,480 THAT NEEDS TO BE ANSWERED AND WE 5285 03:39:00,480 --> 03:39:05,600 HAVE TO GO TO A MULTIMODAL 5286 03:39:05,600 --> 03:39:07,040 SECONDARY ANALYSIS KIND OF. 5287 03:39:07,040 --> 03:39:09,240 >>I AGREE. WE ARE ACTUALLY NOT 5288 03:39:09,240 --> 03:39:10,600 THE FIRST THAT WILL BE DEALING 5289 03:39:10,600 --> 03:39:13,040 WITH IT. ALL OF US HAVE BEEN 5290 03:39:13,040 --> 03:39:15,320 STRUGGLING WITH IT AND GENOME 5291 03:39:15,320 --> 03:39:16,200 INSTITUTE HAS BEEN STRUGGLING 5292 03:39:16,200 --> 03:39:19,320 WITH THIS. 5293 03:39:19,320 --> 03:39:21,960 SO, LET'S NOT INVENT THE WHEEL 5294 03:39:21,960 --> 03:39:23,400 BUT LEARN FROM THEM AND WHAT YOU 5295 03:39:23,400 --> 03:39:25,480 ARE SAYING AND I THINK THAT IT 5296 03:39:25,480 --> 03:39:27,960 WOULD BE A GOOD SUGGESTION. 5297 03:39:27,960 --> 03:39:32,200 REBEKAH, IT IS TO -- AT ONE 5298 03:39:32,200 --> 03:39:35,520 POINT WHEN IS TIMELY TO BRING 5299 03:39:35,520 --> 03:39:37,200 TOGETHER EXPERTS TO DETERMINE 5300 03:39:37,200 --> 03:39:38,520 EXACTLY THOSE DIFFERENT LEVELS 5301 03:39:38,520 --> 03:39:40,360 OF ENTRY AND ACCESS TO DIFFERENT 5302 03:39:40,360 --> 03:39:43,440 TYPES OF DATA THAT I THINK 5303 03:39:43,440 --> 03:39:45,960 HAVING A MODEL THAT CAN HELP US 5304 03:39:45,960 --> 03:39:48,960 WITH THIS WOULD FACILITATE HOW 5305 03:39:48,960 --> 03:39:51,280 TO GO ABOUT IT FURTHER. 5306 03:39:51,280 --> 03:39:52,840 >>YEAH. GREAT SUGGESTION. 5307 03:39:52,840 --> 03:39:55,720 THANK YOU FOR INVOKING ALL OF 5308 03:39:55,720 --> 03:39:58,200 THE RESEARCH PROGRAMS. ONE 5309 03:39:58,200 --> 03:40:00,400 THING THEY TAUGHT US IS YOU CAN 5310 03:40:00,400 --> 03:40:02,720 SUPPORT SMALL RESEARCH STUDIES 5311 03:40:02,720 --> 03:40:03,960 SPECIFICALLY ON THE QUESTION 5312 03:40:03,960 --> 03:40:05,680 TERRY ASKED. IS THIS USEFUL? 5313 03:40:05,680 --> 03:40:07,720 WHAT IF YOU TRY TO DO THIS 5314 03:40:07,720 --> 03:40:09,440 ANALYSIS BASED ON DATA? 5315 03:40:09,440 --> 03:40:13,320 IT COULD BE BOTH A PRESSURE TEST 5316 03:40:13,320 --> 03:40:17,240 OR BETA TEST THAT IS FOR YOUR 5317 03:40:17,240 --> 03:40:18,680 DATABASE WHILE ALSO KIND OF 5318 03:40:18,680 --> 03:40:21,040 GIVING SOME JUICE TO RESEARCH 5319 03:40:21,040 --> 03:40:21,400 COMMUNITIES. 5320 03:40:21,400 --> 03:40:24,400 I APPRECIATE THE SUGGESTIONS AND 5321 03:40:24,400 --> 03:40:25,960 ALL OF THIS REFERENCE. 5322 03:40:25,960 --> 03:40:27,960 I'M LOSING MY VOICE. WE HAVE 5323 03:40:27,960 --> 03:40:29,600 FIVE MINUTES LEFT FOR THE REST 5324 03:40:29,600 --> 03:40:31,320 OF THE MEETING. 5325 03:40:31,320 --> 03:40:33,120 GAIL,LY GIVE YOU THE LAST WORD. 5326 03:40:33,120 --> 03:40:34,400 >>OKAY. 5327 03:40:34,400 --> 03:40:37,080 >>I WILL GIVE A FEW SLIDES ON 5328 03:40:37,080 --> 03:40:40,440 NEXT STEPS BEFORE WE SAY 5329 03:40:40,440 --> 03:40:40,720 GOOD-BYE. 5330 03:40:40,720 --> 03:40:42,280 >>OKAY. LAST WORD AND IN TERMS 5331 03:40:42,280 --> 03:40:44,720 OF DATA TALKING ABOUT SOMETHING 5332 03:40:44,720 --> 03:40:46,560 ELSE AND TERMS OF DATE THAW IS 5333 03:40:46,560 --> 03:40:48,240 HELPFUL IS SOMEHOW IF THERE WAS 5334 03:40:48,240 --> 03:40:49,640 FUNDING THAT IS ALLOWED FOR 5335 03:40:49,640 --> 03:40:53,000 LARGE STUDIES WITH A 5336 03:40:53,000 --> 03:40:54,880 STATISTICIAN THAT WAS REALLY 5337 03:40:54,880 --> 03:40:56,920 RUNNING THAT INITIAL BIG TRIAL. 5338 03:40:56,920 --> 03:41:00,040 I AM ALWAYS WORRIED WHEN PEOPLE 5339 03:41:00,040 --> 03:41:02,440 TAKE SOMETHING THAT THE 5340 03:41:02,440 --> 03:41:03,960 VARIABLES ARE SO COMPLEX AND 5341 03:41:03,960 --> 03:41:06,040 THERE IS SO MUCH DATA THAT IN 5342 03:41:06,040 --> 03:41:07,680 FACT SOMEONE WILL MISS SOMETHING 5343 03:41:07,680 --> 03:41:09,440 OR MISINTERPRET SOMETHING. I 5344 03:41:09,440 --> 03:41:12,440 MEAN, I WORRY ABOUT THIS WHEN WE 5345 03:41:12,440 --> 03:41:14,680 PUBLISH MULTIPLE, MULTIPLE 5346 03:41:14,680 --> 03:41:16,640 STUDIES OUT OF PAPERS AND OUT OF 5347 03:41:16,640 --> 03:41:18,560 ONE STUDY AND WE WANT TO MAKE 5348 03:41:18,560 --> 03:41:20,400 SURE EVERYTHING IS CONSISTENT 5349 03:41:20,400 --> 03:41:24,360 AND WHY WAS IT THIS AND SOMEBODY 5350 03:41:24,360 --> 03:41:26,120 CHOSE SOMETHING AND IT DIDN'T 5351 03:41:26,120 --> 03:41:28,440 WORK OUT AND STATISTICIAN SAID 5352 03:41:28,440 --> 03:41:29,800 YOU HAVE WRONG VARIABLE THERE 5353 03:41:29,800 --> 03:41:32,040 AND PUTTING A PLEA AND SOMEHOW 5354 03:41:32,040 --> 03:41:33,920 WHEN PEOPLE DO LARGE SECONDARY 5355 03:41:33,920 --> 03:41:35,240 ANALYSIS THEY HAVE TO WORK WITH 5356 03:41:35,240 --> 03:41:37,160 A LITTLE BIT WITH A STATISTICIAN 5357 03:41:37,160 --> 03:41:39,080 WHO DID THE ORIGINAL WORK. AT 5358 03:41:39,080 --> 03:41:41,680 LEAST THEY CAN GO OVER WHERE 5359 03:41:41,680 --> 03:41:43,080 THEY ARE DRAWING FROM. 5360 03:41:43,080 --> 03:41:45,680 I THINK ABCD IS ONGOING AND YOU 5361 03:41:45,680 --> 03:41:47,320 HAVE ALL THAT WORK OR THOSE 5362 03:41:47,320 --> 03:41:50,000 PEOPLE THERE. ONCE STUDY STOPS 5363 03:41:50,000 --> 03:41:52,280 THAT STATISTICIAN IS NOT FUNDED 5364 03:41:52,280 --> 03:41:54,840 ANY LONGER AND I JUST -- THAT IS 5365 03:41:54,840 --> 03:41:56,760 MY MAJOR POINT. 5366 03:41:56,760 --> 03:41:58,840 >>POINT WELL-TAKEN. 5367 03:41:58,840 --> 03:42:01,160 GAIL, AS YOU KNOW THAT GENERATED 5368 03:42:01,160 --> 03:42:04,040 CONSTERNATION IN TERMS OF WAY 5369 03:42:04,040 --> 03:42:06,800 THAT NOREPINEPHRINE NAL TRECHL 5370 03:42:06,800 --> 03:42:09,960 YOEN DATE THAW IS EXACTLY A E 5371 03:42:09,960 --> 03:42:12,840 EXAMPLE OF -- 5372 03:42:12,840 --> 03:42:15,080 >>EXACTLY. 5373 03:42:15,080 --> 03:42:17,920 >>OKAY. I'M GOING TO THEN JUST 5374 03:42:17,920 --> 03:42:20,640 SAY ONE MORE TIME THANK YOU TO 5375 03:42:20,640 --> 03:42:23,480 EVERYONE FOR ALL OF YOUR INPUT. 5376 03:42:23,480 --> 03:42:26,360 IT IS -- I GET A LITTLE 5377 03:42:26,360 --> 03:42:27,600 PHILOSOPHICAL BEING WITH THIS 5378 03:42:27,600 --> 03:42:30,560 GROUP THINKING BACK OVER THE 5379 03:42:30,560 --> 03:42:32,240 PAST FEW YEARS HOW MANY 5380 03:42:32,240 --> 03:42:33,480 WONDERFUL SUGGESTIONS YOU HAVE 5381 03:42:33,480 --> 03:42:35,760 MADE AND HOW MANY TIMES YOU HAVE 5382 03:42:35,760 --> 03:42:38,000 PUSHED US AND PUSHED RESEARCHERS 5383 03:42:38,000 --> 03:42:39,920 TO JUST DO A LITTLE BIT MORE AND 5384 03:42:39,920 --> 03:42:42,320 A YEAR OR TWO LATER WE COME TO 5385 03:42:42,320 --> 03:42:44,200 YOU AND I'M REALLY PROUD OF 5386 03:42:44,200 --> 03:42:45,880 PROGRESS WE MADE AND YET WE 5387 03:42:45,880 --> 03:42:47,600 STILL HAVE A BIG CHALLENGE IN 5388 03:42:47,600 --> 03:42:51,080 FRONT OF US AND BIG SET OF 5389 03:42:51,080 --> 03:42:51,720 INTERCONNECTED CHALLENGES AND 5390 03:42:51,720 --> 03:42:55,120 THANK YOU AGAIN FOR AMAZING 5391 03:42:55,120 --> 03:42:56,920 CONTRIBUTIONS AND THIS HAS BEEN 5392 03:42:56,920 --> 03:42:59,040 KIND OF TIME OF INCREASING NEW 5393 03:42:59,040 --> 03:43:01,440 RESEARCH INVESTMENTS AND ALSO 5394 03:43:01,440 --> 03:43:03,320 TURNING TO EXISTING INVESTMENTS 5395 03:43:03,320 --> 03:43:05,040 THINKING ABOUT THEM. 5396 03:43:05,040 --> 03:43:08,600 SO, WE IN HEAL WILL HAVE TO DO 5397 03:43:08,600 --> 03:43:10,600 WORK TO REALLY DETERMINE BEST 5398 03:43:10,600 --> 03:43:12,600 PATH FORWARD WITH YOUR COMMENTS 5399 03:43:12,600 --> 03:43:14,240 AND FEEDBACK OPEN AND THEY HAVE 5400 03:43:14,240 --> 03:43:16,600 BEEN INCREDIBLY VALUABLE TOWARDS 5401 03:43:16,600 --> 03:43:18,520 THAT GOAL. NEXT MEETING IS OVER 5402 03:43:18,520 --> 03:43:24,320 THE SUMMER. I WILL -- ERRIN OR 5403 03:43:24,320 --> 03:43:27,120 I WILL SEND YOU A POLL AROUND 5404 03:43:27,120 --> 03:43:29,000 WHEN WE WILL SCHEDULE THAT. 5405 03:43:29,000 --> 03:43:31,120 PLEASE LOOK OUT FOR E-MAILS FOR 5406 03:43:31,120 --> 03:43:34,840 NEXT SCHEDULES MEETING AND HEAL 5407 03:43:34,840 --> 03:43:35,440 INVESTIGATORS MEETING IS 5408 03:43:35,440 --> 03:43:37,200 ACTUALLY NEXT WEEK. I DON'T 5409 03:43:37,200 --> 03:43:42,160 KNOW THERE IS SLIDES FOR THAT. 5410 03:43:42,160 --> 03:43:45,800 PERHAPS NOT. HEAL -- 4TH ANNUAL 5411 03:43:45,800 --> 03:43:47,640 INVESTIGATOR MEETING IS JANUARY 5412 03:43:47,640 --> 03:43:49,880 21ST AND 22ND AND HYBRID MEETING 5413 03:43:49,880 --> 03:43:51,840 SOME WILL BE IN PERSON AND SOME 5414 03:43:51,840 --> 03:43:53,480 VIRTUAL AND WILL HEAR FROM MANY 5415 03:43:53,480 --> 03:43:55,920 FOLKS YOU HEARD FROM TODAY AND 5416 03:43:55,920 --> 03:43:57,920 IMPORTANTLY ARE INCREDIBLY 5417 03:43:57,920 --> 03:44:01,680 DETERMINED AND INNOVATIVE 5418 03:44:01,680 --> 03:44:03,120 RESEARCHER COMMUNITY AND SOME 5419 03:44:03,120 --> 03:44:04,840 EARLY FINDINGS AND AREAS FOR 5420 03:44:04,840 --> 03:44:07,480 COLLABORATION THEY HAVE. IF YOU 5421 03:44:07,480 --> 03:44:09,920 GO BACK ONE SLIDE, WE ARE ALSO 5422 03:44:09,920 --> 03:44:11,960 BRINGING YOUR ATTENTION AND THE 5423 03:44:11,960 --> 03:44:13,160 MEETING WILL BRING ATTENTION AS 5424 03:44:13,160 --> 03:44:17,200 WELL TO A NEW GROUP OF 5425 03:44:17,200 --> 03:44:17,720 INVESTIGATORS AND THEIR 5426 03:44:17,720 --> 03:44:19,640 COMMUNITY PARTNERS THAT WE 5427 03:44:19,640 --> 03:44:21,840 FUNDED THROUGH HEAL DATA 5428 03:44:21,840 --> 03:44:23,040 ECOSYSTEM THAT WERE IN LINE WITH 5429 03:44:23,040 --> 03:44:24,920 WHAT WE WERE DISCUSSING IN TERMS 5430 03:44:24,920 --> 03:44:28,480 OF REALLY BUILDING OUT A 5431 03:44:28,480 --> 03:44:31,000 MEANINGFUL AVENUE FOR ENGAGEMENT 5432 03:44:31,000 --> 03:44:33,480 WITH END USER OF FINDINGS WE ARE 5433 03:44:33,480 --> 03:44:35,120 SUPPORTING RESEARCH ON AND WHO 5434 03:44:35,120 --> 03:44:37,160 WILL TAKE THEM AND TRANSLATE 5435 03:44:37,160 --> 03:44:38,800 THEM INTO MEANINGFUL CHANGE FOR 5436 03:44:38,800 --> 03:44:40,560 PEOPLE WITH PAIN AND ADDICTION 5437 03:44:40,560 --> 03:44:42,920 AND THEIR COMMUNITIES AND SO 5438 03:44:42,920 --> 03:44:46,000 PLEASE LOOK OUT FOR ADDITIONAL 5439 03:44:46,000 --> 03:44:49,120 INFORMATION ABOUT THAT VERY RICH 5440 03:44:49,120 --> 03:44:53,200 CONSTALLATION OF NETWORK OF 5441 03:44:53,200 --> 03:44:54,640 COLLABORATORS TOO AND IS NOW 3 5442 03:44:54,640 --> 03:44:57,200 O'CLOCK ACCORDING TO MY COMPUTER 5443 03:44:57,200 --> 03:44:59,600 AND THANK YOU TO ERIN FOR 5444 03:44:59,600 --> 03:45:00,600 COORDINATING THIS AND FOR HEAL 5445 03:45:00,600 --> 03:45:02,160 TEAM THAT IS HELPING TO ALL OF 5446 03:45:02,160 --> 03:45:04,880 THE CO-CHAIRS OF OUR DIFFERENT 5447 03:45:04,880 --> 03:45:06,040 SCIENTIFIC TEAMS PRESENTING TO 5448 03:45:06,040 --> 03:45:06,760 YOU TODAY. 5449 03:45:06,760 --> 03:45:08,520 AND TO THE SCIENTISTS THAT 5450 03:45:08,520 --> 03:45:11,320 DEVELOPED THE CONCEPTS MANY 5451 03:45:11,320 --> 03:45:12,600 INTERDISCIPLINARY TEAMS WORKING 5452 03:45:12,600 --> 03:45:14,400 TOGETHER TO PUT FORWARD IDEAS 5453 03:45:14,400 --> 03:45:16,680 FOR YOU AND THANKING MEMBERS OF 5454 03:45:16,680 --> 03:45:18,400 THE HEAL EXECUTIVE COMMITTEE 5455 03:45:18,400 --> 03:45:21,080 THAT JOINED TODAY AND HELPED TO 5456 03:45:21,080 --> 03:45:22,000 FACILITATE A REALLY RICH 5457 03:45:22,000 --> 03:45:23,600 DISCUSSION AND TO ALL OF YOU 5458 03:45:23,600 --> 03:45:26,320 AGAIN AND IT AGAIN FOR ALL 5459 03:45:26,320 --> 03:45:27,480 CONTRIBUTIONS YOU MAKE TO HEAL 5460 03:45:27,480 --> 03:45:29,840 AND NORA WALTER, WOULD YOU LIKE 5461 03:45:29,840 --> 03:45:31,720 ANY FINAL, FINAL WORDS? 5462 03:45:31,720 --> 03:45:35,840 >>THANK YOU TO EVERYONE. 5463 03:45:35,840 --> 03:45:37,960 >>YEAH. SAME HERE. DON'T 5464 03:45:37,960 --> 03:45:40,320 FORGET WE WILL BE BACK ASKING 5465 03:45:40,320 --> 03:45:43,440 FOR MORE HELP. THANK YOU AGAIN. 5466 03:45:43,440 --> 03:45:45,520 >>THANK YOU, EVERYONE. 5467 03:45:45,520 --> 03:45:46,560 >>THANK YOU ALL. 5468 03:45:46,560 --> 03:45:47,000 >>BYE, BYE. 5469 03:45:47,000 --> 00:00:00,000 >>THANK YOU.