1
00:00:06,332 --> 00:00:09,135
THANK YOU SO MUCH.

2
00:00:09,135 --> 00:00:12,972
WELCOME EVERYBODY TO THE HEAL 

3
00:00:12,972 --> 00:00:13,506
MULTI-DISCIPLINARY GROUP 

4
00:00:13,506 --> 00:00:13,739
MEETING.

5
00:00:13,739 --> 00:00:14,774
I WANT TO APPRECIATE THE MEMBERS

6
00:00:14,774 --> 00:00:17,877
FOR MAKING THE EFFORTS AND 

7
00:00:17,877 --> 00:00:20,780
MOVING THINGS ON YOUR CALENDAR 

8
00:00:20,780 --> 00:00:22,281
TO MAKE THE MEETING AND THE 

9
00:00:22,281 --> 00:00:25,151
MEETING WAS ORIGINALLY SCHEDULED

10
00:00:25,151 --> 00:00:25,851
FEBRUARY 10.

11
00:00:25,851 --> 00:00:28,587
I WOULD LIKE TO REMIND EVERYONE 

12
00:00:28,587 --> 00:00:30,056
THIS MEETING IS AN OPEN MEETING 

13
00:00:30,056 --> 00:00:33,292
AND BEING BROADCAST TO THE 

14
00:00:33,292 --> 00:00:34,627
PUBLIC.

15
00:00:34,627 --> 00:00:35,995
PREPARE YOUR SELVES ACCORDINGLY.

16
00:00:35,995 --> 00:00:39,699
AS A REMINDER WE WERE ABLE TO 

17
00:00:39,699 --> 00:00:42,435
COMPLETE THE CLOSED PORTION AS 

18
00:00:42,435 --> 00:00:44,337
SCHEDULED FEBRUARY 10, SO 

19
00:00:44,337 --> 00:00:45,104
THERE'S NO CLOSED SESSION JUST 

20
00:00:45,104 --> 00:00:46,072
THE OPEN SESSION.

21
00:00:46,072 --> 00:00:48,507
I HAVE TO ACKNOWLEDGE IT'S BEEN 

22
00:00:48,507 --> 00:00:50,409
A TUMULTUOUS COUPLE OF MONTHS 

23
00:00:50,409 --> 00:00:52,011
HERE AND WE'RE GRATEFUL TO BE 

24
00:00:52,011 --> 00:00:55,114
ABLE TO TALK WITH YOU TODAY 

25
00:00:55,114 --> 00:01:00,453
ABOUT THE SCIENCE UNDERLYING THE

26
00:01:00,453 --> 00:01:02,521
HEAL INITIATIVE AND YOU'RE A 

27
00:01:02,521 --> 00:01:05,124
TERRIFIC GROUP OF EXPERTS AND 

28
00:01:05,124 --> 00:01:06,025
APPRECIATE YOUR GUIDE IN THE 

29
00:01:06,025 --> 00:01:09,128
HEAL INITIATIVE AS IT MOVES 

30
00:01:09,128 --> 00:01:09,362
FORWARD.

31
00:01:09,362 --> 00:01:11,330
AS A BRIEF REMINDER FOR THOSE 

32
00:01:11,330 --> 00:01:16,102
COMING IN TO THE MEETING WE 

33
00:01:16,102 --> 00:01:18,938
ASSIST THE NIH INSTITUTE AND 

34
00:01:18,938 --> 00:01:20,072
CENTER ADVISORIES COUNCILS TO 

35
00:01:20,072 --> 00:01:23,075
MAKE SURE IT MEETS THE GOALS TO 

36
00:01:23,075 --> 00:01:24,677
ADDRESS THE ONGOING PUBLIC 

37
00:01:24,677 --> 00:01:27,246
HEALTH EMERGENCY OF OPIOID 

38
00:01:27,246 --> 00:01:32,351
RELATE THE OVERDOSE DEATHS AND 

39
00:01:32,351 --> 00:01:34,587
INFORM STRATEGIES TO ADDRESS 

40
00:01:34,587 --> 00:01:35,521
THIS AND IMPROVE THE 

41
00:01:35,521 --> 00:01:36,122
UNDERSTANDING MANAGEMENT AND 

42
00:01:36,122 --> 00:01:37,223
TREATMENT OF PAIN AND IMPROVING 

43
00:01:37,223 --> 00:01:40,393
THE PREVENTION AND TREATMENT OF 

44
00:01:40,393 --> 00:01:41,127
OPIOID USE ADDICTION AND 

45
00:01:41,127 --> 00:01:44,063
OVERDOSE.

46
00:01:44,063 --> 00:01:47,032
THIS GROUP PROVIDES A FORUM TO 

47
00:01:47,032 --> 00:01:48,401
ENGAGE PARTNERS IN THE PRIVATE 

48
00:01:48,401 --> 00:01:49,769
SECTOR AND COMMUNITY TO PROVIDE 

49
00:01:49,769 --> 00:01:57,810
A TRANSPARENT VENUE FOR IT 

50
00:01:57,810 --> 00:01:59,278
STAKEHOLDERS AND EXCHANGE 

51
00:01:59,278 --> 00:02:00,413
INFORMATION IN AND ACROSS THE 

52
00:02:00,413 --> 00:02:03,082
HEAL INITIATIVE PROJECTS.

53
00:02:03,082 --> 00:02:07,887
WILL THAT I'LL HAND IT TO 

54
00:02:07,887 --> 00:02:11,424
DIRECTOR VOLKOW THE DIRECTOR OF 

55
00:02:11,424 --> 00:02:12,758
THE HEAL INITIATIVE AND 

56
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INSTITUTE.

57
00:02:13,025 --> 00:02:13,926
>> GOOD AFTERNOON EVERYONE
AND 

58
00:02:13,926 --> 00:02:17,163
IT'S A PLEASURE TO BE HERE AND 

59
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I'M GLAD WE'RE ABLE TO 

60
00:02:19,865 --> 00:02:21,066
RESUSCITATE THE OPEN SESSION 

61
00:02:21,066 --> 00:02:22,101
BECAUSE IT'S A WAY TO 

62
00:02:22,101 --> 00:02:23,469
COMMUNICATE WITH ALL OF YOU SOME

63
00:02:23,469 --> 00:02:25,971
OF THE ADVANCES THAT HAVE BEEN 

64
00:02:25,971 --> 00:02:26,839
POSSIBLE BECAUSE OF THE HEAL 

65
00:02:26,839 --> 00:02:27,406
INITIATIVE.

66
00:02:27,406 --> 00:02:34,613
AND SINCE WE RELY ON YOUR INPUT 

67
00:02:34,613 --> 00:02:36,715
AND IT DOES REFLECT YOUR 

68
00:02:36,715 --> 00:02:37,450
LEADERSHIP AND VISION IN TERMS 

69
00:02:37,450 --> 00:02:40,186
OF WHAT ARE THINGS THAT ARE 

70
00:02:40,186 --> 00:02:40,653
CONSEQUENTIAL.

71
00:02:40,653 --> 00:02:42,021
THAT'S WHAT I'M GOING TO BE 

72
00:02:42,021 --> 00:02:43,122
DOING TODAY.

73
00:02:43,122 --> 00:02:45,090
I AM SELECTING CERTAIN THINGS 

74
00:02:45,090 --> 00:02:46,125
THAT I WANT TO HIGHLIGHT.

75
00:02:46,125 --> 00:02:49,762
OBVIOUSLY I DON'T HAVE TIME TO 

76
00:02:49,762 --> 00:02:50,729
PRESENT EVERYTHING THAT'S 

77
00:02:50,729 --> 00:02:51,730
HAPPENED SINCE WE LAST MET AND 

78
00:02:51,730 --> 00:02:52,965
THAT'S WHAT I'M GOING TO DO.

79
00:02:52,965 --> 00:02:55,568
I'M NOW GOING TO SHARE MY 

80
00:02:55,568 --> 00:02:55,801
SCREEN.

81
00:02:55,801 --> 00:02:57,036
I'VE NEVER SHARED IN THIS 

82
00:02:57,036 --> 00:02:58,971
PLATFORM SO I ASSUME IT'S 

83
00:02:58,971 --> 00:03:01,140
STRAIGHTFORWARD.

84
00:03:01,140 --> 00:03:03,909
LET ME SEE.

85
00:03:03,909 --> 00:03:05,978
IF IT'S NOT STRAIGHTFORWARD -- 

86
00:03:05,978 --> 00:03:07,213
NO, THIS IS NOT THE ONE.

87
00:03:07,213 --> 00:03:11,317
>> IT LOOKS GREAT TO US,
NORA.

88
00:03:11,317 --> 00:03:14,487
IT LOOKS GREAT ON OUR END.

89
00:03:14,487 --> 00:03:20,659
>> EXCEPT DHTHIS IS NOT
THE LATT

90
00:03:20,659 --> 00:03:22,328
VERSION.

91
00:03:22,328 --> 00:03:22,728
HOLD ON.

92
00:03:22,728 --> 00:03:27,366
THIS IS WHAT HAPPENS WHEN YOU 

93
00:03:27,366 --> 00:03:29,802
HAVE SOMEONE SO OBSESSIVE I LOOK

94
00:03:29,802 --> 00:03:32,304
AT THINGS UNTIL THE LAST MINUTE.

95
00:03:32,304 --> 00:03:33,939
I MAY HAVE TO LIVE WITH IT GUYS.

96
00:03:33,939 --> 00:03:36,575
>> THIS IS RACHEL KELLY I
HAVE 

97
00:03:36,575 --> 00:03:38,878
YOUR MOST RECENT SLIDE DECK UP 

98
00:03:38,878 --> 00:03:49,288
IF YOU WANT ME TO SHARE.

99
00:03:54,393 --> 00:03:55,794
 >> Director Volkow: I
HAVE IT 

100
00:03:55,794 --> 00:03:57,096
HERE AND ONE THING THAT'S 

101
00:03:57,096 --> 00:03:58,531
EXCITING AND I'M PRESENTING TO 

102
00:03:58,531 --> 00:04:00,599
ALL OF YOU IS WE ARE SEEING SOME

103
00:04:00,599 --> 00:04:04,470
VERY GOOD NEWS AS IT RELATES TO 

104
00:04:04,470 --> 00:04:05,671
THE OVERDOSE CRISIS.

105
00:04:05,671 --> 00:04:07,339
YOU CAN SEE THE NEXT SLIDE 

106
00:04:07,339 --> 00:04:09,141
YOU'LL UNDERSTAND WHY I SAY 

107
00:04:09,141 --> 00:04:12,311
THAT.

108
00:04:12,311 --> 00:04:17,783
WHAT YOU SEE IS DECREASES IN 

109
00:04:17,783 --> 00:04:20,686
OVERDOSE DEATHS THAT IN THE PAST

110
00:04:20,686 --> 00:04:24,957
22 MONTHS AND IN THE GREEN ARE 

111
00:04:24,957 --> 00:04:26,926
PERCENTAGE OF CHANGES AND IT'S 

112
00:04:26,926 --> 00:04:28,761
BEEN DRAMATIC BECAUSE WE'VE BEEN

113
00:04:28,761 --> 00:04:30,029
SEEING FOR YEAR AFTER YEAR 

114
00:04:30,029 --> 00:04:32,965
SEEING THE NUMBERS IN RED WITH 

115
00:04:32,965 --> 00:04:33,832
SIGNIFICANT INCREASES THE 

116
00:04:33,832 --> 00:04:36,035
HIGHEST WERE 30% DURING THE 

117
00:04:36,035 --> 00:04:38,804
FIRST YEAR OF THE COVID 

118
00:04:38,804 --> 00:04:39,138
PANDEMIC.

119
00:04:39,138 --> 00:04:41,840
BUT SO TO SEE A DECREASE IS 

120
00:04:41,840 --> 00:04:43,042
QUITE REMARKABLE BUT TO SEE THIS

121
00:04:43,042 --> 00:04:45,477
LEVEL OF DECREASE IS SO MUCH 

122
00:04:45,477 --> 00:04:46,078
MORE.

123
00:04:46,078 --> 00:04:47,580
SO WHAT WE'RE SEEING IN THE 

124
00:04:47,580 --> 00:04:52,718
COUNTRY IS A 25% REDUCTION IN 

125
00:04:52,718 --> 00:04:53,886
OVERDOSE MORTALITY OVER ALL.

126
00:04:53,886 --> 00:04:55,120
IF YOU LOOK AT THE DIFFERENT 

127
00:04:55,120 --> 00:04:56,322
COLUMNS IT TELLS YOU WHAT ARE 

128
00:04:56,322 --> 00:04:58,824
THE DRUGS THAT HAVE BEEN 

129
00:04:58,824 --> 00:05:01,126
ASSOCIATED WITH THAT REDUCTION 

130
00:05:01,126 --> 00:05:02,027
IN OVERDOSE DEATHS.

131
00:05:02,027 --> 00:05:04,797
AND I NEED TO YOU LOOK AT THE 

132
00:05:04,797 --> 00:05:07,433
ONE TO THE LEFT THE THIRD COLUMN

133
00:05:07,433 --> 00:05:08,734
TO THE RIGHT -- TO THE LEFT AT 

134
00:05:08,734 --> 00:05:11,570
THE END OF THE TABLE YOU SEE 

135
00:05:11,570 --> 00:05:15,407
SYNTHETIC OPIOIDS AND FENTANYL 

136
00:05:15,407 --> 00:05:17,910
AND 30% DECLINE.

137
00:05:17,910 --> 00:05:19,678
WHAT'S SO REMARKABLE ABOUT IT IS

138
00:05:19,678 --> 00:05:23,449
THE NUMBERS DO NOT APPEAR TO BE 

139
00:05:23,449 --> 00:05:26,418
JUST RANDOM NOISE AND WITH 

140
00:05:26,418 --> 00:05:29,455
VARIATIONS THEY HAVE BEEN QUITE 

141
00:05:29,455 --> 00:05:30,522
STABLE.

142
00:05:30,522 --> 00:05:34,059
AND IT'S NOTABLE FENTANYL HAS 

143
00:05:34,059 --> 00:05:36,395
BEEN THE MAIN DRIVER OF OVERDOSE

144
00:05:36,395 --> 00:05:37,129
DEATHS AND IT'S GOING DOWN 

145
00:05:37,129 --> 00:05:39,932
DRAMATICALLY.

146
00:05:39,932 --> 00:05:43,102
THERE CONTINUE TO BE SIGNIFICANT

147
00:05:43,102 --> 00:05:46,805
REDUCTIONS IN THE OTHER DRUGS 

148
00:05:46,805 --> 00:05:49,875
FROM OPIOID ANALGESICS AND 

149
00:05:49,875 --> 00:05:51,944
HEROIN AND IMPORTANTLY SEEING 

150
00:05:51,944 --> 00:05:54,680
REDUCTIONS IN OVERDOSE DEATHS 

151
00:05:54,680 --> 00:05:55,881
FROM COCAINE AND METHAMPHETAMINE

152
00:05:55,881 --> 00:05:58,183
WHICH HAVE RECENTLY STARTED TO 

153
00:05:58,183 --> 00:06:01,153
CONTRIBUTE TO THE RISES IN 

154
00:06:01,153 --> 00:06:11,330
OVERDOSES.

155
00:06:14,700 --> 00:06:18,837
MOST WITH COCAINE ARE ASSOCIATED

156
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WITH FENTANYL AND 75% THAT DIE 

157
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FROM COCAINE HAVE FENTANYL AND 

158
00:06:26,578 --> 00:06:32,885
MORE THAN 60% HAD FENTANYL ON 

159
00:06:32,885 --> 00:06:33,085
BOARD.

160
00:06:33,085 --> 00:06:36,021
THE NEXT SHOWS DATA.

161
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THIS IS IMPORTANT BECAUSE WE SEE

162
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THE REAL EFFECT IT'S NOT A 

163
00:06:47,066 --> 00:06:48,100
VARIATION.

164
00:06:48,100 --> 00:06:50,469
STARTING IN 2023, JULY, AUGUST 

165
00:06:50,469 --> 00:06:53,138
WE'RE STARTING TO SEE ALL THE 

166
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DRUGS IN GREEN AND DIVIDED INTO 

167
00:06:57,142 --> 00:06:57,676
OPIOI

168
00:06:57,676 --> 00:07:03,348
OPIOIDS AND YOU'RE COMBINING 

169
00:07:03,348 --> 00:07:05,718
COCAINE AND METHAMPHETAMINE.

170
00:07:05,718 --> 00:07:11,490
AND ONE OF THE THINGS I HAVE 

171
00:07:11,490 --> 00:07:19,965
BEEN VERY CURIOUS ABOUT AND I 

172
00:07:19,965 --> 00:07:20,632
HOPE YOU NOTICE THE COVID 

173
00:07:20,632 --> 00:07:22,968
PANDEMIC IS WHERE WE SEE THE 

174
00:07:22,968 --> 00:07:24,770
STEEP RISE AND CONTINUED TO RISE

175
00:07:24,770 --> 00:07:26,205
AND YOU SEE THAT BETWEEN 2019 

176
00:07:26,205 --> 00:07:28,507
AND 2020 AND THE HIGH INCREASE 

177
00:07:28,507 --> 00:07:28,974
IN OVERDOSE DEATHS.

178
00:07:28,974 --> 00:07:32,978
SO ONE OF THE QUESTIONS WE WANT 

179
00:07:32,978 --> 00:07:35,748
TO ANSWER IS THESE REDUCTION 

180
00:07:35,748 --> 00:07:39,585
JUST THE FACT WE NO LONGER HAVE 

181
00:07:39,585 --> 00:07:41,854
THE COVID PANDEMIC AND STRESSORS

182
00:07:41,854 --> 00:07:43,422
RESPONSIBLE FOR THE REDUCTION.

183
00:07:43,422 --> 00:07:46,692
THAT ONE IS GOING TO 2019 

184
00:07:46,692 --> 00:07:47,292
LEVELS.

185
00:07:47,292 --> 00:07:49,128
WHAT I CAN TELL YOU AND IF YOU 

186
00:07:49,128 --> 00:07:53,832
SEE THIS IS 2019 AND SO IF WE 

187
00:07:53,832 --> 00:07:56,268
MOVE THIS IN A HORIZONTAL LINE 

188
00:07:56,268 --> 00:07:57,536
ALL OVER AND PUSH IT HERE YOU 

189
00:07:57,536 --> 00:08:04,610
CAN SEE -- I CANNOT HAVE THE 

190
00:08:04,610 --> 00:08:06,245
CURSER ON MY COMPUTER BUT SEEING

191
00:08:06,245 --> 00:08:07,412
THE VALUES OF OVERDOSE DEATHS 

192
00:08:07,412 --> 00:08:09,581
ARE LOWER THAN WE HAD IN 2019 CH

193
00:08:09,581 --> 00:08:12,451
IS THE YEAR BEFORE THE COVID 

194
00:08:12,451 --> 00:08:14,486
PANDEMIC INDICATING THESE 

195
00:08:14,486 --> 00:08:16,321
REDUCTIONS ARE NOT JUST A RESULT

196
00:08:16,321 --> 00:08:20,025
OF THE RESOLUTION OF ALL THE 

197
00:08:20,025 --> 00:08:20,926
ADVERSE CIRCUMSTANCES LINKED 

198
00:08:20,926 --> 00:08:21,693
WITH THE PANDEMIC.

199
00:08:21,693 --> 00:08:29,234
BUT UNDERLINE OTHER FACTORS.

200
00:08:29,234 --> 00:08:31,570
OBVIOUSLY IT'S VERY IMPORTANT 

201
00:08:31,570 --> 00:08:34,406
FROM THE FACET OF SCIENCE TO 

202
00:08:34,406 --> 00:08:35,674
UNDERSTAND THE FACTORS DRIVING 

203
00:08:35,674 --> 00:08:37,543
THE DECLINE IN OVERDOSE DEATHS.

204
00:08:37,543 --> 00:08:45,150
I WOULD SAY THERE'S NOT ONE 

205
00:08:45,150 --> 00:08:45,584
SIN

206
00:08:45,584 --> 00:08:45,918
SINGLE FACTOR.

207
00:08:45,918 --> 00:08:48,754
THERE'S MULTIPLE FACTORS 

208
00:08:48,754 --> 00:08:49,621
INCLUDING THE FACT THE MOST 

209
00:08:49,621 --> 00:08:56,261
VULNERABLE PEOPLE MAY HAVE DIED.

210
00:08:56,261 --> 00:08:58,397
IMPORTANTLY THERE MAY BE A SHIFT

211
00:08:58,397 --> 00:09:00,966
IN FENTANYL THAT GETS INTO OUR 

212
00:09:00,966 --> 00:09:05,137
COUNTRY ALSO OTHER INTERVENTION 

213
00:09:05,137 --> 00:09:08,574
S ACCELERATED WITH RESOURCES AND

214
00:09:08,574 --> 00:09:10,976
THE RESEARCH PROJECT PROGRAMS WE

215
00:09:10,976 --> 00:09:14,379
GOT FROM HEAL THAT HAVE MADE 

216
00:09:14,379 --> 00:09:16,215
THIS POSSIBLE.

217
00:09:16,215 --> 00:09:19,117
WHAT ARE THERE?

218
00:09:19,117 --> 00:09:25,123
THE FIRST ONE IS THE RESEARCH 

219
00:09:25,123 --> 00:09:26,558
PROGRAMS WE'VE BEEN ABLE BECAUSE

220
00:09:26,558 --> 00:09:27,726
BECAUSE OF HEAL RESOURCES.

221
00:09:27,726 --> 00:09:31,196
IT WAS CLEAR THAT WE HAVE 

222
00:09:31,196 --> 00:09:33,198
MEDICATION ARE VERY EFFECTIVE 

223
00:09:33,198 --> 00:09:34,800
FOR TREATMENT OF OPIOID USE 

224
00:09:34,800 --> 00:09:36,301
DISORDER AND IF PEOPLE ARE ON 

225
00:09:36,301 --> 00:09:38,303
THE MEDICATIONS THE RISK OF 

226
00:09:38,303 --> 00:09:39,571
OVERDOSE IS DRAMATICALLY 

227
00:09:39,571 --> 00:09:42,274
REDUCED.

228
00:09:42,274 --> 00:09:46,812
AND WE HAVE NALOXONE ANTAGONIST 

229
00:09:46,812 --> 00:09:48,947
VERY EFFECTIVE IN REVERSING AN 

230
00:09:48,947 --> 00:09:49,214
OVERDOSE.

231
00:09:49,214 --> 00:09:52,885
FOR THESE MEDICATIONS FOR OPIOID

232
00:09:52,885 --> 00:09:56,688
USE DISORDER TO PREVENT 

233
00:09:56,688 --> 00:09:57,923
OVERDOSES IT HAS TO BE MADE 

234
00:09:57,923 --> 00:09:58,957
AVAILABLE AND ACCESSIBLE.

235
00:09:58,957 --> 00:10:01,927
IT WAS VERY CLEAR IN 2018 WHEN 

236
00:10:01,927 --> 00:10:08,033
WE GOT THE DOLLARS FOR THE HEAL 

237
00:10:08,033 --> 00:10:10,535
INITIATIVE THE MEDICATION WAS 

238
00:10:10,535 --> 00:10:12,204
VASTLY UNDER UTILIZED WHETHER 

239
00:10:12,204 --> 00:10:13,872
OVERDOSE PREVENTION OR 

240
00:10:13,872 --> 00:10:14,473
MEDICATION.

241
00:10:14,473 --> 00:10:15,374
TAKING ADVANTAGE OF KNOWLEDGE 

242
00:10:15,374 --> 00:10:18,543
GAINED THROUGH THE YEARS OF 

243
00:10:18,543 --> 00:10:26,718
RESEARCH IN EPIDEMIOLOGY IT 

244
00:10:26,718 --> 00:10:27,753
BECOMES CLEAR THERE'S NOT 

245
00:10:27,753 --> 00:10:28,387
SUFFICIENT PROGRAMS IN THE 

246
00:10:28,387 --> 00:10:28,987
UNITED STATES TO PROVIDE AND 

247
00:10:28,987 --> 00:10:29,454
EXPAND THE USE OF THE 

248
00:10:29,454 --> 00:10:34,960
TREATMENTS.

249
00:10:34,960 --> 00:10:36,395
AND THERE'S A HEALTH CARE 

250
00:10:36,395 --> 00:10:38,363
INFRASTRUCTURE THAT COULD BE 

251
00:10:38,363 --> 00:10:40,899
UTILIZED IF APPLIED TOWARDS THE 

252
00:10:40,899 --> 00:10:41,900
SCREENING AND TREATMENT FOR 

253
00:10:41,900 --> 00:10:43,468
PEOPLE WITH OPIOID USE DISORDER.

254
00:10:43,468 --> 00:10:45,137
WE RESTRUCTURED THE CHEMICAL 

255
00:10:45,137 --> 00:10:47,172
TRIAL NETWORKS TO TRY TO 

256
00:10:47,172 --> 00:10:49,141
MAXIMIZE THE DEVELOPMENT OF 

257
00:10:49,141 --> 00:10:51,576
MODELS THAT WILL ENABLE US TO 

258
00:10:51,576 --> 00:10:53,078
BRING THE TREATMENT THE 

259
00:10:53,078 --> 00:10:54,880
RECOGNITION AND TREATMENT AND 

260
00:10:54,880 --> 00:10:57,149
THE FOLLOW-UP OF PEOPLE WITH AN 

261
00:10:57,149 --> 00:10:58,984
OPIOID USE DISORDER IN HEALTH 

262
00:10:58,984 --> 00:11:00,185
CARE SYSTEMS.

263
00:11:00,185 --> 00:11:01,119
AND MULTIPLE MODELS AND I'LL 

264
00:11:01,119 --> 00:11:09,962
HIGHLIGHT ONE OF THEM.

265
00:11:09,962 --> 00:11:12,564
WE RECOGNIZED BASED ON DATA THAT

266
00:11:12,564 --> 00:11:14,366
PUBLISHED AT LEAST 25% OF THE 

267
00:11:14,366 --> 00:11:16,401
PEOPLE THAT HAVE DIED FROM AN 

268
00:11:16,401 --> 00:11:18,103
OVERDOSE HAD IN THE PAST 12 

269
00:11:18,103 --> 00:11:19,604
MONTHS HAD A CONTACT WITH 

270
00:11:19,604 --> 00:11:20,005
JUSTICE SETTINGS.

271
00:11:20,005 --> 00:11:23,041
25% OF THEM.

272
00:11:23,041 --> 00:11:26,578
IMPLICATING JUST WITH THE HEALTH

273
00:11:26,578 --> 00:11:27,446
CARE SYSTEM BETWEEN EMERGENCY 

274
00:11:27,446 --> 00:11:31,950
DEPARTMENTS PREDOMINANTLY OR 

275
00:11:31,950 --> 00:11:34,052
EMERGENCY SERVICES CLOSE TO 60% 

276
00:11:34,052 --> 00:11:37,122
TO 65% OF PEOPLE HAD CONTACT 12 

277
00:11:37,122 --> 00:11:38,323
MONTHS BEFORE THEY DIED.

278
00:11:38,323 --> 00:11:39,124
HIGHLIGHTING THE MISSED 

279
00:11:39,124 --> 00:11:42,461
OPPORTUNITY WE HAD BY NOT HAVING

280
00:11:42,461 --> 00:11:44,029
CREATED A SYSTEM THAT ALLOWS TO 

281
00:11:44,029 --> 00:11:47,299
DO THE SCREENING AND 

282
00:11:47,299 --> 00:11:51,970
INTERVENTION IN THOSE PEOPLE.

283
00:11:51,970 --> 00:11:54,006
IMPLEMENTATION MODELS TO BRING 

284
00:11:54,006 --> 00:11:55,240
THESE INTO THE HEALTH CARE 

285
00:11:55,240 --> 00:11:58,443
SETTING AND THE JUSTICE SETTING 

286
00:11:58,443 --> 00:11:59,378
AND THAT'S WHAT THE J COM 

287
00:11:59,378 --> 00:12:01,580
PROGRAM IS ALL ABOUT.

288
00:12:01,580 --> 00:12:03,582
FINALLY, IT WAS CLEAR THE LOCAL 

289
00:12:03,582 --> 00:12:06,485
SOLUTION BROUGHT UP BY COMMUNITY

290
00:12:06,485 --> 00:12:10,489
S ALSO WERE AN IMPORTANT WAY TO 

291
00:12:10,489 --> 00:12:13,458
PROVIDE TREATMENT ON INDIVIDUALS

292
00:12:13,458 --> 00:12:15,594
THAT OTHERWISE WOULD NOT GET 

293
00:12:15,594 --> 00:12:16,928
TOUCHED THROUGH THE HEALTH CARE 

294
00:12:16,928 --> 00:12:20,265
SYSTEM OR SETTING AND EVEN IF 

295
00:12:20,265 --> 00:12:23,702
THEY WERE ACCESSING THE OTHER 

296
00:12:23,702 --> 00:12:25,570
SYSTEMS THEY WOULD BE 

297
00:12:25,570 --> 00:12:26,671
DISCONNECTED ONCE THEY GOT IN 

298
00:12:26,671 --> 00:12:27,572
THE COMMUNITY.

299
00:12:27,572 --> 00:12:29,408
WE PRIORITIZED INTERVENTIONS 

300
00:12:29,408 --> 00:12:33,145
HEALTH CARE, JUSTICE AND 

301
00:12:33,145 --> 00:12:33,445
COMMUNITY.

302
00:12:33,445 --> 00:12:37,983
SO TODAY I'M GOING TO HIGHLIGHT 

303
00:12:37,983 --> 00:12:40,652
WHERE WE ARE WITH RESPECT TO 

304
00:12:40,652 --> 00:12:45,123
INVESTMENTS WE HAVE DONE IN 

305
00:12:45,123 --> 00:12:47,325
BRINGING SCREENING INTO A HEALTH

306
00:12:47,325 --> 00:12:57,536
CARE SYSTEM.

307
00:13:10,549 --> 00:13:13,919
WHEN THEY HAVE BUPRENORPHINE 

308
00:13:13,919 --> 00:13:15,353
DIRECTLY THEY HAVE BETTER 

309
00:13:15,353 --> 00:13:16,922
TREATMENT AND OVER ALL OUTCOMES.

310
00:13:16,922 --> 00:13:18,857
THIS IS DIFFERENT FROM WHAT WAS 

311
00:13:18,857 --> 00:13:19,825
TYPICALLY FELT WAS NOT SOMETHING

312
00:13:19,825 --> 00:13:21,193
THAT COULD BE DONE IN THE 

313
00:13:21,193 --> 00:13:31,570
EMERGENCY DEPARTMENT.

314
00:13:32,270 --> 00:13:33,138
THEY'VE TRIED TO DOCUMENT THE 

315
00:13:33,138 --> 00:13:37,809
SAFETY OF THE INTERVENTIONS AND 

316
00:13:37,809 --> 00:13:39,077
RESOURCES NECESSARY TO BE ABLE 

317
00:13:39,077 --> 00:13:41,113
TO DO SO AND FOLLOW-UP OF COURSE

318
00:13:41,113 --> 00:13:51,356
WITH PATIENTS.

319
00:13:53,024 --> 00:13:55,494
AND HAVE A NETWORK TO BRING 

320
00:13:55,494 --> 00:13:58,663
ACROSS THE STATES THIS MODEL FOR

321
00:13:58,663 --> 00:14:02,634
THE BUPRENORPHINE IN THE 

322
00:14:02,634 --> 00:14:03,702
EMERGENCY ROOM DEPARTMENT AND 

323
00:14:03,702 --> 00:14:07,639
EVALUATE THE AFFECTS OF HIGHER 

324
00:14:07,639 --> 00:14:12,611
DOSES EXTEND ED AND RECENTLY A 

325
00:14:12,611 --> 00:14:18,049
PAPER CAME UP WITH THE RESULTS 

326
00:14:18,049 --> 00:14:20,018
OF A MODEL IMPLEMENTED IN 

327
00:14:20,018 --> 00:14:25,123
PARTNERSHIP WITH THE CTN AND THE

328
00:14:25,123 --> 00:14:27,726
STATE THAT ACTUALLY SHOWS HOW 

329
00:14:27,726 --> 00:14:31,997
MANY NEW CASES DEAL WITH OPIOID 

330
00:14:31,997 --> 00:14:37,135
USE DISORDER WEREN'T PRESCRIBED 

331
00:14:37,135 --> 00:14:42,307
AND HOW MANY AND HOW MANY 

332
00:14:42,307 --> 00:14:45,143
INCREASED DURING THAT TIME 

333
00:14:45,143 --> 00:14:51,349
PERIOD.

334
00:14:51,349 --> 00:14:57,756
HOW HAVE BEEN ABLE TO IMPLEMENT 

335
00:14:57,756 --> 00:15:00,158
THIS IN EMERGENCY ROOM 

336
00:15:00,158 --> 00:15:03,662
DEPARTMENTS AND BUPRENORPHINE AT

337
00:15:03,662 --> 00:15:05,130
THE EMERGENCY ROOM DEPARTMENT 

338
00:15:05,130 --> 00:15:11,002
AND TENFOLD INCREASE IN 

339
00:15:11,002 --> 00:15:13,572
PROVIDERS GIVING BUPRENORPHINE.

340
00:15:13,572 --> 00:15:14,906
I HIGHLIGHT THIS EXAMPLE BECAUSE

341
00:15:14,906 --> 00:15:17,142
WE'RE ABLE TO CHANGE A CULTURE 

342
00:15:17,142 --> 00:15:27,686
AND THE WAY THINGS ARE DONE AND 

343
00:15:36,962 --> 00:15:37,796
THREES A SEPARATE TREATMENT 

344
00:15:37,796 --> 00:15:39,164
SYSTEM IN OUR COUNTRY TO ADDRESS

345
00:15:39,164 --> 00:15:42,667
THE NEEDS AND IT'S A MISSED 

346
00:15:42,667 --> 00:15:47,172
OPPORTUNITY.

347
00:15:47,172 --> 00:15:49,140
IT SHOWS HOW CRUCIAL THIS IS IN 

348
00:15:49,140 --> 00:15:58,149
MODIFYING PRACTICES.

349
00:15:58,149 --> 00:16:00,719
AND FOUR PROJECTS AT THE 

350
00:16:00,719 --> 00:16:04,022
CLINICAL TRIAL NETWORK IN 

351
00:16:04,022 --> 00:16:07,025
PARTNERSHIP WITH THE HEALTH CARE

352
00:16:07,025 --> 00:16:07,392
SYSTEM.

353
00:16:07,392 --> 00:16:08,593
ONE IS AN EMERGENCY DEPARTMENT 

354
00:16:08,593 --> 00:16:12,063
AND THE OTHERS ARE DONE IN 

355
00:16:12,063 --> 00:16:18,470
PRIMARY CARE AND IN TREATMENT 

356
00:16:18,470 --> 00:16:22,474
CENTERS THAT RELATE TO MOTHER 

357
00:16:22,474 --> 00:16:22,841
WELL BEING.

358
00:16:22,841 --> 00:16:25,143
THESE ARE PROJECTS THAT HAVE 

359
00:16:25,143 --> 00:16:29,114
BEEN COMPLETED AND I HOPE I'VE 

360
00:16:29,114 --> 00:16:32,617
BEEN ABLE TO PRESENT IN THE NEXT

361
00:16:32,617 --> 00:16:33,184
MULTI-DISCIPLINARY GROUP AN 

362
00:16:33,184 --> 00:16:34,786
UPDATE ON THE RESULTS.

363
00:16:34,786 --> 00:16:37,922
THE ONE IS THE TREATMENT OF 

364
00:16:37,922 --> 00:16:40,892
WOMEN WITH AN OPIOID USE 

365
00:16:40,892 --> 00:16:45,764
DISORDER WITH EXTENDED RELEASE 

366
00:16:45,764 --> 00:16:47,365
BUPRENORPHINE PROVIDING MANY S 

367
00:16:47,365 --> 00:16:50,368
AND IN GENERAL S BETTER OUTCOMES

368
00:16:50,368 --> 00:16:55,674
AND WHAT HAS NOT BEEN TESTED EN 

369
00:16:55,674 --> 00:16:56,841
MOTHERS AND PREGNANT WOMEN.

370
00:16:56,841 --> 00:17:01,146
THE SECOND IS A MODEL THAT HAS 

371
00:17:01,146 --> 00:17:03,148
FINISHED EVALUATING AND 

372
00:17:03,148 --> 00:17:03,782
INITIATING BUPRENORPHINE WITH 

373
00:17:03,782 --> 00:17:06,785
HIGH DOSES IN THE EMERGENCY ROOM

374
00:17:06,785 --> 00:17:07,218
DEPARTMENT.

375
00:17:07,218 --> 00:17:10,355
AN AREA THAT'S GENERATED CONCERN

376
00:17:10,355 --> 00:17:12,857
WITH THE CONCERN OF FENTANYL IF 

377
00:17:12,857 --> 00:17:14,259
YOU GIVE A HIGH DOSE YOU CAN 

378
00:17:14,259 --> 00:17:16,628
TRIGGER A WITHDRAWAL.

379
00:17:16,628 --> 00:17:18,697
THE TRIAL EVALUATES HOW TO DO IT

380
00:17:18,697 --> 00:17:20,865
AND DOCUMENTS SAFETY.

381
00:17:20,865 --> 00:17:22,467
AGAIN THE RESULTS WILL BE COMING

382
00:17:22,467 --> 00:17:25,337
UP HOPEFULLY SOON.

383
00:17:25,337 --> 00:17:27,739
ANOTHER IMPORTANT TRIAL THE 

384
00:17:27,739 --> 00:17:29,607
THRESHOLD OPIOID USE DISORDER 

385
00:17:29,607 --> 00:17:32,143
TRIAL IS CRUCIAL.

386
00:17:32,143 --> 00:17:33,645
WHILE WE'VE DONE A LOT OF 

387
00:17:33,645 --> 00:17:37,082
RESEARCH HOW TO TREAT MODERATE 

388
00:17:37,082 --> 00:17:39,150
TO SEVERE OPIOID USE DISORDER 

389
00:17:39,150 --> 00:17:41,786
WHERE WE GIVE MEDICATIONS LIKE 

390
00:17:41,786 --> 00:17:42,420
BUPRENORPHINE IS NOT NECESSARILY

391
00:17:42,420 --> 00:17:45,056
THE CASE WHERE YOU HAVE SOMEONE 

392
00:17:45,056 --> 00:17:46,791
SCREENING FOR A MILD OPIOID USE 

393
00:17:46,791 --> 00:17:50,261
DISORDER WHERE THE MEDICATIONS 

394
00:17:50,261 --> 00:17:51,996
MAY NOT NECESSARILY BE 

395
00:17:51,996 --> 00:17:53,064
INDICATED.

396
00:17:53,064 --> 00:17:55,367
THE QUESTION ARE WHAT ARE THE 

397
00:17:55,367 --> 00:17:56,501
ISSUES THAT NEED TO BE ADDRESSED

398
00:17:56,501 --> 00:17:57,902
AND HOW DO YOU SUPPORT THE 

399
00:17:57,902 --> 00:18:00,505
INDIVIDUAL SO THEY DON'T 

400
00:18:00,505 --> 00:18:03,842
ESCALATE TO THE MODERATE TO 

401
00:18:03,842 --> 00:18:06,811
SEVERE OPIOID USE DISORDER.

402
00:18:06,811 --> 00:18:09,814
AND FINALLY A PROJECT DONE IN 

403
00:18:09,814 --> 00:18:10,915
THE EMERGENCY ROOM DEPARTMENT 

404
00:18:10,915 --> 00:18:13,818
BUT TAKES ADVANTAGE OF A PEER 

405
00:18:13,818 --> 00:18:15,920
RECOVERY INTERVENTION TO ENSURE 

406
00:18:15,920 --> 00:18:19,057
PATIENTS THAT END UP IN THE 

407
00:18:19,057 --> 00:18:19,991
EMERGENCY ROOM DEPARTMENT ARE 

408
00:18:19,991 --> 00:18:25,130
LIKELY TO STAY IN TREATMENT.

409
00:18:25,130 --> 00:18:29,901
AGAIN, THE INVESTIGATORS ARE 

410
00:18:29,901 --> 00:18:31,536
DOING ANALYSIS AND HOPE YOU CAN 

411
00:18:31,536 --> 00:18:32,003
UPDATE YOU SOON.

412
00:18:32,003 --> 00:18:33,371
IN THE NEXT SLIDE I WANT TO MAKE

413
00:18:33,371 --> 00:18:37,142
YOU AWARE OF THE FOUR PROJECTS 

414
00:18:37,142 --> 00:18:39,677
WE'RE PLANNING TO LAUNCH THROUGH

415
00:18:39,677 --> 00:18:41,179
THE CLINICAL TRIAL NETWORKS THAT

416
00:18:41,179 --> 00:18:45,116
RELATE TO ADDRESSING THE URGENT 

417
00:18:45,116 --> 00:18:46,184
NEEDS THAT ARE STILL THERE.

418
00:18:46,184 --> 00:18:49,821
ONE OF THEM IS POPULATIONS AT 

419
00:18:49,821 --> 00:18:51,823
HIGHER RISK WHERE IT'S HARDER 

420
00:18:51,823 --> 00:18:53,858
FOR PEOPLE TO ACCESS TREATMENT.

421
00:18:53,858 --> 00:18:56,361
THAT IS THE INTERVENTION.

422
00:18:56,361 --> 00:18:58,863
ONE OF THE PROJECTS AIMS AT 

423
00:18:58,863 --> 00:19:01,466
EXPANSION OF MEDICATIONS FOR 

424
00:19:01,466 --> 00:19:03,835
OPIOID USE DISORDER AND HERE 

425
00:19:03,835 --> 00:19:04,602
AGAIN THERE'S TREMENDOUS 

426
00:19:04,602 --> 00:19:07,238
ADVANTAGE OF HAVING ACCESS TO 

427
00:19:07,238 --> 00:19:09,140
EXTENDED RELEASE BUPRENORPHINE 

428
00:19:09,140 --> 00:19:18,983
BUT IT HAS NOT BEEN EVALUATED.

429
00:19:18,983 --> 00:19:20,218
THE SECOND IS AN INTERVENTION IN

430
00:19:20,218 --> 00:19:20,819
THE PRIMARY CARE SETTING DECH 

431
00:19:20,819 --> 00:19:27,358
DEF -- CARE SETTING AND IN MANY 

432
00:19:27,358 --> 00:19:29,127
DAYS ACCESSIBLE AND OPPORTUNITY 

433
00:19:29,127 --> 00:19:33,131
TO DETECT AND SCREEN AND DO 

434
00:19:33,131 --> 00:19:34,799
PREVENTION INTERVENTION THAT HAS

435
00:19:34,799 --> 00:19:39,037
BEEN SHOWN CAN ACTUALLY BE VERY 

436
00:19:39,037 --> 00:19:39,337
INFLUENTIAL.

437
00:19:39,337 --> 00:19:40,605
IN THIS CASE, THE TRIAL IS GOING

438
00:19:40,605 --> 00:19:43,875
TO BE TARGETING PARTICULARLY 

439
00:19:43,875 --> 00:19:47,045
INDIVIDUALS AT VERY HIGH RISK OF

440
00:19:47,045 --> 00:19:47,312
OVERDOSES.

441
00:19:47,312 --> 00:19:49,814
THOSE ARE PEOPLE WHILE THEY MAY 

442
00:19:49,814 --> 00:19:52,617
NOT HAVE AN OPIOID USE DISORDER 

443
00:19:52,617 --> 00:19:55,787
AND MISUSING OPIOIDS BUT ALSO 

444
00:19:55,787 --> 00:19:57,822
MISUSING OTHER SUBSTANCES.

445
00:19:57,822 --> 00:20:01,926
PEOPLE WHO TEND TO COMBINE 

446
00:20:01,926 --> 00:20:08,967
ALCOHOL AND DIAZEPINES AND OTHER

447
00:20:08,967 --> 00:20:11,069
WITH ALCOHOL VERSUS SOMEONE ONLY

448
00:20:11,069 --> 00:20:11,803
USING OPIOIDS.

449
00:20:11,803 --> 00:20:14,539
THE THIRD IS THE ONE THAT IS 

450
00:20:14,539 --> 00:20:25,083
GOING TO TAKE THE BUPRENOROHINE 

451
00:20:34,692 --> 00:20:35,994
AND THE RATE OF WITHDRAWAL 

452
00:20:35,994 --> 00:20:37,128
SYSTEMS IN THE PATIENTS WITH 

453
00:20:37,128 --> 00:20:40,732
HIGH DOSES IS NOT VERY DIFFERENT

454
00:20:40,732 --> 00:20:44,435
FROM THOSE INITIATED WITH LOW 

455
00:20:44,435 --> 00:20:54,846
DOSES OF BUPRENORPHINE.

456
00:20:56,648 --> 00:21:07,125
AND THE OTHER IS LOOKING AT AN 

457
00:21:09,093 --> 00:21:10,962
ADOLESCENT TO BE AT RISK TO 

458
00:21:10,962 --> 00:21:12,864
OPIOID USE DISORDER AND WE DON'T

459
00:21:12,864 --> 00:21:15,900
KNOW HOW A CLINICIAN TO TREAT 

460
00:21:15,900 --> 00:21:18,670
SOMEONE WITH ACUTE SEVERE PAIN 

461
00:21:18,670 --> 00:21:21,072
IN ADOLESCENCE WHO ARE AT HIGHER

462
00:21:21,072 --> 00:21:24,576
RISK OF ADDICTION THAN ADULTS 

463
00:21:24,576 --> 00:21:24,742
ARE.

464
00:21:24,742 --> 00:21:35,453
THESE ARE THE FOUR NEW PROJECT  

465
00:21:41,159 --> 00:21:42,760
AND WE HAVE PROGRAMS AND 

466
00:21:42,760 --> 00:21:45,897
EXPANDING THEIR SUCCESS AND ONE 

467
00:21:45,897 --> 00:21:48,800
OF THE MOST CONSEQUENTIAL FACTOR

468
00:21:48,800 --> 00:21:51,002
TO REDUCTION IN OVERDOSE DEATHS 

469
00:21:51,002 --> 00:21:52,837
BUT IT'S CLEAR WE STILL HAVE 

470
00:21:52,837 --> 00:21:53,338
MAJOR CHALLENGES.

471
00:21:53,338 --> 00:21:56,474
NUMBER ONE, MANY OF THE 

472
00:21:56,474 --> 00:21:57,875
OVERDOSES HAPPENING AND MANY OF 

473
00:21:57,875 --> 00:22:00,778
THE FATAL OVERDOSES HAVE 

474
00:22:00,778 --> 00:22:02,780
MULTIPLE SUBSTANCES AND THAT MAY

475
00:22:02,780 --> 00:22:05,550
BE ONE OF THE REASONS THE PERSON

476
00:22:05,550 --> 00:22:08,586
COULD NOT BE RESUSCITATED.

477
00:22:08,586 --> 00:22:11,623
WHILE NALOXONE IS EFFECTIVE FOR 

478
00:22:11,623 --> 00:22:12,824
A PURELY OPIOID OVERDOSE IT'S 

479
00:22:12,824 --> 00:22:15,627
NOT THE CASE WHEN YOU HAVE THE 

480
00:22:15,627 --> 00:22:17,128
COMBINATION OF ALCOHOL OR BENZOS

481
00:22:17,128 --> 00:22:20,298
OR STIMULANTS AND NEED 

482
00:22:20,298 --> 00:22:21,599
ALTERNATIVE INTERVENTIONS FOR 

483
00:22:21,599 --> 00:22:22,767
OVERDOSES DUE TO POLY 

484
00:22:22,767 --> 00:22:25,136
SUBSTANCES.

485
00:22:25,136 --> 00:22:35,513
THAT IS A MAJOR NEED.

486
00:22:37,181 --> 00:22:38,616
WE'RE SEEING A SIGNIFICANT RISE 

487
00:22:38,616 --> 00:22:44,689
IN SUBSTANCES WITH COCAINE AND 

488
00:22:44,689 --> 00:22:48,826
FENTANYL AND THOSE WITH A 

489
00:22:48,826 --> 00:22:50,161
COCAINE OR METHAMPHETAMINE USE 

490
00:22:50,161 --> 00:22:54,666
DISORDER THEY MAY HAVE CONSUMED 

491
00:22:54,666 --> 00:22:56,200
UNBEKNOWNSTED TO THEM CONSUMED 

492
00:22:56,200 --> 00:22:58,202
FENTANYL AND PUTS THEM AT HIGHER

493
00:22:58,202 --> 00:22:59,937
RISK OF OVERDOSING BECAUSE THEY 

494
00:22:59,937 --> 00:23:01,305
DON'T HAVE TOLERANCE.

495
00:23:01,305 --> 00:23:05,176
AND WE DON'T HAVE ANY MEDICATION

496
00:23:05,176 --> 00:23:07,045
APPROVED FOR THE OVERDOSE OF 

497
00:23:07,045 --> 00:23:08,112
STIMULANT USE DISORDER.

498
00:23:08,112 --> 00:23:10,415
THIS IS A TREMENDOUS GAP NEED 

499
00:23:10,415 --> 00:23:11,049
AREA.

500
00:23:11,049 --> 00:23:12,216
WE'RE PRIORITIZING IT IN TERMS 

501
00:23:12,216 --> 00:23:17,288
OF WHETHER IT'S MEDICATIONS OR 

502
00:23:17,288 --> 00:23:18,256
BIOLOG

503
00:23:18,256 --> 00:23:21,192
BIOLOGICALS OR BEHAVIORAL 

504
00:23:21,192 --> 00:23:23,194
INTERVENTIONS.

505
00:23:23,194 --> 00:23:25,129
AND IN TERMS OF WHERE THE 

506
00:23:25,129 --> 00:23:27,532
SCIENCE IS LEADING US, 

507
00:23:27,532 --> 00:23:29,133
INTERVENTIONS NOT SPECIFIC FOR 

508
00:23:29,133 --> 00:23:31,736
ONE ADDITION LIKE OPIOIDS AND 

509
00:23:31,736 --> 00:23:33,671
METHADONE SPECIFIC OR OPIOID USE

510
00:23:33,671 --> 00:23:38,476
DISORDER BUT THE TARGET COMMON 

511
00:23:38,476 --> 00:23:40,578
MOLECULAR PROCESSES THAT I 

512
00:23:40,578 --> 00:23:42,447
ENGAGE WITH MULTIPLE ADDICTIONS.

513
00:23:42,447 --> 00:23:49,120
SUCH THAT YOU CAN THEN USE THEM 

514
00:23:49,120 --> 00:23:51,489
TO TREAT POLYSUBSTANCE USE 

515
00:23:51,489 --> 00:23:54,258
DISORDER THAN SUBSTANCES 

516
00:23:54,258 --> 00:23:54,525
ISOLATED.

517
00:23:54,525 --> 00:23:56,027
THOSE ARE THE LARGE CLUSTER 

518
00:23:56,027 --> 00:23:57,662
AREAS WE'RE PUSHING IN 

519
00:23:57,662 --> 00:23:57,962
DEVELOPMENT.

520
00:23:57,962 --> 00:24:01,132
LET ME GIVE AN EXAMPLE FOR AN 

521
00:24:01,132 --> 00:24:04,535
OVERDOSE WHERE ARE WE?

522
00:24:04,535 --> 00:24:07,438
NEXT SLIDE SHOWS TWO STRATEGIES 

523
00:24:07,438 --> 00:24:11,042
WE'RE USING FOR ADDRESSING 

524
00:24:11,042 --> 00:24:14,445
REVERSAL OF OVERDOSES WITH 

525
00:24:14,445 --> 00:24:20,585
FENTANYL OR AMPHETAMINE AND ONE 

526
00:24:20,585 --> 00:24:24,155
IS A MONOCLONAL ANTIBODY WITH 

527
00:24:24,155 --> 00:24:24,589
STRONG AFFINITY.

528
00:24:24,589 --> 00:24:26,691
IT BINDS TO FENTANYL IN THE 

529
00:24:26,691 --> 00:24:28,760
BLOOD SEQUESTERING IT SO IT 

530
00:24:28,760 --> 00:24:31,796
CANNOT GET IN THE BRAIN OR INTO 

531
00:24:31,796 --> 00:24:32,997
OTHER ORGANS.

532
00:24:32,997 --> 00:24:34,532
IT RESTRICTED THE PHARMACOLOGIC 

533
00:24:34,532 --> 00:24:36,400
AFFECT OF THE AGENT.

534
00:24:36,400 --> 00:24:38,770
THE OTHER BEAUTY ABOUT THESE 

535
00:24:38,770 --> 00:24:41,139
MONOCLONAL ANTIBODY IS THE 

536
00:24:41,139 --> 00:24:44,509
PROTECTION LASTS AT LEAST FROM 

537
00:24:44,509 --> 00:24:47,645
DATA ON NON HUMAN PRIMATES 

538
00:24:47,645 --> 00:24:49,113
APPROXIMATELY FOUR WEEKS.

539
00:24:49,113 --> 00:24:58,623
THEY'RE ON PHASE TWO OF THE 

540
00:24:58,623 --> 00:25:01,526
PHASE II CLINICAL STUDY AND ONE 

541
00:25:01,526 --> 00:25:04,562
TRAPS THE DRUG IN THE 

542
00:25:04,562 --> 00:25:08,032
BLOODSTREAM AND A SEQUESTRATION 

543
00:25:08,032 --> 00:25:10,301
DRUG THAT BIND AT HIGH AFFINITY 

544
00:25:10,301 --> 00:25:13,137
AND BY BINDING IT INTERFERES 

545
00:25:13,137 --> 00:25:16,174
WITH IT BEING DELIVERED INTO THE

546
00:25:16,174 --> 00:25:16,607
BRAIN.

547
00:25:16,607 --> 00:25:18,843
THEY STARTED THEIR PHASE II 

548
00:25:18,843 --> 00:25:21,345
CLINICAL TRIALS LAST WEEK.

549
00:25:21,345 --> 00:25:25,116
SO HOPEFULLY BOTH ARE VERY 

550
00:25:25,116 --> 00:25:28,553
DIFFERENT IN TERMS OF MET

551
00:25:28,553 --> 00:25:33,124
METHODOMET

552
00:25:33,124 --> 00:25:34,525
METHODOLOGIES BUT GIVE TREATMENT

553
00:25:34,525 --> 00:25:38,396
TO REVERSE WITH FENTANYL OR 

554
00:25:38,396 --> 00:25:40,698
OVERDOSES WITH DRUG 

555
00:25:40,698 --> 00:25:41,032
COMBINATIONS.

556
00:25:41,032 --> 00:25:43,234
THE PLATFORM HAS THE FLEXIBILITY

557
00:25:43,234 --> 00:25:45,169
AND OPPORTUNITY TO THEN ADAPT TO

558
00:25:45,169 --> 00:25:47,171
OTHER DRUGS THAT MAY BE EMERGING

559
00:25:47,171 --> 00:25:49,140
AS WE HAVE SEEN IN THE PAST FEW 

560
00:25:49,140 --> 00:25:54,545
YEARS.

561
00:25:54,545 --> 00:25:56,347
THE SECOND EXAMPLE IS THE ONE OF

562
00:25:56,347 --> 00:25:58,950
TARGETING INTERVENTIONS THAT ARE

563
00:25:58,950 --> 00:26:07,725
NOT ONE SPECIFIC ADDICTION BUT 

564
00:26:07,725 --> 00:26:09,527
COULD BE VALUABLE AND TAKING 

565
00:26:09,527 --> 00:26:15,900
ADVANTAGE OF AVAILABILITY OF 

566
00:26:15,900 --> 00:26:16,534
MEDICA

567
00:26:16,534 --> 00:26:20,271
MEDICATIONS THAT ARE A RECEPTOR 

568
00:26:20,271 --> 00:26:24,041
1 AGONIST USED FOR OBESITY OR 

569
00:26:24,041 --> 00:26:25,109
DIABETES NOW BEING WIDELY USED 

570
00:26:25,109 --> 00:26:26,844
VERY EFFECTIVE AND WHERE THE 

571
00:26:26,844 --> 00:26:29,881
REPORTS FIRST STARTED TO NOTICE 

572
00:26:29,881 --> 00:26:31,315
THERE WERE PEOPLE WITH A 

573
00:26:31,315 --> 00:26:32,950
SIGNIFICANT REDUCTION IN THEIR 

574
00:26:32,950 --> 00:26:34,018
DESIRE FOR ALCOHOL OR SMOKE OR 

575
00:26:34,018 --> 00:26:37,355
TAKE OTHER DRUGS.

576
00:26:37,355 --> 00:26:41,125
AND THAT OF COURSE IN CLINICAL 

577
00:26:41,125 --> 00:26:47,465
DATA HAD SHOWED INDEED THESE GLP

578
00:26:47,465 --> 00:26:50,134
1 DRUGS PREVENTED RELAPSE IN 

579
00:26:50,134 --> 00:26:52,970
ANIMAL MODELS OF ADDICTION.

580
00:26:52,970 --> 00:26:57,141
THEY ACTUALLY -- THEY'VE BEEN 

581
00:26:57,141 --> 00:26:58,676
SHOWN WIDELY INVESTIGATED FOR 

582
00:26:58,676 --> 00:27:02,380
ALCOHOL USE DISORDER AND TOBACCO

583
00:27:02,380 --> 00:27:03,814
AND ALCOHOL USE DISORDER AND 

584
00:27:03,814 --> 00:27:05,383
THERE'S BEEN TWO CLINICAL 

585
00:27:05,383 --> 00:27:05,816
TRIALS.

586
00:27:05,816 --> 00:27:09,520
ONE DONE AT DENMARK AND ONE IN 

587
00:27:09,520 --> 00:27:09,987
THE UNITED STATES.

588
00:27:09,987 --> 00:27:14,525
ONE WAS WITH A FIRST GENERATION 

589
00:27:14,525 --> 00:27:20,898
GLP DRUG AND THE ONE IN THE 

590
00:27:20,898 --> 00:27:29,674
UNITED STATES WITH SEMAGLUTE IDE

591
00:27:29,674 --> 00:27:40,217
AND SHOWED REDUCTION IN SMOKING.

592
00:27:40,217 --> 00:27:43,721
AND IT INDICATES REDUCTION IN 

593
00:27:43,721 --> 00:27:54,198
OVERDOSES IN PATIENTS WITH 

594
00:27:55,833 --> 00:27:56,767
OPIOID USE DISORDER AND 

595
00:27:56,767 --> 00:27:59,570
COMBINATION OF SEMAGLUTIDE AND 

596
00:27:59,570 --> 00:28:01,172
YOU CAN CLEARLY SEE SIGNIFICANT 

597
00:28:01,172 --> 00:28:03,207
REDUCTIONS IN THE RISK.

598
00:28:03,207 --> 00:28:04,809
THIS IS FROM ELECTRONIC HEALTH 

599
00:28:04,809 --> 00:28:05,042
RECORDS.

600
00:28:05,042 --> 00:28:07,611
AND OTHER STUDIES HAVE BEEN 

601
00:28:07,611 --> 00:28:08,913
PUBLISHED WITH EQUIVALENT 

602
00:28:08,913 --> 00:28:10,314
RESULTS FOR OTHER DRUGS.

603
00:28:10,314 --> 00:28:12,350
TO YOUR RIGHT YOU HAVE 

604
00:28:12,350 --> 00:28:16,220
PRELIMINARY DATA ON A PILOT 

605
00:28:16,220 --> 00:28:20,691
STUDY SHOWING REDUCTION IN 

606
00:28:20,691 --> 00:28:23,561
PATIENTS WITH OPIOID USE 

607
00:28:23,561 --> 00:28:24,095
DISOR

608
00:28:24,095 --> 00:28:24,362
DISORDER.

609
00:28:24,362 --> 00:28:26,464
SO, A PRIORITY IN DEVELOPMENT OF

610
00:28:26,464 --> 00:28:30,234
MEDICATIONS IS BRINGING THESE TO

611
00:28:30,234 --> 00:28:33,270
A RANDOMIZED CLINICAL TRIAL FOR 

612
00:28:33,270 --> 00:28:35,139
STIMULANT DISORDER AND WE'RE 

613
00:28:35,139 --> 00:28:37,108
USING IT FOR THE CLINICAL TRIAL 

614
00:28:37,108 --> 00:28:38,476
AND CONTACTS THROUGH THE V.A. 

615
00:28:38,476 --> 00:28:41,045
HOSPITAL TO ACCELERATE THE 

616
00:28:41,045 --> 00:28:41,779
DEVELOPMENT OF THESE TRIALS AS 

617
00:28:41,779 --> 00:28:44,148
WELL AS FUNDING RESEARCHERS TO 

618
00:28:44,148 --> 00:28:46,817
ACTUALLY DO THE STUDIES TO 

619
00:28:46,817 --> 00:28:50,287
DETERMINE WHETHER IN FACT IT'S 

620
00:28:50,287 --> 00:28:52,757
EFFICACIOUS OR NOT.

621
00:28:52,757 --> 00:28:58,996
AND THEN I WANT TO GIVE A FAST 

622
00:28:58,996 --> 00:29:02,033
UPDATE OF OUR SMALL BUSINESS 

623
00:29:02,033 --> 00:29:03,734
PROGRAM FUNDED WITH HEAL DOLLARS

624
00:29:03,734 --> 00:29:07,204
ALSO EXTREMELY SUCCESSFUL.

625
00:29:07,204 --> 00:29:14,378
WE HAVE THE HUB, 14 FOR PHARMA 

626
00:29:14,378 --> 00:29:17,548
COTHERAPEUTICS AND FDA REGULATED

627
00:29:17,548 --> 00:29:19,784
THERAPEUTIC DIAGNOSTIC DEVICES 

628
00:29:19,784 --> 00:29:22,119
AND NON-REGULATED PRODUCT AND 

629
00:29:22,119 --> 00:29:22,586
RESEARCH TOOLS.

630
00:29:22,586 --> 00:29:24,388
I'M SHOWING PRODUCTS THAT HAVE 

631
00:29:24,388 --> 00:29:26,757
BASICALLY BEEN APPROVED BY THE 

632
00:29:26,757 --> 00:29:28,392
FDA THAT ACTUALLY ARE OUT IN THE

633
00:29:28,392 --> 00:29:31,595
MARKETS.

634
00:29:31,595 --> 00:29:34,065
ONE IS A STIMULATION DEVICE THAT

635
00:29:34,065 --> 00:29:37,234
TAKES ADVANTAGE OF THE FACT THAT

636
00:29:37,234 --> 00:29:41,939
THE VAGUS NERVE ONE IN THE LOBE 

637
00:29:41,939 --> 00:29:47,144
OF THE EAR AND HAS BEEN SHOWN IT

638
00:29:47,144 --> 00:29:51,015
DECREASES WITHDRAWAL IN ACUTE 

639
00:29:51,015 --> 00:29:52,249
WITHDRAWAL SYNDROME BEING TESTED

640
00:29:52,249 --> 00:29:53,918
ON NEONATES.

641
00:29:53,918 --> 00:29:55,619
ALSO TESTED FOR THE POSSIBILITY 

642
00:29:55,619 --> 00:29:58,255
IT CAN IMPROVE OUTCOMES IN 

643
00:29:58,255 --> 00:30:01,258
PEOPLE WITH OPIOID USE DISORDER.

644
00:30:01,258 --> 00:30:05,162
THE OTHER ONE PRAPELA IS A 

645
00:30:05,162 --> 00:30:08,232
COMPANY THAT DEVELOPED THE 

646
00:30:08,232 --> 00:30:10,234
TACTILE STIMULATION DEVICE TO 

647
00:30:10,234 --> 00:30:12,436
TREAT NEONATAL ABSTINENCE 

648
00:30:12,436 --> 00:30:12,703
SYNDROME.

649
00:30:12,703 --> 00:30:14,371
IT'S SIMPLE.

650
00:30:14,371 --> 00:30:18,642
YOU PUT IT IN THE CRIB AND IT 

651
00:30:18,642 --> 00:30:20,111
VIBRATES AND DECREASES THE 

652
00:30:20,111 --> 00:30:24,815
IRRITABILITY OF THE NEONATES AND

653
00:30:24,815 --> 00:30:30,921
ONE IS ISTANOSIS DETECTING 

654
00:30:30,921 --> 00:30:32,656
FENTANYL WITH A TEST STRIP.

655
00:30:32,656 --> 00:30:36,927
AND THEY WERE NOT AVAILABLE FOR 

656
00:30:36,927 --> 00:30:39,029
PHYSICIANS TO DETERMINE IF 

657
00:30:39,029 --> 00:30:40,197
SOMEONE HAD AN OVERDOSE FROM 

658
00:30:40,197 --> 00:30:42,133
FENTANYL OR NOT.

659
00:30:42,133 --> 00:30:45,169
THIS HAS BEEN CLEARED BY CLIA 

660
00:30:45,169 --> 00:30:52,443
AND NOW WIDELY AVAILABLE AND 

661
00:30:52,443 --> 00:30:54,378
IMPROVING IN THE HEALTH CARE 

662
00:30:54,378 --> 00:30:58,415
SYSTEM TO THE EXTENT EMERGENCY 

663
00:30:58,415 --> 00:31:01,152
ROOM OR OTHER SETTINGS HAVE 

664
00:31:01,152 --> 00:31:04,355
AFFECTED BY FENTANYL.

665
00:31:04,355 --> 00:31:07,057
THE LAST IS WHERE DO WE GO FROM 

666
00:31:07,057 --> 00:31:09,994
HERE AND THE FUTURE.

667
00:31:09,994 --> 00:31:15,166
THERE'S STILL A MAJOR NEED AND 

668
00:31:15,166 --> 00:31:17,168
THERE'S AREAS WE HAVE NOT BEEN 

669
00:31:17,168 --> 00:31:19,203
ABLE TO ADVANCE THE SCIENCE AS 

670
00:31:19,203 --> 00:31:21,205
MUCH AS WE'D LIKE OR NEGLECTED.

671
00:31:21,205 --> 00:31:22,673
I'LL HIGHLIGHT SOME OF THEM.

672
00:31:22,673 --> 00:31:24,108
IMPORTANTLY WE NEED TO ENHANCE 

673
00:31:24,108 --> 00:31:27,144
PREVENTION IN WAYS THAT IS GOING

674
00:31:27,144 --> 00:31:29,046
TO BE SUSTAINABLE AND ACCESSIBLE

675
00:31:29,046 --> 00:31:29,947
AND ADVANCE TREATMENT.

676
00:31:29,947 --> 00:31:33,083
WE ALSO NEED TO ADVANCE 

677
00:31:33,083 --> 00:31:33,350
RECOVERY.

678
00:31:33,350 --> 00:31:36,153
THIS IS A SPACE WHERE THERE'S 

679
00:31:36,153 --> 00:31:40,291
BEEN LIMITED RESOURCES AND AS A 

680
00:31:40,291 --> 00:31:46,830
RESULT OF THAT THERE'S A NEED TO

681
00:31:46,830 --> 00:31:48,866
HAVE THE SUPPORT SYSTEMS 

682
00:31:48,866 --> 00:31:50,734
NECESSARY FOR RECOVERY.

683
00:31:50,734 --> 00:31:52,870
WE NEED TO CONTINUE TO SUPPORT 

684
00:31:52,870 --> 00:31:55,573
THERAPEUTIC STUDIES ON POLY 

685
00:31:55,573 --> 00:31:57,141
SUBSTANCE USE AND OVERDOSES SO 

686
00:31:57,141 --> 00:32:01,145
WE CAN KNOW WHAT DRUGS ARE 

687
00:32:01,145 --> 00:32:04,248
AVAILABLE AND WHAT IS THE 

688
00:32:04,248 --> 00:32:04,882
GEOGRAPHIC DISTRIBUTION OF THE 

689
00:32:04,882 --> 00:32:06,050
DRUGS AND VARIABILITY.

690
00:32:06,050 --> 00:32:09,220
WE ALSO CLEARLY HAVE RECOGNIZED 

691
00:32:09,220 --> 00:32:18,229
FROM THE BEGINNING AND YOU CAN 

692
00:32:18,229 --> 00:32:19,930
HAVE ADVANCED THE AREA OF 

693
00:32:19,930 --> 00:32:23,234
SCIENCE OF COMORBIDITIES AND 

694
00:32:23,234 --> 00:32:33,110
IT'S CLEAR PEOPLE WITH COMORBID 

695
00:32:33,110 --> 00:32:35,346
CONDITIONS ARE AT HIGHER RISK OF

696
00:32:35,346 --> 00:32:41,185
DRUGS AS A WAY OF MEDICATIMEDIC.

697
00:32:41,185 --> 00:32:49,360
THERE'S  A REDUCTION IN AND IT'S

698
00:32:49,360 --> 00:32:51,929
NOT HOMOGENOUS AND SOME PLACES 

699
00:32:51,929 --> 00:32:54,164
THE OVERDOSE MORTALITY ARE 

700
00:32:54,164 --> 00:32:55,466
EXTREMELY HIGH TO THE LEVELS OF 

701
00:32:55,466 --> 00:32:58,135
THE COVID PANDEMIC.

702
00:32:58,135 --> 00:33:02,873
I MENTIONED RURAL AREAS AND 

703
00:33:02,873 --> 00:33:04,808
NATIVE AMERICANS HAVE EXTREMELY 

704
00:33:04,808 --> 00:33:06,110
HIGH RATES OF OVERDOSE DEATHS.

705
00:33:06,110 --> 00:33:08,779
THE FINAL ONE IS SOMETHING WE 

706
00:33:08,779 --> 00:33:10,914
ALL ARE INVOLVED WITH AND NEED 

707
00:33:10,914 --> 00:33:12,516
TO BUILD TOGETHER WHICH IS 

708
00:33:12,516 --> 00:33:14,885
FACILITATING THE GENERATION AND 

709
00:33:14,885 --> 00:33:17,288
USE OF DATA INCLUDING EXISTING 

710
00:33:17,288 --> 00:33:21,191
CLINICAL DATA FOR SECONDARY 

711
00:33:21,191 --> 00:33:21,492
ANALYSIS.

712
00:33:21,492 --> 00:33:26,764
IT'S THIS STRUCTURE THAT IS DONE

713
00:33:26,764 --> 00:33:31,635
FOR WHICH THE HEAL FUNDS HAVE 

714
00:33:31,635 --> 00:33:34,471
ENABLED US TO HAVE THE RESOURCES

715
00:33:34,471 --> 00:33:35,506
CAPABILITY TO MAKE THIS 

716
00:33:35,506 --> 00:33:36,106
POSSIBLE.

717
00:33:36,106 --> 00:33:39,610
I WANT TO END MY PRESENTATION 

718
00:33:39,610 --> 00:33:48,919
HERE.

719
00:33:48,919 --> 00:33:50,521
AND WHAT WE DO IS CRUCIAL FOR 

720
00:33:50,521 --> 00:33:52,122
WHAT WE DO WITH PAIN AND WHAT WE

721
00:33:52,122 --> 00:33:55,826
DO WITH PAIN IS CRUCIAL FOR WHAT

722
00:33:55,826 --> 00:33:58,395
WE DO WITH OPIOID USE DISORDER 

723
00:33:58,395 --> 00:33:58,862
AND OVERDOSES.

724
00:33:58,862 --> 00:34:00,764
YOU HEARD ME SAY AND I'M GOING 

725
00:34:00,764 --> 00:34:03,634
TO REPEAT IT, IF WE DO NOT 

726
00:34:03,634 --> 00:34:04,401
PROVIDE ALTERNATIVE TREATMENTS 

727
00:34:04,401 --> 00:34:06,070
FOR PEOPLE WITH SEVERE PAIN 

728
00:34:06,070 --> 00:34:09,640
THEY'LL GO OUT IN THE ELICIT 

729
00:34:09,640 --> 00:34:12,309
MARKET TO GET RELIEF AND PUT 

730
00:34:12,309 --> 00:34:14,545
THEM AT EXTREMELY HIGH RISK OF 

731
00:34:14,545 --> 00:34:15,512
OVERDOSES.

732
00:34:15,512 --> 00:34:20,551
AS INCREASINGLY MORE POTENT 

733
00:34:20,551 --> 00:34:21,819
SYNTHETIC DRUGS ARE BECOMING 

734
00:34:21,819 --> 00:34:22,453
MORE AVAILABLE AND WIDESPREAD.

735
00:34:22,453 --> 00:34:25,656
I WANT TO THANK YOU FOR YOUR 

736
00:34:25,656 --> 00:34:27,825
ATTENTION AND TURN THE 

737
00:34:27,825 --> 00:34:33,097
MICROPHONE TO MY ESTEEMED 

738
00:34:33,097 --> 00:34:36,467
COLLEAGUE, DR. KOROSHETZ WHO 

739
00:34:36,467 --> 00:34:37,067
CO-LEADS THE HEAL INITIATIVE.

740
00:34:37,067 --> 00:34:47,211
WALTER.

741
00:35:31,922 --> 00:35:33,056
 >> Dr. Koroshetz: IT'S 

742
00:35:33,056 --> 00:35:36,593
REFRESHING TO SEE THE REDUCTION 

743
00:35:36,593 --> 00:35:37,094
IN OVERDOSE DEATHS.

744
00:35:37,094 --> 00:35:39,430
YOU CAN'T BEAT THAT.

745
00:35:39,430 --> 00:35:39,963
THAT'S FANTASTIC.

746
00:35:39,963 --> 00:35:42,266
I'LL SPEAK ON BEHALF OF THE PAIN

747
00:35:42,266 --> 00:35:43,066
I.C. DIRECTORS.

748
00:35:43,066 --> 00:35:46,904
I THINK WE HAVE 14 I.C. 

749
00:35:46,904 --> 00:35:49,173
DIRECTORS IN THE HEAL PAIN GROUP

750
00:35:49,173 --> 00:35:59,116
AND THE CO-CHAIR HELEN LANGEVIN 

751
00:35:59,116 --> 00:36:00,584
AND DR. CRISWELL.

752
00:36:00,584 --> 00:36:07,458
I WISH I HAD BETTER NEWS THAT 

753
00:36:07,458 --> 00:36:10,394
NORA TALKED ABOUT AND IN TERMS 

754
00:36:10,394 --> 00:36:12,029
OF THE PAIN DATA IT PLAY BE 

755
00:36:12,029 --> 00:36:13,697
DIFFICULT IN HOW THINGS WERE 

756
00:36:13,697 --> 00:36:15,599
ASCERTAINED THROUGH THE YEARS 

757
00:36:15,599 --> 00:36:16,700
AND ADULTS EXPERIENCE PAIN MOST 

758
00:36:16,700 --> 00:36:22,139
DAYS WHICH IS AN INDICATOR OF A 

759
00:36:22,139 --> 00:36:24,908
PROBLEM.

760
00:36:24,908 --> 00:36:35,085
[NO AUDIO]

761
00:36:48,632 --> 00:36:52,402
IT'S MORE EFFECTIVE IN TERMS OF 

762
00:36:52,402 --> 00:36:57,140
PREVALENCE OF EXPERIENCING PAIN 

763
00:36:57,140 --> 00:37:04,414
EVERY DAY.

764
00:37:04,414 --> 00:37:07,618
AND PAIN RESTRICTS LIFE/WORK 

765
00:37:07,618 --> 00:37:14,758
ACTIVITIES FROM 7.4% TO 8.5% OF 

766
00:37:14,758 --> 00:37:18,495
ADULTS AND THE PROJECT WE HAVE 

767
00:37:18,495 --> 00:37:19,329
FOCUSSING ON AMERICAN INDIAN AND

768
00:37:19,329 --> 00:37:21,164
NATIVE AMERICANS AND THOSE 

769
00:37:21,164 --> 00:37:25,903
GROUPS ARE MORE LIKELY TO HAVE 

770
00:37:25,903 --> 00:37:26,470
THE AFFECT OF PAIN THAN ANY 

771
00:37:26,470 --> 00:37:33,977
OTHER GROUP.

772
00:37:33,977 --> 00:37:37,447
RURAL AREAS ARE MOST IMPACTED 

773
00:37:37,447 --> 00:37:45,155
AND DEALING WITH HIGH IMPACT 

774
00:37:45,155 --> 00:37:48,825
CHRONIC PAIN.

775
00:37:48,825 --> 00:37:52,396
OLDER ADULTS THAT CAN'T GET AWAY

776
00:37:52,396 --> 00:37:54,231
WITH THINGS THEY USED TO GET 

777
00:37:54,231 --> 00:37:55,198
AWAY WITH AND PAIN IS MUCH MORE 

778
00:37:55,198 --> 00:38:01,138
OF A PROBLEM AS OUR POPULATION 

779
00:38:01,138 --> 00:38:11,248
AGES.

780
00:38:15,385 --> 00:38:20,023
IN THE AGES POPULATIONS 

781
00:38:20,023 --> 00:38:20,991
COMORBIDITIES ONE STARTS TO 

782
00:38:20,991 --> 00:38:22,926
ACQUIRE THOSE AND THAT 

783
00:38:22,926 --> 00:38:24,494
COMPLICATES THINGS.

784
00:38:24,494 --> 00:38:26,830
AGAIN YOU RUN INTO A LITTLE BIT 

785
00:38:26,830 --> 00:38:29,333
OF A CHICKEN AND EGG PROBLEM 

786
00:38:29,333 --> 00:38:37,007
WHERE PAIN ITSELF LEADS TO 

787
00:38:37,007 --> 00:38:38,842
CHRONIC ILLNESSES WHETHER IT'S 

788
00:38:38,842 --> 00:38:43,580
OPIOID ABUSE OR ANALGESIC OR 

789
00:38:43,580 --> 00:38:47,451
DRUG ABUSE OR SEDENTARY 

790
00:38:47,451 --> 00:38:49,152
LIFESTYLE AGGREGATE THESE 

791
00:38:49,152 --> 00:38:51,188
CHRONIC MEDICAL PROBLEMS AND 

792
00:38:51,188 --> 00:38:53,156
THEY ALSO AGGREGATE PAIN 

793
00:38:53,156 --> 00:38:53,890
CONDITIONS.

794
00:38:53,890 --> 00:38:57,060
THERE'S DEFINITELY FEEDBACK 

795
00:38:57,060 --> 00:39:03,567
CYCLE THERE I SAID THIS BEFORE, 

796
00:39:03,567 --> 00:39:05,636
AT SOME POINT WE'LL HAVE TO DEAL

797
00:39:05,636 --> 00:39:07,471
WITH THIS ISSUE.

798
00:39:07,471 --> 00:39:09,673
CLEARLY MOST INVESTIGATORS WOULD

799
00:39:09,673 --> 00:39:12,376
LIKE TO STAY AWAY FROM THIS 

800
00:39:12,376 --> 00:39:14,945
BECAUSE IT MAKES THINGS REALLY 

801
00:39:14,945 --> 00:39:16,647
COMPLICATED WHEN YOU BRING UP 

802
00:39:16,647 --> 00:39:17,047
COMORBIDITIES.

803
00:39:17,047 --> 00:39:18,882
IT'S KIND OF A GLARING PROBLEM 

804
00:39:18,882 --> 00:39:21,018
OUT THERE THAT WOULD BE GREAT IF

805
00:39:21,018 --> 00:39:23,820
WE TRY TO MAKE HEADWAY.

806
00:39:23,820 --> 00:39:28,525
A COUPLE THINGS ABOUT GOING OVER

807
00:39:28,525 --> 00:39:31,161
HOW HEAL'S ADDRESSING PAIN AND 

808
00:39:31,161 --> 00:39:32,029
WE'VE SEEN THIS SLIDE BEFORE.

809
00:39:32,029 --> 00:39:35,732
THE KEY THING TO POINT OUT HERE 

810
00:39:35,732 --> 00:39:40,971
IS WE'RE TRYING TO TAKE 

811
00:39:40,971 --> 00:39:42,272
ADVANTAGE OF ALL THE PAIN 

812
00:39:42,272 --> 00:39:45,108
RESEARCH ACROSS ALL THE 

813
00:39:45,108 --> 00:39:48,512
INSTITUTES AT NIH ON DISCOVERING

814
00:39:48,512 --> 00:39:50,147
PAIN MECHANISMS OR 

815
00:39:50,147 --> 00:39:50,947
CHARACTERISTICS OF PAIN IN 

816
00:39:50,947 --> 00:39:54,384
CERTAIN POPULATIONS BUT THEN 

817
00:39:54,384 --> 00:39:56,620
TAKING THAT INFORMATION AND 

818
00:39:56,620 --> 00:39:59,423
FUNDING WORK THAT WILL GET TO 

819
00:39:59,423 --> 00:40:02,693
TREATMENTS, BETTER TREATMENTS 

820
00:40:02,693 --> 00:40:03,193
FOR PAIN.

821
00:40:03,193 --> 00:40:04,795
BETTER NON ADDICTIVE TREATMENTS 

822
00:40:04,795 --> 00:40:05,095
FOR PAIN.

823
00:40:05,095 --> 00:40:07,564
SO WE START ON THE LEFT.

824
00:40:07,564 --> 00:40:09,800
WE DON'T DO A LOT OF THE BASIC 

825
00:40:09,800 --> 00:40:14,237
DISCOVERY RESEARCH BUT WE DO DO 

826
00:40:14,237 --> 00:40:15,839
WHAT'S CALLED TARGET VALIDATION 

827
00:40:15,839 --> 00:40:17,074
AND TARGET DISCOVERY WHICH IS 

828
00:40:17,074 --> 00:40:18,809
ONCE YOU MAKE A DISCOVERY IN THE

829
00:40:18,809 --> 00:40:21,511
LAB THE QUESTION IS IS IT REALLY

830
00:40:21,511 --> 00:40:24,715
SOMETHING THAT'S DRUGGABLE OR 

831
00:40:24,715 --> 00:40:26,683
GOING TO WORK AND THAT TAKES 

832
00:40:26,683 --> 00:40:30,153
REALLY SOME KIND OF BRUTE FORCE 

833
00:40:30,153 --> 00:40:32,956
WORKS.

834
00:40:32,956 --> 00:40:35,559
OFTEN TIME NOT REALLY ATTRACTIVE

835
00:40:35,559 --> 00:40:39,629
IN AN RO1 APPLICATION AND ANIMAL

836
00:40:39,629 --> 00:40:42,766
MODEL DEVELOPMENT APPLICATION 

837
00:40:42,766 --> 00:40:44,835
CRITICAL IN TRYING TO MOVE PAIN 

838
00:40:44,835 --> 00:40:46,002
THERAPIES TOWARDS PEOPLE AND GET

839
00:40:46,002 --> 00:40:55,846
AWAY FROM THE MISTRUST THAT 

840
00:40:55,846 --> 00:40:57,147
COMPANIES HAVE WITH REGARD TO 

841
00:40:57,147 --> 00:40:59,683
ANIMAL MODELS BECAUSE THEY ARE 

842
00:40:59,683 --> 00:41:01,284
HAVE POORLY PREDICTED WHAT 

843
00:41:01,284 --> 00:41:06,623
HAPPENS IN THE HUMAN AND HOW TO 

844
00:41:06,623 --> 00:41:16,900
IMPROVE ON THAT.

845
00:41:17,267 --> 00:41:18,935
THAT'S NOTHING THAT DIDN'T WORK 

846
00:41:18,935 --> 00:41:19,870
IN THE HUMAN THAT DIDN'T WORK IN

847
00:41:19,870 --> 00:41:20,637
THE ANIMAL.

848
00:41:20,637 --> 00:41:22,506
WE'RE STUCK IN THAT SPACE AND 

849
00:41:22,506 --> 00:41:24,875
TRYING TO MOVE THINGS FORWARD.

850
00:41:24,875 --> 00:41:28,278
THERE MIGHT BE SOME CHANCES OF 

851
00:41:28,278 --> 00:41:35,118
JUMPING OVER INTO HUMAN PAIN.

852
00:41:35,118 --> 00:41:37,721
AND FOCUSSED ON LOOKING AT 

853
00:41:37,721 --> 00:41:41,024
SIGNATURES OF PAIN IN HUMAN 

854
00:41:41,024 --> 00:41:47,798
TISSUES.

855
00:41:47,798 --> 00:41:49,399
BYPASS AND LOOKING AT ABOUT WHAT

856
00:41:49,399 --> 00:41:53,136
THEY USED TO DO AND LOOK AT 

857
00:41:53,136 --> 00:41:54,437
HUMAN SPINAL CORD RELATED TO 

858
00:41:54,437 --> 00:41:58,508
PAIN AND AND WE HAVE A 

859
00:41:58,508 --> 00:41:59,810
PRESCREENING PLATFORM PEOPLE CAN

860
00:41:59,810 --> 00:42:04,581
TEST THEIR ASSETS ON MULTIPLE 

861
00:42:04,581 --> 00:42:06,082
ANIMAL PAIN ASSAYS.

862
00:42:06,082 --> 00:42:08,285
THESE ARE VERY RIGOROUS AND 

863
00:42:08,285 --> 00:42:08,585
REGULARIZED.

864
00:42:08,585 --> 00:42:11,888
WHETHER IT'S ACADEMIC OR BIO 

865
00:42:11,888 --> 00:42:14,758
TECH CAN BE SURE HOW THE DRUG 

866
00:42:14,758 --> 00:42:16,259
STANDS IN RELATIONSHIP TO THESE 

867
00:42:16,259 --> 00:42:18,161
MANY DIFFERENT MODELS.

868
00:42:18,161 --> 00:42:21,631
AND THEN NCATS HAS BEEN VERY 

869
00:42:21,631 --> 00:42:25,001
ACTIVE IN USING THEIR RESOURCES 

870
00:42:25,001 --> 00:42:31,608
TO DEVELOP NEW TARGETS WITH 

871
00:42:31,608 --> 00:42:36,413
TISSUE CHIP TECHNOLOGIES AND THE

872
00:42:36,413 --> 00:42:39,449
REJOIN PROGRAM IS ONE THAT IS A 

873
00:42:39,449 --> 00:42:40,717
PROGRAM LOOKING AT THE 

874
00:42:40,717 --> 00:42:43,787
INNOVATION OF THE ENTIRE JOINT 

875
00:42:43,787 --> 00:42:47,524
SO NOT JUST I THINK THE 

876
00:42:47,524 --> 00:42:57,968
LIGAMENTS AND MUSCLES --  

877
00:42:58,969 --> 00:43:02,005
SOMETHING THAT COMPRISES THE 

878
00:43:02,005 --> 00:43:04,674
WHOLE JOINT AND A MULTI I.C. 

879
00:43:04,674 --> 00:43:11,982
PROJECT WOULD BE HELPFUL.

880
00:43:11,982 --> 00:43:14,150
MORE BASIC PROJECTS NOT AN 

881
00:43:14,150 --> 00:43:15,418
INITIAL I.C. CAN DO IT SELF.

882
00:43:15,418 --> 00:43:19,890
WE HAVE A NUMBER OF THERAPEUTIC 

883
00:43:19,890 --> 00:43:23,393
DEVELOPMENT PROJECTS FOR BOTH 

884
00:43:23,393 --> 00:43:25,595
BIOLOGICS, SMALL MOLECULES, 

885
00:43:25,595 --> 00:43:25,829
DEVICES.

886
00:43:25,829 --> 00:43:28,265
THE HOPE WOULD BE WE GET 

887
00:43:28,265 --> 00:43:32,302
BIOMARKERS FOR PAIN THAT WOULD 

888
00:43:32,302 --> 00:43:36,706
HELP IN TESTING PHASE II TESTING

889
00:43:36,706 --> 00:43:40,043
OF ASSETS AND THEN ONE THING TO 

890
00:43:40,043 --> 00:43:42,045
NOTE IS THE BASIC SCIENCE OF 

891
00:43:42,045 --> 00:43:43,847
PAIN IS REALLY EXPLODED.

892
00:43:43,847 --> 00:43:46,683
IT'S NOT THAT WE DON'T HAVE 

893
00:43:46,683 --> 00:43:51,154
TARGETS BUT THE ISSUE IS HOW YOU

894
00:43:51,154 --> 00:43:55,392
EFFICIENTLY IDENTIFY TARGETS 

895
00:43:55,392 --> 00:43:56,559
THAT ARE GOING TO BE ACTIONABLE 

896
00:43:56,559 --> 00:44:00,230
AND DRUGGABLE IN A PHASE II 

897
00:44:00,230 --> 00:44:00,563
TRIAL.

898
00:44:00,563 --> 00:44:02,799
FOR THAT WE NEED THE BIOMARKERS 

899
00:44:02,799 --> 00:44:03,700
BECAUSE OF THE GREAT VARIATION 

900
00:44:03,700 --> 00:44:04,467
IN SUBJECTIVE RESPONSES ABOUT 

901
00:44:04,467 --> 00:44:12,008
PAIN.

902
00:44:12,008 --> 00:44:13,443
THEN WE HAVE ANOTHER PROJECT 

903
00:44:13,443 --> 00:44:14,744
LOOKING AT BACK PAIN TRYING TO 

904
00:44:14,744 --> 00:44:18,148
GET AGAIN THE BIOMARKERS FOR THE

905
00:44:18,148 --> 00:44:21,184
DIFFERENT TYPES OF CONDITIONS 

906
00:44:21,184 --> 00:44:22,686
THAT CAUSE BACK PAIN AND 

907
00:44:22,686 --> 00:44:24,120
UNDERSTANDING WHICH ARE THE BEST

908
00:44:24,120 --> 00:44:25,155
TREATMENTS FOR THESE DIFFERENT 

909
00:44:25,155 --> 00:44:26,856
TYPES OF BACK PAIN.

910
00:44:26,856 --> 00:44:29,059
OF COURSE BACK AND NECK PAIN 

911
00:44:29,059 --> 00:44:31,127
BEING THE MAJOR COURSE OF 

912
00:44:31,127 --> 00:44:32,495
DISABILITY IN THE UNITED STATES.

913
00:44:32,495 --> 00:44:34,297
SO A REALLY IMPORTANT PROJECT TO

914
00:44:34,297 --> 00:44:37,300
MOVE FORWARD.

915
00:44:37,300 --> 00:44:40,537
WE HAVE MAJOR EFFORTS TO TRY AND

916
00:44:40,537 --> 00:44:42,572
BUILD THE WORKFORCE IN PAIN 

917
00:44:42,572 --> 00:44:44,774
SIMPLY ON THE CLINICAL SIDE.

918
00:44:44,774 --> 00:44:46,409
THE BAD NEWS THIS WEEK THE 

919
00:44:46,409 --> 00:44:51,381
PURPOSE NETWORK WAS CANCELED AND

920
00:44:51,381 --> 00:44:53,116
WE'RE STILL TRYING TO WORK THAT 

921
00:44:53,116 --> 00:44:53,350
THROUGH.

922
00:44:53,350 --> 00:44:56,219
WE'RE TRYING TO DO EVERYTHING WE

923
00:44:56,219 --> 00:44:58,688
CAN TO DEVELOP A BETTER 

924
00:44:58,688 --> 00:45:00,757
WORKFORCE IN THE CLINICAL PAIN 

925
00:45:00,757 --> 00:45:08,031
SPACE AND THE DATA ECO SYSTEM IS

926
00:45:08,031 --> 00:45:10,166
A VERY INNOVATIVE ONE AND DATA 

927
00:45:10,166 --> 00:45:12,235
FROM ALL THE HEAL PROGRAMS CAN 

928
00:45:12,235 --> 00:45:15,305
BE INTEGRATED INTO A SINGLE 

929
00:45:15,305 --> 00:45:19,042
PORTAL AND SO WANTED TO COMPARE 

930
00:45:19,042 --> 00:45:21,578
ACROSS STUDIES BUT THE DATA HAS 

931
00:45:21,578 --> 00:45:24,948
WORKED SO IT'S COMPARABLE, WHICH

932
00:45:24,948 --> 00:45:25,815
IS A MAJOR LIFT.

933
00:45:25,815 --> 00:45:29,786
WE HAVE A NUMBER OF CLINICAL 

934
00:45:29,786 --> 00:45:33,156
TRIALS PROGRAMS GOING ON IN 

935
00:45:33,156 --> 00:45:36,359
RURAL PAIN IN HEALTH CARE 

936
00:45:36,359 --> 00:45:42,332
SYSTEMS AND PEOPLE ON DIALYSIS.

937
00:45:42,332 --> 00:45:45,135
PRAGMATIC TRIALS IN HEALTH CARE 

938
00:45:45,135 --> 00:45:49,139
SYSTEMS AND RESEARCH LOOKING AT 

939
00:45:49,139 --> 00:45:52,642
AS WE MENTIONED THE DIFFERENT 

940
00:45:52,642 --> 00:45:54,844
DEMOGRAPHIC GROUPS THAT SUFFER 

941
00:45:54,844 --> 00:45:57,947
MOST GREATLY FROM PAIN AND MAY 

942
00:45:57,947 --> 00:46:02,585
REQUIRE SPECIAL TENSION AND HAVE

943
00:46:02,585 --> 00:46:07,690
PROGRAMS TO REDUCE THE PAIN.

944
00:46:07,690 --> 00:46:09,959
AS NORA MENTIONED THIS 

945
00:46:09,959 --> 00:46:11,594
INTEGRATION BETWEEN 

946
00:46:11,594 --> 00:46:13,897
UNDERSTANDING HOW FAST TO TREAT 

947
00:46:13,897 --> 00:46:17,167
PAIN WHILE REDUCING RISK OF 

948
00:46:17,167 --> 00:46:21,638
ADDICTION AND A SO VERY 

949
00:46:21,638 --> 00:46:22,672
CHALLENGING PROBLEMS.

950
00:46:22,672 --> 00:46:24,307
PEOPLE WHO HAVE AN OPIOID USE 

951
00:46:24,307 --> 00:46:26,509
DISORDER BUT ALSO HAVE PAIN, 

952
00:46:26,509 --> 00:46:28,411
WHICH IS THE MAJORITY.

953
00:46:28,411 --> 00:46:30,180
HOW ARE THOSE PEOPLE MANAGING.

954
00:46:30,180 --> 00:46:32,615
OF COURSE YOU CAN EASILY 

955
00:46:32,615 --> 00:46:35,718
UNDERSTAND IF THAT'S NOT MANAGED

956
00:46:35,718 --> 00:46:39,022
WELL, TRYING TO TREAT THE OVER 

957
00:46:39,022 --> 00:46:41,157
USE DISORDER YOU MAKE THE PAIN 

958
00:46:41,157 --> 00:46:44,561
WORSE AND TRYING TO TREAT THE 

959
00:46:44,561 --> 00:46:47,397
PAIN YOU MAKE THE DISORDER 

960
00:46:47,397 --> 00:46:48,364
WORSE.

961
00:46:48,364 --> 00:46:51,067
THEY'RE TIED TOGETHER AND THE 

962
00:46:51,067 --> 00:46:54,204
HEAL INITIATIVE IS IMPORTANT 

963
00:46:54,204 --> 00:46:56,106
THIS PARTICULAR GROUP PAY 

964
00:46:56,106 --> 00:46:56,372
ATTENTION.

965
00:46:56,372 --> 00:46:57,507
OKAY, THAT'S WHAT WE'VE DONE SO 

966
00:46:57,507 --> 00:46:57,774
FAR.

967
00:46:57,774 --> 00:47:00,110
WHAT WE'RE GOING TO DO IN THE 

968
00:47:00,110 --> 00:47:02,278
FUTURE YOU'RE GOING TO HEAR FROM

969
00:47:02,278 --> 00:47:04,681
THE RECOMMENDATIONS THAT THE 

970
00:47:04,681 --> 00:47:08,451
WORKING GROUP OF COUNCIL PUT 

971
00:47:08,451 --> 00:47:11,688
TOGETHER AND ROB AND KATHLEEN 

972
00:47:11,688 --> 00:47:13,056
WILL TALK ABOUT THE PAIN 

973
00:47:13,056 --> 00:47:13,756
RESEARCH PRIORITIES THAT CAME 

974
00:47:13,756 --> 00:47:15,425
OUT OF THE WORK THEY'VE DONE IN 

975
00:47:15,425 --> 00:47:19,229
THE LAST YEAR AND THANKS TO 

976
00:47:19,229 --> 00:47:20,864
JACKIE WARD FOR ORGANIZING THESE

977
00:47:20,864 --> 00:47:21,164
FOLKS.

978
00:47:21,164 --> 00:47:22,565
IT'S A PRETTY NICE GROUP.

979
00:47:22,565 --> 00:47:25,135
I DON'T THINK JACKIE WAS SUCH A 

980
00:47:25,135 --> 00:47:25,435
HEAVY LIFT.

981
00:47:25,435 --> 00:47:27,737
THESE ARE EASY FOLKS TO WORK 

982
00:47:27,737 --> 00:47:28,171
WITH.

983
00:47:28,171 --> 00:47:29,239
NOT LIKE SOME OF OUR OTHER 

984
00:47:29,239 --> 00:47:34,077
GROUPS.

985
00:47:34,077 --> 00:47:37,180
CERTAINLY SOME MORE TALK AND 

986
00:47:37,180 --> 00:47:40,783
MENTION ABOUT THE PROGRESS WITH 

987
00:47:40,783 --> 00:47:43,052
REGARD TO THE EARN NETWORK.

988
00:47:43,052 --> 00:47:45,321
YOU CAN SEE HERE THE PROJECTS 

989
00:47:45,321 --> 00:47:47,423
ENROLLMENT IS COMPLETED.

990
00:47:47,423 --> 00:47:50,326
A COUPLE WHERE THERE'S ACTUALLY 

991
00:47:50,326 --> 00:47:52,328
A PUBLICATION BUT MOST OF THE 

992
00:47:52,328 --> 00:47:54,531
PUBLICATIONS HAVE BEEN COMING 

993
00:47:54,531 --> 00:47:56,399
OUT NEXT YEAR OR SO SO REALLY 

994
00:47:56,399 --> 00:48:06,943
INTERESTED IN LOOKING AT THOSE.

995
00:48:20,857 --> 00:48:23,726
AND THIS SHOWS MOST THE PAPER IS

996
00:48:23,726 --> 00:48:24,928
ABOUT THE TRIAL RATIONALE AND 

997
00:48:24,928 --> 00:48:25,295
DESIGN.

998
00:48:25,295 --> 00:48:27,430
I WOULD SAY THE ONE IN THE 

999
00:48:27,430 --> 00:48:30,366
MIDDLE WHICH WAS DONE THROUGH 

1000
00:48:30,366 --> 00:48:33,436
ONE OF THE NICHD NETWORKS LOOKED

1001
00:48:33,436 --> 00:48:37,173
AT AN INDIVIDUALIZED PROGRAM FOR

1002
00:48:37,173 --> 00:48:40,810
MANAGING PAIN IN WOMEN AFTER 

1003
00:48:40,810 --> 00:48:46,883
HAVING A C SECTION.

1004
00:48:46,883 --> 00:48:50,453
WHAT THEY SHOWED COMPARED TO THE

1005
00:48:50,453 --> 00:48:52,422
USUAL FIXED DOSE OF OPIOIDS.

1006
00:48:52,422 --> 00:48:53,456
THIS INDIVIDUALIZED PROGRAM LED 

1007
00:48:53,456 --> 00:48:57,160
TO A LOWER USE OF OPIOIDS 

1008
00:48:57,160 --> 00:49:02,699
ACTUALLY OVER 90 DAYS THAN THE 

1009
00:49:02,699 --> 00:49:04,801
FIXED DOSE AND THE PAIN CONTROL 

1010
00:49:04,801 --> 00:49:12,775
WAS NOT INFERIOR SO EQUAL MAY BE

1011
00:49:12,775 --> 00:49:23,319
CONTROL WITH LESS USE OF DRUGS.

1012
00:49:30,960 --> 00:49:36,065
WE'RE LEVERAGING THE CTSAs TO 

1013
00:49:36,065 --> 00:49:38,801
HELP WITH DEVELOPMENT AND 

1014
00:49:38,801 --> 00:49:40,637
MANAGEMENT THE OF THE TRIALS AND

1015
00:49:40,637 --> 00:49:41,738
IT WILL BE BASED ON DISCUSSIONS 

1016
00:49:41,738 --> 00:49:46,376
THAT OCCUR AFTER WE HEAR FROM 

1017
00:49:46,376 --> 00:49:49,145
THE WORKING GROUP OF COUNCIL AND

1018
00:49:49,145 --> 00:49:54,751
RESEARCH RECOMMENDATIONS.

1019
00:49:54,751 --> 00:49:58,755
EQUALYOU PROBABLY SAW IN THE 

1020
00:49:58,755 --> 00:50:00,556
FIRST PAPERS FOR THE FIRST TIME 

1021
00:50:00,556 --> 00:50:02,225
IN 20 YEARS THERE'S A NEW CLASS 

1022
00:50:02,225 --> 00:50:06,763
FOR PAIN A SODIUM CHANNEL 

1023
00:50:06,763 --> 00:50:07,030
INHIBITOR.

1024
00:50:07,030 --> 00:50:09,532
NIH FOLKS HAVE BEEN DOING ALL 

1025
00:50:09,532 --> 00:50:11,968
THE BASIC SCIENCE ON THESE 

1026
00:50:11,968 --> 00:50:12,235
CHANNELS.

1027
00:50:12,235 --> 00:50:16,205
WE'VE INVESTED IN THE 1.7, WHICH

1028
00:50:16,205 --> 00:50:22,812
I THINK WAS DEVELOPED AND 

1029
00:50:22,812 --> 00:50:25,148
LICENS

1030
00:50:25,148 --> 00:50:27,750
LICENSED WITH VERTEX AND THEY 

1031
00:50:27,750 --> 00:50:30,620
CAME OUT WITH THE INHIBITER 

1032
00:50:30,620 --> 00:50:35,191
SHOWN IN THE ACUTE PAIN MODELS 

1033
00:50:35,191 --> 00:50:45,668
TO BE EQUIVALENT TO OPIOID 

1034
00:50:45,668 --> 00:50:46,836
MEDICATIONS COMMONLY USED AFTER 

1035
00:50:46,836 --> 00:50:47,970
THE SURGERIES.

1036
00:50:47,970 --> 00:50:51,607
WE'RE SEEING A BREAKTHROUGH AND 

1037
00:50:51,607 --> 00:50:52,842
HOPEFULLY THE DOOR IS OPEN AND 

1038
00:50:52,842 --> 00:50:55,978
THERE'LL BE MORE OF THE 

1039
00:50:55,978 --> 00:50:57,714
NON-ADDICTIVE DRUGS COME 

1040
00:50:57,714 --> 00:50:57,947
THROUGH.

1041
00:50:57,947 --> 00:51:00,016
AND ANOTHER INTERESTING PAPER 

1042
00:51:00,016 --> 00:51:02,819
CAME OUT LOOKING AT THE 

1043
00:51:02,819 --> 00:51:04,220
CANNABINOID 1 RECEPTOR.

1044
00:51:04,220 --> 00:51:08,057
THE RECEPTOR IS PRESENT 

1045
00:51:08,057 --> 00:51:09,692
PERIPHERALLY AS WELL AS 

1046
00:51:09,692 --> 00:51:09,959
CENTRALLY.

1047
00:51:09,959 --> 00:51:15,598
WHAT THIS GROUP DID WAS TO USE 

1048
00:51:15,598 --> 00:51:18,735
A.I. INSILICO TECHNIQUES TO 

1049
00:51:18,735 --> 00:51:20,536
DERIVE MOLECULES THAT DON'T GET 

1050
00:51:20,536 --> 00:51:22,705
INTO THE CENTRAL NERVOUS SYSTEM 

1051
00:51:22,705 --> 00:51:26,509
SO THEY'RE PRIMARILY PERIPHERAL 

1052
00:51:26,509 --> 00:51:29,746
AND THEY DO NOT ACT THROUGH THE 

1053
00:51:29,746 --> 00:51:31,013
ARRESTIN PATHWAY WHICH LEADS TO 

1054
00:51:31,013 --> 00:51:35,785
TOLERANCE OVER TIME.

1055
00:51:35,785 --> 00:51:40,690
AND THEN SHOWED THAT THEY 

1056
00:51:40,690 --> 00:51:45,828
COMPARED HERE IN YELLOW IS THE 

1057
00:51:45,828 --> 00:51:47,530
NEW COMPOUND GENERATED NOR GROUP

1058
00:51:47,530 --> 00:51:57,140
AND GREEN IS THE NON SPECIFIC 

1059
00:51:57,140 --> 00:52:07,517
CANNABINOID RECEPTOR.

1060
00:52:08,551 --> 00:52:09,919
AND A GLYCERIN MODEL ON THE 

1061
00:52:09,919 --> 00:52:10,119
RIGHT.

1062
00:52:10,119 --> 00:52:14,157
IT'S NOT A DRUG YET BUT KIND OF 

1063
00:52:14,157 --> 00:52:18,494
OPENS UP A PATHWAY OF ACTING ON 

1064
00:52:18,494 --> 00:52:20,029
THE CANNABINOID RECEPTOR 

1065
00:52:20,029 --> 00:52:22,565
PERIPHERALLY ONLY.

1066
00:52:22,565 --> 00:52:27,570
YOU DON'T GET THE CNS EFFECTS 

1067
00:52:27,570 --> 00:52:33,643
FOR PAIN.

1068
00:52:33,643 --> 00:52:35,244
IN TERMS OF THE BIOMARKER SPACE 

1069
00:52:35,244 --> 00:52:36,045
IS TOUGH GOING.

1070
00:52:36,045 --> 00:52:46,556
TO HAVE A MARKER BETTER THAN 

1071
00:52:46,789 --> 00:52:51,260
THAN A PAIN SCORE WOULD PREDICT 

1072
00:52:51,260 --> 00:52:53,663
WHO WILL HIGH INTENSITY PAIN 

1073
00:52:53,663 --> 00:52:55,598
VERSUS LOW INTENSE 

1074
00:52:55,598 --> 00:52:58,534
I PAIN AFTER AN INSULT WOULD BE 

1075
00:52:58,534 --> 00:53:00,336
FANTASTIC AND TRYING TO DESIGN 

1076
00:53:00,336 --> 00:53:03,005
CLINICAL TRIALS.

1077
00:53:03,005 --> 00:53:06,609
I GUESS THERE'S BEEN LITERATURE 

1078
00:53:06,609 --> 00:53:09,812
LOOKED AT BY THIS GROUP FROM 

1079
00:53:09,812 --> 00:53:11,414
UNIVERSITY OF MARYLAND 

1080
00:53:11,414 --> 00:53:14,283
PARTNERING WITH EXPERIMENTALISTS

1081
00:53:14,283 --> 00:53:24,527
IN AUSTRALIA.

1082
00:53:33,135 --> 00:53:39,475
AND THEY'RE TRYING TO IDENTIFY A

1083
00:53:39,475 --> 00:53:41,511
BIOMARKER WHO DEVELOPS SEVERE 

1084
00:53:41,511 --> 00:53:43,045
VERSUS THOSE WHO DON'T.

1085
00:53:43,045 --> 00:53:46,682
GOOD RESULTS LOOKING AT THE PEAK

1086
00:53:46,682 --> 00:53:48,885
ALPHA FREQUENCY ON THE 

1087
00:53:48,885 --> 00:53:50,286
SENSORIMOTOR EG LEADS.

1088
00:53:50,286 --> 00:53:54,624
BASICALLY WHAT YOU SEE IS THAT 

1089
00:53:54,624 --> 00:53:58,127
THE BLUE WHICH IS THE -- I GET 

1090
00:53:58,127 --> 00:54:01,297
THIS WRONG EVERY TIME.

1091
00:54:01,297 --> 00:54:08,137
THE PEOPLE PREDICTED HIGH PAIN 

1092
00:54:08,137 --> 00:54:14,343
HA

1093
00:54:14,343 --> 00:54:18,481
HAVE A SLOWER FREQUENCY THAN THE

1094
00:54:18,481 --> 00:54:24,420
PEOPLE WITH HIGH PAIN HAVE A 

1095
00:54:24,420 --> 00:54:25,588
LOWER FREQUENCY THAN THE PEOPLE 

1096
00:54:25,588 --> 00:54:27,623
THAT GO ON TO DEVELOP HIGH PAIN.

1097
00:54:27,623 --> 00:54:30,092
AND THEY ALSO LOOK AT WHAT'S 

1098
00:54:30,092 --> 00:54:40,469
CALLED CORTICAL MOTOR 

1099
00:54:41,704 --> 00:54:42,004
ACCELERATION.

1100
00:54:42,004 --> 00:54:46,509
WHAT YOU SEE IS OVER TIME IN THE

1101
00:54:46,509 --> 00:54:50,279
LOWER RIGHT HAND GROUP THE 

1102
00:54:50,279 --> 00:54:59,455
PEOPLE WHO HAVE HAVE LOW PAIN --

1103
00:54:59,455 --> 00:55:02,858
PEOPLE WITH HIGH PAIN HAVE A 

1104
00:55:02,858 --> 00:55:06,395
SHRINKAGE OF THE CORTICAL MOTOR 

1105
00:55:06,395 --> 00:55:09,165
EXCITABILITY OVER TIME.

1106
00:55:09,165 --> 00:55:11,167
CORTICO MOTOR EXCITABILITY.

1107
00:55:11,167 --> 00:55:17,473
AND WITH THE CORTICO MOTOR 

1108
00:55:17,473 --> 00:55:19,642
EXCITABILITY IT PREDICTS WHO 

1109
00:55:19,642 --> 00:55:21,210
GOES ON TO DEVELOP HIGH 

1110
00:55:21,210 --> 00:55:23,012
INTENSITY VERSUS LOW INTENSITY 

1111
00:55:23,012 --> 00:55:23,479
PAIN.

1112
00:55:23,479 --> 00:55:25,681
SO A BIOMARKER COMING RIGHT OUT 

1113
00:55:25,681 --> 00:55:29,952
OF EEG WHICH LOOKS LIKE -- IT 

1114
00:55:29,952 --> 00:55:32,955
LOOKS ROBUST IN THE MODEL WHICH 

1115
00:55:32,955 --> 00:55:36,025
IS AGAIN A CLASS MODEL SO 

1116
00:55:36,025 --> 00:55:39,195
PROBABLY A LITTLE MORE ROBUST 

1117
00:55:39,195 --> 00:55:43,065
THAN YOU MIGHT SEE.

1118
00:55:43,065 --> 00:55:46,068
AND ANOTHER REPORT TO MENTION IS

1119
00:55:46,068 --> 00:55:50,106
WORK BEING DONE ON THE DEVICES.

1120
00:55:50,106 --> 00:55:52,308
THIS ONE COULD GET DEVELOPED TO 

1121
00:55:52,308 --> 00:55:54,477
GET MORE PRECISE STIMULATION OF 

1122
00:55:54,477 --> 00:55:58,514
THE ROOTS THAT ARE INVOLVED IN 

1123
00:55:58,514 --> 00:56:01,017
PAIN WITH A DEVICE AND HAS 

1124
00:56:01,017 --> 00:56:02,785
CONTROLLERS THAT ENABLE YOU TO 

1125
00:56:02,785 --> 00:56:06,822
REALLY GET OUT IN THE LATERAL 

1126
00:56:06,822 --> 00:56:09,158
SURFACE AND BE PRECISE ON WHICH 

1127
00:56:09,158 --> 00:56:10,826
ROOT YOU GO AFTER.

1128
00:56:10,826 --> 00:56:12,862
AND THIS IS A STUDY THAT CAME 

1129
00:56:12,862 --> 00:56:16,632
OUT OF THE HOPE STUDY WHICH IS A

1130
00:56:16,632 --> 00:56:27,143
STUDY OF PATIENTS WITH DYAT

1131
00:56:33,315 --> 00:56:34,984
DYATHATLON DIALYSIS AND DIDN'T 

1132
00:56:34,984 --> 00:56:37,053
SHOW SIGNIFICANT IMPACT ON THE 

1133
00:56:37,053 --> 00:56:39,055
EXTENT TO WHICH THE PAIN 

1134
00:56:39,055 --> 00:56:41,123
INTERFERED WITH THE PATIENT'S 

1135
00:56:41,123 --> 00:56:41,323
LIVES.

1136
00:56:41,323 --> 00:56:44,026
THE AFFECT WAS MODEST BUT HAD A 

1137
00:56:44,026 --> 00:56:46,996
VERY HIGH ACCESSIBILITY AND 

1138
00:56:46,996 --> 00:56:49,365
TOLERABILITY AND SAFETY.

1139
00:56:49,365 --> 00:56:52,068
HOPEFULLY IT'S SOMETHING THAT 

1140
00:56:52,068 --> 00:56:53,135
CAN GO INTO.

1141
00:56:53,135 --> 00:56:57,773
AND ANY RELIEF I'M SURE WOULD BE

1142
00:56:57,773 --> 00:57:01,010
APPRECIATED BY THESE FOLKS.

1143
00:57:01,010 --> 00:57:07,383
SO SO THOSE ARE THE REMARKS FROM

1144
00:57:07,383 --> 00:57:09,852
NORA AND I THAT LET PEOPLE KNOW 

1145
00:57:09,852 --> 00:57:11,020
WHAT'S GOING ON AND WILL BE 

1146
00:57:11,020 --> 00:57:13,622
HAPPY TO ANSWER ANY QUESTIONS 

1147
00:57:13,622 --> 00:57:13,956
NOW.

1148
00:57:13,956 --> 00:57:17,526
WE REALLY HAVE TO STICK TO THE 

1149
00:57:17,526 --> 00:57:18,194
SCIENCE.

1150
00:57:18,194 --> 00:57:19,762
AS THE A LOT GOING ON AT NIH.

1151
00:57:19,762 --> 00:57:21,163
IT'S PROBABLY BEST IF WE DON'T 

1152
00:57:21,163 --> 00:57:26,102
GO THERE.

1153
00:57:26,102 --> 00:57:29,004
BUT HAPPY TO TALK ABOUT WHAT 

1154
00:57:29,004 --> 00:57:31,073
NORA MENTIONED AND WHAT I 

1155
00:57:31,073 --> 00:57:33,142
THOUGHT ABOUT IN REGARD TO THE 

1156
00:57:33,142 --> 00:57:43,419
HEAL INITIATIVE.

1157
00:57:44,520 --> 00:57:45,154
>> Director Volkow: ANYONE
THAT 

1158
00:57:45,154 --> 00:57:47,123
HAS QUESTIONS CAN RAISE THEIR 

1159
00:57:47,123 --> 00:57:57,233
HAND.

1160
00:58:02,772 --> 00:58:04,240
YES, TERRY.

1161
00:58:04,240 --> 00:58:06,842
YOU'RE MUTED.

1162
00:58:06,842 --> 00:58:09,111
>> YES, WELL I'M ACTUALLY 

1163
00:58:09,111 --> 00:58:10,813
PUTTING IT IN THE CHAT.

1164
00:58:10,813 --> 00:58:12,381
I THOUGHT THIS WAS SUCH 

1165
00:58:12,381 --> 00:58:15,518
INCREDIBLY GOOD NEWS ABOUT THE 

1166
00:58:15,518 --> 00:58:16,152
DECREASES IN OVERDOSE DEATHS.

1167
00:58:16,152 --> 00:58:24,226
IT'S TERRIFIC.

1168
00:58:24,226 --> 00:58:26,629
OBVIOUSLY ENORMOUS WORK GOING ON

1169
00:58:26,629 --> 00:58:28,697
AND TREATMENT WITH REGARDS TO 

1170
00:58:28,697 --> 00:58:30,633
NALOXONE AND IT'S CLEAR TO ME A 

1171
00:58:30,633 --> 00:58:33,169
LOT OF THE INTERVENTIONS ARE 

1172
00:58:33,169 --> 00:58:35,805
CLEARLY DRIVING THIS.

1173
00:58:35,805 --> 00:58:38,607
ARE THERE DATA THAT I KNOW THEY 

1174
00:58:38,607 --> 00:58:39,842
COULDN'T PRESENT TODAY BUT TO 

1175
00:58:39,842 --> 00:58:42,578
SUGGEST THE USE IS COMING DOWN?

1176
00:58:42,578 --> 00:58:46,282
IS THIS IS AT LEAST SOME 

1177
00:58:46,282 --> 00:58:53,622
CONTRIBUTOR TO THE CHANGE.

1178
00:58:53,622 --> 00:58:59,829
WITH THE INITIATION OF USE AND 

1179
00:58:59,829 --> 00:59:02,064
IT'S PROBABLY HARD TO GET OTHER 

1180
00:59:02,064 --> 00:59:04,033
DATA BUT JUST CURIOUS.

1181
00:59:04,033 --> 00:59:05,801
>> Director Volkow: THERE
ARE 

1182
00:59:05,801 --> 00:59:07,536
SURVEYS DONE ON A YEARLY BASIS 

1183
00:59:07,536 --> 00:59:09,138
ALLOWING ONE TO LOOK AT THE 

1184
00:59:09,138 --> 00:59:12,842
SURVEYS WHICH ARE PRETTY YARD 

1185
00:59:12,842 --> 00:59:14,143
LIKE ONE FROM SAMHSA WHICH IS 

1186
00:59:14,143 --> 00:59:17,646
PEOPLE 12 YEARS OR OLDER.

1187
00:59:17,646 --> 00:59:20,649
AND ONE TOWARDS PEOPLE NOT 

1188
00:59:20,649 --> 00:59:23,152
HOMELESS AND TO ASSESS WHETHER 

1189
00:59:23,152 --> 00:59:24,954
THERE'S ANY EVIDENCE OF 

1190
00:59:24,954 --> 00:59:26,255
REDUCTION IN SUBSTANCE USE.

1191
00:59:26,255 --> 00:59:28,624
WHAT I CAN TELL YOU IS THE DATA 

1192
00:59:28,624 --> 00:59:32,194
DOES NOT SEEM TO SHOW THERE'S A 

1193
00:59:32,194 --> 00:59:33,729
DECREASE IN SUBSTANCE USE PER SE

1194
00:59:33,729 --> 00:59:36,398
AND SOMETIMES USING THE 

1195
00:59:36,398 --> 00:59:39,501
INITIATION, OPIOID USE 

1196
00:59:39,501 --> 00:59:39,902
INITIATION.

1197
00:59:39,902 --> 00:59:43,572
IN ADOLESCENCE THOUGH YES, AND 

1198
00:59:43,572 --> 00:59:45,708
WE'VE BEEN SEEING FOR MANY 

1199
00:59:45,708 --> 00:59:45,908
YEARS.

1200
00:59:45,908 --> 00:59:46,976
IT'S NOT CONSISTENT IN ANY WAY 

1201
00:59:46,976 --> 00:59:49,478
WITH THE RISE WE WERE SEEING IN 

1202
00:59:49,478 --> 00:59:52,114
OVERDOSES BUT WERE SEEING 

1203
00:59:52,114 --> 00:59:54,450
DECLINE IN SUBSTANCE USE AMONG 

1204
00:59:54,450 --> 00:59:55,150
TEENAGERS AND THAT CONTINUES TO 

1205
00:59:55,150 --> 00:59:56,252
GO AHEAD.

1206
00:59:56,252 --> 00:59:59,521
IT'S NOT SO MUCH PEOPLE ARE 

1207
00:59:59,521 --> 01:00:01,824
USING LESS SUBSTANCES.

1208
01:00:01,824 --> 01:00:05,127
IT'S MORE LIKELY THE SUBSTANCES 

1209
01:00:05,127 --> 01:00:08,163
THE ELICIT DRUGS AVAILABLE ARE 

1210
01:00:08,163 --> 01:00:09,431
LESS DANGEROUS BECAUSE THEY 

1211
01:00:09,431 --> 01:00:11,100
HAVE -- THE FENTANYL THAT'S 

1212
01:00:11,100 --> 01:00:14,336
COMING INTO THE COUNTRY HAS 

1213
01:00:14,336 --> 01:00:15,905
LOWER PURITY AND HAS BECOME 

1214
01:00:15,905 --> 01:00:18,073
HARDER TO BRING IT.

1215
01:00:18,073 --> 01:00:20,009
THE DEALERS DON'T SEE SO MUCH OF

1216
01:00:20,009 --> 01:00:23,545
AN INCENTIVE TO MIX COCAINE WITH

1217
01:00:23,545 --> 01:00:23,913
FENTANYL.

1218
01:00:23,913 --> 01:00:26,649
THAT'S ONE FACTOR THAT WILL MAKE

1219
01:00:26,649 --> 01:00:32,554
THE ILLICIT DRUGS AVAILABLE LESS

1220
01:00:32,554 --> 01:00:32,955
DANGEROUS.

1221
01:00:32,955 --> 01:00:35,190
ALSO THERE'S BEEN AN EDUCATION.

1222
01:00:35,190 --> 01:00:38,627
IN THE BEGINNING WE WERE SEEING 

1223
01:00:38,627 --> 01:00:43,098
THE LATE '20s, BEFORE 2018 

1224
01:00:43,098 --> 01:00:43,899
PEOPLE DIDN'T REALIZE HOW 

1225
01:00:43,899 --> 01:00:46,201
DANGEROUS FENTANYL WAS.

1226
01:00:46,201 --> 01:00:48,837
I RECALL BECAUSE I WAS IN WEST 

1227
01:00:48,837 --> 01:00:51,874
VIRGINIA AROUND IN A TOWN WITH 

1228
01:00:51,874 --> 01:00:53,108
EXTREMELY HIGH RATES OF OVERDOSE

1229
01:00:53,108 --> 01:00:54,643
AND PEOPLE DIDN'T KNOW WHAT 

1230
01:00:54,643 --> 01:00:55,444
FENTANYL WAS.

1231
01:00:55,444 --> 01:00:58,914
IT WAS THE CAPITAL OF OVERDOSE 

1232
01:00:58,914 --> 01:00:59,148
DEATHS.

1233
01:00:59,148 --> 01:01:02,217
SO THROUGH EDUCATION AND PEOPLE 

1234
01:01:02,217 --> 01:01:05,187
HAVE BECOME MORE MINDFUL ABOUT 

1235
01:01:05,187 --> 01:01:09,658
THE DANGERS AND OF COURSE THAT 

1236
01:01:09,658 --> 01:01:14,063
DID NOT STOP THE INCREASE IN THE

1237
01:01:14,063 --> 01:01:17,099
COVID PANDEMIC BUT WITH TIME THE

1238
01:01:17,099 --> 01:01:20,970
MORE YOU SEND A MESSAGE PEOPLE 

1239
01:01:20,970 --> 01:01:21,570
ARE AWARE.

1240
01:01:21,570 --> 01:01:23,872
THEY'VE LEARNED THEY'VE HAD TO 

1241
01:01:23,872 --> 01:01:25,274
TAKE THE DRUGS MORE CAREFULLY 

1242
01:01:25,274 --> 01:01:29,144
AND THE USE OF NALOXONE HAS 

1243
01:01:29,144 --> 01:01:29,812
INCREASED ENORMOUSLY.

1244
01:01:29,812 --> 01:01:33,349
IF I WERE TO PICK UP ONE I WOULD

1245
01:01:33,349 --> 01:01:36,385
SAY PERHAPS NALOXONE HAS BEEN 

1246
01:01:36,385 --> 01:01:37,152
THE MOST CONSEQUENTIAL.

1247
01:01:37,152 --> 01:01:44,560
>> THANK YOU.

1248
01:01:44,560 --> 01:01:45,794
I SEE A HAND RAISED.

1249
01:01:45,794 --> 01:01:46,795
>> THANK YOU BOTH.

1250
01:01:46,795 --> 01:01:48,163
IT'S A GREAT REVIEW.

1251
01:01:48,163 --> 01:01:51,467
I THOUGHT IT'S WORTH 

1252
01:01:51,467 --> 01:01:57,539
HIGHLIGHTING OR MENTION ED 

1253
01:01:57,539 --> 01:01:59,241
CERTAINLY FOR THE PUBLIC THAT'S 

1254
01:01:59,241 --> 01:02:01,110
LISTENING AND WHEN WALTER SPOKE 

1255
01:02:01,110 --> 01:02:04,146
OF THE NEW PAIN RELIEVING DRUG 

1256
01:02:04,146 --> 01:02:06,348
THAT WAS DEVELOPED AGAINST A 

1257
01:02:06,348 --> 01:02:09,151
PARTICULAR TARGET THAT IT WAS 

1258
01:02:09,151 --> 01:02:11,420
REALLY FUNDAMENTAL SCIENCE, PRE 

1259
01:02:11,420 --> 01:02:15,424
CLINICAL SCIENCE EVEN IN RODENTS

1260
01:02:15,424 --> 01:02:16,492
THAT DEMONSTRATED WHAT'S SPECIAL

1261
01:02:16,492 --> 01:02:18,460
ABOUT THE TARGET THAT IT'S ONLY 

1262
01:02:18,460 --> 01:02:21,630
FOUND IN WHAT WE CALL THE PAIN 

1263
01:02:21,630 --> 01:02:23,198
FIBERS MAKES IT A GREAT TARGET 

1264
01:02:23,198 --> 01:02:25,134
AND JUSTIFIED THE EXPENSE TO 

1265
01:02:25,134 --> 01:02:26,535
COME UP WITH THE DRUG THAT 

1266
01:02:26,535 --> 01:02:28,270
TARGETS AND I WOULD SAY I KNOW 

1267
01:02:28,270 --> 01:02:29,405
THERE ARE OTHER COMPANIES THAT 

1268
01:02:29,405 --> 01:02:31,306
ARE GOING AFTER THE SAME TARGET 

1269
01:02:31,306 --> 01:02:33,809
OR RELATED TARGETS AND THE REAL 

1270
01:02:33,809 --> 01:02:35,511
BEAUTY OF IT, IT TURNS OUT THE 

1271
01:02:35,511 --> 01:02:39,715
TARGET IS NOT FOUND IN THE 

1272
01:02:39,715 --> 01:02:41,984
BRAIN, WHICH INCREASES THE 

1273
01:02:41,984 --> 01:02:43,152
LIKELIHOOD OF THAT HAVING WHAT 

1274
01:02:43,152 --> 01:02:44,553
WE CALL A THERAPEUTIC WINDOW TO 

1275
01:02:44,553 --> 01:02:47,289
BLOCK THE PAIN AND NOT PRODUCE 

1276
01:02:47,289 --> 01:02:48,924
THE ADVERSE SIDE EFFECTS THAT 

1277
01:02:48,924 --> 01:02:50,359
LIMIT SO MANY DRUGS.

1278
01:02:50,359 --> 01:02:54,363
THAT'S ALSO THE BEAUTY OF THE 

1279
01:02:54,363 --> 01:02:55,998
CANNABINOID TARGET TO WHICH 

1280
01:02:55,998 --> 01:02:57,566
WALTER MADE REFERENCE SINCE IT'S

1281
01:02:57,566 --> 01:02:59,168
ONLY FOUND OUTSIDE OF THE BRAIN 

1282
01:02:59,168 --> 01:03:02,137
AND AGAIN THE HOPE IS THAT IT 

1283
01:03:02,137 --> 01:03:03,972
WILL BE ABLE TO BLOCK PAIN AND 

1284
01:03:03,972 --> 01:03:05,174
HAVE A BETTER THERAPEUTIC 

1285
01:03:05,174 --> 01:03:05,574
WINDOW.

1286
01:03:05,574 --> 01:03:07,309
I THING THIS IS A BEAUTIFUL 

1287
01:03:07,309 --> 01:03:09,311
EXAMPLE OF WHERE THE PRE 

1288
01:03:09,311 --> 01:03:11,280
CLINICAL FUNDAMENT SCIENCE HAS 

1289
01:03:11,280 --> 01:03:13,582
MADE A DIFFERENCE.

1290
01:03:13,582 --> 01:03:17,152
THAT'S IN DEVELOPING NOVEL 

1291
01:03:17,152 --> 01:03:24,426
DRUGS.

1292
01:03:24,426 --> 01:03:25,094
>> Dr. Koroshetz: WE HAVE
TO GET

1293
01:03:25,094 --> 01:03:27,863
THE DOSES WHERE YOU GET A BIG 

1294
01:03:27,863 --> 01:03:30,732
AFFECT SIZE AND NOT THE SIDE 

1295
01:03:30,732 --> 01:03:30,999
EFFECTS.

1296
01:03:30,999 --> 01:03:31,900
IN THE BLOOD BRAIN BARRIER COULD

1297
01:03:31,900 --> 01:03:33,635
BE OUR FRIEND.

1298
01:03:33,635 --> 01:03:34,837
USUALLY IT'S OUR ENEMY BUT HERE 

1299
01:03:34,837 --> 01:03:37,539
IT COULD BE OUR FRIEND.

1300
01:03:37,539 --> 01:03:38,340
>> Director Volkow: IT'S
USUALLY

1301
01:03:38,340 --> 01:03:39,408
OUR FRIEND, WALTER.

1302
01:03:39,408 --> 01:03:41,510
YOU DON'T WANT ALL THE THINGS 

1303
01:03:41,510 --> 01:03:45,147
CIRCULATING GETTING IN OUR 

1304
01:03:45,147 --> 01:03:51,286
BRAIN.

1305
01:03:51,286 --> 01:03:53,122
THE OTHER BEAUTIFUL EXAMPLE 

1306
01:03:53,122 --> 01:03:55,491
WALTER PRESENTED ABOUT THE 

1307
01:03:55,491 --> 01:03:56,425
CANNABINOID RECEPTOR IT'S 

1308
01:03:56,425 --> 01:03:58,861
UNDERSTANDING THE THREE 

1309
01:03:58,861 --> 01:04:00,129
DIMENSIONAL STRUCTURE OF THE 

1310
01:04:00,129 --> 01:04:01,130
RECEPTOR AND THE DRUG.

1311
01:04:01,130 --> 01:04:03,098
IT'S THAT CHARACTERISTIC THAT 

1312
01:04:03,098 --> 01:04:05,934
MAKES IT PERIPHERALLY 

1313
01:04:05,934 --> 01:04:06,235
RESTRICTIVE.

1314
01:04:06,235 --> 01:04:08,237
THIS IS PURELY BASIC FUNDAMENTAL

1315
01:04:08,237 --> 01:04:08,470
SCIENCE.

1316
01:04:08,470 --> 01:04:12,241
SO THOSE ARE EXAMPLES OF WHY WE 

1317
01:04:12,241 --> 01:04:12,941
CANNOT NEGLECT BASIC SCIENCE AND

1318
01:04:12,941 --> 01:04:15,744
WE DON'T KNOW WHERE IT'S GOING 

1319
01:04:15,744 --> 01:04:16,712
TO GO.

1320
01:04:16,712 --> 01:04:18,213
CERTAINLY IT OPENS UP MANY DOORS

1321
01:04:18,213 --> 01:04:21,183
AND WINDOWS FOR MULTIPLE 

1322
01:04:21,183 --> 01:04:30,592
DISEASES.

1323
01:04:30,592 --> 01:04:33,128
>> ROB, DID YOU HAVE YOUR
HAND 

1324
01:04:33,128 --> 01:04:33,829
UP?

1325
01:04:33,829 --> 01:04:36,098
>> I DID BUT NORA MADE THE
POINT

1326
01:04:36,098 --> 01:04:38,066
OF AMPLIFYING THE BASIC POINT OF

1327
01:04:38,066 --> 01:04:42,204
SCIENCE YOU DON'T KNOW IF IT'S 

1328
01:04:42,204 --> 01:04:47,709
ADVANCES IN CRYO MICROSCOPY OR 

1329
01:04:47,709 --> 01:04:49,811
HOW PROTEINS ARE MOVING IN REAL 

1330
01:04:49,811 --> 01:04:50,913
TAME AND WE JUST DON'T KNOW 

1331
01:04:50,913 --> 01:04:59,288
WHERE IT'S COMING FROM.

1332
01:04:59,288 --> 01:05:00,622
SOMETHING WE HEARD ABOUT IN THE 

1333
01:05:00,622 --> 01:05:01,256
STRATEGIC PLANNING PROCESSES 

1334
01:05:01,256 --> 01:05:11,667
WHICH WE'LL TALK ABOUT.

1335
01:05:16,471 --> 01:05:17,039
>> Dr. Koroshetz: THAT WAS
ALL 

1336
01:05:17,039 --> 01:05:24,446
THE GOOD NEWS.

1337
01:05:24,446 --> 01:05:26,148
WE HAVE A MORE DIFFICULT TOPIC 

1338
01:05:26,148 --> 01:05:28,884
TO TALK ABOUT NEXT.

1339
01:05:28,884 --> 01:05:31,687
>> ERIC HAS HIS HAND UP,
WALTER.

1340
01:05:31,687 --> 01:05:33,789
>> I JUST RAISED IT.

1341
01:05:33,789 --> 01:05:35,691
I WAS SLOW TO THE PUNCH.

1342
01:05:35,691 --> 01:05:38,760
THANK YOU BOTH FOR YOUR 

1343
01:05:38,760 --> 01:05:41,863
FANTASTIC PRESENTATIONS AND 

1344
01:05:41,863 --> 01:05:45,334
THESE NEW DATA THAT ARE SO 

1345
01:05:45,334 --> 01:05:47,369
ENCOURAGING ABOUT THE MASSIVE 

1346
01:05:47,369 --> 01:05:49,004
DECLINE IN OVERDOSE DEATHS.

1347
01:05:49,004 --> 01:05:50,472
OBVIOUSLY WE'RE MAKING GREAT 

1348
01:05:50,472 --> 01:05:52,808
PROGRESS AND I REALLY FEEL LIKE 

1349
01:05:52,808 --> 01:05:55,444
THE FUNDING AND THE RIGOROUS 

1350
01:05:55,444 --> 01:05:57,145
SCIENCE THAT'S BEEN PUSHED BY 

1351
01:05:57,145 --> 01:05:58,547
THE NIH HEAL INITIATIVE HAS BEEN

1352
01:05:58,547 --> 01:06:00,315
PAYING OFF IN TERMS OF SAVING 

1353
01:06:00,315 --> 01:06:02,451
LIVES SO I THINK WE CAN ALL FEEL

1354
01:06:02,451 --> 01:06:05,053
REALLY GOOD ABOUT THAT.

1355
01:06:05,053 --> 01:06:07,155
MY QUESTION TO YOU IS BASED ON 

1356
01:06:07,155 --> 01:06:09,124
YOUR HIGH LEVEL VIEW, NORA, TO 

1357
01:06:09,124 --> 01:06:11,293
WHAT EXTENT IS ACCESS TO 

1358
01:06:11,293 --> 01:06:12,661
EVIDENCE-BASED TREATMENT FOR 

1359
01:06:12,661 --> 01:06:13,295
ADDICTION STILL A PRESSING NEED 

1360
01:06:13,295 --> 01:06:17,766
FOR SOCIETY?

1361
01:06:17,766 --> 01:06:19,368
>> YES, I THINK NORMALLY 

1362
01:06:19,368 --> 01:06:21,169
DEPENDING ON WHAT AREA OF THE 

1363
01:06:21,169 --> 01:06:24,139
COUNTRY YOU ARE AT AND AS I 

1364
01:06:24,139 --> 01:06:26,508
MENTIONED CLEARLY IN RURAL AREAS

1365
01:06:26,508 --> 01:06:28,110
THIS IS A MAJOR DEFICIT BUT SOME

1366
01:06:28,110 --> 01:06:29,745
OF THE URBAN AREAS ACCESS TO 

1367
01:06:29,745 --> 01:06:34,416
TREATMENT IS STILL VERY LIMITED.

1368
01:06:34,416 --> 01:06:37,119
SO AS A RESULT OF THAT AND WE 

1369
01:06:37,119 --> 01:06:39,488
ARE TARGETING -- WE'RE THINKING 

1370
01:06:39,488 --> 01:06:42,924
STRATEGICALLY HOW TO ACTUALLY 

1371
01:06:42,924 --> 01:06:44,559
TARGET THOSE AREAS AND WE 

1372
01:06:44,559 --> 01:06:46,361
HAVE -- WE'RE DOING AN 

1373
01:06:46,361 --> 01:06:48,130
ANALYSIS -- THERE WAS A RECENT 

1374
01:06:48,130 --> 01:06:50,499
ANALYSIS DONE THAT LOOKED AT THE

1375
01:06:50,499 --> 01:06:51,833
COMMUNITIES ACROSS THE UNITED 

1376
01:06:51,833 --> 01:06:55,270
STATES TO GET A SENSE OF THE 

1377
01:06:55,270 --> 01:06:58,340
LEVEL OF INVESTMENT ON HEALTH 

1378
01:06:58,340 --> 01:07:00,842
CARE NEEDS AND HOW WHAT THEY 

1379
01:07:00,842 --> 01:07:03,779
FOUND WAS TREMENDOUS DIVERSITY 

1380
01:07:03,779 --> 01:07:04,913
ACROSS THE UNITED STATES WITH 

1381
01:07:04,913 --> 01:07:06,848
SOME COUNTIES PUTTING MORE MONEY

1382
01:07:06,848 --> 01:07:07,983
THAN OTHERS AND SOME PUTTING 

1383
01:07:07,983 --> 01:07:09,318
MORE FOR A PARTICULAR AREA OF 

1384
01:07:09,318 --> 01:07:10,752
MEDICINE AND NOT THE OTHER.

1385
01:07:10,752 --> 01:07:13,021
WE'RE TRYING TO DO SOMETHING 

1386
01:07:13,021 --> 01:07:14,289
SIMILAR FOR THE SUBSTANCE USE 

1387
01:07:14,289 --> 01:07:16,591
DISORDER SPACE TO GET AN 

1388
01:07:16,591 --> 01:07:17,859
UNDERSTANDING NOT JUST AS WE 

1389
01:07:17,859 --> 01:07:21,163
KNOW THERE IS A DEFICIT BUT WHAT

1390
01:07:21,163 --> 01:07:23,265
ARE THE CHARACTERISTICS OF THOSE

1391
01:07:23,265 --> 01:07:24,833
DEFICITS AND AT THE SAME TIME, 

1392
01:07:24,833 --> 01:07:29,137
WHAT ARE THE CHARACTERISTICS OF 

1393
01:07:29,137 --> 01:07:30,105
THOSE COMMUNITIES?

1394
01:07:30,105 --> 01:07:32,107
ONE CAN GET FLEXIBLE TAILORED 

1395
01:07:32,107 --> 01:07:33,175
INTERVENTIONS TO BE TARGETED 

1396
01:07:33,175 --> 01:07:37,112
BASED ON THE CONTEXT AND 

1397
01:07:37,112 --> 01:07:37,479
CONDITION.

1398
01:07:37,479 --> 01:07:40,782
WE ARE TRYING TO NOW EXPAND WITH

1399
01:07:40,782 --> 01:07:43,885
GREATER UNDERSTANDING THE DATA 

1400
01:07:43,885 --> 01:07:45,287
THAT CAN HELP US IDENTIFY THE 

1401
01:07:45,287 --> 01:07:47,456
SPECIFICS OF THE NEED BECAUSE 

1402
01:07:47,456 --> 01:07:52,694
THE NEED IS OUT THERE, 

1403
01:07:52,694 --> 01:07:54,396
ABSOLUTELY, BUT NOT EQUAL ACROSS

1404
01:07:54,396 --> 01:07:56,598
THE COUNTRY SO HOW DO YOU TARGET

1405
01:07:56,598 --> 01:07:56,798
THAT?

1406
01:07:56,798 --> 01:07:57,332
>> THANK YOU.

1407
01:07:57,332 --> 01:08:07,609
VERY IMPORTANT.

1408
01:08:12,214 --> 01:08:15,817
>> Director Volkow: I
DON'T HEAR

1409
01:08:15,817 --> 01:08:16,752
YOU, WALTER.

1410
01:08:16,752 --> 01:08:18,019
>> Dr. Koroshetz: OKAY, SO
OUR 

1411
01:08:18,019 --> 01:08:22,624
NEXT TOPIC ACTUALLY IS WITH 

1412
01:08:22,624 --> 01:08:29,464
REGARD TO THE MDWG.

1413
01:08:29,464 --> 01:08:29,631
SO DEF 

1414
01:08:31,600 --> 01:08:33,135
SO, THIS GROUP HAS BEEN AMAZING 

1415
01:08:33,135 --> 01:08:43,445
OVER THE YEARS.

1416
01:08:43,445 --> 01:08:44,379
A LOT HAS BEEN THROUGH YOUR 

1417
01:08:44,379 --> 01:08:44,713
CONTRIBUTIONS.

1418
01:08:44,713 --> 01:08:50,519
WE THINK IT'S PROBABLY TIME TO 

1419
01:08:50,519 --> 01:08:54,856
GO THROUGH AND RECONSTITUTE THE 

1420
01:08:54,856 --> 01:08:59,494
MDWG OVER TIME WITH SIMILAR 

1421
01:08:59,494 --> 01:09:00,896
EXPERTISE MAYBE NEW FOLKS AND 

1422
01:09:00,896 --> 01:09:02,831
GIVE NEW FOLKS A CHANCE TO COME 

1423
01:09:02,831 --> 01:09:03,899
IN AND ALSO GIVE YOU GUYS A 

1424
01:09:03,899 --> 01:09:06,067
BREAK FOR A WHILE BEFORE WE CALL

1425
01:09:06,067 --> 01:09:06,968
ON YOU AGAIN.

1426
01:09:06,968 --> 01:09:08,804
WE KNOW WHERE YOU LIVE.

1427
01:09:08,804 --> 01:09:13,175
WE KNOW YOUR E-MAILS SO WE WILL 

1428
01:09:13,175 --> 01:09:15,076
BE CALLING BUT WE THOUGHT IT'S 

1429
01:09:15,076 --> 01:09:16,578
PROBABLY THE RIGHT TIME TO DO 

1430
01:09:16,578 --> 01:09:16,745
IT.

1431
01:09:16,745 --> 01:09:18,447
WE'RE NOT HAPPY ABOUT IT BECAUSE

1432
01:09:18,447 --> 01:09:20,849
WE REALLY LIKE YOU GUYS BUT 

1433
01:09:20,849 --> 01:09:21,483
THINK IT WAS THE RIGHT THING TO 

1434
01:09:21,483 --> 01:09:30,692
DO.

1435
01:09:30,692 --> 01:09:31,460
>> Director Volkow: I WAS
GOING 

1436
01:09:31,460 --> 01:09:33,128
TO COMMENT, WALTER, WE DO THIS 

1437
01:09:33,128 --> 01:09:35,931
FOR OUR COUNCILS AND OTHER 

1438
01:09:35,931 --> 01:09:38,967
GROUPS THAT WE ROTATE THE 

1439
01:09:38,967 --> 01:09:41,470
MEMBERS TO GET DIFFERENT 

1440
01:09:41,470 --> 01:09:41,803
PERSPECTIVES.

1441
01:09:41,803 --> 01:09:44,773
FIRST OF ALL, WE'RE VERY 

1442
01:09:44,773 --> 01:09:47,809
GRATEFUL FOR ALL THE WORK YOU'VE

1443
01:09:47,809 --> 01:09:50,579
DONE AND RECOGNIZE YOU HAVE A 

1444
01:09:50,579 --> 01:09:53,148
UNIQUE PERSPECTIVE AND IT'S MADE

1445
01:09:53,148 --> 01:09:54,149
HEAL MUCH BETTER.

1446
01:09:54,149 --> 01:09:56,685
THE FACT WE'RE GOING TO GO INTO 

1447
01:09:56,685 --> 01:09:59,454
A PROCESS OF ACTUALLY GETTING 

1448
01:09:59,454 --> 01:10:01,556
NEW MEMBERS DOES NOT IN ANY WAY 

1449
01:10:01,556 --> 01:10:03,124
INDICATE THAT WE'RE NOT GOING TO

1450
01:10:03,124 --> 01:10:06,862
BE RELYING ON YOU FOR OTHER 

1451
01:10:06,862 --> 01:10:07,062
TASKS.

1452
01:10:07,062 --> 01:10:09,364
BUT FOR THE MULTI-DISCIPLINARY 

1453
01:10:09,364 --> 01:10:13,435
GROUP LIKE WHAT WE DO WITH OTHER

1454
01:10:13,435 --> 01:10:19,307
GROUPS IS ROTATE THE MEMBERS AND

1455
01:10:19,307 --> 01:10:21,376
REFLECT THE FACT WE ARE NOT VERY

1456
01:10:21,376 --> 01:10:23,378
IMPRESSED AND PLEASED WITH YOUR 

1457
01:10:23,378 --> 01:10:23,778
INVOLVEMENT.

1458
01:10:23,778 --> 01:10:25,347
IN FACT WE'RE BOTH VERY GRATE.

1459
01:10:25,347 --> 01:10:25,714
.

1460
01:10:25,714 --> 01:10:29,117
AND WE'LL MISS YOU AS PART OF 

1461
01:10:29,117 --> 01:10:30,452
THE MULTI-DISCIPLINARY GROUP.

1462
01:10:30,452 --> 01:10:32,988
YES, WE KNOW YOUR E-MAILS AND 

1463
01:10:32,988 --> 01:10:34,256
WE'LL BE SEEING YOU AND RELYING 

1464
01:10:34,256 --> 01:10:37,092
ON YOU TO ACTUALLY KEEP US 

1465
01:10:37,092 --> 01:10:37,392
ACCOUNTABLE.

1466
01:10:37,392 --> 01:10:41,129
THAT IS PART OF YOUR JOB WHETHER

1467
01:10:41,129 --> 01:10:42,464
YOU'RE PART OF THE 

1468
01:10:42,464 --> 01:10:43,665
MULTI-DISCIPLINARY GROUP OR NOT 

1469
01:10:43,665 --> 01:10:45,267
AND YOU REACH OUT TO US FOR 

1470
01:10:45,267 --> 01:10:48,103
SUGGESTIONS.

1471
01:10:48,103 --> 01:10:50,205
WALTER, YOU HAD BASICALLY A 

1472
01:10:50,205 --> 01:10:51,673
PROCESS BY WHICH WE'RE GOING TO 

1473
01:10:51,673 --> 01:10:52,307
BE DOING THESE.

1474
01:10:52,307 --> 01:10:56,444
YOU WANT TO GO OVER IT?

1475
01:10:56,444 --> 01:10:59,381
>> Dr. Koroshetz: SO I
JUST WANT

1476
01:10:59,381 --> 01:11:01,116
TO SAY, NORA SAID FOR COUNCIL 

1477
01:11:01,116 --> 01:11:05,120
IT'S EVERY FOUR YEARS, SAME 

1478
01:11:05,120 --> 01:11:07,188
THING I THINK YOU GUYS HAVE BEEN

1479
01:11:07,188 --> 01:11:09,357
SIX, SEVEN YEARS SOME OF YOU.

1480
01:11:09,357 --> 01:11:11,493
AND THAT'S BECAUSE YEAH IT'S 

1481
01:11:11,493 --> 01:11:21,870
BEEN WORKING SO WELL.

1482
01:11:24,472 --> 01:11:25,140
WE WEREN'T FORCED BUT THINK IT'S

1483
01:11:25,140 --> 01:11:26,942
THE RIGHT THING TO DO AND TO 

1484
01:11:26,942 --> 01:11:28,343
ROTATE SIX OR SEVEN MEMBERS.

1485
01:11:28,343 --> 01:11:30,245
WE HAVE 14 MEMBERS AND ROTATE 

1486
01:11:30,245 --> 01:11:34,416
SIX OR SEVEN OFF FOR THE NEXT 

1487
01:11:34,416 --> 01:11:44,326
MEETING AND THEN GET SIX OR 

1488
01:11:44,326 --> 01:11:48,463
SEVEN AND IN AUGUST AND THEN 

1489
01:11:48,463 --> 01:11:50,498
ROTATE NEW PEOPLE ON.

1490
01:11:50,498 --> 01:11:57,138
THAT'S WHAT WE'RE WORKING ON.

1491
01:11:57,138 --> 01:12:00,342
WE'LL BRING IN NEW MEMBERS AND 

1492
01:12:00,342 --> 01:12:03,078
ONE COHORT WILL PROBABLY ON FOR 

1493
01:12:03,078 --> 01:12:04,512
TWO AND A HALF YEARS AND THEN 

1494
01:12:04,512 --> 01:12:07,782
ROTATE OFF BECAUSE WE WANT TO 

1495
01:12:07,782 --> 01:12:09,150
GET AWAY FROM A SYSTEM WHERE 

1496
01:12:09,150 --> 01:12:10,652
EVERYBODY ROTATES AT THE SAME 

1497
01:12:10,652 --> 01:12:13,121
TIME WHICH IS WHAT WE GOT 

1498
01:12:13,121 --> 01:12:18,460
OURSELVES INTO HERE.

1499
01:12:18,460 --> 01:12:20,862
THE FIRST WILL BE ON 2.5 YEARS 

1500
01:12:20,862 --> 01:12:22,030
AND THE NEXT GROUP ON FOUR YEARS

1501
01:12:22,030 --> 01:12:23,765
AND THEN ROTATION OF NEW PEOPLE 

1502
01:12:23,765 --> 01:12:32,307
EVERY FEW YEARS OR SO.

1503
01:12:32,307 --> 01:12:34,409
WE THINK WE HAD A GOOD SPREAD OF

1504
01:12:34,409 --> 01:12:35,644
EXPERTISE HERE.

1505
01:12:35,644 --> 01:12:37,879
WHAT WE'D LIKE YOU TO DO, IF 

1506
01:12:37,879 --> 01:12:41,549
YOU'RE WILLING, IS TO TRY TO 

1507
01:12:41,549 --> 01:12:44,486
THINK OF PEOPLE LIKE YOU OR 

1508
01:12:44,486 --> 01:12:46,421
SIMILAR IN TERM OF EXPERTISE 

1509
01:12:46,421 --> 01:12:49,791
THAT YOU WOULD SUGGEST WOULD BE 

1510
01:12:49,791 --> 01:12:53,595
GOOD PEOPLE TO THINK ABOUT FOR 

1511
01:12:53,595 --> 01:12:55,964
THE REPLACEMENT GROUPS COMING 

1512
01:12:55,964 --> 01:12:56,131
IN.

1513
01:12:56,131 --> 01:12:59,601
WE'RE HOPING A PLAN WOULD BE TO 

1514
01:12:59,601 --> 01:13:07,509
HAVE AT LEAST ONE NUMBER AN 

1515
01:13:07,509 --> 01:13:11,212
NINDS COUNCIL MEMBER AND ONE 

1516
01:13:11,212 --> 01:13:14,849
NIDA MEMBER LINKING MDWG TO 

1517
01:13:14,849 --> 01:13:15,083
COUNCIL.

1518
01:13:15,083 --> 01:13:16,518
IT'S AN UNOFFICIAL WORKING GROUP

1519
01:13:16,518 --> 01:13:17,118
OF COUNCILS.

1520
01:13:17,118 --> 01:13:21,022
WE DEFINITELY NEED AT LEAST ONE 

1521
01:13:21,022 --> 01:13:23,658
MEMBER POTENTIALLY MORE OF 

1522
01:13:23,658 --> 01:13:29,130
PEOPLE WHO HAVE HAD LIVED 

1523
01:13:29,130 --> 01:13:32,967
EXPERIENCE IN EITHER PAIN OR 

1524
01:13:32,967 --> 01:13:34,169
OPIOID USE DISORDER OR A 

1525
01:13:34,169 --> 01:13:35,603
COMBINATION.

1526
01:13:35,603 --> 01:13:40,642
I THINK FOR SOME COMMITTEES AND 

1527
01:13:40,642 --> 01:13:42,644
AT NIH YOU CAN'T BE ON ANOTHER 

1528
01:13:42,644 --> 01:13:43,111
STUDY SECTION.

1529
01:13:43,111 --> 01:13:47,615
FOR US I DON'T THINK IT THE 

1530
01:13:47,615 --> 01:13:52,754
MATTER SO SERVICE ON AN NIH 

1531
01:13:52,754 --> 01:13:53,555
FACULTY COMMITTEE IS NOT AN 

1532
01:13:53,555 --> 01:13:54,122
EXCLUSION BUT NOT REQUIRED 

1533
01:13:54,122 --> 01:14:00,028
EITHER.

1534
01:14:00,028 --> 01:14:02,997
SO WE HAVE A LITTLE BIT OF A 

1535
01:14:02,997 --> 01:14:04,899
TIME PLANNED FOR DOING THIS 

1536
01:14:04,899 --> 01:14:06,267
STUFF AND HAVE WIDE SOLICITATION

1537
01:14:06,267 --> 01:14:08,803
PROBABLY STARTING NEXT MONTH.

1538
01:14:08,803 --> 01:14:11,439
THEN TRYING TO DEVELOP A SLATE 

1539
01:14:11,439 --> 01:14:14,509
SOME TIME IN APRIL, LATE APRIL 

1540
01:14:14,509 --> 01:14:20,515
AND THEN SEE WHO WE CAN CAJOLE 

1541
01:14:20,515 --> 01:14:21,950
TO COME IN.

1542
01:14:21,950 --> 01:14:24,753
AND WHAT'S OFTEN VERY HELPFUL 

1543
01:14:24,753 --> 01:14:27,722
PEOPLE DON'T KNOW EXACTLY WHAT 

1544
01:14:27,722 --> 01:14:30,191
IT'S LIKE BUT ANYBODY ON THIS 

1545
01:14:30,191 --> 01:14:32,026
GROUP WOULD BE WILLING TO TALK 

1546
01:14:32,026 --> 01:14:34,329
TO PEOPLE THINKING ABOUT COMING 

1547
01:14:34,329 --> 01:14:36,865
ON, I THINK THAT WOULD BE 

1548
01:14:36,865 --> 01:14:38,133
HELPFUL SO THEY KNOW WHAT 

1549
01:14:38,133 --> 01:14:39,901
THEY'RE GETTING INTO AND ALSO 

1550
01:14:39,901 --> 01:14:43,638
KNOW HOW GOOD A GROUP IT'S BEEN.

1551
01:14:43,638 --> 01:14:45,140
SO THAT'S KIND OF OUR PLAN FOR 

1552
01:14:45,140 --> 01:14:51,279
NOW.

1553
01:14:51,279 --> 01:14:52,614
IF THERE ARE PEOPLE WILLING TO 

1554
01:14:52,614 --> 01:14:54,816
COME OFF IN THE FIRST GROUP, 

1555
01:14:54,816 --> 01:14:57,452
PLEASE LET US KNOW AND EVERYONE 

1556
01:14:57,452 --> 01:15:07,929
IF YOU CAN THINK ABOUT THAT.

1557
01:15:14,102 --> 01:15:16,671
>> OUR NEXT MEETING IS
APRIL 29 

1558
01:15:16,671 --> 01:15:18,139
AND STILL KEEP THE CURRENT 

1559
01:15:18,139 --> 01:15:19,474
MEMBERSHIP FOR THAT AND START 

1560
01:15:19,474 --> 01:15:23,645
ROTATING IN AUGUST, WHICH IS TWO

1561
01:15:23,645 --> 01:15:24,946
MEETINGS FROM NOW.

1562
01:15:24,946 --> 01:15:25,580
>> Dr. Koroshetz: TWO
MEETINGS.

1563
01:15:25,580 --> 01:15:35,623
OKAY.

1564
01:15:35,623 --> 01:15:37,859
ALL RIGHT -- 

1565
01:15:37,859 --> 01:15:43,498
>> CAN YOU HEAR ME?

1566
01:15:43,498 --> 01:15:45,133
JUST WANTED TO THANK YOU BOTH 

1567
01:15:45,133 --> 01:15:46,734
FOR YOUR UPDATE.

1568
01:15:46,734 --> 01:15:47,435
ALL THE TREMENDOUS PROGRESS THAT

1569
01:15:47,435 --> 01:15:49,504
YOU'RE MAKING AND FOR YOUR KIND 

1570
01:15:49,504 --> 01:15:52,207
WORDS ABOUT OUR SERVICE ON THE 

1571
01:15:52,207 --> 01:15:52,540
GROUP.

1572
01:15:52,540 --> 01:15:55,376
I THINK THIS IS -- NO ONE WOULD 

1573
01:15:55,376 --> 01:15:56,744
SAY THIS IS THE WRONG MOVE.

1574
01:15:56,744 --> 01:15:58,880
WE CLEARLY NEED TO HEAR FROM A 

1575
01:15:58,880 --> 01:16:00,882
WIDER MORE DIVERSE GROUP OF 

1576
01:16:00,882 --> 01:16:01,649
PEOPLE AND GIVE PEOPLE 

1577
01:16:01,649 --> 01:16:03,551
OPPORTUNITIES TO ROTATE ON AND 

1578
01:16:03,551 --> 01:16:03,718
OFF.

1579
01:16:03,718 --> 01:16:06,087
I JUST DID HAVE A QUESTION ABOUT

1580
01:16:06,087 --> 01:16:09,090
THE LIVED EXPERIENCE 

1581
01:16:09,090 --> 01:16:09,390
PERSPECTIVE.

1582
01:16:09,390 --> 01:16:16,097
I KNOW THAT  BOTH INSTITUTES 

1583
01:16:16,097 --> 01:16:18,733
WITH THE GENERATION OF HEAL 2.0 

1584
01:16:18,733 --> 01:16:20,935
WITH LIVED EXPERIENCE PANELS 

1585
01:16:20,935 --> 01:16:21,336
INDIVIDUALLY.

1586
01:16:21,336 --> 01:16:22,804
JUST CURIOUS WHERE THAT STANDS.

1587
01:16:22,804 --> 01:16:27,041
ALSO, SIMILARLY TO HAVING OUR 

1588
01:16:27,041 --> 01:16:28,243
REPRESENTATIVE FOR EACH OF THE 

1589
01:16:28,243 --> 01:16:32,180
COUNCILS ON THIS MDWG IT WOULD 

1590
01:16:32,180 --> 01:16:34,449
MAKE SENSE IF THE GROUPS ARE IN 

1591
01:16:34,449 --> 01:16:36,451
PLACE YOU HAVE A LIVED 

1592
01:16:36,451 --> 01:16:37,886
EXPERIENCE LIAISON FROM THOSE 

1593
01:16:37,886 --> 01:16:43,625
TWO GROUPS ALSO REPRESENTED ON 

1594
01:16:43,625 --> 01:16:44,592
THE MDWG.

1595
01:16:44,592 --> 01:16:47,061
IT'S CERTAINLY BEEN MY PRIVILEGE

1596
01:16:47,061 --> 01:16:47,996
TO BE THE LIVED EXPERIENCE 

1597
01:16:47,996 --> 01:16:50,131
PERSON ON THE GROUP BUT I DON'T 

1598
01:16:50,131 --> 01:16:53,134
HAVE ANY EXPERIENCE WITH OUD OR 

1599
01:16:53,134 --> 01:16:53,635
OVERDOSE.

1600
01:16:53,635 --> 01:16:57,138
SO I THINK THAT PERSPECTIVE HAS 

1601
01:16:57,138 --> 01:16:59,007
BEEN MISSING ON THE MDWG BUT I 

1602
01:16:59,007 --> 01:17:01,109
WAS JUST CURIOUS WHERE THE 

1603
01:17:01,109 --> 01:17:02,343
DEVELOPMENT OF THAT STANDS WITH 

1604
01:17:02,343 --> 01:17:03,945
BOTH INSTITUTES AND WHETHER 

1605
01:17:03,945 --> 01:17:05,013
YOU'VE HAD ANY CONSIDERATION OF 

1606
01:17:05,013 --> 01:17:09,117
HAVING THERE BE A LIAISON TO THE

1607
01:17:09,117 --> 01:17:10,618
MDWG.

1608
01:17:10,618 --> 01:17:11,686
>> Director Volkow: IS
THAT 

1609
01:17:11,686 --> 01:17:13,454
OKAY, WALTER IF I START GIVING A

1610
01:17:13,454 --> 01:17:16,291
DESCRIPTION OF WHAT WE'VE DONE?

1611
01:17:16,291 --> 01:17:18,526
BECAUSE THIS IS A SPACE WE HAVE 

1612
01:17:18,526 --> 01:17:21,262
BEEN WORKING ON BEFORE THE HEAL 

1613
01:17:21,262 --> 01:17:22,964
INITIATIVE.

1614
01:17:22,964 --> 01:17:33,074
SO THERE IS A GROUP AT IS THE 

1615
01:17:33,074 --> 01:17:37,111
CLINICAL TRIAL NETWORK AND THE 

1616
01:17:37,111 --> 01:17:39,480
JCOM JUSTICE COMMUNITY 

1617
01:17:39,480 --> 01:17:42,283
INNOVATION NETWORK AS WELL AS 

1618
01:17:42,283 --> 01:17:43,985
THOSE PEOPLE WHO HAVE BEEN 

1619
01:17:43,985 --> 01:17:44,319
INCARCERATED.

1620
01:17:44,319 --> 01:17:45,687
IT'S BEEN PLANNED FOR THE 

1621
01:17:45,687 --> 01:17:56,064
NETWORK OF RECOVERY.

1622
01:17:56,064 --> 01:17:59,233
WHAT WE'VE DONE IS CREATE A 

1623
01:17:59,233 --> 01:18:01,636
GROUP FOR THE COUNCIL WITH 

1624
01:18:01,636 --> 01:18:02,804
PEOPLE WITH EXPERIENCES 

1625
01:18:02,804 --> 01:18:05,640
REPORTING TO OUR COUNCIL.

1626
01:18:05,640 --> 01:18:08,943
ONE OF THE COUNCIL MEMBERS WILL 

1627
01:18:08,943 --> 01:18:11,813
BE A PERMANENT INDIVIDUAL WITH A

1628
01:18:11,813 --> 01:18:22,123
LIVED EXPERIENCE.

1629
01:18:28,963 --> 01:18:33,634
AND I THINK IT'S A GOOD 

1630
01:18:33,634 --> 01:18:35,770
SUGGESTION AND ABSOLUTELY OPEN 

1631
01:18:35,770 --> 01:18:36,137
TO IT.

1632
01:18:36,137 --> 01:18:37,905
>> Dr. Koroshetz: I THINK
WE'RE 

1633
01:18:37,905 --> 01:18:40,475
THINKING SOMETHING ON THE PAIN 

1634
01:18:40,475 --> 01:18:40,675
SIDE.

1635
01:18:40,675 --> 01:18:42,310
IS IT SOMEWHAT DERAILED BY 

1636
01:18:42,310 --> 01:18:43,344
WHAT'S HAPPENING IN THE LAST 

1637
01:18:43,344 --> 01:18:46,080
COUPLE MONTHS.

1638
01:18:46,080 --> 01:18:56,591
THE PLAN WAS TO REACH OUT TO 

1639
01:18:57,191 --> 01:18:59,360
PEOPLE INVOLVED IN THE RESEARCH 

1640
01:18:59,360 --> 01:19:09,537
PROJEC

1641
01:19:17,178 --> 01:19:19,280
PROJECTS AND THE TRIALS AND BE A

1642
01:19:19,280 --> 01:19:21,983
GROUP IN AND OF THEMSELVES AND 

1643
01:19:21,983 --> 01:19:22,817
HAVE REPRESENTATIVES TO THE MDWG

1644
01:19:22,817 --> 01:19:33,327
AND MDWG THEN TO THE COUNCIL.

1645
01:19:48,876 --> 01:19:51,512
NOW WE HAVE THOUSANDS.

1646
01:19:51,512 --> 01:19:55,183
I'D LIKE TO ORGANIZE IT SO THE 

1647
01:19:55,183 --> 01:19:56,651
GROUP IS EFFECTIVE AT ADVISING 

1648
01:19:56,651 --> 01:20:06,994
THE ONGOING TRIALS.

1649
01:20:13,301 --> 01:20:13,801
LINKING THEM TO THE ACTUAL 

1650
01:20:13,801 --> 01:20:19,974
TRIALS IS THE BEST WAY.

1651
01:20:19,974 --> 01:20:23,277
AND WE ROSE TO HAVE THE SKILL 

1652
01:20:23,277 --> 01:20:25,480
SET THAT WOULD BE VALUABLE.

1653
01:20:25,480 --> 01:20:28,116
BUT MAYBE MORE IMPORTANTLY I 

1654
01:20:28,116 --> 01:20:33,321
THOUGHT GOING FORWARD WE WOULD 

1655
01:20:33,321 --> 01:20:36,157
MANDATE THAT PEOPLE DOING THE 

1656
01:20:36,157 --> 01:20:39,026
TRIALS WOULD HIRE FOLKS WHO THEY

1657
01:20:39,026 --> 01:20:40,995
HAD EXPERIENCE WITH IN PREVIOUS 

1658
01:20:40,995 --> 01:20:45,133
TRIALS WHO COULD HELP THEM IN 

1659
01:20:45,133 --> 01:20:48,703
THE ACTUAL DESIGN AS WELL AS THE

1660
01:20:48,703 --> 01:20:49,303
OPERATION OF THE TRIAL.

1661
01:20:49,303 --> 01:20:52,340
I WAS HOPING TO GET PEOPLE WITH 

1662
01:20:52,340 --> 01:20:53,741
LIVED EXPERIENCE FROM THE GROUND

1663
01:20:53,741 --> 01:20:55,776
UP AND INTEGRATE THEM IN ALL 

1664
01:20:55,776 --> 01:20:57,145
DIFFERENT LEVELS UP TO THE 

1665
01:20:57,145 --> 01:21:07,455
LEADERSHIP LEVEL.

1666
01:21:09,524 --> 01:21:10,358
ONCE WE GET THINGS GOING AGAIN 

1667
01:21:10,358 --> 01:21:12,593
WE CAN START WORKING ON THAT 

1668
01:21:12,593 --> 01:21:13,127
AGAIN.

1669
01:21:13,127 --> 01:21:15,163
>> THE ONLY OTHER THING --

1670
01:21:15,163 --> 01:21:16,430
SORRY, GO AHEAD.

1671
01:21:16,430 --> 01:21:17,798
>> NOTHING ELSE FROM ME.

1672
01:21:17,798 --> 01:21:18,399
GO AHEAD.

1673
01:21:18,399 --> 01:21:19,167
>> SORRY.

1674
01:21:19,167 --> 01:21:21,636
I WAS GOING TO ADD I THINK 

1675
01:21:21,636 --> 01:21:22,537
THAT'S GREAT.

1676
01:21:22,537 --> 01:21:25,339
I'D PUT A MAJOR PLUG IN FOR 

1677
01:21:25,339 --> 01:21:27,175
DOING SOME SORT OF EDUCATION AND

1678
01:21:27,175 --> 01:21:30,311
TRAINING OF THE FOLKS WITH LIVED

1679
01:21:30,311 --> 01:21:40,855
EXPERIENCE BEFORE THEY COME ON 

1680
01:21:42,990 --> 01:21:45,159
AND DIFFICULT FOR SOMEONE TO 

1681
01:21:45,159 --> 01:21:55,636
HAVE A GRASP ON ALL OF HEAL.

1682
01:21:59,407 --> 01:22:02,009
I CAN BE HELPFUL IN THE TOPICS 

1683
01:22:02,009 --> 01:22:03,945
AND I KNOW YOU HAVE A GREAT 

1684
01:22:03,945 --> 01:22:05,446
INTERNAL TEAM BUT IF I CAN BE 

1685
01:22:05,446 --> 01:22:09,951
HELPFUL, LET ME KNOW.

1686
01:22:09,951 --> 01:22:10,851
>> Dr. Koroshetz: THAT'D
BE 

1687
01:22:10,851 --> 01:22:11,219
GREAT.

1688
01:22:11,219 --> 01:22:13,120
YOU'RE ABSOLUTELY RIGHT.

1689
01:22:13,120 --> 01:22:17,124
IT'S A VERY DIFFERENT WORLD TO 

1690
01:22:17,124 --> 01:22:27,301
COME INTO.

1691
01:22:32,607 --> 01:22:34,275
WE HAVE PEOPLE WHO I THINK WILL 

1692
01:22:34,275 --> 01:22:41,315
BE ABLE TO DO IT.

1693
01:22:41,315 --> 01:22:49,323
IT HAS TO BE THE RIGHT PERSON.

1694
01:22:49,323 --> 01:22:50,791
>> Director Volkow: I
THINK JUST

1695
01:22:50,791 --> 01:22:52,927
LIKE YOU'RE POINTING OUT WALTER,

1696
01:22:52,927 --> 01:22:55,896
TO BE DEMONSTRATIVE BECAUSE SO 

1697
01:22:55,896 --> 01:22:57,832
MANY WOULD HAVE THE LIVED 

1698
01:22:57,832 --> 01:23:01,135
EXPERIENCE AND WHAT HAVING A 

1699
01:23:01,135 --> 01:23:02,370
SPECIFIC GOAL ALSO IN THE 

1700
01:23:02,370 --> 01:23:04,272
SELECTION PROCESS WOULD BE VERY 

1701
01:23:04,272 --> 01:23:05,239
VERY HELPFUL AND CERTAINLY 

1702
01:23:05,239 --> 01:23:07,275
WALTER IS SPEAKING ABOUT SOMEONE

1703
01:23:07,275 --> 01:23:09,143
THAT HAS EXPERIENCE THEMSELVES 

1704
01:23:09,143 --> 01:23:11,312
SOME PARTICIPATING AND CLINICAL 

1705
01:23:11,312 --> 01:23:11,545
TRIALS.

1706
01:23:11,545 --> 01:23:14,348
WE HAVE BEEN APPROACHED BY 

1707
01:23:14,348 --> 01:23:16,684
PEOPLE, HAVE BEEN APPROACHED BY 

1708
01:23:16,684 --> 01:23:19,086
PEOPLE WHO HAD AN SUBSTANCE AND 

1709
01:23:19,086 --> 01:23:19,720
OPIOID USE DISORDER AND HAVE 

1710
01:23:19,720 --> 01:23:21,155
EXPERIENCE WITH RESEARCH AND 

1711
01:23:21,155 --> 01:23:22,323
WANT TO BE ACTIVELY INVOLVED 

1712
01:23:22,323 --> 01:23:23,858
WITH IT.

1713
01:23:23,858 --> 01:23:26,460
I THINK THERE ARE VERY DIFFERENT

1714
01:23:26,460 --> 01:23:27,895
WAYS IN WHICH TO LOOK AT WHAT 

1715
01:23:27,895 --> 01:23:29,096
THEY CAN BRING THAT IS VERY 

1716
01:23:29,096 --> 01:23:32,900
UNIQUE IN MANY SPACES.

1717
01:23:32,900 --> 01:23:33,901
SO THAT KNOWLEDGE OF HAVING BEEN

1718
01:23:33,901 --> 01:23:37,071
DOING IT NOW MANY YEARS AND ALL 

1719
01:23:37,071 --> 01:23:42,009
YOUR INPUT IN TERMS OF HAVING 

1720
01:23:42,009 --> 01:23:44,045
THE MULTI-DISCIPLINARY GROUP 

1721
01:23:44,045 --> 01:23:46,113
HAVING AN OPPORTUNITY TO GET 

1722
01:23:46,113 --> 01:23:48,849
EXPOSED TO OTHER AREAS, FOR 

1723
01:23:48,849 --> 01:23:56,190
EXAMPLE IN THE FIELD OF OPIOID 

1724
01:23:56,190 --> 01:23:57,024
USE DISORDER AND PAIN.

1725
01:23:57,024 --> 01:24:05,933
WE'LL BE ADVANCING AND EVOLVE 

1726
01:24:05,933 --> 01:24:08,102
WE'RE TAKING ADVANTAGE OF THE 

1727
01:24:08,102 --> 01:24:09,503
UNIQUENESS AND HAVE PEOPLE WHO 

1728
01:24:09,503 --> 01:24:12,373
HAVE THE CONDITION THAT THOUGHT 

1729
01:24:12,373 --> 01:24:22,083
ABOUT IT AND HAVE LIVED THE 

1730
01:24:22,083 --> 01:24:25,186
CONSEQUENCES.

1731
01:24:25,186 --> 01:24:26,520
I DON'T SEE ANYMORE HANDS 

1732
01:24:26,520 --> 01:24:30,191
RAISED.

1733
01:24:30,191 --> 01:24:32,093
>> I THINK WE CAN MOVE TO
A 

1734
01:24:32,093 --> 01:24:33,127
BREAK.

1735
01:24:33,127 --> 01:24:35,930
WE WERE ORIGINALLY SCHEDULED TO 

1736
01:24:35,930 --> 01:24:39,600
BE ON BREAK UNTIL 3:00 -- WE'RE 

1737
01:24:39,600 --> 01:24:42,370
ABOUT 15 MINUTES AHEAD OF 

1738
01:24:42,370 --> 01:24:42,837
SCHEDULE.

1739
01:24:42,837 --> 01:24:46,574
>> SO, WHY DON'T WE PLAN
TO 

1740
01:24:46,574 --> 01:24:49,076
RECONVENE AT 2:45.

1741
01:24:49,076 --> 01:24:51,345
ABOUT 15 MINUTES TO REGROUP AND 

1742
01:24:51,345 --> 01:24:53,114
WE LOOK FORWARD TO SEEING 

1743
01:24:53,114 --> 01:24:57,284
EVERYBODY IN ABOUT 17 MINUTES.

1744
01:24:57,284 --> 01:25:05,326
THANK YOU SO MUCH.

1745
01:25:05,326 --> 01:25:10,030
WELCOME BACK 

1746
01:25:10,030 --> 01:25:10,230
FOLKS.

1747
01:25:10,230 --> 01:25:10,864
WE TALKED ABOUT ROTATING OFF AND

1748
01:25:10,864 --> 01:25:11,498
I HAVE ANOTHER PERSON TO TALK 

1749
01:25:11,498 --> 01:25:13,701
ABOUT, LINDA PORTER BUT WE'RE 

1750
01:25:13,701 --> 01:25:15,836
NOT ROTATING HER OFF, SHE'S 

1751
01:25:15,836 --> 01:25:21,879
ROTATING US OFF.

1752
01:25:21,879 --> 01:25:24,348
SHE'S BEEN PLANNING TO RETIRE 

1753
01:25:24,348 --> 01:25:25,015
AND DECIDED SHE'S ACTUALLY GOING

1754
01:25:25,015 --> 01:25:35,192
TO DO IT.

1755
01:25:37,561 --> 01:25:38,996
THAT'S BEEN A TREMENDOUS LOSS.

1756
01:25:38,996 --> 01:25:43,167
SHE'S BEEN A LEAD HERE AT NIH 

1757
01:25:43,167 --> 01:25:44,502
SINCE 2003 AND SO MANY THINGS 

1758
01:25:44,502 --> 01:25:47,538
HAVE HAPPENED SINCE THEN.

1759
01:25:47,538 --> 01:25:56,213
GOOD THINGS FOR PAIN RESEARCH 

1760
01:25:56,213 --> 01:26:02,753
AND LINDA PUT TOGETHER THE PAIN 

1761
01:26:02,753 --> 01:26:06,123
CONSORTIUM AND WORKED WITH PAIN 

1762
01:26:06,123 --> 01:26:09,727
STRATEGY AND GOT THE INSTITUTES 

1763
01:26:09,727 --> 01:26:10,094
COORDINATED.

1764
01:26:10,094 --> 01:26:12,730
GOT US ALL TO SEE EXACTLY WHAT 

1765
01:26:12,730 --> 01:26:16,500
WE'RE FUNDING IN PAIN RESEARCH 

1766
01:26:16,500 --> 01:26:17,668
AND HAS BEEN A GREAT AMBASSADOR 

1767
01:26:17,668 --> 01:26:25,309
TO ALL THE SCIENTISTS AND STO 

1768
01:26:25,309 --> 01:26:26,710
THE PATIENTS WHO SUFFER WITH 

1769
01:26:26,710 --> 01:26:30,414
PAIN AND THE HEAL INITIATIVE.

1770
01:26:30,414 --> 01:26:31,749
GIST TREMENDOUS OPPORTUNITY THAT

1771
01:26:31,749 --> 01:26:33,617
FELL RIGHT INTO HER HANDS 

1772
01:26:33,617 --> 01:26:38,255
BECAUSE SHE WAS PREPARED AND WAS

1773
01:26:38,255 --> 01:26:42,159
ABLE TO SHEPHERD THE HEAL 

1774
01:26:42,159 --> 01:26:43,327
INITIATIVE TO WHERE IT IS NOW.

1775
01:26:43,327 --> 01:26:49,934
WE'RE GOING TO MISS HER A LOT 

1776
01:26:49,934 --> 01:26:51,535
WE'RE NOT GOING TO BE ABLE TO 

1777
01:26:51,535 --> 01:26:53,003
REPLACE HERE.

1778
01:26:53,003 --> 01:26:56,340
WE'LL BE TAKING OVER BEING 

1779
01:26:56,340 --> 01:27:00,144
CLINICAL PERSON HERE AT NINDS 

1780
01:27:00,144 --> 01:27:03,981
FOR THE CLINICAL PAIN RESEARCH 

1781
01:27:03,981 --> 01:27:06,050
WE THROUGH HEAL.

1782
01:27:06,050 --> 01:27:10,487
I JUST WANTED TO CONGRATULATE 

1783
01:27:10,487 --> 01:27:12,690
LINDA FOR ALL THE WORK SHE'S 

1784
01:27:12,690 --> 01:27:12,890
DONE.

1785
01:27:12,890 --> 01:27:14,358
AND LET PEOPLE KNOW IT'S A TIME 

1786
01:27:14,358 --> 01:27:18,762
TO REFLECT ON WHERE WE'RE COME 

1787
01:27:18,762 --> 01:27:22,800
IN 21 YEARS.

1788
01:27:22,800 --> 01:27:26,337
NOT TOO SHABBY.

1789
01:27:26,337 --> 01:27:27,037
THANKS, LINDA.

1790
01:27:27,037 --> 01:27:28,939
SPEF SPEF 

1791
01:27:30,808 --> 01:27:30,808
 

1792
01:27:38,549 --> 01:27:40,985
>> Linda: IT'S BEEN A
PLEASURE 

1793
01:27:40,985 --> 01:27:42,052
AND HONOR.

1794
01:27:42,052 --> 01:27:45,856
>> WE'LL TAKE A MINUTE AND
PIVOT

1795
01:27:45,856 --> 01:27:49,760
TOWARDS THE DISCUSSION OF WHAT 

1796
01:27:49,760 --> 01:27:51,762
MIGHT SOME RESEARCH PRIORITIES 

1797
01:27:51,762 --> 01:27:52,062
BE.

1798
01:27:52,062 --> 01:27:57,268
TO THAT END I WANT TO INTRODUCE 

1799
01:27:57,268 --> 01:28:00,271
THE DISCUSSION OF THE HEAL PAIN 

1800
01:28:00,271 --> 01:28:01,071
STRATEGIC RESEARCH PRIORITIES.

1801
01:28:01,071 --> 01:28:04,908
I'M GOING TO HAND IT OVER TO 

1802
01:28:04,908 --> 01:28:08,045
JACKIE WARD, SENIOR ADVISER FOR 

1803
01:28:08,045 --> 01:28:10,781
THE HEAL INITIATIVE AT NINDS WHO

1804
01:28:10,781 --> 01:28:13,484
HAS BEEN WORKING WITH LINDA THE 

1805
01:28:13,484 --> 01:28:16,920
LAST COUPLE YEAR AND SERVED AS 

1806
01:28:16,920 --> 01:28:19,523
THE FEDERAL OFFICIAL FOR THE 

1807
01:28:19,523 --> 01:28:20,824
WORKING GROUP WHO DEVELOPED THE 

1808
01:28:20,824 --> 01:28:21,625
STRATEGIES AND DESCRIBE WHAT'S 

1809
01:28:21,625 --> 01:28:32,102
BEEN IN STORE FOR ALL OF US.

1810
01:28:32,770 --> 01:28:35,572
 >> Jackie: THANK YOU YOU,

1811
01:28:35,572 --> 01:28:35,773
LINDA.

1812
01:28:35,773 --> 01:28:37,341
I'LL START WITH SOME SLIDES BUT 

1813
01:28:37,341 --> 01:28:39,243
BEFORE I GET THERE, I HAVE THE 

1814
01:28:39,243 --> 01:28:40,544
GREAT HONOR AS WALTER MENTIONED 

1815
01:28:40,544 --> 01:28:42,579
THE CO-CHAIRS FOR THE EFFORT.

1816
01:28:42,579 --> 01:28:44,415
ONE OF WHOM THIS GROUP KNOWS BUT

1817
01:28:44,415 --> 01:28:47,084
I'M NOT GOING TO GIVE HIM SHORT 

1818
01:28:47,084 --> 01:28:50,421
SHIRT FOR THE VIEWING AUDIENCE.

1819
01:28:50,421 --> 01:28:55,125
AND THEN WE HAVE A GUEST MEMBER 

1820
01:28:55,125 --> 01:28:58,195
I'LL START WITH ROB THE DIRECTOR

1821
01:28:58,195 --> 01:29:01,665
OF THE WASHINGTON UNIVERSITY 

1822
01:29:01,665 --> 01:29:05,436
PAIN CENTER AND THE ROSE T. 

1823
01:29:05,436 --> 01:29:06,804
BROWN PROFESSOR IN THE 

1824
01:29:06,804 --> 01:29:10,808
DEPARTMENT OFFENCE THESIOLOGY IN

1825
01:29:10,808 --> 01:29:13,110
ST. LOUIS OWNED WORKING ON THE 

1826
01:29:13,110 --> 01:29:15,846
CIRCUITS AN MOLECULAR MECHANISMS

1827
01:29:15,846 --> 01:29:17,948
INVOLVED IN CHRONIC PAIN 

1828
01:29:17,948 --> 01:29:19,817
CONDITIONS WITH THE EYE TO NEW 

1829
01:29:19,817 --> 01:29:21,719
DEVELOPMENT FOR THE MANAGEMENT 

1830
01:29:21,719 --> 01:29:24,655
OF CHRONIC PAIN AND ITS 

1831
01:29:24,655 --> 01:29:24,988
COMORBIDITIES.

1832
01:29:24,988 --> 01:29:29,026
AS THIS GROUP KNOWS HE'S A 

1833
01:29:29,026 --> 01:29:32,096
MEMBER OF THE MDWG AND HAVING 

1834
01:29:32,096 --> 01:29:33,731
RECEIVED AN NINDS LANDISAWARD 

1835
01:29:33,731 --> 01:29:38,669
FOR OUTSTANDING MEMBERSHIP IN TO

1836
01:29:38,669 --> 01:29:39,703
2020.

1837
01:29:39,703 --> 01:29:42,973
KATHLEEN SLUKA IS AT THE 

1838
01:29:42,973 --> 01:29:44,441
UNIVERSITY OF IOWA COLLEGE OF 

1839
01:29:44,441 --> 01:29:46,043
MEDICINE WORKING ON THE 

1840
01:29:46,043 --> 01:29:47,711
PERIPHERAL AND CENTRAL 

1841
01:29:47,711 --> 01:29:51,248
MECHANISMS OF CHRONIC 

1842
01:29:51,248 --> 01:29:51,849
MUSCULOSKELETAL PAIN AND 

1843
01:29:51,849 --> 01:29:52,649
TREATMENT FOR CHRONIC PAIN.

1844
01:29:52,649 --> 01:29:55,386
SHE'S A P.I. ON A NUMBER OF NIH 

1845
01:29:55,386 --> 01:29:57,755
AND HEAL AWARDS INCLUDING OF THE

1846
01:29:57,755 --> 01:29:59,323
CLINICAL COORDINATING CENTER FOR

1847
01:29:59,323 --> 01:30:02,259
THE ACUTE TO CHRONIC SIGNATURE 

1848
01:30:02,259 --> 01:30:04,762
PROGRAM AND ON THE IOWA T32 

1849
01:30:04,762 --> 01:30:05,963
TRAINING PROGRAM IN PAIN 

1850
01:30:05,963 --> 01:30:06,230
RESEARCH.

1851
01:30:06,230 --> 01:30:09,366
SHE WAS ALSO A RECIPIENT OF THE 

1852
01:30:09,366 --> 01:30:12,269
2024 HEAL MENTORSHIP AWARD.

1853
01:30:12,269 --> 01:30:14,071
SO THEY'LL DRIVE THE BULK OF THE

1854
01:30:14,071 --> 01:30:15,472
CONVERSATION BUT I'LL GIVE A 

1855
01:30:15,472 --> 01:30:19,510
LITTLE BIT OF CONTEXT HERE AS TO

1856
01:30:19,510 --> 01:30:22,780
WHAT -- HOW WE'VE COME TO THESE 

1857
01:30:22,780 --> 01:30:26,583
RESEARCH PRIORITIES THE PROPOSED

1858
01:30:26,583 --> 01:30:36,794
PRIORITIES.

1859
01:30:39,229 --> 01:30:41,098
 CONGRESS ADDED TO SUPPORT 

1860
01:30:41,098 --> 01:30:42,800
SUPPORT A NEW INITIATIVE ON 

1861
01:30:42,800 --> 01:30:44,234
RESEARCH FOR OPIOID ADDICTION 

1862
01:30:44,234 --> 01:30:45,969
AND DEVELOPMENT OF ALTERNATIVE 

1863
01:30:45,969 --> 01:30:48,205
PAIN MANAGEMENT AND ADDICTION 

1864
01:30:48,205 --> 01:30:48,472
TREATMENT.

1865
01:30:48,472 --> 01:30:52,042
SO THE EARLY DAYS ALL HAPPENED 

1866
01:30:52,042 --> 01:30:54,311
REALLY QUICKLY AND WE WERE 

1867
01:30:54,311 --> 01:30:55,612
GUIDED BY A NUMBER OF MEETINGS 

1868
01:30:55,612 --> 01:30:57,614
THAT HAPPENED IN 2017.

1869
01:30:57,614 --> 01:30:59,016
A SERIES OF CUTTING EDGE SCIENCE

1870
01:30:59,016 --> 01:31:03,921
MEETING TO END THE OPIOID 

1871
01:31:03,921 --> 01:31:05,689
CRISIS.

1872
01:31:05,689 --> 01:31:08,325
FORTUNATELY THANKS TO LINDA WE 

1873
01:31:08,325 --> 01:31:09,493
HAVE THE STRATEGY AND ON THE 

1874
01:31:09,493 --> 01:31:11,695
PAIN STRATEGY IT WAS A GUIDING 

1875
01:31:11,695 --> 01:31:13,497
LIGHT FOR INVESTMENT AND PAIN 

1876
01:31:13,497 --> 01:31:13,797
MANAGEMENT.

1877
01:31:13,797 --> 01:31:15,833
AND ALL THOSE THINGS SORT OF 

1878
01:31:15,833 --> 01:31:19,136
WENT INTO IN FORMING THE HEAL 

1879
01:31:19,136 --> 01:31:20,304
RESEARCH STRATEGY PUBLISHED BY 

1880
01:31:20,304 --> 01:31:22,773
NORA, WALTER AND DR. COLLINS AT 

1881
01:31:22,773 --> 01:31:32,950
THE TIME.

1882
01:31:35,018 --> 01:31:36,687
 SO SET THE PRIORITIES.

1883
01:31:36,687 --> 01:31:43,594
THE INITIATIVE IS NOW CO-LED IN 

1884
01:31:43,594 --> 01:31:44,595
WITH NIDA IN COLLABORATION WITH 

1885
01:31:44,595 --> 01:31:46,163
13 OTHER INSTITUTES AND OFFICES.

1886
01:31:46,163 --> 01:31:48,265
SINCE 2018 THERE'S BEEN OVER 

1887
01:31:48,265 --> 01:31:51,401
2200 RESEARCH PROJECTS IN ALL 50

1888
01:31:51,401 --> 01:31:55,839
STATES TOTALLING OVER $3.9 

1889
01:31:55,839 --> 01:31:56,073
BILLION.

1890
01:31:56,073 --> 01:31:57,641
IT'S BEEN A VERY COLLABORATIVE 

1891
01:31:57,641 --> 01:31:58,175
EFFORT.

1892
01:31:58,175 --> 01:31:59,877
WE'RE JOINED TODAY BY A NUMBER 

1893
01:31:59,877 --> 01:32:02,479
OF THE INSTITUTE, CENTER AND 

1894
01:32:02,479 --> 01:32:03,380
OFFICE DIRECTORS INVOLVED IN 

1895
01:32:03,380 --> 01:32:06,383
HEAL AND PROUD TO SAY THERE'S A 

1896
01:32:06,383 --> 01:32:08,652
NUMBER OF ACCOMPLISHMENTS.

1897
01:32:08,652 --> 01:32:10,821
WALTER POINTED OUT RECENT ONES 

1898
01:32:10,821 --> 01:32:14,024
AND I'LL HIGHLIGHT SOME IN A FEW

1899
01:32:14,024 --> 01:32:17,027
MINUTES BUT OVER 40 FDA 

1900
01:32:17,027 --> 01:32:17,895
APPROVALS FOR INVESTIGATIONAL 

1901
01:32:17,895 --> 01:32:20,297
NEW DRUGS OR CLEARANCES FOR 

1902
01:32:20,297 --> 01:32:20,531
DEVICES.

1903
01:32:20,531 --> 01:32:22,966
THERE'S OVER 300 CLINICAL TRIALS

1904
01:32:22,966 --> 01:32:24,935
UNDERWAY AND MANY OF THE INITIAL

1905
01:32:24,935 --> 01:32:27,070
PROJECTS LAUNCHED IN THE FIRST 

1906
01:32:27,070 --> 01:32:28,639
COUPLE OF YEARS ARE EITHER 

1907
01:32:28,639 --> 01:32:30,774
WRAPPING UP, HAVE WRAPPED UP 

1908
01:32:30,774 --> 01:32:32,276
RECENTLY OR AT A TRANSITION 

1909
01:32:32,276 --> 01:32:32,910
POINT.

1910
01:32:32,910 --> 01:32:35,279
THAT BRINGS US TO A 

1911
01:32:35,279 --> 01:32:36,914
RECOMMENDATION THIS GROUP HAD 

1912
01:32:36,914 --> 01:32:39,116
PROVIDED TO DEVELOP A STRATEGIC 

1913
01:32:39,116 --> 01:32:42,786
PLAN TO GUIDE FUTURE HEAL 

1914
01:32:42,786 --> 01:32:52,996
INVESTMENTS.

1915
01:32:53,530 --> 01:33:04,007
 WE TOOK A VERY DELIBERATIVE AND

1916
01:33:04,708 --> 01:33:05,342
MULTI-DISCIPLINARY APPROACH FOR 

1917
01:33:05,342 --> 01:33:06,043
RESEARCH PRIORITIES.

1918
01:33:06,043 --> 01:33:09,179
THIS WAS CONVENED AS A WORKING 

1919
01:33:09,179 --> 01:33:12,316
GROUP OF THE NINDS ADVISORY 

1920
01:33:12,316 --> 01:33:12,849
COUNCIL WHICH ALLOWED 

1921
01:33:12,849 --> 01:33:13,984
INDEPENDENCE AND THE ABILITY FOR

1922
01:33:13,984 --> 01:33:15,586
THE RECOMMENDATIONS TO BE 

1923
01:33:15,586 --> 01:33:17,521
TRANSMITTED AS FORMAL ADVICE TO 

1924
01:33:17,521 --> 01:33:19,423
NIH OR WHAT WE HOPE WILL BE WHEN

1925
01:33:19,423 --> 01:33:20,591
WE HAVE OUR NEXT COUNCIL 

1926
01:33:20,591 --> 01:33:25,362
MEETING.

1927
01:33:25,362 --> 01:33:26,863
I'LL GO MORE IN THAT PROCESS IN 

1928
01:33:26,863 --> 01:33:28,165
A MOMENT.

1929
01:33:28,165 --> 01:33:30,634
BEFORE WE GET THERE I WANT TO 

1930
01:33:30,634 --> 01:33:32,002
POINT OUT PAIN RESEARCH AT NIH 

1931
01:33:32,002 --> 01:33:33,704
IS NOT LIMITED TO HEAL SUPPORT 

1932
01:33:33,704 --> 01:33:35,839
OR EVEN THE MAJORITY 

1933
01:33:35,839 --> 01:33:36,139
CONTRIBUTOR.

1934
01:33:36,139 --> 01:33:38,208
IT'S LARGELY FUNDED BY THE 

1935
01:33:38,208 --> 01:33:40,277
INDIVIDUAL INSTITUTES AND 

1936
01:33:40,277 --> 01:33:40,677
CENTERS.

1937
01:33:40,677 --> 01:33:42,746
SO THIS GRAPH HERE, THE REDDISH 

1938
01:33:42,746 --> 01:33:44,281
COLOR SHOWS THE INVESTMENT FROM 

1939
01:33:44,281 --> 01:33:47,184
THE I.C.s IN PAIN RESEARCH OVER 

1940
01:33:47,184 --> 01:33:50,654
THE YEARS BOTH PROCEEDING HEAL 

1941
01:33:50,654 --> 01:33:53,490
IN 2018 AND TO DATE TO FY23 

1942
01:33:53,490 --> 01:33:56,760
WHERE WE HAVE THE MOST RECENT 

1943
01:33:56,760 --> 01:33:57,194
DATA.

1944
01:33:57,194 --> 01:33:59,763
YOU CAN SEE THAT, THAT SALMON 

1945
01:33:59,763 --> 01:34:01,898
REDDISH COLOR LARGELY TRACKS 

1946
01:34:01,898 --> 01:34:03,734
WITH THE BLUE BAR THAT 

1947
01:34:03,734 --> 01:34:05,068
REPRESENTS THE OVER ALL NIH 

1948
01:34:05,068 --> 01:34:05,569
BUDGET.

1949
01:34:05,569 --> 01:34:07,738
SO THE TEAL COLOR ON TOP OF THAT

1950
01:34:07,738 --> 01:34:10,807
IS WHAT HEAL HAS CONTRIBUTED TO 

1951
01:34:10,807 --> 01:34:12,242
SINCE THE FIRST APPROPRIATION IN

1952
01:34:12,242 --> 01:34:13,543
2018 WHICH I'LL MENTION WAS 

1953
01:34:13,543 --> 01:34:15,746
TWO-YEAR MONEY A LOT OF THAT WAS

1954
01:34:15,746 --> 01:34:18,081
CARRIED INTO 2019 WHICH IS WHY 

1955
01:34:18,081 --> 01:34:23,220
YOU SEE THE BOLUS THERE.

1956
01:34:23,220 --> 01:34:30,427
HEAL FUNDING HAS BEEN AT TIF -- 

1957
01:34:30,427 --> 01:34:32,429
ADDITIVE AND WE TRIED TO 

1958
01:34:32,429 --> 01:34:34,498
PRESERVE THE FOCUS BY FOCUSSING 

1959
01:34:34,498 --> 01:34:36,266
HEAL FUNDING ON A SPECIFIC 

1960
01:34:36,266 --> 01:34:36,500
MISSION.

1961
01:34:36,500 --> 01:34:37,734
SO YOU ALL HAVE HEARD THIS 

1962
01:34:37,734 --> 01:34:41,271
BEFORE BUT THE MISSION FOR HEAL 

1963
01:34:41,271 --> 01:34:50,714
PAIN SO TO REDUCE PAIN IN OPIOID

1964
01:34:50,714 --> 01:34:51,815
USE DISORDER AND IMPROVE QUALITY

1965
01:34:51,815 --> 01:34:53,250
OF LIFE FOR ALL PEOPLE.

1966
01:34:53,250 --> 01:34:54,785
I.C.s CONTINUE TO SUPPORT 

1967
01:34:54,785 --> 01:34:56,153
RESEARCH WITHIN THEIR OWN 

1968
01:34:56,153 --> 01:34:56,453
MISSIONS.

1969
01:34:56,453 --> 01:34:58,422
I'LL ALSO TAKE THE OPPORTUNITY 

1970
01:34:58,422 --> 01:35:01,558
TO SAY IT'S LARGELY SUPPORTED BY

1971
01:35:01,558 --> 01:35:04,394
THE NIH PAIN CONSORTIUM LINDA 

1972
01:35:04,394 --> 01:35:06,797
HAS BEEN LEADING SINCE THAT 

1973
01:35:06,797 --> 01:35:07,698
STARTED.

1974
01:35:07,698 --> 01:35:09,032
WHAT HAS THAT INVESTMENT DONE 

1975
01:35:09,032 --> 01:35:09,433
FOR US?

1976
01:35:09,433 --> 01:35:13,203
THIS IS JUST A VERY HIGH LEVEL 

1977
01:35:13,203 --> 01:35:14,604
SMATTERING LOOK BACK AT THE 

1978
01:35:14,604 --> 01:35:15,205
SELECTED HIGHLIGHTS FROM THE 

1979
01:35:15,205 --> 01:35:18,775
BEGINNING.

1980
01:35:18,775 --> 01:35:20,677
THERE HAVE BEEN A NUMBER OF 

1981
01:35:20,677 --> 01:35:21,878
VALIDATED AND DEVELOPED 

1982
01:35:21,878 --> 01:35:23,547
NON-OPIOID TARGETS.

1983
01:35:23,547 --> 01:35:26,083
WALTER MENTIONED THE CANNABINOID

1984
01:35:26,083 --> 01:35:27,951
RECEPTOR EARLIER THAT JUST 

1985
01:35:27,951 --> 01:35:28,218
HAPPENED.

1986
01:35:28,218 --> 01:35:30,787
THERE'S A SMATTERING OF OTHERS 

1987
01:35:30,787 --> 01:35:34,791
INCLUDING THE ENZYME SOLUBLE 

1988
01:35:34,791 --> 01:35:38,762
AP

1989
01:35:38,762 --> 01:35:42,766
APOXIDE MODULATOR AND DEVELOPED 

1990
01:35:42,766 --> 01:35:44,835
ACETAMINOPHEN ANALOGS FOR TEXAS 

1991
01:35:44,835 --> 01:35:47,237
AND OTHERS IN DEVELOPMENT AS 

1992
01:35:47,237 --> 01:35:47,437
WELL.

1993
01:35:47,437 --> 01:35:49,306
THIS IS JUST HITTING THE 

1994
01:35:49,306 --> 01:35:50,140
HIGHLIGHTS.

1995
01:35:50,140 --> 01:35:51,241
SOW YOU'RE WELCOME TO GO AND 

1996
01:35:51,241 --> 01:35:56,980
CLICK ON THESE LINKS AND TAKE A 

1997
01:35:56,980 --> 01:36:07,524
LOOK IN MORE DETAIL AND THERE'S 

1998
01:36:10,227 --> 01:36:12,496
BEEN THE FIRST IN HUMAN 

1999
01:36:12,496 --> 01:36:14,197
PREDICTION OF THE CHRONIC PAIN 

2000
01:36:14,197 --> 01:36:17,367
STATE USING INTRACRANIAL NEURAL 

2001
01:36:17,367 --> 01:36:18,769
BIOMARKERS AND THROUGH THE 

2002
01:36:18,769 --> 01:36:22,339
BACKPACK PROGRAM THERE'S BEEN 

2003
01:36:22,339 --> 01:36:23,373
IMAGING BIOMARKERS THAT CAN 

2004
01:36:23,373 --> 01:36:26,409
DISTINGUISH BETWEEN NORMAL AGING

2005
01:36:26,409 --> 01:36:28,245
AND CHRONIC CHANGES ASSOCIATE 

2006
01:36:28,245 --> 01:36:30,514
WITH LOW BACK PAIN.

2007
01:36:30,514 --> 01:36:34,084
WE HAD A SIGNIFICANT INVESTMENT 

2008
01:36:34,084 --> 01:36:37,988
IN PAIN LEADING TO OPTIMIZING 

2009
01:36:37,988 --> 01:36:39,756
STIMULATION FOR IBS PAIN AND THE

2010
01:36:39,756 --> 01:36:41,958
FDA CLEARANCE FOR A VIRTUAL 

2011
01:36:41,958 --> 01:36:43,560
REALITY DEVICE TO TREAT CHRONIC 

2012
01:36:43,560 --> 01:36:44,528
PAIN.

2013
01:36:44,528 --> 01:36:48,098
AND THERE'S BEEN A NUMBER OF 

2014
01:36:48,098 --> 01:36:50,066
CLINICAL TRIALS MANY OF WHICH 

2015
01:36:50,066 --> 01:36:51,968
ARE ONGOING AND WRAPPING UP IN 

2016
01:36:51,968 --> 01:36:52,702
THE COMING YEARS.

2017
01:36:52,702 --> 01:36:55,505
I'LL POINT OUT IN JANUARY WE HAD

2018
01:36:55,505 --> 01:36:57,808
PUBLICATIONS FROM THE HOPE 

2019
01:36:57,808 --> 01:37:01,111
TRIAL, WHICH FOUND PEOPLE ON 

2020
01:37:01,111 --> 01:37:06,783
CHEMO DIALYSIS WITH ASSOCIATED 

2021
01:37:06,783 --> 01:37:16,293
PAIN COULD BENEFIT FROM OTHER 

2022
01:37:16,293 --> 01:37:17,494
DEVICES AND WE HAVE EARLY CAREER

2023
01:37:17,494 --> 01:37:18,795
RESEARCHERS AND THE PURPOSE 

2024
01:37:18,795 --> 01:37:20,330
NETWORK HAS BEEN A GREAT 

2025
01:37:20,330 --> 01:37:22,799
RESOURCE OF CONNECTING PAIN 

2026
01:37:22,799 --> 01:37:33,276
RESEARCHERS ACROSS CAREERS.

2027
01:37:33,810 --> 01:37:35,111
I'LL RUN THROUGH WHERE WE'VE 

2028
01:37:35,111 --> 01:37:36,346
COME THROUGH IN THE LAST YEAR.

2029
01:37:36,346 --> 01:37:39,850
SO ABOUT A YEAR AGO WE CONVENED 

2030
01:37:39,850 --> 01:37:45,355
THE INITIAL WORKING GROUP OF THE

2031
01:37:45,355 --> 01:37:46,590
NINDS ADVISORY COUNCIL TO 

2032
01:37:46,590 --> 01:37:47,824
PROVIDE SCIENTIFIC GUIDANCE HOW 

2033
01:37:47,824 --> 01:37:49,593
TO BEST ADVANCE PAIN RESEARCH IN

2034
01:37:49,593 --> 01:37:52,495
HEAL BY PROPOSING AND 

2035
01:37:52,495 --> 01:37:54,798
PRIORITIZING FUTURE LOOKING 

2036
01:37:54,798 --> 01:38:03,707
STRATEGIC RESEARCH PRIORITIES.

2037
01:38:03,707 --> 01:38:05,842
AND THAT GROUP WAS INFORMED BY A

2038
01:38:05,842 --> 01:38:08,545
REQUEST FOR INFORMATION THAT WE 

2039
01:38:08,545 --> 01:38:11,014
PUT OUT AS NIH THAT SOLICITED 

2040
01:38:11,014 --> 01:38:14,184
INPUT FROM THE BROADER COMMUNITY

2041
01:38:14,184 --> 01:38:20,257
AS TO WHAT SHOULD BE PRIORITIZED

2042
01:38:20,257 --> 01:38:22,125
AS PART OF THE HEAL INITIATIVE 

2043
01:38:22,125 --> 01:38:22,359
BROADLY.

2044
01:38:22,359 --> 01:38:25,629
STARTING IN THE SUMMER THE 

2045
01:38:25,629 --> 01:38:36,172
WORKING GROUP AND THEY FLUSHED 

2046
01:38:36,573 --> 01:38:37,774
OUT THEIR EXPERTISE WITH 

2047
01:38:37,774 --> 01:38:39,342
ADDITIONAL MEMBERS, HOSTED 

2048
01:38:39,342 --> 01:38:40,210
PUBLIC WORKSHOPS AND REVIEWED 

2049
01:38:40,210 --> 01:38:42,779
THE INPUT THAT CAME OUT OF THE 

2050
01:38:42,779 --> 01:38:44,915
REQUEST FOR INFORMATION.

2051
01:38:44,915 --> 01:38:47,317
AND THEN LATE IN 2024, WE 

2052
01:38:47,317 --> 01:38:50,453
BROUGHT THE GROUP TOGETHER TO 

2053
01:38:50,453 --> 01:39:00,530
NARROW DOWN AND WE'RE A FEW 

2054
01:39:00,530 --> 01:39:02,766
MONTHS BEHIND BUT WE ARE HERE 

2055
01:39:02,766 --> 01:39:05,568
PRESENTING IT NOW AT THE MDWG 

2056
01:39:05,568 --> 01:39:06,770
BUT THESE ARE NOT OFFICIAL AND 

2057
01:39:06,770 --> 01:39:09,139
THESE ARE GOING TO HAVE TO BE 

2058
01:39:09,139 --> 01:39:12,809
REVIEWED AND VOTED UPON BY THE 

2059
01:39:12,809 --> 01:39:17,514
PARENT ADVISORY COUNCIL THE 

2060
01:39:17,514 --> 01:39:18,415
NINDS COUNCIL AND THAT SHOULD BE

2061
01:39:18,415 --> 01:39:20,717
HAPPENING IN MID MAY.

2062
01:39:20,717 --> 01:39:22,819
AFTER THAT IT WILL ALL BE UP TO 

2063
01:39:22,819 --> 01:39:26,790
US TO THREAD THESE PRIORITIES 

2064
01:39:26,790 --> 01:39:28,024
INTO CONCEPTS AND FUNDING 

2065
01:39:28,024 --> 01:39:29,159
OPPORTUNITIES AND WE NEED TO 

2066
01:39:29,159 --> 01:39:31,795
START THAT WITH FY27 IN THE 

2067
01:39:31,795 --> 01:39:32,128
COMING YEAR.

2068
01:39:32,128 --> 01:39:33,630
SO I WILL LEAVE IT THERE AND 

2069
01:39:33,630 --> 01:39:37,300
TURN IT OVER TO MY ESTEEMED 

2070
01:39:37,300 --> 01:39:38,768
COLLEAGUES, ROB AND KATHLEEN SO 

2071
01:39:38,768 --> 01:39:41,571
I'M IN CHARGE OF THE SLIDES, 

2072
01:39:41,571 --> 01:39:44,841
GUYS, SO LET ME KNOW WHEN YOU 

2073
01:39:44,841 --> 01:39:48,411
WANT ME TO ADVANCE IT.

2074
01:39:48,411 --> 01:39:49,679
>> Dr. Gereau: THANKS,
JACKIE.

2075
01:39:49,679 --> 01:39:56,319
THAT'S A GREAT SUMMARY THERE.

2076
01:39:56,319 --> 01:39:57,487
SO, WITH THAT PROCESS IN MIND 

2077
01:39:57,487 --> 01:39:59,923
WHAT YOU SEE ON THE SLIDE IS THE

2078
01:39:59,923 --> 01:40:01,391
SEVEN DIFFERENT SUBCOMMITTEES 

2079
01:40:01,391 --> 01:40:04,627
FOCUS AREAS THAT WE FOCUSSED ON 

2080
01:40:04,627 --> 01:40:05,428
FOR THE DELIBERATION.

2081
01:40:05,428 --> 01:40:06,796
AND I WANTED TO POINT OUT A 

2082
01:40:06,796 --> 01:40:08,665
COUPLE OF THINGS.

2083
01:40:08,665 --> 01:40:10,800
THERE WAS SOME GUIDING 

2084
01:40:10,800 --> 01:40:13,236
PRINCIPLES AT THE OUTSET AND 

2085
01:40:13,236 --> 01:40:14,838
JACKIE SORT OF TOUCHED ON THESE.

2086
01:40:14,838 --> 01:40:17,774
ONE WAS THAT -- AND HIS CAME 

2087
01:40:17,774 --> 01:40:20,744
FROM FEEDBACK MEMBERS THE MDWG 

2088
01:40:20,744 --> 01:40:22,979
RECEIVED AND QUESTIONS FROM THE 

2089
01:40:22,979 --> 01:40:26,783
OUTSIDE AND ONE WAS CONCERNS 

2090
01:40:26,783 --> 01:40:30,787
THAT WANTING TO MAKE SURE THE 

2091
01:40:30,787 --> 01:40:33,289
I.C.s WEREN'T TAKING THEIR FOOT 

2092
01:40:33,289 --> 01:40:36,893
OFF THE GAS AND YOU SAW THE NICE

2093
01:40:36,893 --> 01:40:40,530
ANALYSIS THE NIH STAFF PUT 

2094
01:40:40,530 --> 01:40:41,865
TOGETHER SHOWING THE FUNDING IS 

2095
01:40:41,865 --> 01:40:42,332
ACTIVE.

2096
01:40:42,332 --> 01:40:44,901
THE SECOND IS BECAUSE OF THE 

2097
01:40:44,901 --> 01:40:46,803
NATURE OF THE WAY HEAL STARTED 

2098
01:40:46,803 --> 01:40:50,774
AND ESPECIALLY WITH PAIN, THERE 

2099
01:40:50,774 --> 01:40:53,076
WASN'T A STRATEGIC PLANNING THAT

2100
01:40:53,076 --> 01:40:54,644
REALLY FOCUSSED ON THE HEAL 

2101
01:40:54,644 --> 01:40:56,946
MISSION IN TERMS OF DEVELOPING 

2102
01:40:56,946 --> 01:40:58,948
NEW TREATMENTS AND REDUCING THE 

2103
01:40:58,948 --> 01:41:00,617
IMPACT OF PAIN.

2104
01:41:00,617 --> 01:41:02,285
SO EVERYTHING THAT HAD TO BE 

2105
01:41:02,285 --> 01:41:05,255
DONE QUICKLY AT THE BEGINNING OF

2106
01:41:05,255 --> 01:41:07,991
HEAL RELIED ON THE PRIOR 

2107
01:41:07,991 --> 01:41:09,859
PLANNING PROCESSES BUT YOU HAD 

2108
01:41:09,859 --> 01:41:12,896
TO PULL THE THREADS OUT TO 

2109
01:41:12,896 --> 01:41:16,933
INFORM THAT.

2110
01:41:16,933 --> 01:41:17,801
YOU'VE SEEN A LOT OF PROGRESS 

2111
01:41:17,801 --> 01:41:19,669
HERE AND THE ADDITIONAL THING 

2112
01:41:19,669 --> 01:41:23,206
PEOPLE WANTED IS TO MAKE SURE 

2113
01:41:23,206 --> 01:41:26,476
THERE WAS BROAD STAKEHOLDER 

2114
01:41:26,476 --> 01:41:37,353
INPUT AND YEAR NINITIATED THE R 

2115
01:41:38,855 --> 01:41:41,157
AND -- RFI AND WHAT HAS HEAL 

2116
01:41:41,157 --> 01:41:42,725
DONE WELL AND SHOULD BE 

2117
01:41:42,725 --> 01:41:45,495
CONTINUED BUT ALSO REALLY TO 

2118
01:41:45,495 --> 01:41:46,162
LOOK AT GAPS.

2119
01:41:46,162 --> 01:41:49,232
WE'VE ALL DONE BEST WE CAN BUT 

2120
01:41:49,232 --> 01:41:52,769
HAVE SPOTS AND AS HEAL BEEN OUT 

2121
01:41:52,769 --> 01:41:53,837
IN THE WILD NOW MANY YEARS, 

2122
01:41:53,837 --> 01:41:54,771
PEOPLE HAVE THE OPPORTUNITY TO 

2123
01:41:54,771 --> 01:41:57,640
SPEAK UP AND OFFER THEIR 

2124
01:41:57,640 --> 01:41:59,209
OPINIONS ON WHERE THESE 

2125
01:41:59,209 --> 01:42:00,243
OPPORTUNITIES ARE AND WHERE THE 

2126
01:42:00,243 --> 01:42:02,145
AREAS OF FOCUS SHOULD BE GOING 

2127
01:42:02,145 --> 01:42:02,412
FORWARD.

2128
01:42:02,412 --> 01:42:06,783
SO THAT INFORMED THE DEVELOPMENT

2129
01:42:06,783 --> 01:42:11,154
OF THESE SEVEN COMMITTEES.

2130
01:42:11,154 --> 01:42:13,990
I WON'T READ THE CO-CHAIRS FOR 

2131
01:42:13,990 --> 01:42:15,725
THE SUBCOMMITTEES BUT EACH WAS 

2132
01:42:15,725 --> 01:42:18,795
POPULATED WITH MEMBERS OF THE 

2133
01:42:18,795 --> 01:42:20,130
EXECUTIVE COMMITTEE AND 

2134
01:42:20,130 --> 01:42:23,266
LEADERSHIP COMMITTEE FOR THE 

2135
01:42:23,266 --> 01:42:26,636
RESEARCH PRIORITIZATION PROCESS 

2136
01:42:26,636 --> 01:42:28,104
AND ADDITIONAL MEMBERS THE 

2137
01:42:28,104 --> 01:42:28,371
COMMUNITY.

2138
01:42:28,371 --> 01:42:30,206
THEY BUILT THE SUBCOMMITTEES 

2139
01:42:30,206 --> 01:42:31,641
AROUND THESE FOCUS AREAS.

2140
01:42:31,641 --> 01:42:34,210
YOU SEE THEM HEALTH, EQUITY AND 

2141
01:42:34,210 --> 01:42:38,314
PAIN ACROSS THE LIFE COURSE, 

2142
01:42:38,314 --> 01:42:40,216
NON-ADDICTIVE THERAPEUTIC 

2143
01:42:40,216 --> 01:42:42,785
DEVELOPMENT AND OPTIMIZATION OF 

2144
01:42:42,785 --> 01:42:46,356
INTERVENTIONS TO IMPROVE PAIN, 

2145
01:42:46,356 --> 01:42:48,491
POLITICIAN OF HEALTH AND SERVICE

2146
01:42:48,491 --> 01:42:50,326
AND INTERSECTION OF PAIN AND 

2147
01:42:50,326 --> 01:42:50,994
SUBSTANCE USE DISORDER AND PAIN 

2148
01:42:50,994 --> 01:42:53,796
RESEARCH WORKFORCE AND TRAINING.

2149
01:42:53,796 --> 01:42:58,768
SO, WE CAN MOVE ON TO THE NEXT 

2150
01:42:58,768 --> 01:43:03,806
SLIDE EACH OF THESE GROUPED WAS 

2151
01:43:03,806 --> 01:43:08,278
CONVENED AND MET A FEW TIMES AND

2152
01:43:08,278 --> 01:43:12,582
HAVE THOUGHTS AND IDEAS THEY 

2153
01:43:12,582 --> 01:43:15,885
MIGHT PRIORITIZE AND AS A 

2154
01:43:15,885 --> 01:43:18,321
MICROCOSM OF THE LARGER GROUP TO

2155
01:43:18,321 --> 01:43:19,789
GET ADDITIONAL PUBLIC INPUT.

2156
01:43:19,789 --> 01:43:22,392
THAT HAPPENED IN THE FORM OF 

2157
01:43:22,392 --> 01:43:26,763
PUBLIC WORKSHOPS THE 

2158
01:43:26,763 --> 01:43:31,267
SUBCOMMITTEES CONVENED.

2159
01:43:31,267 --> 01:43:33,002
WE HEARD AGAIN FROM PEOPLE ON 

2160
01:43:33,002 --> 01:43:33,203
BOARD.

2161
01:43:33,203 --> 01:43:35,672
WE SAW PEOPLE FROM THE COMMUNITY

2162
01:43:35,672 --> 01:43:38,775
JOINING AND THE IS LOTS OF 

2163
01:43:38,775 --> 01:43:42,312
DIFFERENT STAKEHOLDERS.

2164
01:43:42,312 --> 01:43:46,616
THEY'RE PATIENTS AND PHYSICIANS 

2165
01:43:46,616 --> 01:43:50,954
AND SCIENTISTS AND THERE'S GOOD 

2166
01:43:50,954 --> 01:43:52,822
CROSS COMMUNICATION BETWEEN THE 

2167
01:43:52,822 --> 01:43:54,290
GROUPS.

2168
01:43:54,290 --> 01:43:54,791
THOSE WORKSHOPS.

2169
01:43:54,791 --> 01:43:56,626
EVERYBODY HAD ONE OF THE THREE 

2170
01:43:56,626 --> 01:43:59,229
OR FOUR OUR LONG WORKSHOPS.

2171
01:43:59,229 --> 01:44:01,698
SO BETWEEN JACKIE AND KATHLEEN 

2172
01:44:01,698 --> 01:44:02,532
WE WERE PRESENT IN COMBINATION 

2173
01:44:02,532 --> 01:44:12,575
IN ALL SEVEN OF THOSE.

2174
01:44:12,575 --> 01:44:14,410
THOSE SUBCOMMITTEES CAME UP WITH

2175
01:44:14,410 --> 01:44:16,446
PRIORITIES WERE THE MARCHING 

2176
01:44:16,446 --> 01:44:18,047
ORDERS THERE THEY THOUGHT WERE 

2177
01:44:18,047 --> 01:44:19,682
THE MOST IMPORTANT THING WITHIN 

2178
01:44:19,682 --> 01:44:20,583
THEIR GROUP.

2179
01:44:20,583 --> 01:44:22,785
AND THEN THERE'S STILL OTHER 

2180
01:44:22,785 --> 01:44:25,688
TOPICS THAT ARE STILL CONTAINED 

2181
01:44:25,688 --> 01:44:27,757
IN SOME OF THE APPENDIX 

2182
01:44:27,757 --> 01:44:29,926
MATERIALS FOR THE DRAFT REPORT.

2183
01:44:29,926 --> 01:44:30,627
ALL THIS DELIBERATION AND 

2184
01:44:30,627 --> 01:44:33,830
DISCUSSION IS AVAILABLE.

2185
01:44:33,830 --> 01:44:35,898
BASED ON THAT THE CO-CHAIRS 

2186
01:44:35,898 --> 01:44:37,467
REFINED AND COMBINED THE 

2187
01:44:37,467 --> 01:44:39,569
CO-CHAIRS BEING KATHLEEN AND I.

2188
01:44:39,569 --> 01:44:41,337
SO WE GOT ALL THESE DISCUSSIONS 

2189
01:44:41,337 --> 01:44:42,238
FROM THE DIFFERENT SUBCOMMITTEES

2190
01:44:42,238 --> 01:44:44,107
AND SOME WERE OVERLAPPING.

2191
01:44:44,107 --> 01:44:47,677
SO SOME THAT WERE COMBINED INTO 

2192
01:44:47,677 --> 01:44:53,549
SINGLE RESEARCH PRIORITIES AND 

2193
01:44:53,549 --> 01:44:55,785
PUT BACK TO ALL THE MEMBERS OF 

2194
01:44:55,785 --> 01:44:59,088
THE SUBCOMMITTEES AND THEY WERE 

2195
01:44:59,088 --> 01:45:04,260
VOTED ON IN A MALFI, DELPHI 

2196
01:45:04,260 --> 01:45:05,895
PROCESS TO RANK AND PRIORITIZE 

2197
01:45:05,895 --> 01:45:06,362
THESE.

2198
01:45:06,362 --> 01:45:09,032
BASED ON THE STATED GOAL OF 

2199
01:45:09,032 --> 01:45:10,300
ADVANCING THE MISSION AND STATED

2200
01:45:10,300 --> 01:45:12,468
ON THE SLIDE, DON'T HAVE TO SAY 

2201
01:45:12,468 --> 01:45:15,038
IT AGAIN BUT KEEPING THAT IN 

2202
01:45:15,038 --> 01:45:15,238
MIND.

2203
01:45:15,238 --> 01:45:18,308
THERE'S A HUGE UNIVERSE OF PAIN 

2204
01:45:18,308 --> 01:45:20,076
RESEARCH AND NEEDS TO FOCUS ON 

2205
01:45:20,076 --> 01:45:22,078
WHAT WILL ADVANCE THE HEAL/PAIN 

2206
01:45:22,078 --> 01:45:22,312
MISSION.

2207
01:45:22,312 --> 01:45:23,646
THROUGH THAT PROCESS WE CAME UP 

2208
01:45:23,646 --> 01:45:26,783
WITH A NUMBER OF DIFFERENT 

2209
01:45:26,783 --> 01:45:30,486
THINGS.

2210
01:45:30,486 --> 01:45:33,122
WHAT CAN LEAN AND I WILL PRESENT

2211
01:45:33,122 --> 01:45:36,059
ARE THE RESEARCH PRIORITIES AND 

2212
01:45:36,059 --> 01:45:39,128
THERE'S 10 OF THOSE WE'LL PUT 

2213
01:45:39,128 --> 01:45:42,098
FORWARD HERE AND SET UP CORE 

2214
01:45:42,098 --> 01:45:42,398
PRINCIPLES.

2215
01:45:42,398 --> 01:45:45,134
YOU CAN GO TO THE NEXT SLIDE, 

2216
01:45:45,134 --> 01:45:55,278
JACKIE.

2217
01:45:55,745 --> 01:45:58,181
SHE'S ARE THINGS THAT CAME TO 

2218
01:45:58,181 --> 01:45:59,682
THE TOP OF SUBCOMMITTEES.

2219
01:45:59,682 --> 01:46:04,487
AND WE ALL FELT SHOULD BE 

2220
01:46:04,487 --> 01:46:06,189
CONSIDERED ACROSS VARIOUS 

2221
01:46:06,189 --> 01:46:07,023
DIFFERENT SCIENTIFIC FOCUS AREAS

2222
01:46:07,023 --> 01:46:09,125
IN PAIN RESEARCH AND SO WE'RE 

2223
01:46:09,125 --> 01:46:10,426
RECOMMENDING THAT HEAL 

2224
01:46:10,426 --> 01:46:12,061
INCORPORATE THESE PRINCIPLES 

2225
01:46:12,061 --> 01:46:13,796
ACROSS ALL PAIN PROGRAMS TO 

2226
01:46:13,796 --> 01:46:16,132
ADVANCE THE HEAL/PAIN MISSION.

2227
01:46:16,132 --> 01:46:17,467
YOU CAN SEE THESE HERE.

2228
01:46:17,467 --> 01:46:19,168
THE FIRST IS THE INVOLVEMENT OF 

2229
01:46:19,168 --> 01:46:21,104
PEOPLE WITH LIVED EXPERIENCE.

2230
01:46:21,104 --> 01:46:22,305
THAT'S BEEN ADDRESSED IN OUR 

2231
01:46:22,305 --> 01:46:28,277
DISCUSSION BY WALTER AND NORA.

2232
01:46:28,277 --> 01:46:31,214
THAT INCLUDES INVOLVEMENT IN THE

2233
01:46:31,214 --> 01:46:32,849
TRAINING OF INVESTIGATORS IN 

2234
01:46:32,849 --> 01:46:33,816
TRAINING AND BASIC RESEARCH AND 

2235
01:46:33,816 --> 01:46:36,452
FROM DESIGN ALL THE WAY THROUGH 

2236
01:46:36,452 --> 01:46:37,653
DATA ANALYSIS IN THAT PROCESS.

2237
01:46:37,653 --> 01:46:39,055
THAT WAS SOMETHING THAT CAME TO 

2238
01:46:39,055 --> 01:46:45,528
THE TOP AGAIN AND AGAIN.

2239
01:46:45,528 --> 01:46:47,830
THERE WAS A SENSE THERE NEEDED 

2240
01:46:47,830 --> 01:46:48,664
TO BE A BETTER EDUCATION PROGRAM

2241
01:46:48,664 --> 01:46:59,075
IN PUBLIC AND PROVIDERS.

2242
01:47:05,782 --> 01:47:07,884
WE NEED BETTER EDUCATION OF 

2243
01:47:07,884 --> 01:47:09,385
PUBLIC AND PROVIDERS AND 

2244
01:47:09,385 --> 01:47:09,919
IMPLEMENTATION AND PUBLIC 

2245
01:47:09,919 --> 01:47:20,096
CAMPAIGN.

2246
01:47:21,697 --> 01:47:24,534
REPORTING OF SEX AND LONGER TERM

2247
01:47:24,534 --> 01:47:25,668
OUTCOMES ACROSS THE LIFE SPAN SO

2248
01:47:25,668 --> 01:47:29,305
USING AGE TO ANIMALS TO REFLECT 

2249
01:47:29,305 --> 01:47:30,773
THE VARIANCE OF PAIN AND ITS 

2250
01:47:30,773 --> 01:47:31,974
EFFECTIVE TREATMENTS ACROSS THE 

2251
01:47:31,974 --> 01:47:33,876
LIFE SPAN.

2252
01:47:33,876 --> 01:47:35,344
AGAIN, WE HEARD THIS EARLIER THE

2253
01:47:35,344 --> 01:47:36,913
IMPORTANCE OF UNDERSTANDING 

2254
01:47:36,913 --> 01:47:39,015
CO-OCCURRING OR CO-MORBID 

2255
01:47:39,015 --> 01:47:39,315
CONDITIONS.

2256
01:47:39,315 --> 01:47:42,318
THE INFLUENCE OF SOCIAL FACTORS 

2257
01:47:42,318 --> 01:47:49,826
AND YOU A BIG ONE IS THE 

2258
01:47:49,826 --> 01:47:51,127
IMPLEMENTATION PRINCIPLES 

2259
01:47:51,127 --> 01:47:52,261
ILLUSTRATE HOW LONG IMPORTANT IT

2260
01:47:52,261 --> 01:47:55,398
IS WITH THE ROLLING OUT OF 

2261
01:47:55,398 --> 01:47:57,433
OPIOID USE AND OVERDOSE DISORDER

2262
01:47:57,433 --> 01:47:58,234
AND PREVENTION STRATEGIES.

2263
01:47:58,234 --> 01:48:01,404
THE IMPORTANCE OF THOSE 

2264
01:48:01,404 --> 01:48:05,208
INTEGRATION -- IMPLEMENTATION 

2265
01:48:05,208 --> 01:48:06,409
PRINCIPLES TO THE SCIENCE.

2266
01:48:06,409 --> 01:48:07,944
BUILDING AND SUPPORTING 

2267
01:48:07,944 --> 01:48:11,247
INTRODUCED BY OUR TEAMS TO 

2268
01:48:11,247 --> 01:48:14,784
CAPITALIZE ON DIVERSE SKILLS AND

2269
01:48:14,784 --> 01:48:17,954
METHODOLOGIES.

2270
01:48:17,954 --> 01:48:19,989
AGAIN A THEME WE HEARD EARLIER 

2271
01:48:19,989 --> 01:48:21,123
SUPPORTING SECONDARY ANALYSIS 

2272
01:48:21,123 --> 01:48:22,758
AND SUPPORTING DATA SETS AND 

2273
01:48:22,758 --> 01:48:26,762
SAMPLES GENERATED THROUGH ALL OF

2274
01:48:26,762 --> 01:48:28,064
THIS.

2275
01:48:28,064 --> 01:48:31,467
AND AGAIN MUCH OF THIS IS 

2276
01:48:31,467 --> 01:48:34,303
ALREADY BEING STORED IN THE HEAL

2277
01:48:34,303 --> 01:48:38,774
ECO SYSTEM THAT YIELDS INSIGHTS 

2278
01:48:38,774 --> 01:48:40,109
INTO GENESIS AND EXISTENCE OF 

2279
01:48:40,109 --> 01:48:40,676
CHRONIC PAIN.

2280
01:48:40,676 --> 01:48:45,147
THAT'S THE BACKGROUND FOR HOW WE

2281
01:48:45,147 --> 01:48:53,122
THINK ALL OF THESE.

2282
01:48:53,122 --> 01:48:54,924
AND THIS IS IN NO PARTICULAR 

2283
01:48:54,924 --> 01:48:57,159
ORDER AND RESEARCH PRIORITY A.

2284
01:48:57,159 --> 01:48:58,761
I'LL START WITH RESEARCH 

2285
01:48:58,761 --> 01:49:02,765
PRIORITY ALPHA INSTEAD WHICH IS 

2286
01:49:02,765 --> 01:49:05,001
TO SAY IT'S A MISCARRIAGE OF 

2287
01:49:05,001 --> 01:49:08,471
JUSTICE WE HAD TO HEAR ABOUT 

2288
01:49:08,471 --> 01:49:10,806
LINDA'S RETIREMENT AT THIS NOT 

2289
01:49:10,806 --> 01:49:12,675
IN PERSON MEETING.

2290
01:49:12,675 --> 01:49:14,710
AS SOMEONE THERE FROM YEAR ONE 

2291
01:49:14,710 --> 01:49:15,878
IS THE WAS MY PROGRAM OFFICER 

2292
01:49:15,878 --> 01:49:17,914
WHEN I STARTED FROM YEAR ONE.

2293
01:49:17,914 --> 01:49:18,781
THANK YOU, LINDA FOR EVERYTHING 

2294
01:49:18,781 --> 01:49:19,382
YOU'VE DONE.

2295
01:49:19,382 --> 01:49:21,918
YOU NEED TO COPY ALL THESE 

2296
01:49:21,918 --> 01:49:22,952
COMMENTS IN THE CHAT TO KEEP AND

2297
01:49:22,952 --> 01:49:24,186
REMEMBER HOW MUCH WE APPRECIATE 

2298
01:49:24,186 --> 01:49:24,353
YOU.

2299
01:49:24,353 --> 01:49:30,760
OKAY.

2300
01:49:30,760 --> 01:49:33,996
SO, PROPOSED SCIENTIFIC RESEARCH

2301
01:49:33,996 --> 01:49:34,630
PRIORITIES.

2302
01:49:34,630 --> 01:49:36,566
SUPPORTING COMPREHENSIVE 

2303
01:49:36,566 --> 01:49:37,733
FELLOWSHIP AND CAREER 

2304
01:49:37,733 --> 01:49:38,768
DEVELOPMENT AND MENTORED 

2305
01:49:38,768 --> 01:49:40,970
RESEARCH SCHOLAR AWARDS FOR 

2306
01:49:40,970 --> 01:49:42,471
INDIVIDUALS ACROSS ALL CAREER 

2307
01:49:42,471 --> 01:49:43,472
STAGES.

2308
01:49:43,472 --> 01:49:46,142
IT WAS A POINT MADE TO INCLUDE 

2309
01:49:46,142 --> 01:49:48,678
NON-U.S. CITIZENS AS FOLKS TO 

2310
01:49:48,678 --> 01:49:49,211
HAVE OPPORTUNITIES IN THE 

2311
01:49:49,211 --> 01:49:52,548
TRAINING DOMAINS.

2312
01:49:52,548 --> 01:49:54,784
THERE'S A LOT OF SUPPORT AND 

2313
01:49:54,784 --> 01:49:58,721
DISCUSSION IN THE GROUP FOR 

2314
01:49:58,721 --> 01:50:00,289
EXISTING TRAINING PROGRAMS PAIN 

2315
01:50:00,289 --> 01:50:01,791
HAS DEVELOPED AND IN ADDITION TO

2316
01:50:01,791 --> 01:50:03,359
WHAT'S THERE LIKE THE K 

2317
01:50:03,359 --> 01:50:03,826
PROGRAMS.

2318
01:50:03,826 --> 01:50:05,127
PEOPLE LIKE THE K PROGRAMS, FOR 

2319
01:50:05,127 --> 01:50:05,828
EXAMPLE.

2320
01:50:05,828 --> 01:50:12,902
THIS IS TO FOSTER CONTINUED 

2321
01:50:12,902 --> 01:50:14,604
GROWTH FOR ESTABLISHED PAIN 

2322
01:50:14,604 --> 01:50:15,838
RESEARCHERS AND PROVIDE TARGETED

2323
01:50:15,838 --> 01:50:17,974
OPPORTUNITIES FOR INDIVIDUALS 

2324
01:50:17,974 --> 01:50:18,608
WITH NO PRIERP PAIN RESEARCH 

2325
01:50:18,608 --> 01:50:19,508
EXPERIENCE BUT HAVE STRONG 

2326
01:50:19,508 --> 01:50:22,778
POTENTIAL TO DEVELOP IMPACT.

2327
01:50:22,778 --> 01:50:24,680
CAREERS IN PAIN SCIENCE.

2328
01:50:24,680 --> 01:50:26,382
AN OPPORTUNITY FOR SOMEONE WITH 

2329
01:50:26,382 --> 01:50:28,985
A UNIQUE SKILL SET TO WORK WIN A

2330
01:50:28,985 --> 01:50:31,587
MENTOR IN THE PAIN SPACE AND 

2331
01:50:31,587 --> 01:50:33,055
REALLY PROVIDE SUBSTANTIAL 

2332
01:50:33,055 --> 01:50:34,256
IMPACT TO THE PAIN FIELD IN 

2333
01:50:34,256 --> 01:50:36,092
BRINGING NEW THOUGHTS AND NEW 

2334
01:50:36,092 --> 01:50:38,027
APPROACHES TO THE PAIN FIELD.

2335
01:50:38,027 --> 01:50:39,495
THIS IS REALLY A CAREER 

2336
01:50:39,495 --> 01:50:40,129
DEVELOPMENT PRIORITY AND ONE 

2337
01:50:40,129 --> 01:50:45,134
THAT RANKED VERY HIGH.

2338
01:50:45,134 --> 01:50:50,239
PRIORITY B, OKAY, THIS IS STATED

2339
01:50:50,239 --> 01:50:54,777
AS SUPPORT FOR THE DEVELOPMENT 

2340
01:50:54,777 --> 01:50:58,180
OF MECHANISTICALLY VARIED AND 

2341
01:50:58,180 --> 01:51:00,416
PHARMACEUTICAL PAIN MODALITIES.

2342
01:51:00,416 --> 01:51:04,553
IT SOUNDS COMPLICATED BUT THIS 

2343
01:51:04,553 --> 01:51:08,824
PRIORITY COMES OUT OF AN 

2344
01:51:08,824 --> 01:51:09,458
APPRECIATION FOR THE SUCCESS OF 

2345
01:51:09,458 --> 01:51:15,431
THE ROBUST ECO SYSTEM FOR TAKING

2346
01:51:15,431 --> 01:51:17,133
ONLY CANDIDATES THROUGH THE 

2347
01:51:17,133 --> 01:51:18,768
WHOLE PROGRAM WALTER TALKED 

2348
01:51:18,768 --> 01:51:19,402
ABOUT BEFORE.

2349
01:51:19,402 --> 01:51:21,537
EVERYONE WAS VERY HAPPY WITH THE

2350
01:51:21,537 --> 01:51:24,940
IMPACT THAT HAS HAD ON THE PAIN 

2351
01:51:24,940 --> 01:51:26,442
FIELD FOR MOTIVATING THERAPEUTIC

2352
01:51:26,442 --> 01:51:27,309
DEVELOPMENT IN THE CONTEXT OF 

2353
01:51:27,309 --> 01:51:35,451
ACADEMIC LABS.

2354
01:51:35,451 --> 01:51:38,754
THAT SHOULD CONTINUE TO BE 

2355
01:51:38,754 --> 01:51:46,128
FOCUSSED.

2356
01:51:46,128 --> 01:51:50,666
TARGET PROTEIN DEGRADATION AND 

2357
01:51:50,666 --> 01:51:53,235
NEW MODALITIES ARISING TO MAKE 

2358
01:51:53,235 --> 01:51:56,305
SURE THERE'S CAPABILITY AND 

2359
01:51:56,305 --> 01:52:00,810
SUPPORT FOR THOSE INNOVATIVE 

2360
01:52:00,810 --> 01:52:02,778
APPROACHES IN THE HEAL PACKAGE 

2361
01:52:02,778 --> 01:52:11,454
OF OPPORTUNITIES.

2362
01:52:11,454 --> 01:52:14,223
PRIORITY C WAS SEEING A LOT OF 

2363
01:52:14,223 --> 01:52:16,125
IMPACT OF THE EARLIER 

2364
01:52:16,125 --> 01:52:19,261
INVESTMENTS FROM HEAL ON HUMAN 

2365
01:52:19,261 --> 01:52:29,672
TISSUES BASED RESEARCH.

2366
01:52:31,073 --> 01:52:32,408
AND TO SUPPORT THERAPEUTICS IN A

2367
01:52:32,408 --> 01:52:33,175
COUPLE WAYS.

2368
01:52:33,175 --> 01:52:39,782
ONE IS USING THE KNOWLEDGE TO 

2369
01:52:39,782 --> 01:52:41,650
IDENTIFY TARGETS BY 

2370
01:52:41,650 --> 01:52:42,218
UNDERSTANDING INTERACTIONS 

2371
01:52:42,218 --> 01:52:44,820
BETWEEN CELLS AND NETWORKS IN 

2372
01:52:44,820 --> 01:52:46,756
HUMAN TISSUES, IDENTIFYING 

2373
01:52:46,756 --> 01:52:50,192
TARGETS THAT HAVE A MUCH HIGHER 

2374
01:52:50,192 --> 01:52:50,993
PROBABILITY OF BEING ATTRACTABLE

2375
01:52:50,993 --> 01:52:54,764
FOR TREATMENT OF HUMAN PAIN BUT 

2376
01:52:54,764 --> 01:52:57,533
ALSO USING INFORMATION FROM 

2377
01:52:57,533 --> 01:53:01,070
HUMAN BIOLOGY WITH EYES TO VERY 

2378
01:53:01,070 --> 01:53:01,904
SPECIFIC DISEASE CONDITIONS.

2379
01:53:01,904 --> 01:53:02,938
USING THAT INFORMATION TO 

2380
01:53:02,938 --> 01:53:06,242
DEVELOP A NEW GENERATION OF 

2381
01:53:06,242 --> 01:53:07,810
HIGHLY PREDICTIVE AND DISEASE 

2382
01:53:07,810 --> 01:53:09,278
SPECIFIC ANIMAL AND CELLULAR 

2383
01:53:09,278 --> 01:53:09,678
MODELS.

2384
01:53:09,678 --> 01:53:13,716
THAT IS TO SAY, IF YOU LEARN 

2385
01:53:13,716 --> 01:53:14,750
SOMETHING UNIQUE ABOUT SOMETHING

2386
01:53:14,750 --> 01:53:16,819
CHANGING IN DEGENERATIVE DISK, 

2387
01:53:16,819 --> 01:53:18,354
FOR EXAMPLE, YOU MIGHT BE ABLE 

2388
01:53:18,354 --> 01:53:20,656
TO DEVELOP AN ANIMAL MODEL THAT 

2389
01:53:20,656 --> 01:53:22,424
SPECIFICALLY INCORPORATES THAT 

2390
01:53:22,424 --> 01:53:24,693
ASPECT AND A LOT OF OTHER 

2391
01:53:24,693 --> 01:53:28,998
DISCUSSION ABOUT THE USE OF IPSC

2392
01:53:28,998 --> 01:53:31,867
DERIVED NEURONS TO RECAPITULATE 

2393
01:53:31,867 --> 01:53:34,770
HUMAN BIOLOGY IN ANIMAL AND 

2394
01:53:34,770 --> 01:53:35,604
CELLULAR MODELS.

2395
01:53:35,604 --> 01:53:37,773
AT THIS POINT I'LL PASS ON TO 

2396
01:53:37,773 --> 01:53:42,778
KATHLEEN TO PICK UP THE 

2397
01:53:42,778 --> 01:53:53,122
REMAINDER AT LEAST.

2398
01:53:54,456 --> 01:53:56,292
>> Dr. Sluka: WE'LL TALK
ABOUT 

2399
01:53:56,292 --> 01:53:58,327
THE CHANGING PATTERNS AND HOW TO

2400
01:53:58,327 --> 01:53:59,195
IMPROVEMENT TREATMENT.

2401
01:53:59,195 --> 01:54:02,064
THE NEXT PRIORITY IS REALLY TO 

2402
01:54:02,064 --> 01:54:04,600
DEVELOP PAIN PREVENTION 

2403
01:54:04,600 --> 01:54:06,769
STRATEGIES TO PREVENT 

2404
01:54:06,769 --> 01:54:10,573
DEVELOPMENT OF CHRONIC PAIN.

2405
01:54:10,573 --> 01:54:12,875
AND IT FOCUSES ON KEY POSITIONS 

2406
01:54:12,875 --> 01:54:14,043
BUT IT FOCUSES ON PAIN.

2407
01:54:14,043 --> 01:54:16,278
MOST OF WHAT WE'VE DONE TO THIS 

2408
01:54:16,278 --> 01:54:20,549
DATE IS A FOCUS ON TREATING 

2409
01:54:20,549 --> 01:54:21,283
EXISTING CHRONIC PAIN.

2410
01:54:21,283 --> 01:54:31,827
AND WE'VE DEVELOPED PSYCHOSOCIAL

2411
01:54:36,565 --> 01:54:38,767
MODELS TO PREDICT BUT DON'T 

2412
01:54:38,767 --> 01:54:39,635
PREVENT CHRONIC PAIN.

2413
01:54:39,635 --> 01:54:44,340
THIS IS LOOKING AT WAYS TO 

2414
01:54:44,340 --> 01:54:46,075
PREVENT TO DEVELOP A TEST AND 

2415
01:54:46,075 --> 01:54:47,610
NUMBER OF SCREENING TOOLS TO 

2416
01:54:47,610 --> 01:54:50,446
LOOK FOR BIOMARKERS THAT CAN 

2417
01:54:50,446 --> 01:54:51,247
PREDICT THAT TRANSITION IN 

2418
01:54:51,247 --> 01:54:53,182
RESILIENCE AND SIMULTANEOUSLY 

2419
01:54:53,182 --> 01:54:55,885
LOOKING AT DEVELOPING STRATEGIES

2420
01:54:55,885 --> 01:55:03,259
THAT CAN PREVENT PRIMARY MEANING

2421
01:55:03,259 --> 01:55:13,535
CAN WE CREATE LIFE STYLE CHANGES

2422
01:55:13,535 --> 01:55:15,271
AND DO THINGS WITH DIET TO 

2423
01:55:15,271 --> 01:55:15,671
PREVENT DIABETES.

2424
01:55:15,671 --> 01:55:17,172
YOU'RE STARTING TO LOOK FOR WAYS

2425
01:55:17,172 --> 01:55:20,175
TO PREVENT PAIN ALTOGETHER TO 

2426
01:55:20,175 --> 01:55:22,611
REDUCE THE NUMBER FROM 25% WHERE

2427
01:55:22,611 --> 01:55:25,481
IT IS NOW TO SAY 15% AND 10%.

2428
01:55:25,481 --> 01:55:27,216
AND THEN TO DEVELOP AND TEST 

2429
01:55:27,216 --> 01:55:29,551
STRATEGIES THAT KIND OF PREVENT 

2430
01:55:29,551 --> 01:55:31,420
WHAT WE CALL SECONDARY PAIN.

2431
01:55:31,420 --> 01:55:33,155
AFTER SOMETHING GETS IN ACUTE 

2432
01:55:33,155 --> 01:55:35,257
PAIN CONDITION CAN WE PREVENT IT

2433
01:55:35,257 --> 01:55:38,027
FROM TRANSITIONING TO CHRONIC.

2434
01:55:38,027 --> 01:55:41,964
SO IN ORDER TO DO THAT WE DENOTE

2435
01:55:41,964 --> 01:55:44,066
TOOLS IN THE BIOMARKERS AND 

2436
01:55:44,066 --> 01:55:47,469
FIGURE OUT ABOUT WHAT ARE 

2437
01:55:47,469 --> 01:55:50,239
PREDICTORS AND RISK FACTORS AND 

2438
01:55:50,239 --> 01:55:54,777
IF WE PREVENT ACUTE PAIN BETTER 

2439
01:55:54,777 --> 01:56:02,351
DO WE PREVENT IT ALTOGETHER AND 

2440
01:56:02,351 --> 01:56:04,687
HAVE BIOMARKERS TO PRE-CLINICAL 

2441
01:56:04,687 --> 01:56:05,988
STUDIES TO SEE IF THEY'RE 

2442
01:56:05,988 --> 01:56:06,655
CONTRIBUTING TO THE DISEASE AND 

2443
01:56:06,655 --> 01:56:07,256
TRANSITION ITSELF TO CHRONIC 

2444
01:56:07,256 --> 01:56:08,624
PAIN.

2445
01:56:08,624 --> 01:56:12,061
SO THIS ONE IS REALLY GEARED 

2446
01:56:12,061 --> 01:56:14,964
TOWARDS PREVENTION STRATEGIES TO

2447
01:56:14,964 --> 01:56:16,899
PREVENT CHRONIC PAIN AND 

2448
01:56:16,899 --> 01:56:18,934
HOPEFULLY REDUCE OUR OVER ALL 

2449
01:56:18,934 --> 01:56:29,144
PERCENTAGE.

2450
01:56:31,213 --> 01:56:32,514
ONE IS GEARED FOR HAVE 

2451
01:56:32,514 --> 01:56:34,016
BIOMARKERS TO PREDICT THE 

2452
01:56:34,016 --> 01:56:36,652
RESPONSE TO TREATMENT?

2453
01:56:36,652 --> 01:56:38,754
CAN WE PREDICT SAFETY OR 

2454
01:56:38,754 --> 01:56:45,027
ENGAGEMENT IN THE TREATMENT?

2455
01:56:45,027 --> 01:56:47,496
THEY MIGHT SERVE AS END POINTS 

2456
01:56:47,496 --> 01:56:49,398
IN CLINICAL TRIALS.

2457
01:56:49,398 --> 01:56:51,066
THIS ONE CAME OUT THROUGH PEOPLE

2458
01:56:51,066 --> 01:56:54,770
WITH LIVED EXPERIENCE THIS WAS 

2459
01:56:54,770 --> 01:56:56,238
REALLY IMPORTANT TO THEM.

2460
01:56:56,238 --> 01:56:57,039
WHAT HAPPENS CURRENTLY WITH 

2461
01:56:57,039 --> 01:56:59,975
PEOPLE IS WE HAVE A LOT OF 

2462
01:56:59,975 --> 01:57:02,745
TREATMENTS AND THEY GO THROUGH 

2463
01:57:02,745 --> 01:57:03,946
ONE TREATMENT AND THAT FAILS AND

2464
01:57:03,946 --> 01:57:06,081
SPEND YEARS GETTING ON THE BEST 

2465
01:57:06,081 --> 01:57:06,415
TREATMENT.

2466
01:57:06,415 --> 01:57:08,017
IF WE KNOW WHO RESPONDED TO 

2467
01:57:08,017 --> 01:57:09,485
WHAT, WE COULD MAYBE START THEM 

2468
01:57:09,485 --> 01:57:15,491
UP AT THE BEGINNING WITH 

2469
01:57:15,491 --> 01:57:20,863
SOMETHING ADD EFFICACIOUS YAESHL

2470
01:57:20,863 --> 01:57:25,667
AND WE THOUGHT WE COUPREDICT TH 

2471
01:57:25,667 --> 01:57:28,170
IN CLINICAL TRIALS AND THERE WAS

2472
01:57:28,170 --> 01:57:30,706
ALREADY A BIOMARKER PROGRAM THAT

2473
01:57:30,706 --> 01:57:31,740
COULD BE UTILIZED FOR THIS.

2474
01:57:31,740 --> 01:57:34,410
AND WE COULD BE LOOKING 

2475
01:57:34,410 --> 01:57:40,049
PRIMARILY AT PREDICTIVE, 

2476
01:57:40,049 --> 01:57:44,353
PROGNOSTIC AND PHARMACO DYNAMIC 

2477
01:57:44,353 --> 01:57:45,487
MARKERS TO USING THE TREATMENT 

2478
01:57:45,487 --> 01:57:50,759
WE HAVE AND MOVE THEM MORE 

2479
01:57:50,759 --> 01:57:56,765
EFFECTIVELY IN THE CLINIC.

2480
01:57:56,765 --> 01:57:58,367
THIS TURN THE OUT TO BE A RATHER

2481
01:57:58,367 --> 01:58:02,771
LARGE ONE BECAUSE IT WAS BROUGHT

2482
01:58:02,771 --> 01:58:05,174
UP BY SEVERAL GROUPS.

2483
01:58:05,174 --> 01:58:08,544
WE'RE TALKING ABOUT TESTING 

2484
01:58:08,544 --> 01:58:10,245
WHETHER AN INDIVIDUALIZED 

2485
01:58:10,245 --> 01:58:10,846
TAILORED TREATMENT BASED ON 

2486
01:58:10,846 --> 01:58:13,582
KNOWN MECHANISMS CAN IMPROVE 

2487
01:58:13,582 --> 01:58:13,849
OUTCOMES?

2488
01:58:13,849 --> 01:58:15,884
AND CLINICIANS DO THIS AND SAY 

2489
01:58:15,884 --> 01:58:17,019
THIS ALL THE TIME.

2490
01:58:17,019 --> 01:58:18,754
MOST OF OUR DRUGS ARE AIMED AT A

2491
01:58:18,754 --> 01:58:25,594
MECHANISM.

2492
01:58:25,594 --> 01:58:27,196
WE THINK THE MECHANISM IS 

2493
01:58:27,196 --> 01:58:28,230
INVOLVED AND IN ORDER TO DO THIS

2494
01:58:28,230 --> 01:58:30,499
WE HAVE TO TAKE SEVERAL STEPS.

2495
01:58:30,499 --> 01:58:34,770
FIRST WE HAVE TO DEVELOP 

2496
01:58:34,770 --> 01:58:36,872
COMPOSITE BIOMARKER SIGNATURES 

2497
01:58:36,872 --> 01:58:37,973
WHERE WE DEEPLY PHENOTYPE PEOPLE

2498
01:58:37,973 --> 01:58:40,776
AND SEE IF THEY'LL FIT INTO 

2499
01:58:40,776 --> 01:58:47,983
DIFFERENT BIOLOGICAL GROUPS.

2500
01:58:47,983 --> 01:58:50,752
BASED ON MECHANISMS AND THEY 

2501
01:58:50,752 --> 01:58:54,756
INCLUDE BIOLOGICAL MARKERS AND 

2502
01:58:54,756 --> 01:58:56,859
BIOLOGICAL COMPONENTS AS WELL AS

2503
01:58:56,859 --> 01:58:59,628
PATIENT-REPORTED OUTCOMES LIKE 

2504
01:58:59,628 --> 01:59:00,395
BIO-SOCIAL FACTORS COMBINED 

2505
01:59:00,395 --> 01:59:02,764
TOGETHER TO FIGURE OUT 

2506
01:59:02,764 --> 01:59:05,033
MECHANISMS IN INDIVIDUALS.

2507
01:59:05,033 --> 01:59:10,806
WE CAN THEN SIMULTANEOUSLY LOOK 

2508
01:59:10,806 --> 01:59:13,408
AT WHAT WE'RE LOOKING AT AND 

2509
01:59:13,408 --> 01:59:14,776
INVESTIGATE A PERSONALIZED 

2510
01:59:14,776 --> 01:59:17,246
APPROACH BY MATCHING A PERSON'S 

2511
01:59:17,246 --> 01:59:20,182
PHENOTYPE OR SIGNATURE WITH THE 

2512
01:59:20,182 --> 01:59:20,749
UNDERLYING MECHANISMS AND 

2513
01:59:20,749 --> 01:59:21,350
TREATMENTS THAT ADDRESS THOSE 

2514
01:59:21,350 --> 01:59:30,359
MECHANISMS.

2515
01:59:30,359 --> 01:59:34,763
AND INVESTIGATE HOW OUR 

2516
01:59:34,763 --> 01:59:37,232
NON-PHARMACOLOGIC TREATMENTS 

2517
01:59:37,232 --> 01:59:42,204
WORK WHILE MANY -- MAY REDUCE 

2518
01:59:42,204 --> 01:59:43,739
PAIN WE DON'T KNOW HOW THEY WORK

2519
01:59:43,739 --> 01:59:45,908
AND WE CAN MATCH THE 

2520
01:59:45,908 --> 01:59:47,743
NON-PHARMACOLOGICAL 

2521
01:59:47,743 --> 01:59:49,311
INTERVENTION.

2522
01:59:49,311 --> 01:59:51,780
THIS WOULD BE MULTI-STEP PROCESS

2523
01:59:51,780 --> 01:59:57,452
WILL LEADING TO A TAILORED 

2524
01:59:57,452 --> 01:59:58,487
MECHANISTIC BASED APPROACH WE 

2525
01:59:58,487 --> 02:00:08,931
LOPE TO IMPROVE OUTCOMES.

2526
02:00:09,665 --> 02:00:11,800
THE NEXT WAS TO TEST THE INITIAL

2527
02:00:11,800 --> 02:00:15,337
PAIN THERAPY AND ORDER OF TIMING

2528
02:00:15,337 --> 02:00:19,875
OF MULTI-MODAL APPROACHES AND I 

2529
02:00:19,875 --> 02:00:21,109
USUALLY GIVE PEOPLE THIS AND 

2530
02:00:21,109 --> 02:00:21,777
THAT DIDN'T WORK, LET'S PUT YOU 

2531
02:00:21,777 --> 02:00:31,954
ON THIS.

2532
02:00:31,954 --> 02:00:33,722
IS IT BETTER TO START SOMEBODY 

2533
02:00:33,722 --> 02:00:34,923
WITH THAT PHARMACEUTICAL 

2534
02:00:34,923 --> 02:00:36,925
TREATMENT OR FOLLOW-UP WITH 

2535
02:00:36,925 --> 02:00:38,026
ANOTHER INTERVENTION OR THE 

2536
02:00:38,026 --> 02:00:39,962
OTHER WAY?

2537
02:00:39,962 --> 02:00:41,430
AGAIN, ALL OF OUR TREATMENTS 

2538
02:00:41,430 --> 02:00:44,933
HAVE NON-SPECIFIC AFFECTS WHICH 

2539
02:00:44,933 --> 02:00:46,268
COULD BE A PLACEBO AFFECT.

2540
02:00:46,268 --> 02:00:51,206
IT COULD BE AN AFFECT OF THE 

2541
02:00:51,206 --> 02:00:51,873
CLINICIAN-PATIENT INTERACTION 

2542
02:00:51,873 --> 02:00:53,475
AND THAT'S PART OF THE PROCESS.

2543
02:00:53,475 --> 02:00:57,179
THIS PRIORITY IS TO LOOK AT AND 

2544
02:00:57,179 --> 02:00:57,913
GEARED TOWARDS INDIVIDUALIZATION

2545
02:00:57,913 --> 02:00:59,581
OF THE TREATMENT.

2546
02:00:59,581 --> 02:01:03,418
AGAIN, WE WOULD NEED TO IDENTIFY

2547
02:01:03,418 --> 02:01:04,419
PREDICTORS OF TREATMENT RESPONSE

2548
02:01:04,419 --> 02:01:08,457
WHICH MATCHED WITH ONE OF OUR 

2549
02:01:08,457 --> 02:01:08,890
PRIORITIES ALREADY.

2550
02:01:08,890 --> 02:01:09,992
WE WOULD EVALUATE COMBINATIONS 

2551
02:01:09,992 --> 02:01:17,866
AND TIMING OF APPROACHES.

2552
02:01:17,866 --> 02:01:22,971
THIS WOULD INCLUDE ALL THERAPIES

2553
02:01:22,971 --> 02:01:33,482
AND NON-DRUG APPROACHES AND  

2554
02:01:38,987 --> 02:01:40,455
PHARMACEUTICALS AND THIS IS 

2555
02:01:40,455 --> 02:01:42,424
STILL GEARED TOWARDS MORE 

2556
02:01:42,424 --> 02:01:45,294
INDIVIDUALIZATION BUT ALSO ORDER

2557
02:01:45,294 --> 02:01:55,837
AND TIMING AND WHICH THERAPIES 

2558
02:01:58,840 --> 02:02:01,109
GO WHEN THIS PRIORITY IS TO 

2559
02:02:01,109 --> 02:02:02,778
PRIORITIZE CLINICAL AND 

2560
02:02:02,778 --> 02:02:07,716
COMMUNITY EMBEDDED RESEARCH.

2561
02:02:07,716 --> 02:02:09,618
IMPLEMENTATION EFFECTS OF THE 

2562
02:02:09,618 --> 02:02:11,486
STUDIES AND PRAGMATIC TRIALS 

2563
02:02:11,486 --> 02:02:14,756
LOOKING FOR REAL WORLD IMPACT 

2564
02:02:14,756 --> 02:02:19,361
SCALABILITY AND SUSTAINABILITY.

2565
02:02:19,361 --> 02:02:21,363
WHILE WE CAN DO ALL THE STUDIES 

2566
02:02:21,363 --> 02:02:24,232
IN THE WORLD, AS NORA SAID, IF 

2567
02:02:24,232 --> 02:02:26,601
WE DON'T ACTUALLY CHANGE 

2568
02:02:26,601 --> 02:02:28,503
CLINICAL PRACTICE, WE'VE MADE NO

2569
02:02:28,503 --> 02:02:28,870
PROGRESS.

2570
02:02:28,870 --> 02:02:30,505
SO THESE ARE ABOUT GETTING IN 

2571
02:02:30,505 --> 02:02:32,941
THE REAL WORLD AND PARTNERING 

2572
02:02:32,941 --> 02:02:34,776
WITH STAKEHOLDERS INCLUDING 

2573
02:02:34,776 --> 02:02:37,012
CLINICIANS AND PAYERS AND HEALTH

2574
02:02:37,012 --> 02:02:38,580
CARE SYSTEMS TO CHANGE PRACTICE 

2575
02:02:38,580 --> 02:02:40,816
AND ASSESS IF WE CAN GET THIS IN

2576
02:02:40,816 --> 02:02:41,783
THE REAL WORLD.

2577
02:02:41,783 --> 02:02:43,719
WILL IT BE USED?

2578
02:02:43,719 --> 02:02:48,690
IS IT EFFECTIVE AND CAN WE KEEP 

2579
02:02:48,690 --> 02:02:49,658
IT IN THAT PRACTICE FOR LONG 

2580
02:02:49,658 --> 02:02:50,392
TERM WHICH IS THE SUSTAINABILITY

2581
02:02:50,392 --> 02:02:58,734
PART.

2582
02:02:58,734 --> 02:03:00,268
ASSESSING AND INTEGRATING SHARED

2583
02:03:00,268 --> 02:03:03,638
DECISION MAKING TOOLS OFTEN 

2584
02:03:03,638 --> 02:03:06,475
TALKED ABOUT IN IN CLINICAL 

2585
02:03:06,475 --> 02:03:07,676
RESEARCH AND PRACTICE BUT HAVE 

2586
02:03:07,676 --> 02:03:09,444
NOT BEEN WELL TESTED.

2587
02:03:09,444 --> 02:03:12,781
WE NEED TO EVALUATE INTEGRATE 

2588
02:03:12,781 --> 02:03:23,325
IVE CARE MODELS AND HAVE ACCESS 

2589
02:03:24,126 --> 02:03:25,961
TO A LARGE PAIN SYSTEM IN WHICH 

2590
02:03:25,961 --> 02:03:27,095
THE WORK AND COMMUNITY SETTINGS 

2591
02:03:27,095 --> 02:03:30,699
MAY BE A GREAT WAY TO GET SOME 

2592
02:03:30,699 --> 02:03:41,209
OF THESE TREATMENTS AND HAVE 

2593
02:03:46,448 --> 02:03:47,449
HIGH-VALUED PAIN INTERVENTIONS 

2594
02:03:47,449 --> 02:03:50,685
AND IT MAY BE A PHARMACEUTICAL 

2595
02:03:50,685 --> 02:03:55,457
OR A COMBINATION OF A MULTIMODAL

2596
02:03:55,457 --> 02:03:58,727
APPROACH WITH DE-IMPLEMENTATION 

2597
02:03:58,727 --> 02:04:00,829
OF LOW INTERVENTIONS WE KNOW ARE

2598
02:04:00,829 --> 02:04:01,797
HIGH COST OR HIGH RISK.

2599
02:04:01,797 --> 02:04:05,367
AND SO THIS IS REALLY ABOUT REAL

2600
02:04:05,367 --> 02:04:08,603
WORLD IMPACT AND TRANSLATING OUR

2601
02:04:08,603 --> 02:04:19,014
FINDINGS DIRECTLY INTO CLINICS.

2602
02:04:19,014 --> 02:04:21,516
NEXT IS TO IDENTIFY POPULATIONS 

2603
02:04:21,516 --> 02:04:23,418
DISPROPORTIONATELY AND HIGHLY 

2604
02:04:23,418 --> 02:04:26,755
IMPACTED BY PAIN AND SUBSTANCE 

2605
02:04:26,755 --> 02:04:26,955
USE.

2606
02:04:26,955 --> 02:04:28,523
WE NEED TO UNDERSTAND THE 

2607
02:04:28,523 --> 02:04:29,558
MECHANISMS THAT DIFFERENTLY 

2608
02:04:29,558 --> 02:04:32,127
IMPACT THESE POPULATIONS AND WE 

2609
02:04:32,127 --> 02:04:34,763
NEED TO DEVELOP INTERVENTIONS TO

2610
02:04:34,763 --> 02:04:39,701
ADDRESS THIS IMPACT.

2611
02:04:39,701 --> 02:04:43,238
AS WE KNOW, MANY PEOPLE GOT TO 

2612
02:04:43,238 --> 02:04:48,577
PAIN OR CHRONIC PAIN BECAUSE OF 

2613
02:04:48,577 --> 02:04:49,478
SUBSTANCE USE.

2614
02:04:49,478 --> 02:04:51,146
NOW, BECAUSE THEY WERE TRYING TO

2615
02:04:51,146 --> 02:04:52,581
REDUCE THEIR PAIN.

2616
02:04:52,581 --> 02:04:53,982
IF WE DON'T REDUCE THEIR PAIN, 

2617
02:04:53,982 --> 02:04:57,652
WE CAN'T MOVE THAT FORWARD.

2618
02:04:57,652 --> 02:05:00,155
SIMULTANEOUSLY, SUBSTANCE USE 

2619
02:05:00,155 --> 02:05:01,323
ITSELF AND REPETITIVE USE CAN 

2620
02:05:01,323 --> 02:05:02,324
RESULT IN INCREASED PAIN.

2621
02:05:02,324 --> 02:05:04,092
THERE'S AN INTERACTION WE NEED 

2622
02:05:04,092 --> 02:05:05,293
TO BE LOOKING AT.

2623
02:05:05,293 --> 02:05:07,796
AND WE NEED TO DEVELOP HIGH 

2624
02:05:07,796 --> 02:05:14,736
IMPACT OR HIGH POTENTIAL FOR 

2625
02:05:14,736 --> 02:05:15,203
IMPACT INTERVENTION.

2626
02:05:15,203 --> 02:05:20,075
THIS MAY BE DESCRIBING OPIOIDS 

2627
02:05:20,075 --> 02:05:21,376
AND REPLACING THEM WITH 

2628
02:05:21,376 --> 02:05:22,544
SOMETHING ELSE OR OTHER PAIN 

2629
02:05:22,544 --> 02:05:22,844
MEDICATIONS.

2630
02:05:22,844 --> 02:05:24,679
THERE'S A WHOLE LIFT IN THE 

2631
02:05:24,679 --> 02:05:25,046
PRIORITIES.

2632
02:05:25,046 --> 02:05:27,449
WE NEED TO -- LIST IN THE 

2633
02:05:27,449 --> 02:05:27,749
PRIORITIES.

2634
02:05:27,749 --> 02:05:30,919
WE NEED TO TEST THEM FOR IMPACT.

2635
02:05:30,919 --> 02:05:32,287
PRECLINICAL STUDIES AND NEED TO 

2636
02:05:32,287 --> 02:05:33,355
BE DONE THAT ADDRESS THE 

2637
02:05:33,355 --> 02:05:35,190
MECHANISMS OF THE RELATIONSHIP 

2638
02:05:35,190 --> 02:05:38,560
BETWEEN THIS SO THAT WE CAN THEN

2639
02:05:38,560 --> 02:05:40,295
DEVELOP NOVEL INTERVENTIONS 

2640
02:05:40,295 --> 02:05:50,739
BASED ON THOSE MECHANISMS.

2641
02:05:51,172 --> 02:05:53,341
YOU CAN SEE COMMUNITY ENGAGEMENT

2642
02:05:53,341 --> 02:05:55,010
WHICH IS CRITICALLY IMPORTANT IN

2643
02:05:55,010 --> 02:06:05,420
THE POPULATION AS WELL.

2644
02:06:09,291 --> 02:06:15,130
LOOK TO IMPLEMENT THIS IN 

2645
02:06:15,130 --> 02:06:15,764
POPULATIONS WITH SUBSTANCE USE 

2646
02:06:15,764 --> 02:06:16,765
DISORDERS.

2647
02:06:16,765 --> 02:06:23,905
I THINK THIS IS THE LAST ONE.

2648
02:06:23,905 --> 02:06:27,375
AND THE LAST ONE IS INTERVENTION

2649
02:06:27,375 --> 02:06:27,876
OF CHRONIC PAIN.

2650
02:06:27,876 --> 02:06:32,147
MOST NON-DRUG APPROACHES ARE 

2651
02:06:32,147 --> 02:06:38,520
SAFE AND HAVE EFFICACY.

2652
02:06:38,520 --> 02:06:40,689
YET, WE DON'T NECESSARILY KNOW 

2653
02:06:40,689 --> 02:06:41,489
HOW THEY ALL WORK.

2654
02:06:41,489 --> 02:06:43,124
SO WE NEED TO UNDERSTAND HOW 

2655
02:06:43,124 --> 02:06:45,560
THEY ARE WORK TO IMPROVE THEM 

2656
02:06:45,560 --> 02:06:47,929
CLINICALLY.

2657
02:06:47,929 --> 02:06:54,769
WE NEED TO IDENTIFY EXISTING 

2658
02:06:54,769 --> 02:06:56,504
EVIDENCE-BASED APPROACHES FOR 

2659
02:06:56,504 --> 02:07:07,048
ADDICTION NOBODY RESPOND TO ALL 

2660
02:07:15,724 --> 02:07:21,496
TREATME

2661
02:07:21,496 --> 02:07:22,764
TREATMENTS LOOK AT PREDICTORS 

2662
02:07:22,764 --> 02:07:25,100
AND BIOMARKERS TO IMPROVE AND 

2663
02:07:25,100 --> 02:07:26,267
IDENTIFY THE PEOPLE WHO WILL 

2664
02:07:26,267 --> 02:07:29,537
RESPOND AND THIS COMES BACK TO 

2665
02:07:29,537 --> 02:07:30,939
OPTIMAL TIMING OF THE 

2666
02:07:30,939 --> 02:07:32,107
INTERVENTION, SHARED DECISION 

2667
02:07:32,107 --> 02:07:33,742
MAKING AND PERSON-CENTERED CARE.

2668
02:07:33,742 --> 02:07:36,711
THIS IS A CALL OUT TO NOT ONLY 

2669
02:07:36,711 --> 02:07:40,382
DO THE THINGS WE TALKED ABOUT 

2670
02:07:40,382 --> 02:07:42,283
AND THE OTHER PRIORITIES FROM 

2671
02:07:42,283 --> 02:07:42,917
PHARMACEUTICAL TREATMENTS BUT 

2672
02:07:42,917 --> 02:07:45,353
ALSO MAKE SURE THIS IS DONE FOR 

2673
02:07:45,353 --> 02:07:47,122
NON-DRUG APPROACHES WHICH UP 

2674
02:07:47,122 --> 02:07:50,325
UNTIL THE HEAL INITIATIVE HAVE 

2675
02:07:50,325 --> 02:07:52,193
BEEN QUITE UNDER STUDIED.

2676
02:07:52,193 --> 02:07:55,096
HEAL HAS DONE A GREAT OF 

2677
02:07:55,096 --> 02:07:57,766
SUPPORTING THESE NON-DRUG 

2678
02:07:57,766 --> 02:08:01,436
APPROACHES.

2679
02:08:01,436 --> 02:08:03,138
THAT IS THE LAST OF OUR 

2680
02:08:03,138 --> 02:08:03,438
PRIORITIES.

2681
02:08:03,438 --> 02:08:13,114
THIS IS JUST A REVIEW OF THEM.

2682
02:08:13,114 --> 02:08:18,019
THEY'RE VERY BROAD AND MANY ARE 

2683
02:08:18,019 --> 02:08:19,988
ABOUT DRUG DISCOVERY RESEARCH 

2684
02:08:19,988 --> 02:08:21,623
WITHIN HUMANS OR BASIC PRE 

2685
02:08:21,623 --> 02:08:23,224
CLINICAL STUDIES TO IDENTIFY 

2686
02:08:23,224 --> 02:08:25,060
MECHANISMS THAT THEN COULD BE 

2687
02:08:25,060 --> 02:08:28,596
TAKEN BACK TO THE CLINIC OR FROM

2688
02:08:28,596 --> 02:08:30,765
THE CLINIC, VICE VERSA.

2689
02:08:30,765 --> 02:08:33,535
IT INCLUDES BOTH PREVENTION AS 

2690
02:08:33,535 --> 02:08:38,306
WELL AS TREATMENT OF EXISTING 

2691
02:08:38,306 --> 02:08:38,506
PAIN.

2692
02:08:38,506 --> 02:08:46,748
IMPLEMENTATION AND OF COURSE 

2693
02:08:46,748 --> 02:08:48,817
DIFFERENT CO-OCCURRING PAIN IN 

2694
02:08:48,817 --> 02:08:50,452
INDIVIDUALS WHICH IS VERY 

2695
02:08:50,452 --> 02:08:51,453
IMPORTANT.

2696
02:08:51,453 --> 02:08:53,054
LASTLY, I WILL THANK OUR 

2697
02:08:53,054 --> 02:08:56,791
COMMITTEE, I BELIEVE.

2698
02:08:56,791 --> 02:08:58,793
SO, YOU IS YOU THE COMMITTEES.

2699
02:08:58,793 --> 02:09:00,128
THESE HAVE THE SUBCOMMITTEE 

2700
02:09:00,128 --> 02:09:00,361
MEMBERS.

2701
02:09:00,361 --> 02:09:02,430
AND THERE WERE A LOT OF THEM WHO

2702
02:09:02,430 --> 02:09:03,832
ALL VOLUNTEERED THEIR TIME AND 

2703
02:09:03,832 --> 02:09:11,139
WERE AMAZING.

2704
02:09:11,139 --> 02:09:12,907
THEY CAME TO THE TABLE WITHOUT 

2705
02:09:12,907 --> 02:09:15,043
ALL THEIR BIASES TO TRY TO BRING

2706
02:09:15,043 --> 02:09:17,712
WHERE WE REALLY THINK THE DEAL 

2707
02:09:17,712 --> 02:09:19,914
NEEDS TO GO AND FROM THAT AND 

2708
02:09:19,914 --> 02:09:21,049
THE EXECUTIVE COMMITTEE AS WELL 

2709
02:09:21,049 --> 02:09:23,985
WAS JUST AMAZING TO WORK WITH 

2710
02:09:23,985 --> 02:09:24,652
BECAUSE EVERYBODY THOUGHT WHERE 

2711
02:09:24,652 --> 02:09:33,294
DO WE REALLY NEED TO BE GOING.

2712
02:09:33,294 --> 02:09:34,562
AND TRIED TO BRING TOGETHER 

2713
02:09:34,562 --> 02:09:35,964
WHERE WE ARE NOW AND WHERE WE'D 

2714
02:09:35,964 --> 02:09:37,132
LIKE TO BE IN THE NEXT FIVE 

2715
02:09:37,132 --> 02:09:37,432
YEARS.

2716
02:09:37,432 --> 02:09:38,933
WE THINK THESE WILL HELP PROPEL 

2717
02:09:38,933 --> 02:09:39,834
US THERE.

2718
02:09:39,834 --> 02:09:41,136
WE WANT TO THANK ALL OF THEM AND

2719
02:09:41,136 --> 02:09:51,679
OF COURSE ALL OF OUR STAFF THE 

2720
02:09:53,882 --> 02:09:54,949
ADD NIH AND PAIN RESEARCH BACK 

2721
02:09:54,949 --> 02:09:56,117
WHEN WE DIDN'T HAVE MUCH 

2722
02:09:56,117 --> 02:09:57,085
SUPPORT.

2723
02:09:57,085 --> 02:09:58,753
WE WERE REALLY THANKFUL FOR THAT

2724
02:09:58,753 --> 02:10:00,522
AND REALLY THANKFUL FOR SUPPORT 

2725
02:10:00,522 --> 02:10:02,724
THROUGH ALL OF THESE INITIATIVES

2726
02:10:02,724 --> 02:10:04,025
AS WE MOVE THE HEAL STRATEGIC 

2727
02:10:04,025 --> 02:10:07,328
PLAN FORWARD.

2728
02:10:07,328 --> 02:10:09,230
WITH THAT, I THINK I GET TO TURN

2729
02:10:09,230 --> 02:10:19,541
IT BACK TO JACKIE.

2730
02:10:24,445 --> 02:10:24,646
 

2731
02:10:24,646 --> 02:10:25,847
>> Jackie: IS THERE
ANYTHING YOU

2732
02:10:25,847 --> 02:10:28,716
WANT TO ADD ABOUT NEXT STEPS 

2733
02:10:28,716 --> 02:10:36,257
BEFORE I GET THERE, ROB?

2734
02:10:36,257 --> 02:10:37,625
>> Dr. Gereau: IT'S GOOD.

2735
02:10:37,625 --> 02:10:39,093
THERE'S A LOT.

2736
02:10:39,093 --> 02:10:41,095
WE HAD A LOT OF HELP FROM 

2737
02:10:41,095 --> 02:10:44,766
MICHAEL AS OUR LEADERSHIP 

2738
02:10:44,766 --> 02:10:46,835
MEMBER, PERSON WITH LIVED 

2739
02:10:46,835 --> 02:10:47,168
EXPERIENCE.

2740
02:10:47,168 --> 02:10:49,037
I WAS CHECKING TO SEE IF HE WAS 

2741
02:10:49,037 --> 02:10:52,807
ON THE CALL BUT I DON'T THINK HE

2742
02:10:52,807 --> 02:10:52,974
IS.

2743
02:10:52,974 --> 02:10:54,509
IF YOU'RE HERE AND WANTED TO SAY

2744
02:10:54,509 --> 02:10:58,313
ANYTHING, THAT'D BE GREAT.

2745
02:10:58,313 --> 02:11:01,749
AND WE HAVE MEMBERS OF THE 

2746
02:11:01,749 --> 02:11:03,051
EXECUTIVE COMMITTEE HERE IF THEY

2747
02:11:03,051 --> 02:11:05,520
HAVE ANYTHING THEY'D LIKE TO ADD

2748
02:11:05,520 --> 02:11:06,120
AT THIS POINT.

2749
02:11:06,120 --> 02:11:09,757
>> I WAS GOING TO PUT IT
IN THE 

2750
02:11:09,757 --> 02:11:10,859
CHAT BUT MY CHAT IS DISABLED FOR

2751
02:11:10,859 --> 02:11:11,826
SOME REASON.

2752
02:11:11,826 --> 02:11:14,229
I WANT TO UNDERSCORE THE 

2753
02:11:14,229 --> 02:11:16,364
LEADERSHIP OF ROB AND KATHLEEN 

2754
02:11:16,364 --> 02:11:17,899
AND JACKIE.

2755
02:11:17,899 --> 02:11:19,534
THIS WAS AN INCREDIBLY 

2756
02:11:19,534 --> 02:11:20,668
ACCELERATED PROCESS AND I THINK 

2757
02:11:20,668 --> 02:11:22,470
PEOPLE CAME TOGETHER REALLY 

2758
02:11:22,470 --> 02:11:22,770
WELL.

2759
02:11:22,770 --> 02:11:25,139
IT MAY BE EVIDENT OR NOT BUT I 

2760
02:11:25,139 --> 02:11:26,841
THINK THE WAY WHEN WE GOT 

2761
02:11:26,841 --> 02:11:28,376
TOGETHER AS EXECUTIVE COMMITTEE 

2762
02:11:28,376 --> 02:11:32,380
IN JANUARY TO REALLY MAKE 

2763
02:11:32,380 --> 02:11:34,249
DECISIONS ABOUT PRIORITIES, I 

2764
02:11:34,249 --> 02:11:37,452
THINK PEOPLE WERE SO THOUGHTFUL 

2765
02:11:37,452 --> 02:11:39,821
ABOUT THE WAY THESE THINGS 

2766
02:11:39,821 --> 02:11:41,589
INTERWOVE AND ROB STARTED WITH 

2767
02:11:41,589 --> 02:11:42,557
THE CORE THEMES.

2768
02:11:42,557 --> 02:11:46,027
I THINK A LOT OF THOSE ARE 

2769
02:11:46,027 --> 02:11:48,263
CARRIED THROUGHOUT THIS.

2770
02:11:48,263 --> 02:11:51,299
I LOVE THE CONFIDENCE IT WOULD 

2771
02:11:51,299 --> 02:11:51,966
POTENTIATE RESEARCH ACROSS THE 

2772
02:11:51,966 --> 02:11:54,669
BOARD AND I THINK REALLY 

2773
02:11:54,669 --> 02:11:56,604
REFLECTED THE PRINCIPLES OF THIS

2774
02:11:56,604 --> 02:11:58,206
GROUP IN TERMS OF THE INTERFACES

2775
02:11:58,206 --> 02:12:01,142
IN THESE AREAS.

2776
02:12:01,142 --> 02:12:02,977
JUST REALLY APPRECIATED BEING 

2777
02:12:02,977 --> 02:12:04,679
PART OF THE PROCESS AND WANT IT 

2778
02:12:04,679 --> 02:12:07,148
UNDER SCORE MY CONFIDENCE AND 

2779
02:12:07,148 --> 02:12:07,682
HOW IT WILL SUPPORT THE 

2780
02:12:07,682 --> 02:12:10,051
STRATEGIC PLANNING MOVING 

2781
02:12:10,051 --> 02:12:10,285
FORWARD.

2782
02:12:10,285 --> 02:12:20,295
>> THANK YOU.

2783
02:12:20,295 --> 02:12:22,030
SO, AS FAR AS NEXT STEPS WE'RE 

2784
02:12:22,030 --> 02:12:25,133
HERE WITH YOU AT AN 

2785
02:12:25,133 --> 02:12:26,134
INFORMATIONAL STAGE BUT THEY'RE 

2786
02:12:26,134 --> 02:12:27,735
DRAFT AND THESE WILL BE 

2787
02:12:27,735 --> 02:12:29,771
PRESENTED I BELIEVE MAY 14 -- 

2788
02:12:29,771 --> 02:12:30,772
FORGIVE MY TYPO.

2789
02:12:30,772 --> 02:12:34,442
MAY 14 AT THE OPEN SESSION OF 

2790
02:12:34,442 --> 02:12:35,443
THE NINDS ADVISORY COUNCIL FOR 

2791
02:12:35,443 --> 02:12:37,145
FINAL DISCUSSION AND THEN A VOTE

2792
02:12:37,145 --> 02:12:39,948
FOR APPROVAL AT WHICH POINT 

2793
02:12:39,948 --> 02:12:42,450
THEY'LL BE OFFICIALLY 

2794
02:12:42,450 --> 02:12:42,884
TRANSMITTED TO NIH.

2795
02:12:42,884 --> 02:12:45,486
SO WE WELCOME YOUR THOUGHTS HERE

2796
02:12:45,486 --> 02:12:48,222
NOW AND THEN IF ACCEPTED AT THAT

2797
02:12:48,222 --> 02:12:51,759
MEETING IN MAY, NIH WILL 

2798
02:12:51,759 --> 02:12:52,827
IMPLEMENT THESE THROUGH CONCEPT 

2799
02:12:52,827 --> 02:12:53,962
DEVELOPMENT AND BEYOND.

2800
02:12:53,962 --> 02:12:55,663
I'LL GO TO THE LAST SLIDE WHICH 

2801
02:12:55,663 --> 02:12:56,864
WAS THE PICTURE.

2802
02:12:56,864 --> 02:13:00,168
WE HAD TO ADD ZOOM SQUARES HERE 

2803
02:13:00,168 --> 02:13:02,203
OF OUR IN PERSON MEETING IN 

2804
02:13:02,203 --> 02:13:05,340
JANUARY KINDLY HOSTED BY ROBIN 

2805
02:13:05,340 --> 02:13:06,307
ST. LOUIS AND GLAD WE WERE ABLE 

2806
02:13:06,307 --> 02:13:09,210
TO DO THAT WHEN WE COULD AND 

2807
02:13:09,210 --> 02:13:10,812
THANKS TO MY NIH COLLEAGUES WHO 

2808
02:13:10,812 --> 02:13:12,146
WERE CRITICAL IN THIS ENTIRE 

2809
02:13:12,146 --> 02:13:13,581
PROCESS AND THERE WERE MANY OF 

2810
02:13:13,581 --> 02:13:15,583
THEM AS YOU CAN SEE ON THE SLIDE

2811
02:13:15,583 --> 02:13:18,953
AS WELL AS THE GROUP HERE, THE 

2812
02:13:18,953 --> 02:13:19,220
CO-CHAIRS.

2813
02:13:19,220 --> 02:13:22,690
IT WAS A FRUITFUL AND 

2814
02:13:22,690 --> 02:13:23,491
COLLABORATIVE ENDEAVOR.

2815
02:13:23,491 --> 02:13:25,526
I REALLY APPRECIATE KATHLEEN AND

2816
02:13:25,526 --> 02:13:28,663
ROB, YOUR LEADERSHIP ON THIS.

2817
02:13:28,663 --> 02:13:36,671
I'LL LEAVE THIS SLIDE UP AND  IF

2818
02:13:36,671 --> 02:13:46,914
WE HAVE TIME.

2819
02:14:02,497 --> 02:14:06,768
WE'VE STUNNED THEM INTO SILENCE.

2820
02:14:06,768 --> 02:14:17,178
>> TOO MUCH INFORMATION.

2821
02:14:18,780 --> 02:14:19,547
PERHAPS THE GROUP ALONG WITH 

2822
02:14:19,547 --> 02:14:22,450
DR. SMITH AGREE WILDLY WITH THE 

2823
02:14:22,450 --> 02:14:23,718
CONCLUSIONS, WHICH I APPRECIATE 

2824
02:14:23,718 --> 02:14:24,385
THE PHRASING.

2825
02:14:24,385 --> 02:14:28,823
I WAND YOU ALL TO KNOW THAT WE 

2826
02:14:28,823 --> 02:14:30,458
APPRECIATE AN ADDITIONAL INPUT, 

2827
02:14:30,458 --> 02:14:33,027
THOUGHTS AND REFLECTIONS 

2828
02:14:33,027 --> 02:14:35,229
ESPECIALLY BETWEEN NOW AND MAY 

2829
02:14:35,229 --> 02:14:38,399
14 BUT ALSO BEYOND.

2830
02:14:38,399 --> 02:14:40,234
AGAIN, WE REALLY APPRECIATE 

2831
02:14:40,234 --> 02:14:41,302
EVERYBODY'S HARD AND THOUGHTFUL 

2832
02:14:41,302 --> 02:14:42,336
WORK ON THIS.

2833
02:14:42,336 --> 02:14:52,880
IT'S REALLY AN IMPORTANT EFFORT.

2834
02:14:54,148 --> 02:14:58,686
>> I WANT TO THANK THE
GROUP.

2835
02:14:58,686 --> 02:15:01,389
IT REFLECTS, BROAD THOUGHTFUL 

2836
02:15:01,389 --> 02:15:08,763
INPUT AND I REALLY LIKE HOW THIS

2837
02:15:08,763 --> 02:15:09,931
SPEAKS TO WHAT WE'VE DONE 

2838
02:15:09,931 --> 02:15:10,998
ALREADY AND EXPANDING THAT AND 

2839
02:15:10,998 --> 02:15:14,635
ALSO NEW POINTS OF VIEW.

2840
02:15:14,635 --> 02:15:20,208
NEW WAYS TO THINK ABOUT AND 

2841
02:15:20,208 --> 02:15:21,142
SHOUT OUT TO THE EFFORTS OF 

2842
02:15:21,142 --> 02:15:22,944
RAISING THE IMPORTANCE OF 

2843
02:15:22,944 --> 02:15:23,344
PREVENTION.

2844
02:15:23,344 --> 02:15:24,378
THIS IS SOMETHING THAT IS NOT 

2845
02:15:24,378 --> 02:15:31,219
EASY.

2846
02:15:31,219 --> 02:15:33,154
I APPRECIATE THE GROUP.

2847
02:15:33,154 --> 02:15:35,590
I KNOW IT WAS PROBABLY DIFFICULT

2848
02:15:35,590 --> 02:15:38,759
TO COME UP WITH RECOMMENDATIONS 

2849
02:15:38,759 --> 02:15:41,963
BECAUSE WE'RE KIND OF ALMOST 

2850
02:15:41,963 --> 02:15:44,599
STARTING FROM SCRATCH.

2851
02:15:44,599 --> 02:15:48,603
WE KNOW SOME OF IT ABOUT 

2852
02:15:48,603 --> 02:15:49,270
PREVENTING CHRONIC PAIN BUT ALSO

2853
02:15:49,270 --> 02:15:51,572
ABOUT MAKING SURE THAT PEOPLE 

2854
02:15:51,572 --> 02:15:52,940
WITH ACUTE PAIN DON'T 

2855
02:15:52,940 --> 02:15:53,241
TRANSITION.

2856
02:15:53,241 --> 02:15:56,811
WE FOCUSSED ON UNDERSTANDING THE

2857
02:15:56,811 --> 02:15:59,147
TRANSITION BUT DON'T REALLY 

2858
02:15:59,147 --> 02:16:02,216
UNDERSTAND HOW TO NOT TRANSITION

2859
02:16:02,216 --> 02:16:06,487
AND TO RESOLVE ACUTE PAIN.

2860
02:16:06,487 --> 02:16:08,723
I'M VERY HOPEFUL YOUR 

2861
02:16:08,723 --> 02:16:11,759
RECOMMENDATIONS WILL REALLY 

2862
02:16:11,759 --> 02:16:16,764
ENCOURAGE MORE WORK IN THIS AREA

2863
02:16:16,764 --> 02:16:19,033
ALSO IN THE AREAS OF 

2864
02:16:19,033 --> 02:16:19,700
IMPLEMENTATION OF HOW TO MAKE 

2865
02:16:19,700 --> 02:16:20,935
SURE -- AND THIS IS SOMETHING 

2866
02:16:20,935 --> 02:16:24,672
THAT FALLS IN THE OTHER CATEGORY

2867
02:16:24,672 --> 02:16:26,107
OF WORK THE HEAL INITIATIVE 

2868
02:16:26,107 --> 02:16:30,144
SPENT A GOOD AMOUNT OF TIME AND 

2869
02:16:30,144 --> 02:16:31,479
EFFORT ON AND WITH SOME GOOD 

2870
02:16:31,479 --> 02:16:33,214
RESULTS ALREADY BUT WE NEED MORE

2871
02:16:33,214 --> 02:16:36,517
SO I APPRECIATE YOU ARE 

2872
02:16:36,517 --> 02:16:36,951
HIGHLIGHTING THIS.

2873
02:16:36,951 --> 02:16:39,620
I THINK BOTH ENDS OF THE 

2874
02:16:39,620 --> 02:16:40,988
SPECTRUM IN THE AREAS WHERE 

2875
02:16:40,988 --> 02:16:42,456
WE'VE ALREADY DONE A LOT BUT 

2876
02:16:42,456 --> 02:16:43,591
WANT MORE AND IN NEW AREAS THAT 

2877
02:16:43,591 --> 02:16:46,160
ARE CHALLENGING.

2878
02:16:46,160 --> 02:16:48,229
I'M REALLY GLAD YOU'VE COVERED 

2879
02:16:48,229 --> 02:16:50,998
THAT WHOLE SPECTRUM.

2880
02:16:50,998 --> 02:16:53,467
THANK YOU VERY MUCH.

2881
02:16:53,467 --> 02:16:56,804
>> Dr. Gereau: THANK YOU, 

2882
02:16:56,804 --> 02:16:58,439
DR. LANGEVIN.

2883
02:16:58,439 --> 02:17:01,342
SOME IS OVERLAPPING AS YOU 

2884
02:17:01,342 --> 02:17:02,743
MENTIONED WITH THINGS WE'RE 

2885
02:17:02,743 --> 02:17:04,212
ALREADY DOING AND RE-EMPHASIZING

2886
02:17:04,212 --> 02:17:06,981
THAT BUT THERE'S A TENDENCY TO 

2887
02:17:06,981 --> 02:17:17,158
FOCUS ON GAPS AND IT WAS HARD TO

2888
02:17:17,158 --> 02:17:20,895
CAPTURE WHAT THINGS PEOPLE WERE 

2889
02:17:20,895 --> 02:17:22,129
SAYING WERE GOING WELL.

2890
02:17:22,129 --> 02:17:24,131
THERE WAS SUPPORT IN THE 

2891
02:17:24,131 --> 02:17:25,066
MEETINGS FOR THAT BUT DOESN'T 

2892
02:17:25,066 --> 02:17:26,734
ALWAYS COME UP HERE.

2893
02:17:26,734 --> 02:17:28,369
YOU SEE BIOMARKERS AND THINGS 

2894
02:17:28,369 --> 02:17:30,871
LIKE THIS THAT HAVE ALWAYS BEEN 

2895
02:17:30,871 --> 02:17:31,405
THERE IN THE HUMAN TISSUE 

2896
02:17:31,405 --> 02:17:41,582
RESEARCH.

2897
02:17:59,667 --> 02:18:03,170
 >> THIS HAS BEEN A
HERCULEAN 

2898
02:18:03,170 --> 02:18:04,572
EFFORT AND WHEN I READ THE SLIDE

2899
02:18:04,572 --> 02:18:07,975
DECK I WAS EXCITED TO SEE THE 

2900
02:18:07,975 --> 02:18:11,145
IMPLEMENTATION AND HOW SERVICES 

2901
02:18:11,145 --> 02:18:15,716
PILLAR WHICH AS A CLINICIAN 

2902
02:18:15,716 --> 02:18:16,784
WE'RE ALWAYS INTO IMPLEMENTATION

2903
02:18:16,784 --> 02:18:20,921
AND HOW TO GET CLINICIANS ON 

2904
02:18:20,921 --> 02:18:21,889
BOARD AND CLINICIAN EDUCATION IS

2905
02:18:21,889 --> 02:18:23,758
HUGE AND THAT'S ONE OF YOUR 

2906
02:18:23,758 --> 02:18:25,293
GOALS AND PRIORITIES.

2907
02:18:25,293 --> 02:18:26,027
ANOTHER PLACE THAT NEEDS 

2908
02:18:26,027 --> 02:18:27,461
ATTENTION AND I DON'T THINK 

2909
02:18:27,461 --> 02:18:29,897
WE'RE THERE YET IS LOOKING AT 

2910
02:18:29,897 --> 02:18:32,066
THE SYSTEMATIC BARRIERS THAT GET

2911
02:18:32,066 --> 02:18:34,769
IN CLINICIANS WAY OF 

2912
02:18:34,769 --> 02:18:35,436
IMPLEMENTING BEST PRACTICE.

2913
02:18:35,436 --> 02:18:39,040
I DIDN'T SEE IT IN YOUR SLIDE 

2914
02:18:39,040 --> 02:18:43,778
DECK BUT I THINK IT'S THAT WHAT 

2915
02:18:43,778 --> 02:18:46,514
GETS IN THE WAY OF IMPLEMENTING 

2916
02:18:46,514 --> 02:18:52,219
BEST PRACTICE AND CLINICIANS' 

2917
02:18:52,219 --> 02:18:54,455
HEARTS IN THE RIGHT PLACE AND 

2918
02:18:54,455 --> 02:18:58,392
IT'S EASY TO TARGET EDUCATION 

2919
02:18:58,392 --> 02:19:00,561
PROGRAMS, PROFESSIONAL EDUCATION

2920
02:19:00,561 --> 02:19:02,096
PROGRAMS AND P.T. AND ALL THAT 

2921
02:19:02,096 --> 02:19:03,331
BUT THERE'S CLINICIANS ALREADY 

2922
02:19:03,331 --> 02:19:04,165
DOING WHAT THEY'VE BEEN DOING 

2923
02:19:04,165 --> 02:19:14,475
FOR 20, 30 YEARS.

2924
02:19:14,809 --> 02:19:17,478
HOW DO YOU CHANGE ATTITUDES AND 

2925
02:19:17,478 --> 02:19:19,747
PERCEPTIONS OF EXISTING 

2926
02:19:19,747 --> 02:19:21,082
CLINICIANS AND THE CLINICIAN 

2927
02:19:21,082 --> 02:19:22,750
BECOMES THE SUBJECT IN THE 

2928
02:19:22,750 --> 02:19:22,950
STUDY.

2929
02:19:22,950 --> 02:19:26,253
I DON'T THINK WE'VE DONE THAT 

2930
02:19:26,253 --> 02:19:30,291
ENOUGH.

2931
02:19:30,291 --> 02:19:32,493
WE NEED ALL OF THAT BUT AT HUMAN

2932
02:19:32,493 --> 02:19:39,367
BEING   -- AT 4:00 I HAVE 

2933
02:19:39,367 --> 02:19:41,135
PATIENTS COMING IN THAT NEED 

2934
02:19:41,135 --> 02:19:41,335
HELP.

2935
02:19:41,335 --> 02:19:44,638
I WOULD PUT IN A PLUG FOR THE 

2936
02:19:44,638 --> 02:19:47,141
IMPLEMENTATION OF SYSTEMATIC 

2937
02:19:47,141 --> 02:19:49,210
BARRIERS AND FINDING WAYS TO 

2938
02:19:49,210 --> 02:19:50,511
PUSH THIS OUT THE DOOR FOR 

2939
02:19:50,511 --> 02:19:50,945
EXISTING CLINICIAN.

2940
02:19:50,945 --> 02:20:01,355
THANK YOU FOR YOUR WORK.

2941
02:20:04,558 --> 02:20:06,627
>> LIN, YOU MAY WANT TO
ADDRESS 

2942
02:20:06,627 --> 02:20:10,131
SOME OF THIS BECAUSE I KNOW WE 

2943
02:20:10,131 --> 02:20:16,237
TALKED ABOUT A LOT OF.

2944
02:20:16,237 --> 02:20:17,104
>> I APPRECIATE THE
COMMENTS.

2945
02:20:17,104 --> 02:20:18,406
THEY WERE SPOT ON.

2946
02:20:18,406 --> 02:20:21,008
I ALLUDED TO BUT DIDN'T SAY MUCH

2947
02:20:21,008 --> 02:20:22,109
ELSE ABOUT THE CORE THEMES.

2948
02:20:22,109 --> 02:20:24,845
ONE OF THE THEMES THAT CAME UP 

2949
02:20:24,845 --> 02:20:27,715
IN THE IMPLEMENTATION HEALTH 

2950
02:20:27,715 --> 02:20:32,920
SERVICES GROUP IS THE IMPORTANCE

2951
02:20:32,920 --> 02:20:43,330
BAKING THAT IN FROM THE 

2952
02:20:46,367 --> 02:20:49,270
CONCEPTION AROUND THEY KNOW THE 

2953
02:20:49,270 --> 02:20:50,738
BARRIERS AND WE HAVE TO PLAN 

2954
02:20:50,738 --> 02:20:53,274
THAT IN AND CAN'T BE AN 

2955
02:20:53,274 --> 02:20:53,607
AFTERTHOUGHT.

2956
02:20:53,607 --> 02:20:55,142
WE TRIED AS BEST WE COULD TO 

2957
02:20:55,142 --> 02:20:56,277
BUILD THAT IN.

2958
02:20:56,277 --> 02:21:00,214
I ALSO THINK, KATHLEEN, YOU 

2959
02:21:00,214 --> 02:21:04,151
HIGHLIGHTED THE COUPLING OF OR 

2960
02:21:04,151 --> 02:21:06,720
GETTING THINGS OUT AND 

2961
02:21:06,720 --> 02:21:08,989
IMPLEMENTED BUT ALSO THE 

2962
02:21:08,989 --> 02:21:11,091
IMPLEMENTATION WE HAVEN'T BEEN 

2963
02:21:11,091 --> 02:21:12,760
SO GOOD AT.

2964
02:21:12,760 --> 02:21:14,562
IT ALSO CALLS FOR INVOLVEMENT OF

2965
02:21:14,562 --> 02:21:16,197
THE HEALTH CARE SYSTEMS AND 

2966
02:21:16,197 --> 02:21:17,131
CLINICIANS TO HELP US THINK 

2967
02:21:17,131 --> 02:21:20,568
THROUGH THE BARRIERS OF DOING 

2968
02:21:20,568 --> 02:21:22,102
THAT.

2969
02:21:22,102 --> 02:21:23,804
THAT WERE PARTICULAR KINDS OF 

2970
02:21:23,804 --> 02:21:24,939
APPROACHES THAT ALLOWED FOR 

2971
02:21:24,939 --> 02:21:25,372
THAT.

2972
02:21:25,372 --> 02:21:28,809
I THINK THIS WAS METHED.

2973
02:21:28,809 --> 02:21:30,811
WE ALL DID HALF DAY VIRTUAL 

2974
02:21:30,811 --> 02:21:33,948
WORKSHOPS AND SOME WERE 

2975
02:21:33,948 --> 02:21:43,991
HIGHLIGHTED IN THE PROGRAMS AND 

2976
02:21:43,991 --> 02:21:44,892
PLEASE MAKE RECOMMENDATIONS IF 

2977
02:21:44,892 --> 02:21:46,360
IT'S POSSIBLE TO EDIT THEM AT 

2978
02:21:46,360 --> 02:21:46,927
ALL.

2979
02:21:46,927 --> 02:21:48,696
>> GO BACK TO THE WORDING
AND 

2980
02:21:48,696 --> 02:21:50,764
MAKE SURE THAT'S INCLUDED IN 

2981
02:21:50,764 --> 02:21:53,100
THAT PRIORITY AS WELL WHICH WE 

2982
02:21:53,100 --> 02:21:54,835
WILL BE LOOKING AT.

2983
02:21:54,835 --> 02:21:57,705
THAT'S WHY WE'RE HERE TO GET 

2984
02:21:57,705 --> 02:21:58,072
FEEDBACK.

2985
02:21:58,072 --> 02:21:59,006
>> Dr. Gereau: AND BAKED
INTO 

2986
02:21:59,006 --> 02:22:02,676
WHAT YOU WERE SAYING, SHARON, 

2987
02:22:02,676 --> 02:22:03,777
BARRIERS TO ACTUALLY HAVING THE 

2988
02:22:03,777 --> 02:22:11,986
CHANGES OCCURRING.

2989
02:22:11,986 --> 02:22:15,589
AND THERE'S SO MUCH DISCUSSION 

2990
02:22:15,589 --> 02:22:18,759
ALONG THE WAY AND AREAS WHERE 

2991
02:22:18,759 --> 02:22:21,862
NIH IS NOT ABLE TO OPERATE ARE 

2992
02:22:21,862 --> 02:22:23,664
CHALLENGES TO THAT.

2993
02:22:23,664 --> 02:22:26,767
I THINK WHAT YOU'RE TALKING 

2994
02:22:26,767 --> 02:22:29,670
ABOUT WAS SO PERVASIVE AMONG THE

2995
02:22:29,670 --> 02:22:32,373
HEALTH CARE DELIVERY AND ALL 

2996
02:22:32,373 --> 02:22:32,806
THAT.

2997
02:22:32,806 --> 02:22:35,209
THAT DEFINITELY NEEDS TO BE TOP 

2998
02:22:35,209 --> 02:22:37,978
OF MIND IF IT'S NOT ADEQUATELY 

2999
02:22:37,978 --> 02:22:38,279
IN THERE.

3000
02:22:38,279 --> 02:22:45,119
>> YES, WE NEED TO EDUCATE
THE 

3001
02:22:45,119 --> 02:22:46,754
CLINICIANS AND PULL IN SOME 

3002
02:22:46,754 --> 02:22:49,657
HOSPITAL ADMINISTRATORS BECAUSE 

3003
02:22:49,657 --> 02:22:51,292
THEY HOLD THE PULSE STRINGS AND 

3004
02:22:51,292 --> 02:22:53,794
IMPLEMENT WHAT THE CLINICIAN IS 

3005
02:22:53,794 --> 02:22:54,228
DESPERATELY WANTING.

3006
02:22:54,228 --> 02:22:56,931
THAT'S A WHOLE OTHER LEVEL AND 

3007
02:22:56,931 --> 02:23:00,234
COULD BE UNDER THE NIH PURVIEW 

3008
02:23:00,234 --> 02:23:01,502
BUT IN THE LONG RUN THAT'S WHERE

3009
02:23:01,502 --> 02:23:04,538
A LOT OF THE BARRIERS ARE.

3010
02:23:04,538 --> 02:23:06,740
>> AND A LOT OF THAT COULD
BE IN

3011
02:23:06,740 --> 02:23:12,880
THE DESIGN OF YOUR TRIAL.

3012
02:23:12,880 --> 02:23:14,748
>> Dr. Sluka: BAKED IN
FROM THE 

3013
02:23:14,748 --> 02:23:16,650
BEGINNING IN THE TRIAL.

3014
02:23:16,650 --> 02:23:18,752
>> I DON'T THINK
RESEARCHERS 

3015
02:23:18,752 --> 02:23:19,954
THINK IN THOSE TERMS WHEN 

3016
02:23:19,954 --> 02:23:30,497
THEY'RE RIGHT WRITING THEIR RO1.

3017
02:23:36,503 --> 02:23:38,439
>> Dr. Sluka: 

3018
02:23:40,908 --> 02:23:41,408
>> 

3019
02:23:41,408 --> 02:23:44,144
>> Jackie: I WANT TO ECHO 

3020
02:23:44,144 --> 02:23:45,546
EVERYBODY'S THANKS TO YOU.

3021
02:23:45,546 --> 02:23:49,083
YOU DESERVE A HUGE RAISE COMING 

3022
02:23:49,083 --> 02:23:50,384
YOUR WAY.

3023
02:23:50,384 --> 02:23:53,854
IT WAS REALLY HARD FOR JUST OUR 

3024
02:23:53,854 --> 02:23:56,290
GROUP SO I CAN IMAGINE HOW HARD 

3025
02:23:56,290 --> 02:23:58,292
IT WAS LOOKING AT ALL THE 

3026
02:23:58,292 --> 02:23:59,827
RECOMMENDATIONS THAT CAME IN 

3027
02:23:59,827 --> 02:24:01,462
FROM EACH OF THE WORK GROUPS.

3028
02:24:01,462 --> 02:24:07,835
BUT YOU BOTH DID AN AMAZING JOB.

3029
02:24:07,835 --> 02:24:10,004
JACKIE AS WELL AND THANK YOU FOR

3030
02:24:10,004 --> 02:24:10,804
INCLUDING THE DIVERSE 

3031
02:24:10,804 --> 02:24:13,374
PERSPECTIVES AND HATS OFF TO 

3032
02:24:13,374 --> 02:24:14,508
VIVIAN AND OTHERS INVOLVED IN 

3033
02:24:14,508 --> 02:24:15,943
SUPPORTING PEOPLE WITH LIVED 

3034
02:24:15,943 --> 02:24:17,411
EXPERIENCE TO BETTER UNDERSTAND 

3035
02:24:17,411 --> 02:24:18,412
THE PROCESS AND BE ABLE TO 

3036
02:24:18,412 --> 02:24:20,514
CONTRIBUTE TO IT.

3037
02:24:20,514 --> 02:24:22,950
I GUESS MY ONE QUESTION IS WHEN 

3038
02:24:22,950 --> 02:24:25,185
I THINK OF THE OVER ARCHING 

3039
02:24:25,185 --> 02:24:28,422
THEMES MORE OF A LOGISTICAL AND 

3040
02:24:28,422 --> 02:24:29,490
PRAGMATIC QUESTION AND MAYBE TOO

3041
02:24:29,490 --> 02:24:31,225
EARLY TO ANSWER BUT WHEN I THINK

3042
02:24:31,225 --> 02:24:33,927
ABOUT THE THEMES THAT CUT ACROSS

3043
02:24:33,927 --> 02:24:37,731
THE RESEARCH PRIORITIES AND 

3044
02:24:37,731 --> 02:24:40,934
RECOMMENDATIONS SOME SEEM EASY 

3045
02:24:40,934 --> 02:24:43,737
OR SIMPLE TO INCORPORATE INTO 

3046
02:24:43,737 --> 02:24:45,873
FOAs ACROSS ALL KINDS OF 

3047
02:24:45,873 --> 02:24:46,140
RESEARCH.

3048
02:24:46,140 --> 02:24:47,808
FOR EXAMPLE, INCLUSION OF 

3049
02:24:47,808 --> 02:24:49,977
PATIENT AND OTHER COMMUNITY 

3050
02:24:49,977 --> 02:24:53,080
STAKEHOLDERS BUT OTHER ONES LIKE

3051
02:24:53,080 --> 02:24:57,017
PUBLIC EDUCATION CAMPAIGN ON 

3052
02:24:57,017 --> 02:24:57,985
PAIN OR PAIN RESEARCH DON'T.

3053
02:24:57,985 --> 02:24:59,453
I GUESS MY QUESTION IS HOW DO 

3054
02:24:59,453 --> 02:25:02,489
YOU ENVISION DEALING WITH THOSE 

3055
02:25:02,489 --> 02:25:03,490
CROSS-CUTTING THEMES?

3056
02:25:03,490 --> 02:25:05,526
ARE THEY MORE THEMES THAT HAVE 

3057
02:25:05,526 --> 02:25:06,393
BEEN HIGHLIGHTED AND THAT YOU'LL

3058
02:25:06,393 --> 02:25:08,162
ENCOURAGE PEOPLE TO TRY TO 

3059
02:25:08,162 --> 02:25:09,063
ADDRESS ACROSS THE RESEARCH 

3060
02:25:09,063 --> 02:25:12,433
PRIORITIES AS THEY SUBMIT 

3061
02:25:12,433 --> 02:25:12,833
PROPOSALS?

3062
02:25:12,833 --> 02:25:15,069
OR ARE THOSE GOING TO BE HANDLED

3063
02:25:15,069 --> 02:25:16,937
SEPARATELY IN SOME INSTANCES?

3064
02:25:16,937 --> 02:25:18,372
AGAIN, IF IT'S TOO SOON TO 

3065
02:25:18,372 --> 02:25:21,542
ANSWER THIS QUESTION, SORRY.

3066
02:25:21,542 --> 02:25:22,543
>> SOUNDS LIKE A WALTER
QUESTION

3067
02:25:22,543 --> 02:25:26,714
TO ME.

3068
02:25:26,714 --> 02:25:28,449
>> IT DEFINITELY SOUNDS
LIKE 

3069
02:25:28,449 --> 02:25:30,751
SOMEBODY ELSE'S QUESTION.

3070
02:25:30,751 --> 02:25:31,618
WE DON'T IMPLEMENT.

3071
02:25:31,618 --> 02:25:32,386
>> I REALIZE THAT.

3072
02:25:32,386 --> 02:25:34,621
IT'S MORE OF A BROAD QUESTION TO

3073
02:25:34,621 --> 02:25:37,691
THE NIH ABOUT HOW YOU'RE 

3074
02:25:37,691 --> 02:25:39,460
THINKING HOW THESE THEMES ALIGN 

3075
02:25:39,460 --> 02:25:40,828
WITH THE PRIORITIES AND HOW 

3076
02:25:40,828 --> 02:25:42,529
THOSE MIGHT BE INCLUDED OR NOT 

3077
02:25:42,529 --> 02:25:45,833
INCLUDED OR HANDLED SEPARATELY 

3078
02:25:45,833 --> 02:25:47,968
WITH FOAs.

3079
02:25:47,968 --> 02:25:50,104
>> I'LL TAKE A STAB AND
THEN 

3080
02:25:50,104 --> 02:25:52,473
PASS IT TO WALTER IF HE WANTS TO

3081
02:25:52,473 --> 02:25:53,107
ADD ANYTHING ELSE.

3082
02:25:53,107 --> 02:25:54,374
ONE OF THE THINGS WE TALKED 

3083
02:25:54,374 --> 02:25:57,444
ABOUT THINGS ON THE CUSP OR 

3084
02:25:57,444 --> 02:26:00,180
OUTSIDE OF NIH'S PURVIEW, WE 

3085
02:26:00,180 --> 02:26:01,682
STILL HAVE OTHER CHANNELS 

3086
02:26:01,682 --> 02:26:02,783
POTENTIALLY NOT THROUGH HEAL 

3087
02:26:02,783 --> 02:26:04,485
FUNDING OPPORTUNITIES BUT 

3088
02:26:04,485 --> 02:26:06,220
THROUGH OUR INTERAGENCY 

3089
02:26:06,220 --> 02:26:08,789
COMMITTEES WHERE WE WORK WITH 

3090
02:26:08,789 --> 02:26:14,094
THE CDC OR WORK WITH OTHER 

3091
02:26:14,094 --> 02:26:15,395
COLLEAGUES AT HHS TO PROMOTE 

3092
02:26:15,395 --> 02:26:16,463
PAIN RESEARCH ACROSS THE FEDERAL

3093
02:26:16,463 --> 02:26:24,471
GOVERNMENT.

3094
02:26:24,471 --> 02:26:27,741
I THINK THOSE CAME THROUGH FOR 

3095
02:26:27,741 --> 02:26:33,313
OTHER WAYS TO THREAD THEM 

3096
02:26:33,313 --> 02:26:34,748
THROUGH NIH PROCESSES AND 

3097
02:26:34,748 --> 02:26:36,750
INTEGRATED INTO FUNDING 

3098
02:26:36,750 --> 02:26:37,818
OPPORTUNITY AND WOE MAY HAVE TO 

3099
02:26:37,818 --> 02:26:39,486
FIND OTHER CHANNELS AND HOW TO 

3100
02:26:39,486 --> 02:26:40,320
PROMOTE THOSE.

3101
02:26:40,320 --> 02:26:43,457
I KNOW WE HAD DISCUSSED WITH 

3102
02:26:43,457 --> 02:26:45,259
LINDA'S LEADERSHIP DEVELOPED 

3103
02:26:45,259 --> 02:26:46,393
INTERAGENCY PAIN RESEARCH 

3104
02:26:46,393 --> 02:26:48,662
COORDINATING COMMITTEE.

3105
02:26:48,662 --> 02:26:51,665
THAT'S ONE IN PARTICULAR WHERE 

3106
02:26:51,665 --> 02:26:54,501
THE DISCUSSION OF THE BROADER 

3107
02:26:54,501 --> 02:26:56,203
PUBLIC MIGHT BE MORE APPROPRIATE

3108
02:26:56,203 --> 02:26:58,472
VENUE THAN HEAL FUNDING 

3109
02:26:58,472 --> 02:27:00,808
OPPORTUNITIES.

3110
02:27:00,808 --> 02:27:04,812
I WELCOME YOUR ADDITIONAL TAKE, 

3111
02:27:04,812 --> 02:27:05,345
WALTER?

3112
02:27:05,345 --> 02:27:11,819
>> Dr. Koroshetz: I THINK
TO GET

3113
02:27:11,819 --> 02:27:17,624
TO THE GENERIC POINT ABOUT NIH'S

3114
02:27:17,624 --> 02:27:18,759
ROLE OF DEVELOP DATA AND 

3115
02:27:18,759 --> 02:27:22,930
POLICIES MADE FOR HEALTH.

3116
02:27:22,930 --> 02:27:25,365
SO WE DON'T DO GUIDE RYANS.

3117
02:27:25,365 --> 02:27:26,567
-- GUIDELINES.

3118
02:27:26,567 --> 02:27:30,470
WE RELY ON PASSING THE DATA TO 

3119
02:27:30,470 --> 02:27:37,978
OTHER GROUPS TO OPERATIONAL IIZ 

3120
02:27:37,978 --> 02:27:40,547
IS AND WE ALL KNOW HOW IMPERFECT

3121
02:27:40,547 --> 02:27:41,215
THE SYSTEM IS.

3122
02:27:41,215 --> 02:27:45,385
WHAT WE DO IS LOOK FOR PARTNERS 

3123
02:27:45,385 --> 02:27:47,321
THAT WOULD BE CONDUCIVE TO THAT 

3124
02:27:47,321 --> 02:27:49,256
TYPE OF RESEARCH THAT WOULD THEN

3125
02:27:49,256 --> 02:27:56,864
LEAD TO ACTIONABLE CHANGES.

3126
02:27:56,864 --> 02:28:00,167
SO, I THINK WE BENEFIT A LOT BY 

3127
02:28:00,167 --> 02:28:02,603
WORKING WITH PEOPLE LIKE GLEN AT

3128
02:28:02,603 --> 02:28:02,836
KAISER.

3129
02:28:02,836 --> 02:28:08,575
WE HAVE A CALL OUT NOW FOR 

3130
02:28:08,575 --> 02:28:10,377
PROGRAMS TO DO PAIN RESEARCH IN 

3131
02:28:10,377 --> 02:28:10,811
HEALTH CARE SYSTEMS.

3132
02:28:10,811 --> 02:28:14,314
I THINK IT'S BEEN VERY HARD TO 

3133
02:28:14,314 --> 02:28:19,853
MOVE THAT NEEDLE BUT I WOULD SAY

3134
02:28:19,853 --> 02:28:22,489
HELEN COULD CHIME IN ONE OF THE 

3135
02:28:22,489 --> 02:28:26,026
REAL SWATS IN WORKING WITH THE 

3136
02:28:26,026 --> 02:28:30,764
V.A. WHERE WE CAN DO PRAGMATIC 

3137
02:28:30,764 --> 02:28:32,733
RESEARCH AND IF IT WORKS THEY 

3138
02:28:32,733 --> 02:28:35,035
CAN TAKE IT ON IN THEIR CLINICAL

3139
02:28:35,035 --> 02:28:38,739
PRACTICE AND THERE'S A GOOD 

3140
02:28:38,739 --> 02:28:49,249
PROGRAM WITH THE V.A. SYSTEM.

3141
02:28:52,986 --> 02:28:58,258
AND V.A. DOES A GOOD JOB.

3142
02:28:58,258 --> 02:29:00,894
WE REALLY NEED PARTNERS WILLING 

3143
02:29:00,894 --> 02:29:05,899
TO PLAY BALL AND I THINK THE 

3144
02:29:05,899 --> 02:29:09,303
PERCENT STRING IS THE BIG 

3145
02:29:09,303 --> 02:29:10,404
ELEPHANT IN THE ROOM.

3146
02:29:10,404 --> 02:29:12,973
IF YOU'RE MAKING A LOT OF MONEY 

3147
02:29:12,973 --> 02:29:14,741
OFF BACK PAIN SURGERY YOU'RE NOT

3148
02:29:14,741 --> 02:29:16,510
GOING TO BE THAT INTERESTED IN 

3149
02:29:16,510 --> 02:29:18,679
PREVENTING BACK PAIN SURGERY BY 

3150
02:29:18,679 --> 02:29:23,617
USING ALTERNATIVE METHODS.

3151
02:29:23,617 --> 02:29:25,819
IT'S KIND OF CRUDE BUT I THINK 

3152
02:29:25,819 --> 02:29:28,522
WE KNOW WHAT THE ISSUES ARE OUT 

3153
02:29:28,522 --> 02:29:31,758
THERE AND OUR SYSTEM IS HEAVILY 

3154
02:29:31,758 --> 02:29:34,294
RUN BY FINANCES AND NOT PATIENT 

3155
02:29:34,294 --> 02:29:37,597
OUTCOMES EXCEPT IN THESE 

3156
02:29:37,597 --> 02:29:40,567
ORGANIZATIONS WHERE THEY ARE 

3157
02:29:40,567 --> 02:29:41,268
BASICALLY OUT OF CONTROL OF THE 

3158
02:29:41,268 --> 02:29:46,273
FINANCES.

3159
02:29:46,273 --> 02:29:49,476
IT'S PROBABLY CHEAPER TO RUN AN 

3160
02:29:49,476 --> 02:29:51,712
EFFECTIVE PAIN MANAGEMENT SYSTEM

3161
02:29:51,712 --> 02:29:53,146
WHERE THERE'S GOOD EVIDENCE ON 

3162
02:29:53,146 --> 02:29:55,682
WHO NEEDS TO GET IMAGING AND WHO

3163
02:29:55,682 --> 02:29:59,252
NEEDS TO GET INJECTIONS OR WHO 

3164
02:29:59,252 --> 02:30:02,756
DOESN'T NEED INJECTIONS BUT 

3165
02:30:02,756 --> 02:30:04,424
NEEDS IMAGING.

3166
02:30:04,424 --> 02:30:08,161
SO THAT MIGHT BE THE PLACE TO GO

3167
02:30:08,161 --> 02:30:09,863
IF YOU CAN GET A REALLY 

3168
02:30:09,863 --> 02:30:12,833
INTERESTED PARTNER.

3169
02:30:12,833 --> 02:30:18,739
WE'RE LOOKING AT THEM BUT 

3170
02:30:18,739 --> 02:30:18,972
HELENE.

3171
02:30:18,972 --> 02:30:19,639
>> Dr. Langevin: I LOVE 

3172
02:30:19,639 --> 02:30:20,907
EVERYTHING YOU JUST SAID WALTER 

3173
02:30:20,907 --> 02:30:23,510
AND GO A STEP FURTHER IN THAT 

3174
02:30:23,510 --> 02:30:25,779
THE V.A. IS AN INTERESTING 

3175
02:30:25,779 --> 02:30:26,747
LABORATORY TO EXPLORE -- IF YOU 

3176
02:30:26,747 --> 02:30:28,915
THINK ABOUT IT, IT'S A SINGLE 

3177
02:30:28,915 --> 02:30:31,585
PAIR, GOVERNMENT-RUN SYSTEM 

3178
02:30:31,585 --> 02:30:35,989
WHERE DECISIONS CAN BE MADE AND 

3179
02:30:35,989 --> 02:30:37,024
IMPLEMENTED VERY EFFECTIVELY.

3180
02:30:37,024 --> 02:30:38,759
THE OTHER THING THE V.A. IS 

3181
02:30:38,759 --> 02:30:40,627
DOING VERY INTERESTING RIGHT NOW

3182
02:30:40,627 --> 02:30:46,633
IS THE IDEA THAT PAIN IS NOT 

3183
02:30:46,633 --> 02:30:48,702
JUST AN ISOLATED THING.

3184
02:30:48,702 --> 02:30:50,337
THERE'S A WHOLE PERSON AROUND IT

3185
02:30:50,337 --> 02:30:53,440
AND THEY'RE REALLY INCORPORATING

3186
02:30:53,440 --> 02:30:55,442
WHOLE PAIN CARE WITH PERSON CARE

3187
02:30:55,442 --> 02:30:57,077
AND THAT'S HOW THEY'RE LOOKING 

3188
02:30:57,077 --> 02:30:57,444
AT IT.

3189
02:30:57,444 --> 02:30:58,645
TO ADDRESS SOMEBODY'S PAIN IT'S 

3190
02:30:58,645 --> 02:31:02,315
NOT DISCONNECTED FROM HELPING 

3191
02:31:02,315 --> 02:31:03,316
THEM WITH ALL THE OTHER ISSUES 

3192
02:31:03,316 --> 02:31:05,819
THEY HAVE IB THEIR HEALTH AND 

3193
02:31:05,819 --> 02:31:07,854
LIFE SO I THINK THE V.A. IS 

3194
02:31:07,854 --> 02:31:11,958
REALLY THE PLACE TO LOOK FOR 

3195
02:31:11,958 --> 02:31:14,761
INNOVATION IN MANY AREAS 

3196
02:31:14,761 --> 02:31:16,863
INCLUDING PAIN MANAGEMENT AND 

3197
02:31:16,863 --> 02:31:22,836
ALSO MAKING SURE IT'S CONNECTED.

3198
02:31:22,836 --> 02:31:24,805
THANKS FOR MENTIONING THAT, 

3199
02:31:24,805 --> 02:31:25,038
WALTER.

3200
02:31:25,038 --> 02:31:28,408
THE FACT THAT WE HAVE LEARNED 

3201
02:31:28,408 --> 02:31:30,277
HOW TO WORK IN COLLABORATION 

3202
02:31:30,277 --> 02:31:32,446
WITH THE V.A., TO DO -- BECAUSE 

3203
02:31:32,446 --> 02:31:35,916
IT'S NOT A SIMPLE THING.

3204
02:31:35,916 --> 02:31:36,917
WE'RE NOW HAVING TO HAVE SERIOUS

3205
02:31:36,917 --> 02:31:38,752
COLLABORATION WITH THE V.A. ON 

3206
02:31:38,752 --> 02:31:40,954
PROJECTS WITH THE PAIN RESEARCH 

3207
02:31:40,954 --> 02:31:43,957
COLLABORATORY THAT IS WORKING 

3208
02:31:43,957 --> 02:31:44,658
REALLY WELL.

3209
02:31:44,658 --> 02:31:46,660
I THINK THE HEAL INITIATIVE IS 

3210
02:31:46,660 --> 02:31:50,130
NOW PART OF THIS.

3211
02:31:50,130 --> 02:31:55,602
SO I THINK IT'S VERY 

3212
02:31:55,602 --> 02:31:55,902
ENCOURAGING.

3213
02:31:55,902 --> 02:31:59,873
>> I THINK WE STILL HAVE
NORA 

3214
02:31:59,873 --> 02:32:01,374
AND WALLY'S HANDS UP.

3215
02:32:01,374 --> 02:32:02,576
DO WE HAVE TIME.

3216
02:32:02,576 --> 02:32:04,511
>> WE HAVE TIME.

3217
02:32:04,511 --> 02:32:13,320
>> DR. VOLKOW.

3218
02:32:13,320 --> 02:32:17,657
>> Director Volkow: I ALSO
C

3219
02:32:17,657 --> 02:32:23,330
CONGRATULATE YOU AND THE ONLY I 

3220
02:32:23,330 --> 02:32:26,733
THINK TO HIGHLIGHT OVER ALL 

3221
02:32:26,733 --> 02:32:30,070
BECAUSE IT'S SPECIFICALLY A 

3222
02:32:30,070 --> 02:32:31,438
GREAT PRIORITY TO THE CURRENT 

3223
02:32:31,438 --> 02:32:33,740
ADMINISTRATION IS THE NOTION 

3224
02:32:33,740 --> 02:32:34,741
THAT CHRONIC PAIN IS A CHRONIC 

3225
02:32:34,741 --> 02:32:38,745
CONDITION THAT IS EXTREMELY 

3226
02:32:38,745 --> 02:32:43,416
WIDESPREAD.

3227
02:32:43,416 --> 02:32:45,986
AND WE NEGLECTED CHRONIC PAIN 

3228
02:32:45,986 --> 02:32:48,655
CONDITIONS WHICH IS NEGATIVELY 

3229
02:32:48,655 --> 02:32:49,623
IMPACTING OUTCOMES IN HEALTH IN 

3230
02:32:49,623 --> 02:32:51,258
GENERAL IS AN OPPORTUNITY TO 

3231
02:32:51,258 --> 02:32:53,093
BRING IT FORWARD AS ONE OF THE 

3232
02:32:53,093 --> 02:32:56,496
CONDITIONS THAT WE NEED TO 

3233
02:32:56,496 --> 02:33:00,100
ACTUALLY ADDRESS AS A CHRONIC 

3234
02:33:00,100 --> 02:33:03,136
CONDITION AND AN UNFORTUNATE 

3235
02:33:03,136 --> 02:33:05,138
CHRONIC CONDITION YOU CAN START 

3236
02:33:05,138 --> 02:33:06,239
IN EARLY CHILDHOOD AND 

3237
02:33:06,239 --> 02:33:11,978
THROUGHOUT AND YOU LOOK AT 

3238
02:33:11,978 --> 02:33:13,780
HYPERTENSION AND DIABETES AND 

3239
02:33:13,780 --> 02:33:17,651
PAIN IS A CHRONIC CONDITION AND 

3240
02:33:17,651 --> 02:33:20,353
MAKING IT CLEARLY IN THE 

3241
02:33:20,353 --> 02:33:21,421
NARRATIVE NOT THAT UNDERLYING 

3242
02:33:21,421 --> 02:33:23,823
THE IMPORTANCE OF ACUTE PAIN, 

3243
02:33:23,823 --> 02:33:27,327
BUT I ALWAYS VIEW IT TO A 

3244
02:33:27,327 --> 02:33:29,596
CERTAIN EXTENT WITH DIFFERENT 

3245
02:33:29,596 --> 02:33:32,732
SORT OF UMBRELLAS OF WHAT YOU 

3246
02:33:32,732 --> 02:33:33,433
NEED TO ADDRESS.

3247
02:33:33,433 --> 02:33:34,668
ONE IS MORE COMPLEX THAN THE 

3248
02:33:34,668 --> 02:33:39,105
OTHER.

3249
02:33:39,105 --> 02:33:41,274
YOU WANT TO BE AWARE THAT 

3250
02:33:41,274 --> 02:33:43,843
CURRENTLY AS THIS CHRONIC 

3251
02:33:43,843 --> 02:33:46,313
DISEASES ARE OUR PRIORITY FOR 

3252
02:33:46,313 --> 02:33:49,015
THE ADMINISTRATION, TO MAKE 

3253
02:33:49,015 --> 02:33:52,018
EVERYONE AWARE THAT THIS IS ONE 

3254
02:33:52,018 --> 02:33:53,720
OF THE MOST PREVALENT CHRONIC 

3255
02:33:53,720 --> 02:33:54,020
CONDITIONS.

3256
02:33:54,020 --> 02:33:55,355
>> IT'S A GOOD POINT.

3257
02:33:55,355 --> 02:33:56,990
VERY GOOD POINT.

3258
02:33:56,990 --> 02:33:59,492
I THINK WE CAN CERTAINLY WORK 

3259
02:33:59,492 --> 02:34:02,762
ADDITIONAL WORDING INTO THE 

3260
02:34:02,762 --> 02:34:09,469
INTRO.

3261
02:34:09,469 --> 02:34:10,904
>> WALLY.

3262
02:34:10,904 --> 02:34:14,407
>> I WAS THINKING ABOUT
OUR 

3263
02:34:14,407 --> 02:34:21,848
FEDERAL PARTNERS PCORI, CDC, FDA

3264
02:34:21,848 --> 02:34:26,653
AND OTHERS WHO ALSO HAVE THIS ON

3265
02:34:26,653 --> 02:34:28,822
THEIR AGENDA AND HOW WE 

3266
02:34:28,822 --> 02:34:33,260
COOPERATE WITH THEM AND WONDERED

3267
02:34:33,260 --> 02:34:36,930
FROM WALTER AND NORA ARE YOU ALL

3268
02:34:36,930 --> 02:34:38,431
STILL MEETING?

3269
02:34:38,431 --> 02:34:40,066
IS THERE STILL THE POSSIBILITY 

3270
02:34:40,066 --> 02:34:42,102
OF MEETING WITH THEM AROUND THIS

3271
02:34:42,102 --> 02:34:45,839
AREA OF PAIN SO THAT THINGS LIKE

3272
02:34:45,839 --> 02:34:48,708
POLICY AND WHO IS GOING TO PAY 

3273
02:34:48,708 --> 02:34:51,544
AND HOW DO YOU DO IT CHEAPER AND

3274
02:34:51,544 --> 02:34:52,445
IMPLEMENTATION SCIENCE AND ALL 

3275
02:34:52,445 --> 02:34:53,513
THE THINGS WE TALKED ABOUT 

3276
02:34:53,513 --> 02:34:55,348
TODAY, GETTING THIS IN THE HANDS

3277
02:34:55,348 --> 02:34:58,518
OF CLINICIANS AND INTO THE 

3278
02:34:58,518 --> 02:35:02,756
POLICY ARENA IS COORDINATED IN A

3279
02:35:02,756 --> 02:35:09,362
BETTER WAY.

3280
02:35:09,362 --> 02:35:12,198
>> Director Volkow: I
THINK IT'S

3281
02:35:12,198 --> 02:35:15,935
AN EXCELLENT POINT AND RIGHT NOW

3282
02:35:15,935 --> 02:35:19,306
SOME OF OUR REGULAR MEETINGS ARE

3283
02:35:19,306 --> 02:35:20,974
ON HOLD FINALIZING WHO WILL BE 

3284
02:35:20,974 --> 02:35:21,608
THE LEAD PERSON.

3285
02:35:21,608 --> 02:35:22,976
I THINK IT'S CLEAR ON EVERYONE'S

3286
02:35:22,976 --> 02:35:26,713
BRAIN THAT WE NEED TO CONTINUE 

3287
02:35:26,713 --> 02:35:28,048
THE INTERACTIONS BECAUSE WE CAN 

3288
02:35:28,048 --> 02:35:31,251
SHOW SOMETHING WORKS IF IT'S NOT

3289
02:35:31,251 --> 02:35:34,421
REIMBURSED BY CMS THEN IT'S NOT 

3290
02:35:34,421 --> 02:35:35,088
GOING TO TRANSFORM INTO A CHANGE

3291
02:35:35,088 --> 02:35:40,293
POPULATION OUTCOME.

3292
02:35:40,293 --> 02:35:42,862
WE'VE COME TO REALIZE HOW 

3293
02:35:42,862 --> 02:35:45,298
INCREDIBLY IMPORTANT IT IS TO 

3294
02:35:45,298 --> 02:35:47,767
HAVE THIS CLOSE DIALOGUE WITH 

3295
02:35:47,767 --> 02:35:54,574
CMS, WITH THE FDA AND WITH CDC 

3296
02:35:54,574 --> 02:35:56,876
BECAUSE THEY'RE THE ONES THAT 

3297
02:35:56,876 --> 02:35:58,745
ULTIMATELY TAKE THE KNOWLEDGE 

3298
02:35:58,745 --> 02:36:01,514
AND TRANSLATE IT TO A PRODUCT 

3299
02:36:01,514 --> 02:36:03,550
THAT WILL BE REIMBURSED OR 

3300
02:36:03,550 --> 02:36:04,551
REIMBURSE THEM THEMSELVES.

3301
02:36:04,551 --> 02:36:06,219
RIGHT NOW I KNOW THE MEETINGS WE

3302
02:36:06,219 --> 02:36:08,722
WERE HAVING WITH THE VARIOUS 

3303
02:36:08,722 --> 02:36:10,056
AGENCIES FROM HHS ARE PUT ON 

3304
02:36:10,056 --> 02:36:10,423
HOLD.

3305
02:36:10,423 --> 02:36:14,627
WE HAVE SOME INFORMAL ONES IN 

3306
02:36:14,627 --> 02:36:16,096
THE ARENA OF OPIOID OVERDOSES 

3307
02:36:16,096 --> 02:36:18,465
BUT THOSE DON'T REALLY TYPICALLY

3308
02:36:18,465 --> 02:36:19,366
ADDRESS PAIN.

3309
02:36:19,366 --> 02:36:22,469
THEY ADDRESS THE OTHER ASPECTS 

3310
02:36:22,469 --> 02:36:25,038
OF ADDICTION AND OVERDOSES.

3311
02:36:25,038 --> 02:36:25,905
I DON'T KNOW.

3312
02:36:25,905 --> 02:36:28,742
WALTER AND LINDA MAY HAVE MORE 

3313
02:36:28,742 --> 02:36:29,275
SPECIFICS REGARDING PAIN.

3314
02:36:29,275 --> 02:36:37,317
OR JACKIE.

3315
02:36:37,317 --> 02:36:40,787
>> I'VE ALREADY MENTIONED
THE 

3316
02:36:40,787 --> 02:36:42,489
INTERAGENCY SEARCH COORDINATING 

3317
02:36:42,489 --> 02:36:44,991
COMMITTEE BUT WILL LET LINDA SAY

3318
02:36:44,991 --> 02:36:54,000
A FEW THINGS ABOUT IT AS WELL.

3319
02:36:54,000 --> 02:36:55,402
>> Linda: WE'VE SPOKE WITH
MANY 

3320
02:36:55,402 --> 02:36:58,738
AGENCIES MENTIONS BY WAY OF THE 

3321
02:36:58,738 --> 02:36:59,639
COORDINATING COMMITTEE.

3322
02:36:59,639 --> 02:37:03,643
THE MEMBER INCLUDES CDC, NOT, 

3323
02:37:03,643 --> 02:37:06,746
CMS BUT WE'RE INVITING THEM AS 

3324
02:37:06,746 --> 02:37:08,615
AN AD HOC MEMBER.

3325
02:37:08,615 --> 02:37:10,717
HELENE HAS BEEN PROMOTING 

3326
02:37:10,717 --> 02:37:12,218
INCLUDING THEIR MEMBERSHIP.

3327
02:37:12,218 --> 02:37:14,754
THE FDA'S ON, THE DOD'S ON AND 

3328
02:37:14,754 --> 02:37:18,324
V.A. IS ON.

3329
02:37:18,324 --> 02:37:20,226
SO, THOSE GROUPS ONLY MEET TWICE

3330
02:37:20,226 --> 02:37:23,263
A WEEK BUT WE HAVE TWICE A 

3331
02:37:23,263 --> 02:37:24,931
YEAR -- WE'RE BUSY HERE.

3332
02:37:24,931 --> 02:37:29,302
WE DO HAVE REGULAR WORKING GROUP

3333
02:37:29,302 --> 02:37:31,604
MEETINGS AND ACTIVITIES THAT GO 

3334
02:37:31,604 --> 02:37:34,741
ON IN BETWEEN THE ACTUAL MEETING

3335
02:37:34,741 --> 02:37:36,576
OF THAT.

3336
02:37:36,576 --> 02:37:37,844
THERE'S BEEN A LOT OF 

3337
02:37:37,844 --> 02:37:40,146
COMMUNICATION WITH CMS IN THE 

3338
02:37:40,146 --> 02:37:41,948
PAST YEAR AND SHERRY LING IS 

3339
02:37:41,948 --> 02:37:45,051
INTERESTED IN IMPROVING THE 

3340
02:37:45,051 --> 02:37:45,385
COMMUNICATION.

3341
02:37:45,385 --> 02:37:49,456
WE'VE WORKED WITH ALAN BLACKWELL

3342
02:37:49,456 --> 02:37:56,062
WITH  -- THE BILL WAS DRAFT AND 

3343
02:37:56,062 --> 02:37:58,364
TALKING HOW TO ENHANCE 

3344
02:37:58,364 --> 02:38:01,501
REIMBURSEMENT AND THERE WERE 

3345
02:38:01,501 --> 02:38:02,769
CO-CHANGES THAT HAPPENED THERE 

3346
02:38:02,769 --> 02:38:06,272
TO INCREASE TIME AND 

3347
02:38:06,272 --> 02:38:07,273
REIMBURSEMENT FOR ASSESSMENT OF 

3348
02:38:07,273 --> 02:38:07,607
CHRONIC PAIN.

3349
02:38:07,607 --> 02:38:10,543
WE WORKED WITH THEM AND PUT 

3350
02:38:10,543 --> 02:38:12,512
TOGETHER RESOURCES FOR HOW 

3351
02:38:12,512 --> 02:38:13,813
PHYSICIANS IN DIFFERENT SETTINGS

3352
02:38:13,813 --> 02:38:16,549
COULD USE OR DIFFERENT CDE 

3353
02:38:16,549 --> 02:38:16,749
TOOLS.

3354
02:38:16,749 --> 02:38:19,419
THAT'S ON OUR WEBSITE.

3355
02:38:19,419 --> 02:38:22,088
THERE'S A GROUP THAT MEETS WITH 

3356
02:38:22,088 --> 02:38:24,991
CMS MONTHLY I THINK TO TALK 

3357
02:38:24,991 --> 02:38:27,227
ABOUT RESEARCH THAT'S GOING 

3358
02:38:27,227 --> 02:38:27,460
FORWARD.

3359
02:38:27,460 --> 02:38:30,430
SO THERE'S A LOT OF INTERACTION 

3360
02:38:30,430 --> 02:38:33,099
AND I THINK IT WOULD BE ENHANCED

3361
02:38:33,099 --> 02:38:35,201
ESPECIALLY WITH CMS.

3362
02:38:35,201 --> 02:38:38,872
THAT'S A REALLY IMPORTANT 

3363
02:38:38,872 --> 02:38:39,739
RESOURCE.

3364
02:38:39,739 --> 02:38:43,276
>> PCORI IS A GOOD IDEA.

3365
02:38:43,276 --> 02:38:45,612
>> Dr. Koroshetz: WE PUT
OUT 

3366
02:38:45,612 --> 02:38:50,750
RFAs AND THEY APPLY FOR THEM AND

3367
02:38:50,750 --> 02:38:58,024
THEY WIN.

3368
02:38:58,024 --> 02:38:59,926
>> THEY'VE STARTED
INFORMALLY 

3369
02:38:59,926 --> 02:39:02,729
JOINING THE IPRCC AS AN AD HOC 

3370
02:39:02,729 --> 02:39:03,196
MEMBER TO BE ABLE TO 

3371
02:39:03,196 --> 02:39:07,901
PARTICIPATE.

3372
02:39:07,901 --> 02:39:11,604
AND WE ARE IN THE -- IN APRIL 

3373
02:39:11,604 --> 02:39:13,239
WE'RE STARTING WITH OUR FEDERAL 

3374
02:39:13,239 --> 02:39:14,574
PARTNERS ON A MORE REGULAR BASIS

3375
02:39:14,574 --> 02:39:18,177
THROUGH THE IPRCC TO TALK ABOUT 

3376
02:39:18,177 --> 02:39:20,980
COMMUNICATION AND DISSEMINATION 

3377
02:39:20,980 --> 02:39:22,682
OF PAIN RESEARCH POLICY, 

3378
02:39:22,682 --> 02:39:26,085
ETCETERA AT EACH OF THE AGENCIES

3379
02:39:26,085 --> 02:39:30,757
TO BE ABLE TO BECOME MORE 

3380
02:39:30,757 --> 02:39:33,092
DIRECTLY AWARE AROUND BEING ABLE

3381
02:39:33,092 --> 02:39:34,527
TO CENTRALIZE THE RESOURCES.

3382
02:39:34,527 --> 02:39:38,731
>> I HAD A CONVERSATION
WITH A 

3383
02:39:38,731 --> 02:39:41,668
PROGRAM DIRECTOR AT ARPA-H A 

3384
02:39:41,668 --> 02:39:43,269
COUPLE WEEKS AGO.

3385
02:39:43,269 --> 02:39:44,571
THEY HAVE A COUPLE PROGRAMS THEY

3386
02:39:44,571 --> 02:39:46,573
STARTED IN THE AREA OF PAIN 

3387
02:39:46,573 --> 02:39:47,941
ESPECIALLY IN WOMEN'S HEALTH.

3388
02:39:47,941 --> 02:39:50,743
I DON'T THINK I'M SUPPOSED TO 

3389
02:39:50,743 --> 02:39:53,212
ANNOUNCE THIS PUBLICALLY BUT 

3390
02:39:53,212 --> 02:39:54,747
THIS ISN'T PUBLIC -- 

3391
02:39:54,747 --> 02:40:04,924
>> IT IS.

3392
02:40:18,504 --> 02:40:19,639
>> OKAY.

3393
02:40:19,639 --> 02:40:21,107
THANK YOU BOTH VERY MUCH.

3394
02:40:21,107 --> 02:40:23,943
THANKS EVERYONE FOR A HELPFUL 

3395
02:40:23,943 --> 02:40:24,611
AND CONSTRUCTIVE DISCUSSION.

3396
02:40:24,611 --> 02:40:26,546
WE'LL TAKE THE OPINION AND ANY 

3397
02:40:26,546 --> 02:40:28,881
ADDITIONAL INPUT WE RECEIVED AND

3398
02:40:28,881 --> 02:40:33,119
FURTHER THE DISCUSSION.

3399
02:40:33,119 --> 02:40:35,521
WE'LL DISCUSS ON OUR COUNCIL 

3400
02:40:35,521 --> 02:40:36,923
MEETING MAY 15.

3401
02:40:36,923 --> 02:40:40,560
NOW I'LL PIVOT TO OUR FINAL 

3402
02:40:40,560 --> 02:40:41,494
DISCUSSION TOPIC OF THE 

3403
02:40:41,494 --> 02:40:43,429
AFTERNOON AND MY PLEASURE TO 

3404
02:40:43,429 --> 02:40:45,698
INTRODUCE DR. AMY GOLDSTEIN THE 

3405
02:40:45,698 --> 02:40:47,000
CHIEF OF THE PREVENTION RESEARCH

3406
02:40:47,000 --> 02:40:49,235
BRANCH IN THE DIVISION OF 

3407
02:40:49,235 --> 02:40:49,969
EPIDEMIOLOGY SERVICES AT 

3408
02:40:49,969 --> 02:40:54,007
PREVENTION RESEARCH AT NIDA.

3409
02:40:54,007 --> 02:40:57,310
SHE HAS SPENT A DECADE PRIOR TO 

3410
02:40:57,310 --> 02:41:01,080
COMING TO NIDA SHE SPENT A 

3411
02:41:01,080 --> 02:41:05,852
DECADE AT NIMHD WHERE SHE HELD 

3412
02:41:05,852 --> 02:41:08,655
ROLES INCLUDING THE NIH RECOVERY

3413
02:41:08,655 --> 02:41:11,524
AFTER AN INITIAL SCHIZOPHRENIA 

3414
02:41:11,524 --> 02:41:13,259
EPISODE AND NATIONAL SUICIDE 

3415
02:41:13,259 --> 02:41:13,726
PREVENTION PROJECTS.

3416
02:41:13,726 --> 02:41:16,929
SHE GOT HER BACHELOR'S DEGREE IN

3417
02:41:16,929 --> 02:41:18,631
PSYCHOLOGY FROM WASHINGTON 

3418
02:41:18,631 --> 02:41:20,867
UNIVERSITY AT ST. LOUIS AND 

3419
02:41:20,867 --> 02:41:25,438
Ph.D. IN CLINICAL CHILD 

3420
02:41:25,438 --> 02:41:30,743
PSYCHOLOGY FROM CASE WESTERN AND

3421
02:41:30,743 --> 02:41:32,512
COMPLETED AT JOHNS HOPKINS 

3422
02:41:32,512 --> 02:41:34,013
SCHOOL OF PUBLIC HEALTH AND 

3423
02:41:34,013 --> 02:41:35,281
LEADS THE RESEARCH PROGRAM.

3424
02:41:35,281 --> 02:41:37,684
WE APPRECIATE HER COMING TODAY 

3425
02:41:37,684 --> 02:41:38,317
TO PROVIDE A PROGRAM OVERVIEW 

3426
02:41:38,317 --> 02:41:48,528
AND UPDATE.

3427
02:41:51,330 --> 02:41:52,932
>> Dr. Goldstein:
PREVENTION IS 

3428
02:41:52,932 --> 02:41:54,967
IMPORTANT AND THERE'S SYSTEMATIC

3429
02:41:54,967 --> 02:41:57,937
BARRIERS TO IMPLEMENTATION AND 

3430
02:41:57,937 --> 02:42:02,108
WE NEED TO ENGAGE KEY 

3431
02:42:02,108 --> 02:42:12,819
STAKEHOLDERS AND THOSE ARE KEY 

3432
02:42:12,819 --> 02:42:13,019
TAKEAWAYS.

3433
02:42:13,019 --> 02:42:15,188
I WANTED TO PROVIDE AN OVERVIEW 

3434
02:42:15,188 --> 02:42:16,923
OF ALL INITIATIVES UNDER THE 

3435
02:42:16,923 --> 02:42:21,527
UMBRELLA OF HEAL PREVENTION AND 

3436
02:42:21,527 --> 02:42:22,729
TALK ABOUT WHERE SOME RESEARCH 

3437
02:42:22,729 --> 02:42:23,463
IS NOW.

3438
02:42:23,463 --> 02:42:24,997
LOOKING BACK I THINK IT'S BEEN A

3439
02:42:24,997 --> 02:42:26,599
HOT LIKE TWO YEARS SINCE I 

3440
02:42:26,599 --> 02:42:28,367
PRESENTED TO THIS GROUP.

3441
02:42:28,367 --> 02:42:31,037
SO A LOT'S BEEN HAPPENING SINCE 

3442
02:42:31,037 --> 02:42:40,313
THEN.

3443
02:42:40,313 --> 02:42:42,081
STARTING WITH OUR GUIDING VISION

3444
02:42:42,081 --> 02:42:43,349
OUD VISION IS HEALTH CARE 

3445
02:42:43,349 --> 02:42:46,753
ORGANIZATIONS AND PUBLIC SYSTEMS

3446
02:42:46,753 --> 02:42:49,889
ARE ABLE TO MAKE EVIDENCE-BASED 

3447
02:42:49,889 --> 02:42:52,925
SERVICES ACCESSIBLE TO ALL WHO 

3448
02:42:52,925 --> 02:42:54,660
RISK OPIOID OR SUBSTANCE USE 

3449
02:42:54,660 --> 02:42:55,261
DISORDER.

3450
02:42:55,261 --> 02:42:57,230
IT'S MY GUIDING STAR.

3451
02:42:57,230 --> 02:42:59,999
WE ARE LEARNING HOW TO DO 

3452
02:42:59,999 --> 02:43:02,769
PREVENTION OF OPIOID MISUSE BUT 

3453
02:43:02,769 --> 02:43:12,044
THERE'S AN IMPLEMENTATION GAP.

3454
02:43:12,044 --> 02:43:12,578
IS EVERYONE OKAY?

3455
02:43:12,578 --> 02:43:17,583
>> YOU'RE GOOD.

3456
02:43:17,583 --> 02:43:18,518
>> Dr. Goldstein: THIS IS
MY 

3457
02:43:18,518 --> 02:43:19,752
NORTH STAR WHEN I THINK ABOUT 

3458
02:43:19,752 --> 02:43:21,053
THE WORK WE'RE DOING WHICH IS 

3459
02:43:21,053 --> 02:43:25,858
THE IDEA WE'RE DEVELOPING AND 

3460
02:43:25,858 --> 02:43:26,559
TESTING INTERVENTIONS TO PREVENT

3461
02:43:26,559 --> 02:43:28,995
SUBSTANCE MISUSE BUT THERE'S A 

3462
02:43:28,995 --> 02:43:30,329
BIG GAP IN IMPLEMENTING THE 

3463
02:43:30,329 --> 02:43:33,432
PROGRAM AND HOW DO WE DESIGN 

3464
02:43:33,432 --> 02:43:34,600
RESEARCH TO ENSURE EVERYTHING 

3465
02:43:34,600 --> 02:43:37,737
WE'RE TESTING CAN BE IMPLEMENTED

3466
02:43:37,737 --> 02:43:40,940
IN THE REAL WORLD.

3467
02:43:40,940 --> 02:43:44,277
BY WAY OF BACKGROUND.

3468
02:43:44,277 --> 02:43:46,145
THE TRENDS ARE THE SAME BUT THIS

3469
02:43:46,145 --> 02:43:47,480
IS DATA FROM NATIONAL SERVICE ON

3470
02:43:47,480 --> 02:43:49,382
DRUG USE AND HEALTH FROM 2020 

3471
02:43:49,382 --> 02:43:53,920
WHERE WE SEE ABOUT 9.5 MILLION 

3472
02:43:53,920 --> 02:43:58,391
PEOPLE 12 AND OLDER MISUSED 

3473
02:43:58,391 --> 02:44:02,762
OPIOIDS AND ONLY 278,000 

3474
02:44:02,762 --> 02:44:05,431
RECEIVED TREATMENT FOR OUD.

3475
02:44:05,431 --> 02:44:07,300
THERE'S A LOT OF WORK AROUND 

3476
02:44:07,300 --> 02:44:12,338
TREATMENT ENGAGEMENT AND 

3477
02:44:12,338 --> 02:44:14,407
EFFECTIVE PREVENTION CAN WORK IN

3478
02:44:14,407 --> 02:44:14,974
DECREASING THE NEED FOR THE 

3479
02:44:14,974 --> 02:44:16,475
TREATMENT PROGRAM.

3480
02:44:16,475 --> 02:44:20,713
SO WHEN WE LAUNCHED PREVENTION 

3481
02:44:20,713 --> 02:44:22,515
WE TALKED ABOUT FOUR STRATEGIC 

3482
02:44:22,515 --> 02:44:23,316
AREAS WE THOUGHT WERE IMPORTANT 

3483
02:44:23,316 --> 02:44:25,618
IN ORDER TO DO THE WORK AND 

3484
02:44:25,618 --> 02:44:26,886
RESEARCH AND RISK IDENTIFICATION

3485
02:44:26,886 --> 02:44:28,521
AND SOCIAL AND ENVIRONMENTAL 

3486
02:44:28,521 --> 02:44:33,192
FACTORS THAT MAY PLAY A ROLE AND

3487
02:44:33,192 --> 02:44:34,460
IMPLEMENTATION SCALE UP AND 

3488
02:44:34,460 --> 02:44:34,827
SUSTAINABILITY.

3489
02:44:34,827 --> 02:44:38,264
WE HAVE PROJECTS GOING IN ALL 

3490
02:44:38,264 --> 02:44:38,764
THOSE SPACES RIGHT NOW.

3491
02:44:38,764 --> 02:44:41,000
I'M GOING TO START WHERE WE 

3492
02:44:41,000 --> 02:44:46,072
BEGAN IN FY19.

3493
02:44:46,072 --> 02:44:48,207
WHEN HEAL PREVENTION LAUNCHED, 

3494
02:44:48,207 --> 02:44:51,911
WE DID SO WITH A NOTICE FOR 

3495
02:44:51,911 --> 02:44:53,646
ADMINISTRATIVE SUPPLEMENTS AND 

3496
02:44:53,646 --> 02:44:55,648
ANNOUNCEMENT FOR APPLICATIONS 

3497
02:44:55,648 --> 02:44:58,684
AND HEAL PREVENTION COORDINATING

3498
02:44:58,684 --> 02:44:58,918
CENTER.

3499
02:44:58,918 --> 02:45:01,120
OUR STARTING POINT WAS WE NEEDED

3500
02:45:01,120 --> 02:45:03,055
TO ESTABLISH EVIDENCE-BASED 

3501
02:45:03,055 --> 02:45:03,823
INTERVENTIONS SPECIFIC TO OPIOID

3502
02:45:03,823 --> 02:45:08,327
MISUSE AND THE DEVELOPMENT OF 

3503
02:45:08,327 --> 02:45:14,133
OPIOID USE DISORDER IN 

3504
02:45:14,133 --> 02:45:16,302
ADOLESCENTSES AND YOUNG ADULTS 

3505
02:45:16,302 --> 02:45:19,906
AND THE GOAL HERE WAS TO SOLICIT

3506
02:45:19,906 --> 02:45:21,140
RESEARCH TO DEVELOP ADAPT AND 

3507
02:45:21,140 --> 02:45:23,075
TEST INTERVENTIONS AND STRATEGY 

3508
02:45:23,075 --> 02:45:26,779
TO PREVENT THE INITIATION OF 

3509
02:45:26,779 --> 02:45:29,115
OPIOID MISUSE IN ADOLESCENTS AND

3510
02:45:29,115 --> 02:45:30,850
YOUNG ADULTS AND HAD A 

3511
02:45:30,850 --> 02:45:31,684
COMMUNITY-ENGAGED APPROACH AND 

3512
02:45:31,684 --> 02:45:33,986
HAD A COMMUNITY PARTNER AND HAD 

3513
02:45:33,986 --> 02:45:34,854
TO HAVE IMPLEMENTATION AIMS AND 

3514
02:45:34,854 --> 02:45:38,991
AN ECONOMIC ANALYSIS.

3515
02:45:38,991 --> 02:45:40,826
OUR GOAL IS PRETTY BROAD IN 

3516
02:45:40,826 --> 02:45:43,896
TERMS OF THE RANGE OF SYSTEMS 

3517
02:45:43,896 --> 02:45:50,169
AND STUDIES AND I'LL COME BACK 

3518
02:45:50,169 --> 02:45:52,538
BUT THIS IS WHERE WITH STARTED.

3519
02:45:52,538 --> 02:45:56,142
AND ONCE WE HAD THOSE PROJECTS 

3520
02:45:56,142 --> 02:46:02,715
IN THE FIELD WE DECIDED WE 

3521
02:46:02,715 --> 02:46:04,483
NEEDED TO PAY ATTENTION TO 

3522
02:46:04,483 --> 02:46:04,784
CONTEXT.

3523
02:46:04,784 --> 02:46:05,651
ALL OUR PROGRAMS ARE INDIVIDUAL 

3524
02:46:05,651 --> 02:46:07,853
OR FAMILY-BASED INTERVENTIONS.

3525
02:46:07,853 --> 02:46:09,956
BUT WHAT WE WERE FINDING WAS 

3526
02:46:09,956 --> 02:46:10,656
CONTEXT MATTERS.

3527
02:46:10,656 --> 02:46:12,692
WE WEREN'T GOING TO FULLY 

3528
02:46:12,692 --> 02:46:14,627
ADDRESS THE PROBLEM BY FOCUSSING

3529
02:46:14,627 --> 02:46:15,828
ON THE INDIVIDUAL ROLE BUT 

3530
02:46:15,828 --> 02:46:17,129
NEEDED TO THINK BROADLY ABOUT 

3531
02:46:17,129 --> 02:46:18,764
THE SYSTEMS IN WHICH PEOPLE WERE

3532
02:46:18,764 --> 02:46:19,398
LIVING.

3533
02:46:19,398 --> 02:46:22,101
SO WE LAUNCHED TWO INITIATIVES 

3534
02:46:22,101 --> 02:46:25,705
IN FY22 AND FY23 WHICH WERE 

3535
02:46:25,705 --> 02:46:27,506
FOCUSSED ON PREVENTING OPIOID 

3536
02:46:27,506 --> 02:46:29,608
MISUSE AND CO-OCCURRING 

3537
02:46:29,608 --> 02:46:40,119
CONDITIONS BY INTERVENING ON 

3538
02:46:46,092 --> 02:46:48,461
SOCIAL DETERMINATES AND THERE'S 

3539
02:46:48,461 --> 02:46:49,996
A REAL BROAD AWAY OF WHAT WE'RE 

3540
02:46:49,996 --> 02:46:53,132
FINDING AND WHAT THE RESEARCH IS

3541
02:46:53,132 --> 02:47:02,775
DOING AND THIS IS WORK FROM 

3542
02:47:02,775 --> 02:47:06,779
SILVIA MARTIN AND HER COLLEAGUES

3543
02:47:06,779 --> 02:47:09,782
FROM A SOCIAL DETERMINATES AND 

3544
02:47:09,782 --> 02:47:13,753
ADDRESSING THE RISK FACTORS WE 

3545
02:47:13,753 --> 02:47:14,987
KNOW GO TO OVERDOSE.

3546
02:47:14,987 --> 02:47:17,623
THEY WERE LOOKING AT THE 

3547
02:47:17,623 --> 02:47:21,260
ASSOCIATION BETWEEN UNEMPLOYMENT

3548
02:47:21,260 --> 02:47:24,430
INSURANCE AND OVERDOSE DEATHS.

3549
02:47:24,430 --> 02:47:26,632
THAT COVERS THE PERIOD OF COVID 

3550
02:47:26,632 --> 02:47:28,200
AND START OF THE COVID PANDEMIC 

3551
02:47:28,200 --> 02:47:29,702
AND USED UNEMPLOYMENT INSURANCE 

3552
02:47:29,702 --> 02:47:33,439
AS A WEEKLY BENEFIT ALLOWANCE 

3553
02:47:33,439 --> 02:47:34,774
REPLACING WHICH IS THE 

3554
02:47:34,774 --> 02:47:37,143
PROPORTION OF SOMEONE'S WEEKLY 

3555
02:47:37,143 --> 02:47:37,810
EARNINGS FOR UNEMPLOYMENT 

3556
02:47:37,810 --> 02:47:40,246
INSURANCE.

3557
02:47:40,246 --> 02:47:42,715
WHAT YOU CAN SEE HERE IS THE 

3558
02:47:42,715 --> 02:47:45,518
DISTRIBUTION OF THE BENEFIT IN 

3559
02:47:45,518 --> 02:47:47,453
20 14 AND 2020.

3560
02:47:47,453 --> 02:47:50,589
A SMALLER PERCENTAGE OF 

3561
02:47:50,589 --> 02:47:51,724
SOMEBODY'S INCOME REPLACED BY 

3562
02:47:51,724 --> 02:47:53,159
INSURANCE AND THIS REPRESENTS A 

3563
02:47:53,159 --> 02:48:01,133
GREATER PERCENTAGE IN ORANGE AND

3564
02:48:01,133 --> 02:48:02,701
IT INCREASED OVER TIME AND WHERE

3565
02:48:02,701 --> 02:48:06,272
THEY PROVIDED A GREATER 

3566
02:48:06,272 --> 02:48:14,013
PERCENTAGE OF SOMEBODY'S 

3567
02:48:14,013 --> 02:48:17,183
COVERAGE OVERDOSES DECREASED IN 

3568
02:48:17,183 --> 02:48:20,519
THE AMOUNT OF UNEMPLOYMENT.

3569
02:48:20,519 --> 02:48:22,254
AS WE THINK ABOUT RESEARCH WE 

3570
02:48:22,254 --> 02:48:23,889
NEED TO THINK ABOUT THE 

3571
02:48:23,889 --> 02:48:25,858
MECHANISM OF ACTION BY WHICH THE

3572
02:48:25,858 --> 02:48:27,026
INTERVENTIONS OR SOCIAL 

3573
02:48:27,026 --> 02:48:28,894
INTERVENTIONS ARE EXERTING THEIR

3574
02:48:28,894 --> 02:48:29,562
AFFECT.

3575
02:48:29,562 --> 02:48:30,763
I THOUGHT IT WAS AN INTERESTING 

3576
02:48:30,763 --> 02:48:34,767
EARLY FINDING TO COME FROM THE 

3577
02:48:34,767 --> 02:48:39,605
RESEARCH.

3578
02:48:39,605 --> 02:48:43,876
WE FOCUSSED ON THE INDIVIDUAL 

3579
02:48:43,876 --> 02:48:46,445
AND THIRD LOOKING AT SERVICES 

3580
02:48:46,445 --> 02:48:46,712
RESEARCH.

3581
02:48:46,712 --> 02:48:50,216
AS CAME UP IN THE LAST SET OF 

3582
02:48:50,216 --> 02:48:55,821
PRESENTATIONS AND DISCUSSIONS, 

3583
02:48:55,821 --> 02:48:57,823
THERE'S AN A REAL CHALLENGE AND 

3584
02:48:57,823 --> 02:48:58,757
THERE'S INTERVENTIONS THAT CAN 

3585
02:48:58,757 --> 02:49:00,359
HAVE BROAD PUBLIC IMPACT BUT 

3586
02:49:00,359 --> 02:49:01,760
DON'T HAVE EFFECTIVE PATHWAYS 

3587
02:49:01,760 --> 02:49:03,796
FOR DELIVERING INTERVENTIONS.

3588
02:49:03,796 --> 02:49:08,767
THE GOAL RFAs ARE TO SUPPORT 

3589
02:49:08,767 --> 02:49:12,304
RESEARCH AND THAT COULD BE ON 

3590
02:49:12,304 --> 02:49:15,908
STRATEGY TO IMPLEMENT AND 

3591
02:49:15,908 --> 02:49:17,209
SUSTAIN EVIDENCE-BASED SERVICES 

3592
02:49:17,209 --> 02:49:18,444
IN SYSTEMS AND SETTINGS.

3593
02:49:18,444 --> 02:49:20,312
WE DON'T HAVE A PREVENTION 

3594
02:49:20,312 --> 02:49:22,114
SYSTEM BUT IT'S OCCURRING IN 

3595
02:49:22,114 --> 02:49:24,216
SCHOOLS AND JUVENILE JUSTICE AND

3596
02:49:24,216 --> 02:49:25,184
CHILD WELFARE AND WHAT RESEARCH 

3597
02:49:25,184 --> 02:49:29,221
CAN WE DO TO ENHANCE THE 

3598
02:49:29,221 --> 02:49:33,859
DELIVERY OF THE PROGRAMS IN 

3599
02:49:33,859 --> 02:49:36,395
THOSE SETTINGS OR DEVELOP A 

3600
02:49:36,395 --> 02:49:38,130
WORKFORCE OR INFRASTRUCTURE TO 

3601
02:49:38,130 --> 02:49:39,999
HAVE THE SYSTEM AND SETTING BY 

3602
02:49:39,999 --> 02:49:40,766
WHICH TO DELIVER EFFECTIVE 

3603
02:49:40,766 --> 02:49:41,133
PROGRAMS.

3604
02:49:41,133 --> 02:49:44,737
THIS IS AN ACTIVE ANNOUNCEMENT.

3605
02:49:44,737 --> 02:49:46,605
WE HAD TWO RECEIPT DATES SO FAR 

3606
02:49:46,605 --> 02:49:47,239
WITH A REVIEW PENDING NEXT 

3607
02:49:47,239 --> 02:49:51,243
MONTH.

3608
02:49:51,243 --> 02:49:53,479
I'M EXCITING TO SEE THE RESEARCH

3609
02:49:53,479 --> 02:49:54,780
HAPPENING IN THIS SPACE AND 

3610
02:49:54,780 --> 02:49:57,283
HOPEFULLY I CAN COME BACK IN A 

3611
02:49:57,283 --> 02:50:01,420
YEAR OR SO AND GIVE AN UPDATE OF

3612
02:50:01,420 --> 02:50:01,954
WHAT'S HAPPENING THERE.

3613
02:50:01,954 --> 02:50:03,522
THAT'S WHERE WE ARE IN OUR 

3614
02:50:03,522 --> 02:50:04,023
FUNDING INITIATIVE.

3615
02:50:04,023 --> 02:50:05,858
I WANT TO GO BACK TO WHERE WE 

3616
02:50:05,858 --> 02:50:06,792
STARTED WHICH IS THE HEAL 

3617
02:50:06,792 --> 02:50:17,169
PREVENTION COOPERATE.

3618
02:50:17,803 --> 02:50:19,238
THESE WERE CLINICAL TRIALS 

3619
02:50:19,238 --> 02:50:20,673
OCCURRING IN AN ARRAY OF 

3620
02:50:20,673 --> 02:50:21,473
SERVICES AND SYSTEM SETTINGS YOU

3621
02:50:21,473 --> 02:50:21,907
SEE HERE.

3622
02:50:21,907 --> 02:50:26,779
WE HAVE PROJECTS THAT ARE IN 

3623
02:50:26,779 --> 02:50:28,881
HEALTH CARE SO EMERGENCY 

3624
02:50:28,881 --> 02:50:30,249
DEPARTMENTS AND CHILD WELFARE 

3625
02:50:30,249 --> 02:50:32,284
SYSTEM AND COMMUNITY-BASED 

3626
02:50:32,284 --> 02:50:35,821
PREVENTION, TWO PROGRAMS 

3627
02:50:35,821 --> 02:50:36,755
TARGETING JUVENILE JUSTICE 

3628
02:50:36,755 --> 02:50:39,558
SETTINGS AND A COUPLE HOME-BASED

3629
02:50:39,558 --> 02:50:39,825
PROJECTS.

3630
02:50:39,825 --> 02:50:44,230
THESE ARE PRETTY DISPARATE 

3631
02:50:44,230 --> 02:50:44,496
SETTINGS.

3632
02:50:44,496 --> 02:50:47,600
THERE'S OVERLAP IN TERMS OF 

3633
02:50:47,600 --> 02:50:51,437
POPULATIONS AT RISK BUT WHAT'S 

3634
02:50:51,437 --> 02:50:54,473
BEEN GREAT IS THEY COME TOGETHER

3635
02:50:54,473 --> 02:50:56,942
AS A LEARNING COOPERATE AND 

3636
02:50:56,942 --> 02:50:58,077
TRIED TO STANDARDIZE SOME ASPECT

3637
02:50:58,077 --> 02:51:06,352
OF THEIR WORK.

3638
02:51:06,352 --> 02:51:07,586
THERE'S COMMON DATA MEASURES AND

3639
02:51:07,586 --> 02:51:11,457
ONCE THEY HAVE THEIR OUTCOMES 

3640
02:51:11,457 --> 02:51:12,958
RELEASED THEY'LL HAVE A 

3641
02:51:12,958 --> 02:51:14,760
HARMONIZED APPROACH TO 

3642
02:51:14,760 --> 02:51:16,095
INTERVENTION COSTS.

3643
02:51:16,095 --> 02:51:18,397
THEY'LL BE DOING BUDGET IMPACT 

3644
02:51:18,397 --> 02:51:29,108
IN HOUSE AS PART OF THE WORK AND

3645
02:51:29,108 --> 02:51:29,975
THEY'VE BROUGHT TOGETHER COMMON 

3646
02:51:29,975 --> 02:51:31,076
DATA MEASURES.

3647
02:51:31,076 --> 02:51:32,845
RIGHT NOW WE DON'T HAVE THE DATA

3648
02:51:32,845 --> 02:51:33,445
TO REPORT.

3649
02:51:33,445 --> 02:51:35,314
LOOKING AT THE TIMING THE 

3650
02:51:35,314 --> 02:51:37,416
PROJECTS LAUNCHED AROUND THE 

3651
02:51:37,416 --> 02:51:38,851
SAME TIME AS COVID-19 PANDEMIC.

3652
02:51:38,851 --> 02:51:39,918
THEY HAD TO TAKE A LITTLE BIT OF

3653
02:51:39,918 --> 02:51:42,321
A PAUSE AND REGROUP.

3654
02:51:42,321 --> 02:51:43,489
HOPEFULLY IN THE NEXT COMING 

3655
02:51:43,489 --> 02:51:46,759
MONTHS TO YEAR WE'LL HAVE 

3656
02:51:46,759 --> 02:51:57,036
OUTCOME PAPERS.

3657
02:52:00,606 --> 02:52:01,774
SOME ARE INDICATED IF YOU DO 

3658
02:52:01,774 --> 02:52:04,777
QUICK MATH YOU CAN SEE WE HAVE 

3659
02:52:04,777 --> 02:52:05,311
SO PROJECTS.

3660
02:52:05,311 --> 02:52:08,347
THAT'S BECAUSE SOME OF WORK IS 

3661
02:52:08,347 --> 02:52:10,582
TIERED INTERVENTION THERE'S AN 

3662
02:52:10,582 --> 02:52:12,184
OVERLAY OF THE APPROACH.

3663
02:52:12,184 --> 02:52:14,787
REALLY MOST EFFECTIVE IN 

3664
02:52:14,787 --> 02:52:16,155
PREVENTING OPIOID DISORDER AND 

3665
02:52:16,155 --> 02:52:18,757
COMMUNITIES NEED TO OFFER AN 

3666
02:52:18,757 --> 02:52:20,859
ARRAY OF SERVICES TO MEET PEOPLE

3667
02:52:20,859 --> 02:52:22,761
WHERE THEY ARE IN TERMS OF THEIR

3668
02:52:22,761 --> 02:52:32,871
NEED.

3669
02:52:37,242 --> 02:52:39,945
AND THERE'S RISK BEHAVIORS OR NO

3670
02:52:39,945 --> 02:52:40,946
KNOWN FACTORS.

3671
02:52:40,946 --> 02:52:42,214
I DON'T HAVE DATA BUT HAVE 

3672
02:52:42,214 --> 02:52:43,248
BASELINE DATA TO PRESENT BECAUSE

3673
02:52:43,248 --> 02:52:45,317
I THINK IT TELLS AN INTERESTING 

3674
02:52:45,317 --> 02:52:46,518
STORY ABOUT THE POPULATION AND 

3675
02:52:46,518 --> 02:52:47,319
AS WE THINK ABOUT WHERE TO GO 

3676
02:52:47,319 --> 02:52:52,491
FROM HERE.

3677
02:52:52,491 --> 02:52:56,462
THIS IS UNPUBLISHED DATA AND ALL

3678
02:52:56,462 --> 02:52:58,230
ARE PROCESS AND PROTOCOL.

3679
02:52:58,230 --> 02:53:01,333
BUT I DID ASK THE P.I.'S AT 

3680
02:53:01,333 --> 02:53:02,401
LEAST TO SHARE THIS THE NEXT 

3681
02:53:02,401 --> 02:53:12,811
COUPLE SLIDES WITH YOU.

3682
02:53:15,714 --> 02:53:18,117
I WANT RESEARCHERS TO TALK ABOUT

3683
02:53:18,117 --> 02:53:20,152
THIS THEMSELVES BUT IT'S 

3684
02:53:20,152 --> 02:53:20,753
BASELINE DATA FROM THE TEN 

3685
02:53:20,753 --> 02:53:21,687
RESEARCH PROJECTS.

3686
02:53:21,687 --> 02:53:23,655
WHAT I HAVE UP HERE IS A LIFE 

3687
02:53:23,655 --> 02:53:26,692
TIME REPORTING OF PERCENT HAVING

3688
02:53:26,692 --> 02:53:28,794
EVER USED CANNABIS OR MISUSED 

3689
02:53:28,794 --> 02:53:29,027
OPIOIDS.

3690
02:53:29,027 --> 02:53:30,729
WHAT WAS STRIKING WHEN THE DATA 

3691
02:53:30,729 --> 02:53:33,232
WAS FIRST PRESENTED A YEAR AGO 

3692
02:53:33,232 --> 02:53:37,236
WAS THE PREVALENCE OF CANNABIS 

3693
02:53:37,236 --> 02:53:40,005
USE YOU CAN SEE THERE'S A COUPLE

3694
02:53:40,005 --> 02:53:42,141
IN THE LOW END WITH THE 

3695
02:53:42,141 --> 02:53:44,676
REPORTING BUT THE RANGE IS MORE 

3696
02:53:44,676 --> 02:53:46,912
IN THE 70 TO 90%.

3697
02:53:46,912 --> 02:53:49,148
THESE ARE INDIVIDUALS WITHOUT 

3698
02:53:49,148 --> 02:53:50,082
SUBSTANCE USE DISORDER AGES 16 

3699
02:53:50,082 --> 02:53:57,756
TO 30 AND SO I THINK AS A GROUP 

3700
02:53:57,756 --> 02:54:00,325
WE WERE BLOWN AWAY HOW THE 

3701
02:54:00,325 --> 02:54:01,560
CANNABIS WAS BEING USED AND 

3702
02:54:01,560 --> 02:54:02,327
ADDRESS THIS IN THE RESEARCH 

3703
02:54:02,327 --> 02:54:05,297
MOVING FORWARD.

3704
02:54:05,297 --> 02:54:07,633
THE OTHER THING THAT CAME OUT 

3705
02:54:07,633 --> 02:54:11,036
WAS THE MEAN AGE OF INITIATION 

3706
02:54:11,036 --> 02:54:11,370
FOR THOSE.

3707
02:54:11,370 --> 02:54:16,475
AMONG THOSE REPORTING CANNABIS 

3708
02:54:16,475 --> 02:54:19,812
AND OPIOID MISUSE THE CANNABIS 

3709
02:54:19,812 --> 02:54:21,079
PRECEDES THE OPIOID MISUSE AND 

3710
02:54:21,079 --> 02:54:22,614
THERE'S A RELATIVELY SHORT 

3711
02:54:22,614 --> 02:54:25,083
WINDOW OF TIME BEFORE SOMEONE 

3712
02:54:25,083 --> 02:54:26,452
WHO INITIATED CANNABIS 

3713
02:54:26,452 --> 02:54:27,352
TRANSITION TO USING OPIOIDS.

3714
02:54:27,352 --> 02:54:30,522
FOR SOME STUDIES IT'S A YEAR, 

3715
02:54:30,522 --> 02:54:31,723
MAYOR TWO YEARS.

3716
02:54:31,723 --> 02:54:33,292
FOR ME AS I THINK ABOUT NEXT 

3717
02:54:33,292 --> 02:54:36,728
STEPS IS THE IDEA WE HAVE A 

3718
02:54:36,728 --> 02:54:39,598
WINDOW OF OPPORTUNITY TO 

3719
02:54:39,598 --> 02:54:41,300
INTERVENE BEFORE SUBSTANCE USE 

3720
02:54:41,300 --> 02:54:43,469
BECOMES POLY SUBSTANCE USE.

3721
02:54:43,469 --> 02:54:46,038
THE QUESTION OF PREVENTING OTHER

3722
02:54:46,038 --> 02:54:48,106
USE IS PREVENTING CANNABIS EARLY

3723
02:54:48,106 --> 02:54:48,340
ON.

3724
02:54:48,340 --> 02:54:51,777
TO ME IT SPEAKS TO THE NEED FOR 

3725
02:54:51,777 --> 02:54:55,547
EARLY INTERVENTION AND THINK OF 

3726
02:54:55,547 --> 02:54:58,884
PREVENTION OF USE TO MISUSE.

3727
02:54:58,884 --> 02:55:01,954
AND SOME OF THE DATA WITH THE 

3728
02:55:01,954 --> 02:55:04,323
FACT THERE'S LARGE DATA 

3729
02:55:04,323 --> 02:55:05,324
DEVIATION BUT IT WAS INTERESTING

3730
02:55:05,324 --> 02:55:06,859
TO THINK AS WE THINK ABOUT NEXT 

3731
02:55:06,859 --> 02:55:17,236
STEPS FOR PREVENTION.

3732
02:55:19,605 --> 02:55:22,574
THE LAST IS INDIVIDUALS AT RISK 

3733
02:55:22,574 --> 02:55:25,077
FOR OPIOID MISUSE AND THE 

3734
02:55:25,077 --> 02:55:26,845
PERCENT WERE REPORTING MODERATE 

3735
02:55:26,845 --> 02:55:29,615
OR GREATER SEVERITY AT BASELINE.

3736
02:55:29,615 --> 02:55:33,285
THE GREEN PAR IS PHQ DATA AND 

3737
02:55:33,285 --> 02:55:35,521
THE BLUE IS THE GAD SETTING.

3738
02:55:35,521 --> 02:55:38,757
YOU SEE SUBSTANTIAL 

3739
02:55:38,757 --> 02:55:41,393
COMORBIDITIES WITH RESPECT TO 

3740
02:55:41,393 --> 02:55:44,162
THE POPULATION.

3741
02:55:44,162 --> 02:55:46,765
AS WE THINK OF INTERVENTION 

3742
02:55:46,765 --> 02:55:54,039
DEVELOPMENT MOVING FORWARD.

3743
02:55:54,039 --> 02:55:56,074
I WANTED TO SHOW SOMETHING THAT 

3744
02:55:56,074 --> 02:55:57,109
CAME UP FOR A PROJECT WE'RE 

3745
02:55:57,109 --> 02:55:57,576
FUNDING.

3746
02:55:57,576 --> 02:56:02,047
THIS IS AN INTERVENTION AT 

3747
02:56:02,047 --> 02:56:04,750
CHESTNUT HEALTH SYSTEM WORKING 

3748
02:56:04,750 --> 02:56:06,718
WITH WELFARE INVOLVED FAMILIES 

3749
02:56:06,718 --> 02:56:10,188
AND WHAT SHE FOUND IS THERE'S 

3750
02:56:10,188 --> 02:56:11,924
CHALLENGING IN UPSTREAM 

3751
02:56:11,924 --> 02:56:12,491
PREVENTION.

3752
02:56:12,491 --> 02:56:14,760
OFTEN THE NEED FOR TREATMENT 

3753
02:56:14,760 --> 02:56:17,629
OUTWEIGHS THAT OF PREVENTION.

3754
02:56:17,629 --> 02:56:20,933
YOU NEED A BETWEEN ACCESS TO 

3755
02:56:20,933 --> 02:56:23,402
TREATMENT AND REFERRALS.

3756
02:56:23,402 --> 02:56:26,338
SHE DEVELOPED A CONTINUUM OF 

3757
02:56:26,338 --> 02:56:29,408
CARE MODEL ADAPTING A TERTIARY 

3758
02:56:29,408 --> 02:56:30,576
PREVENTION PROGRAM TO CREATE A 

3759
02:56:30,576 --> 02:56:33,845
MODEL THAT SPANS PREVENTION AND 

3760
02:56:33,845 --> 02:56:36,481
TREATMENT IN ORDER TO REACH MORE

3761
02:56:36,481 --> 02:56:36,848
FAMILIES.

3762
02:56:36,848 --> 02:56:37,916
HER PROGRAM CALLED JUST CARE FOR

3763
02:56:37,916 --> 02:56:39,618
FAMILIES IS AN INTERVENTION FOR 

3764
02:56:39,618 --> 02:56:42,354
FAMILIES AT RISK OR ALREADY 

3765
02:56:42,354 --> 02:56:46,758
INVOLVED IN CHILD WELFARE AND 

3766
02:56:46,758 --> 02:56:50,228
INVOLVES A CONTINUUM OF 

3767
02:56:50,228 --> 02:56:52,898
SERVICES, SYSTEM NAVIGATION AND 

3768
02:56:52,898 --> 02:56:54,299
COMMUNITY BUILDING AND PARENTING

3769
02:56:54,299 --> 02:56:55,534
AND ADDRESSING SOCIAL NEEDS OF 

3770
02:56:55,534 --> 02:56:56,635
THE FAMILIES INVOLVED IN THE 

3771
02:56:56,635 --> 02:56:56,868
SYSTEM.

3772
02:56:56,868 --> 02:57:00,072
THE REASON WHY I WANTED TO BRING

3773
02:57:00,072 --> 02:57:07,012
THIS UP IS BECAUSE IT WAS EASIER

3774
02:57:07,012 --> 02:57:08,113
TO IMPLEMENT AND SUSTAIN.

3775
02:57:08,113 --> 02:57:10,782
THE STATE HAS A FUNDING MODEL 

3776
02:57:10,782 --> 02:57:14,886
FOR HER TO SUPPORT THE 

3777
02:57:14,886 --> 02:57:15,454
NON-REIMBURSABLE COMPONENT 

3778
02:57:15,454 --> 02:57:17,022
ALLOWING THE RESEARCH TO HAVE A 

3779
02:57:17,022 --> 02:57:22,494
CHANCE OF SUSTAINING AFTER THE 

3780
02:57:22,494 --> 02:57:23,395
RESEARCH BECAUSE SHE FOUND 

3781
02:57:23,395 --> 02:57:24,630
SUPPORT FROM THE STATE IN WHICH 

3782
02:57:24,630 --> 02:57:27,399
TO DO IT.

3783
02:57:27,399 --> 02:57:32,170
THIS IS REALLY THE WAY I'M 

3784
02:57:32,170 --> 02:57:33,038
TRYING TO GET RESEARCHERS TO 

3785
02:57:33,038 --> 02:57:34,206
THINK ABOUT THEIR WORK AND WHAT 

3786
02:57:34,206 --> 02:57:36,908
HAPPENS NEXT AND HOW DO WE GET 

3787
02:57:36,908 --> 02:57:39,511
IMPLEMENTATIONS SUSTAINED AND 

3788
02:57:39,511 --> 02:57:46,418
IMPLEMENTED AND TAKEN TO SCALE.

3789
02:57:46,418 --> 02:57:48,353
THE LAST IS TO GIVE A SHOUT OUT 

3790
02:57:48,353 --> 02:57:48,854
AND ACKNOWLEDGE THE 

3791
02:57:48,854 --> 02:57:51,690
DISSEMINATION ACHIEVEMENTS AND 

3792
02:57:51,690 --> 02:57:53,425
ACTIVITIES OF THE GROUP UNDER 

3793
02:57:53,425 --> 02:57:56,328
THE DIRECTION OF RTI.

3794
02:57:56,328 --> 02:57:58,130
BECAUSE THE STUDIES HAVE BEEN A 

3795
02:57:58,130 --> 02:57:59,598
BIT DELAYS BECAUSE OF COVID AND 

3796
02:57:59,598 --> 02:58:00,932
DON'T HAVE A LOT OF OUTCOME 

3797
02:58:00,932 --> 02:58:02,768
PAPERS THE GROUP DID A NICE JOB 

3798
02:58:02,768 --> 02:58:05,771
OF MAKING SURE THEY WERE 

3799
02:58:05,771 --> 02:58:06,438
COMMUNICATING GENERALLY WHAT'S 

3800
02:58:06,438 --> 02:58:07,773
BEEN HAPPENING WITH THE HEAL 

3801
02:58:07,773 --> 02:58:09,241
INITIATIVE AND COMING AT IT FROM

3802
02:58:09,241 --> 02:58:10,842
DIFFERENT ANGLES.

3803
02:58:10,842 --> 02:58:15,313
THEY HAD A GREAT POD SERIES 

3804
02:58:15,313 --> 02:58:16,581
WHERE THAT ARE WE INTERVIEWING 

3805
02:58:16,581 --> 02:58:17,516
WOMEN INVESTIGATORS AROUND THEIR

3806
02:58:17,516 --> 02:58:19,284
WORK IN PREVENTION SCIENCE AND 

3807
02:58:19,284 --> 02:58:24,222
HAD MANUSCRIPTS, BLOGS, REGULAR 

3808
02:58:24,222 --> 02:58:25,857
NEWSLETTERS TO SYSTEMATIC 

3809
02:58:25,857 --> 02:58:29,161
REVIEWS FOCUSSED ON SOCIAL 

3810
02:58:29,161 --> 02:58:31,730
CONNECTIONS AND ROLE ON OPIOID 

3811
02:58:31,730 --> 02:58:33,765
MISUSE AND LOOKING AT OPIOID AND

3812
02:58:33,765 --> 02:58:36,702
SUICIDE AND HAVE DONE WEBINARS.

3813
02:58:36,702 --> 02:58:38,370
MANY CONFERENCE PRESENTATIONS.

3814
02:58:38,370 --> 02:58:40,038
THERE'S GREAT RESOURCES AND 

3815
02:58:40,038 --> 02:58:40,972
INFORMATION THAT'S COME OUT 

3816
02:58:40,972 --> 02:58:44,409
ABOUT THE INITIATIVE AS WE WAIT 

3817
02:58:44,409 --> 02:58:46,578
FOR THE ABILITY TO PRESENT SOME 

3818
02:58:46,578 --> 02:58:48,980
OUTCOME DATA.

3819
02:58:48,980 --> 02:58:50,782
IN TERMS OF NEXT STEPS, WE'RE 

3820
02:58:50,782 --> 02:58:52,084
STARTING TO THINK ABOUT WHERE WE

3821
02:58:52,084 --> 02:58:53,819
WANT TO GO WITH INTERVENTION 

3822
02:58:53,819 --> 02:58:54,119
DEVELOPMENT.

3823
02:58:54,119 --> 02:58:58,056
THE IDEA OF TARGETING IDENTIFIED

3824
02:58:58,056 --> 02:58:59,624
RISK POPULATIONS.

3825
02:58:59,624 --> 02:59:00,726
FOCUSSING ON SYSTEMS BASED 

3826
02:59:00,726 --> 02:59:02,360
PREVENTION AND MEETING 

3827
02:59:02,360 --> 02:59:04,496
INDIVIDUALS WHERE THEY ARE AND 

3828
02:59:04,496 --> 02:59:05,397
THE STUDIES ARE TOUCHING 

3829
02:59:05,397 --> 02:59:06,131
MULTIPLE SYSTEMS.

3830
02:59:06,131 --> 02:59:08,233
HOW DO WE DO A BETTER JOB OF 

3831
02:59:08,233 --> 02:59:11,603
ENGAGING INDIVIDUALS IN MULTIPLE

3832
02:59:11,603 --> 02:59:18,210
SYSTEMS AND THINKING ABOUT 

3833
02:59:18,210 --> 02:59:20,011
IMPLEMENTING ACROSS TWO SYSTEMS 

3834
02:59:20,011 --> 02:59:21,379
INSTEAD OF ONE AND DOING 

3835
02:59:21,379 --> 02:59:22,447
IMPLEMENTATION AND SERVICES 

3836
02:59:22,447 --> 02:59:25,117
RESEARCH SO THE RFA HAS A REVIEW

3837
02:59:25,117 --> 02:59:27,953
MEETING SCHEDULED FOR APRIL.

3838
02:59:27,953 --> 02:59:30,088
I'M EXCITED TO SEE WHAT COMES 

3839
02:59:30,088 --> 02:59:31,289
FROM THERE AND THERE WAS A 

3840
02:59:31,289 --> 02:59:34,760
COMMENT ABOUT PARTNERSHIP OF 

3841
02:59:34,760 --> 02:59:39,531
OTHER FEDERAL AGENCIES.

3842
02:59:39,531 --> 02:59:44,069
WE'VE HAD A LOT OF DIALOGUE WITH

3843
02:59:44,069 --> 02:59:46,638
SAMHSA AND TAKE WHAT WE'RE 

3844
02:59:46,638 --> 02:59:49,141
LEARNING FROM OUR INTERVENTIONS 

3845
02:59:49,141 --> 02:59:50,909
AND PUSHING THEM OUT TO OTHER 

3846
02:59:50,909 --> 02:59:51,276
PROGRAMS.

3847
02:59:51,276 --> 02:59:52,444
HOPEFULLY THAT'S SOMETHING WE 

3848
02:59:52,444 --> 02:59:53,111
CAN CONTINUE TO THINK ABOUT 

3849
02:59:53,111 --> 02:59:54,780
MOVING FORWARD IN THE COMING 

3850
02:59:54,780 --> 03:00:04,923
MONTHS.

3851
03:00:09,161 --> 03:00:10,796
AND THERE'S THE CHALLENGE OF 

3852
03:00:10,796 --> 03:00:12,197
PREVENTION AND WE KNOW 

3853
03:00:12,197 --> 03:00:14,032
PREVENTION MAKES GOOD FINANCIAL 

3854
03:00:14,032 --> 03:00:14,766
SENSE BUT THERE'S A LOT OF 

3855
03:00:14,766 --> 03:00:18,770
IMPLEMENTATION BARRIERS TO 

3856
03:00:18,770 --> 03:00:19,070
PREVENTION.

3857
03:00:19,070 --> 03:00:21,406
WHAT I HAVE IS THE TABLE FROM 

3858
03:00:21,406 --> 03:00:22,107
THE WASHINGTON STATE INSTITUTE 

3859
03:00:22,107 --> 03:00:23,742
FOR PUBLIC POLICY.

3860
03:00:23,742 --> 03:00:26,411
FOR THOSE NOT FAMILIAR IT'S A 

3861
03:00:26,411 --> 03:00:28,914
SEPARATE INDEPENDENT RESEARCH 

3862
03:00:28,914 --> 03:00:30,749
AGENCY THAT THE WASHINGTONS 

3863
03:00:30,749 --> 03:00:35,353
STATE LEGISLATURE USES TO HELP 

3864
03:00:35,353 --> 03:00:36,688
USES AROUND IMPLEMENTATION FOR 

3865
03:00:36,688 --> 03:00:39,457
POLICY MAKE AND DETERMINING 

3866
03:00:39,457 --> 03:00:41,526
BENEFIT PER DOLLAR IN VARIOUS 

3867
03:00:41,526 --> 03:00:41,793
PROGRAMS.

3868
03:00:41,793 --> 03:00:45,030
THIS IS AN EXAMPLE OF ANALYSIS 

3869
03:00:45,030 --> 03:00:51,770
THEY DID IT MAKE THE POINT THEY 

3870
03:00:51,770 --> 03:00:53,505
REVIEWED DIFFERENT PROGRAMS AND 

3871
03:00:53,505 --> 03:00:56,007
AS AN EXAMPLE OF A PROGRAM IN 

3872
03:00:56,007 --> 03:00:57,509
NIDA THEY FIND EVERY DOLLAR 

3873
03:00:57,509 --> 03:01:00,178
SPENT IN THE PROGRAM THEY ARE 

3874
03:01:00,178 --> 03:01:01,513
IDENTIFIED THREE DOLLARS IN 

3875
03:01:01,513 --> 03:01:02,714
HEALTH AND SOCIAL SAVINGS.

3876
03:01:02,714 --> 03:01:04,816
THERE'S AN IDEA OVER TIME THE 

3877
03:01:04,816 --> 03:01:05,750
INVESTMENT AND PREVENTION MAKES 

3878
03:01:05,750 --> 03:01:07,686
SENSE FOR COMMUNITIES.

3879
03:01:07,686 --> 03:01:10,655
WE KNOW THIS AND HAVE PROGRAMS 

3880
03:01:10,655 --> 03:01:13,024
BUT THERE'S A STAFF IN TERMS OF 

3881
03:01:13,024 --> 03:01:14,426
NOT BEING IMPLEMENTED.

3882
03:01:14,426 --> 03:01:16,895
I SPENT A LOT OF TIME THE LAST 

3883
03:01:16,895 --> 03:01:18,196
COUPLE YEARS GOING OUT TO 

3884
03:01:18,196 --> 03:01:19,998
COMMUNITIES AND TALKING TO RS 

3885
03:01:19,998 --> 03:01:23,401
FROM THE NATIONAL PREVENTION 

3886
03:01:23,401 --> 03:01:24,669
NETWORK, ON THE GROUND PROVIDERS

3887
03:01:24,669 --> 03:01:25,737
AND PREVENTION SERVICES TO LEARN

3888
03:01:25,737 --> 03:01:26,705
WHAT BARRIERS ARE.

3889
03:01:26,705 --> 03:01:31,376
I'VE LISTED THEM HERE.

3890
03:01:31,376 --> 03:01:33,478
THERE'S LIMITED FUNDING FOR 

3891
03:01:33,478 --> 03:01:35,547
PREVENTION AND MANY ARE 

3892
03:01:35,547 --> 03:01:36,514
IMPLEMENTED THROUGH GRANTS.

3893
03:01:36,514 --> 03:01:40,852
SO ONCE THE GRANT ENDS, THE 

3894
03:01:40,852 --> 03:01:41,519
PROGRAM ENDS.

3895
03:01:41,519 --> 03:01:43,688
THERE'S A LACK OF WORKFORCE AND 

3896
03:01:43,688 --> 03:01:45,223
PROGRAMS ARE NOT UNIVERSALLY 

3897
03:01:45,223 --> 03:01:46,424
ACCESSIBLE AND DON'T HAVE A GOOD

3898
03:01:46,424 --> 03:01:47,792
TRACKING SYSTEM TO UNDERSTAND 

3899
03:01:47,792 --> 03:01:51,263
WHAT'S GOING ON WITH PREVENTION.

3900
03:01:51,263 --> 03:01:58,236
TAKING THIS TOGETHER NIDA 

3901
03:01:58,236 --> 03:02:01,773
CHAMPIONED BY NORA VOLKOW AND 

3902
03:02:01,773 --> 03:02:05,076
SAMHSA AND CDC SUPPORTED A 

3903
03:02:05,076 --> 03:02:06,211
NATIONAL ACADEMIES STUDY FOR 

3904
03:02:06,211 --> 03:02:08,446
BEHAVIORAL HEALTH DISORDERS.

3905
03:02:08,446 --> 03:02:12,117
THIS WAS LAUNCHED IN DECEMBER OF

3906
03:02:12,117 --> 03:02:14,586
'23 AND IT WAS AN AD HOC 

3907
03:02:14,586 --> 03:02:18,456
COMMITTEE TO DEVELOP A BLUEPRINT

3908
03:02:18,456 --> 03:02:20,859
FOR DELIVERING PREVENTION 

3909
03:02:20,859 --> 03:02:21,760
INTERVENTIONS FOR BEHAVIORAL 

3910
03:02:21,760 --> 03:02:22,761
HEALTH DISORDER.

3911
03:02:22,761 --> 03:02:25,196
WE TASKED THE COMMITTEE FOR BEST

3912
03:02:25,196 --> 03:02:26,264
PRACTICES WHAT THAT WOULD LOOK 

3913
03:02:26,264 --> 03:02:28,066
LIKE AND WHAT THE FUNDING NEEDS 

3914
03:02:28,066 --> 03:02:30,769
AND STRATEGIES ARE AND 

3915
03:02:30,769 --> 03:02:31,770
ACTIONABLE RECOMMENDATIONS IN 

3916
03:02:31,770 --> 03:02:32,837
ORDER TO IMPLEMENT 

3917
03:02:32,837 --> 03:02:34,306
INFRASTRUCTURE SO WE CAN ADDRESS

3918
03:02:34,306 --> 03:02:36,007
THIS RESEARCH TO PRACTICE GAP.

3919
03:02:36,007 --> 03:02:38,209
AND I'M EXCITED TO SAY THE 

3920
03:02:38,209 --> 03:02:40,378
REPORT IS DUE TO US IMMINENTLY 

3921
03:02:40,378 --> 03:02:43,348
AND THAT WILL BE A REAL HELP IN 

3922
03:02:43,348 --> 03:02:45,417
ADDING TO LIKE HOW WE THINK OF 

3923
03:02:45,417 --> 03:02:46,751
DOING PREVENTION RESEARCH MOVING

3924
03:02:46,751 --> 03:02:49,054
FORWARD.

3925
03:02:49,054 --> 03:02:52,924
THIS IS JUST WHAT WE ASKED FOR 

3926
03:02:52,924 --> 03:02:58,763
IN THE BLUEPRINT AND HAVE ASKED 

3927
03:02:58,763 --> 03:03:02,400
FOR AN OUTLINE TO MAKE 

3928
03:03:02,400 --> 03:03:03,435
PREVENTION AFFORDABLE, 

3929
03:03:03,435 --> 03:03:05,103
ACCESSIBLE AND AVAILABLE TO ALL 

3930
03:03:05,103 --> 03:03:06,104
WHO MAY BENEFIT.

3931
03:03:06,104 --> 03:03:07,472
WE'LL READ THE REPORT SOON AND 

3932
03:03:07,472 --> 03:03:09,441
USE IT TO THINK THROUGH OUR NEXT

3933
03:03:09,441 --> 03:03:14,779
STEPS BOTH FOR HEAL PREVENTION 

3934
03:03:14,779 --> 03:03:25,223
AND PREVENTION WRIT LARGE.

3935
03:03:28,293 --> 03:03:29,561
THESE ARE THE PEOPLE ON THE 

3936
03:03:29,561 --> 03:03:30,895
GROUND HELPING US PREVENT OPIOID

3937
03:03:30,895 --> 03:03:37,402
USE DISORDER.

3938
03:03:37,402 --> 03:03:39,404
I KNOW I COVER A LOT OF GROUND 

3939
03:03:39,404 --> 03:03:41,539
IN NOT A LOT OF TIME BUT HAPPY 

3940
03:03:41,539 --> 03:03:42,674
TO TAKE QUESTIONS OR ADDRESS THE

3941
03:03:42,674 --> 03:03:53,151
PROGRAMS I MENTIONED SO FAR.

3942
03:04:01,626 --> 03:04:02,527
>> Dr. Koroshetz: TO MAKE
A 

3943
03:04:02,527 --> 03:04:05,864
LARGER IMPACT THIS IS THE WAY TO

3944
03:04:05,864 --> 03:04:06,765
GO.

3945
03:04:06,765 --> 03:04:08,066
>> Dr. Goldstein: THANKS.

3946
03:04:08,066 --> 03:04:09,968
THERE'S A QUESTION FROM ERIC.

3947
03:04:09,968 --> 03:04:12,337
>> THANK YOU FOR THE
EXCELLENT 

3948
03:04:12,337 --> 03:04:14,773
PRESENTATION.

3949
03:04:14,773 --> 03:04:18,143
I WAS CURIOUS ABOUT THE PASSING 

3950
03:04:18,143 --> 03:04:20,211
COMMENT ABOUT WORKING WITH 

3951
03:04:20,211 --> 03:04:22,747
SAMHSA WITH THE DISCOVERIES VIA 

3952
03:04:22,747 --> 03:04:24,082
THE BLOCK GRANTS TO THE STATES.

3953
03:04:24,082 --> 03:04:25,350
I WAS HOPING YOU CAN SPEAK MORE 

3954
03:04:25,350 --> 03:04:26,751
TO THAT.

3955
03:04:26,751 --> 03:04:30,021
THAT'S EXCITING.

3956
03:04:30,021 --> 03:04:31,923
>> IT'S BEEN REALLY
EXCITING FOR

3957
03:04:31,923 --> 03:04:36,895
THE LAST THREE YEARS I'VE HAD A 

3958
03:04:36,895 --> 03:04:37,862
BIWEEKLY PHONE CALL TO THINK 

3959
03:04:37,862 --> 03:04:41,533
ABOUT HOW WE DO A BETTER JOB OF 

3960
03:04:41,533 --> 03:04:42,333
GETTING EVIDENCE-BASED 

3961
03:04:42,333 --> 03:04:44,335
INTERVENTIONS IN THE HANDS OF 

3962
03:04:44,335 --> 03:04:45,437
COMMUNITIES.

3963
03:04:45,437 --> 03:04:47,906
WE HAVEN'T FULLY FIGURED IT OUT 

3964
03:04:47,906 --> 03:04:49,908
YET BUT HAVE IDEAS WHAT WE CAN 

3965
03:04:49,908 --> 03:04:50,375
DO.

3966
03:04:50,375 --> 03:04:53,678
SAMHSA HAS BEEN A PARTNER AROUND

3967
03:04:53,678 --> 03:04:55,580
THE INFRASTRUCTURE STUDY AND 

3968
03:04:55,580 --> 03:04:56,648
TALKING ABOUT DIFFERENT GRANT 

3969
03:04:56,648 --> 03:04:57,449
MECHANISMS.

3970
03:04:57,449 --> 03:04:59,517
WE HAVE A HEAL PREVENTION 

3971
03:04:59,517 --> 03:05:02,720
MEETING OF INVESTIGATORS AND HAD

3972
03:05:02,720 --> 03:05:03,521
SAMHSA LEADERSHIP AT OUR MEETING

3973
03:05:03,521 --> 03:05:05,390
LAST APRIL TO HEAR ABOUT THE 

3974
03:05:05,390 --> 03:05:06,791
PROJECTS AND THINK WHAT MIGHT 

3975
03:05:06,791 --> 03:05:10,395
MAKE SENSE FOR THE SAMHSA FUNDED

3976
03:05:10,395 --> 03:05:10,795
COMMUNITY.

3977
03:05:10,795 --> 03:05:13,031
THEY HAVE A LOT OF IDEAS AND 

3978
03:05:13,031 --> 03:05:14,299
GETTING CLOSER TO EXECUTION BUT 

3979
03:05:14,299 --> 03:05:17,402
HOPEFULLY WE CAN DO A BETTER JOB

3980
03:05:17,402 --> 03:05:24,609
OF MAKING SURE THE PROGRAM IS 

3981
03:05:24,609 --> 03:05:25,677
RECEIVING DOLLARS THAT IS 

3982
03:05:25,677 --> 03:05:28,046
EVIDENCE-BASED.

3983
03:05:28,046 --> 03:05:30,148
>> SUPER IMPORTANT.

3984
03:05:30,148 --> 03:05:33,818
>> IT'S A NECESSARY NEXT
STEP TO

3985
03:05:33,818 --> 03:05:37,188
TURN HEAL INTO A REDUCTION OF 

3986
03:05:37,188 --> 03:05:38,323
MORALITY AND MORBIDITY RELATED 

3987
03:05:38,323 --> 03:05:41,626
TO ADDICTION SO THANKS A LOT.

3988
03:05:41,626 --> 03:05:50,368
>> Dr. Goldstein: THANK
YOU.

3989
03:05:50,368 --> 03:05:51,169
WALLY.

3990
03:05:51,169 --> 03:05:53,438
>> I WAS STRUCK BY THE 

3991
03:05:53,438 --> 03:05:55,507
INVESTIGATORS WHO THEN WENT ON 

3992
03:05:55,507 --> 03:06:05,483
TO GET SPLN TO PAY TO GET THE 

3993
03:06:05,483 --> 03:06:07,252
INTERVENTION AND PRACTICE AND 

3994
03:06:07,252 --> 03:06:09,687
STRUCK BY THE MODEL AND THAT IT 

3995
03:06:09,687 --> 03:06:12,824
STILL ALLOWED THOUGH I REMEMBER 

3996
03:06:12,824 --> 03:06:16,828
WAY BACK WHEN THE WHEEL CHAIR 

3997
03:06:16,828 --> 03:06:22,867
BOUND PERSON WHO NEED ED BREAST 

3998
03:06:22,867 --> 03:06:25,003
CANCER CHEMOTHERAPY AND IT 

3999
03:06:25,003 --> 03:06:27,038
WASN'T COST EFFECTIVE AND THEY 

4000
03:06:27,038 --> 03:06:28,907
WHEELED THE PERSON IN TO SAY 

4001
03:06:28,907 --> 03:06:33,144
YOUR METRICS ARE NOT GOOD BUT IT

4002
03:06:33,144 --> 03:06:36,247
SEEMS THEY SURVIVED THE FIASCO 

4003
03:06:36,247 --> 03:06:38,383
AND STILL OUT THERE SHOWING 

4004
03:06:38,383 --> 03:06:40,051
THESE COST EFFECTIVENESS 

4005
03:06:40,051 --> 03:06:42,554
MEASURES OR COST BENEFIT RATIOS.

4006
03:06:42,554 --> 03:06:45,023
I WANTED TO HEAR A LITTLE BIT 

4007
03:06:45,023 --> 03:06:51,229
ABOUT BOTH OF THOSE AND WHERE 

4008
03:06:51,229 --> 03:06:52,096
OTHER STATES ADOPTED IT.

4009
03:06:52,096 --> 03:07:00,538
>> THAT'S A GREAT
QUESTION.

4010
03:07:00,538 --> 03:07:03,641
>> THEY PRESENTED TO THE 

4011
03:07:03,641 --> 03:07:04,576
NATIONAL ACADEMIES.

4012
03:07:04,576 --> 03:07:07,312
WASHINGTON STATE I HAD A LOT OF 

4013
03:07:07,312 --> 03:07:08,379
CONVERSATIONS WITH FOLKS IN 

4014
03:07:08,379 --> 03:07:09,013
WASHINGTON STATE BECAUSE THEY 

4015
03:07:09,013 --> 03:07:18,923
HAVE A GREAT EXAMPLE OF ACADEMIC

4016
03:07:18,923 --> 03:07:23,628
PRACTITIONER PARTNERSHIPS AND 

4017
03:07:23,628 --> 03:07:32,337
REPRESENT WASHINGTON HAS BEEN 

4018
03:07:32,337 --> 03:07:33,905
GREAT IN TERMS OF WHAT 

4019
03:07:33,905 --> 03:07:35,206
ADAPTATIONS HAVE TO HAPPEN AND 

4020
03:07:35,206 --> 03:07:41,379
HOW TO GET IT PAID FOR.

4021
03:07:41,379 --> 03:07:43,114
AND HOW TO USE MONEY 

4022
03:07:43,114 --> 03:07:45,883
THOUGHTFULLY AND FOCUSSED ON 

4023
03:07:45,883 --> 03:07:48,319
INTERVENTIONS AND ALSO DONE IN 

4024
03:07:48,319 --> 03:07:50,255
PARTNERSHIP WITH THE DEVELOPERS 

4025
03:07:50,255 --> 03:07:53,024
TO STAY IN TOUCH WITH WHAT IS 

4026
03:07:53,024 --> 03:07:53,391
EVIDENCE-BASED.

4027
03:07:53,391 --> 03:07:55,193
IT'S AN EXAMPLE TO SEE.

4028
03:07:55,193 --> 03:07:56,094
PENNSYLVANIA IS ANOTHER GOOD 

4029
03:07:56,094 --> 03:08:01,466
EXAMPLE OF ACADEMIC PAR NERSHIPS

4030
03:08:01,466 --> 03:08:03,368
AND HAVING CENTERS THAT WANT TO 

4031
03:08:03,368 --> 03:08:06,170
IMPLEMENT THE RESEARCH AND 

4032
03:08:06,170 --> 03:08:08,439
STUDYING AND MAKING SURE 

4033
03:08:08,439 --> 03:08:09,474
EVIDENCE-BASED INTERVENTION IS 

4034
03:08:09,474 --> 03:08:10,742
HAPPENING AND HAPPY TO FOLLOW-UP

4035
03:08:10,742 --> 03:08:13,611
AND POINT YOU IN THOSE 

4036
03:08:13,611 --> 03:08:15,980
DIRECTIONS AND LISA SALDANA IS 

4037
03:08:15,980 --> 03:08:19,050
IN OREGOREGON.

4038
03:08:19,050 --> 03:08:21,419
I DON'T KNOW HOW IT UNFOLDED.

4039
03:08:21,419 --> 03:08:24,088
I'M HAPPY TO HAVE THAT 

4040
03:08:24,088 --> 03:08:25,556
CONVERSATION TOO BUT SHOWING THE

4041
03:08:25,556 --> 03:08:27,091
IMPACT OF HER CONTINUING CARE 

4042
03:08:27,091 --> 03:08:28,426
MODEL GOT STATE FUNDING TO 

4043
03:08:28,426 --> 03:08:29,427
PERSIST WITH HER WORK.

4044
03:08:29,427 --> 03:08:32,330
THERE'S A COUPLE EXAMPLES OF 

4045
03:08:32,330 --> 03:08:33,564
THAT THAT HAPPENED OVER TIME 

4046
03:08:33,564 --> 03:08:34,299
TOO.

4047
03:08:34,299 --> 03:08:35,633
IT'S HAPPENING.

4048
03:08:35,633 --> 03:08:46,110
IT'S JUST NOT AS WIDESPREAD.

4049
03:08:54,485 --> 03:08:56,688
>> Dr. Koroshetz: WE TALK
ABOUT 

4050
03:08:56,688 --> 03:09:04,996
PEOPLE WITH LIVED EXPERIENCE AND

4051
03:09:04,996 --> 03:09:08,066
ADOLESCENTS IS A DIFFERENT 

4052
03:09:08,066 --> 03:09:08,499
GROUP.

4053
03:09:08,499 --> 03:09:14,839
DO YOU BRING IN KIDS INTO THE 

4054
03:09:14,839 --> 03:09:17,642
PROGRAMS AND HAS THAT BEEN TRIED

4055
03:09:17,642 --> 03:09:25,483
AND HELPFUL?

4056
03:09:25,483 --> 03:09:26,150
>> Dr. Goldstein: WE'RE
TRYING 

4057
03:09:26,150 --> 03:09:29,921
TO FOCUS MORE AND HAVE A COUPLE 

4058
03:09:29,921 --> 03:09:32,557
GRANTS ON YOUTH ENGAGEMENT AND 

4059
03:09:32,557 --> 03:09:32,824
RESEARCH.

4060
03:09:32,824 --> 03:09:38,763
WE'RE TRYING TO DO MORE OF THAT.

4061
03:09:38,763 --> 03:09:40,598
I HAVE A HIGH SCHOOL STUDENT IN 

4062
03:09:40,598 --> 03:09:41,966
MY HOUSE I TALK TO ABOUT SOME OF

4063
03:09:41,966 --> 03:09:43,901
THIS STUFF BUT AT A BROADER 

4064
03:09:43,901 --> 03:09:45,403
LEVEL WE'RE TRYING TO GET THE 

4065
03:09:45,403 --> 03:09:46,771
YOUTH PERSPECTIVE IN THE WORK 

4066
03:09:46,771 --> 03:09:48,373
BECAUSE OFTEN THERE'S A 

4067
03:09:48,373 --> 03:09:50,475
DISCONNECT ON WHAT INVESTIGATORS

4068
03:09:50,475 --> 03:09:51,909
THINK WILL RESONATE WITH YOUTH 

4069
03:09:51,909 --> 03:09:53,144
AND WHAT RESONATES WITH YOUTH SO

4070
03:09:53,144 --> 03:09:54,379
WE'RE TRYING TO DO MORE OF THAT.

4071
03:09:54,379 --> 03:10:04,822
>> Dr. Koroshetz: THANKS.

4072
03:10:08,259 --> 03:10:10,795
>> Director Volkow: WE
HAVE NOT 

4073
03:10:10,795 --> 03:10:14,265
FOCUS THE THAT MUCH ON 

4074
03:10:14,265 --> 03:10:17,635
ADOLESCENCE TO ADULTHOOD AND 

4075
03:10:17,635 --> 03:10:19,036
WE'RE TRYING TO REMEDY IS AND 

4076
03:10:19,036 --> 03:10:21,139
WHAT ARE THE PRIORITIES AND HOW 

4077
03:10:21,139 --> 03:10:22,573
WILL THEY RESPOND AND WHAT IS 

4078
03:10:22,573 --> 03:10:23,641
THE MOST VALUABLE FOR RESEARCH 

4079
03:10:23,641 --> 03:10:26,744
AND NEVER HAD THE CONVERSATION 

4080
03:10:26,744 --> 03:10:32,550
WITH YOUNG PEOPLE.

4081
03:10:32,550 --> 03:10:34,519
IT'S ABOUT TIME WE DO AND TRYING

4082
03:10:34,519 --> 03:10:37,789
TO ALEIF IATE THAT NEGLECT.

4083
03:10:37,789 --> 03:10:46,030
-- ALLEVIATE THAT NEGLECT.

4084
03:10:46,030 --> 03:10:48,699
I SEE A MESSAGE FROM GAIL.

4085
03:10:48,699 --> 03:10:53,738
ARE YOU WORRIED ABOUT THE GRANTS

4086
03:10:53,738 --> 03:10:58,743
FROM SAMHSA?

4087
03:10:58,743 --> 03:10:59,210
DO YOU WANT TO ANSWER?

4088
03:10:59,210 --> 03:11:06,517
>> Dr. Koroshetz: DON'T
ANSWER.

4089
03:11:06,517 --> 03:11:07,819
>> YOU'LL HAVE OTHER 

4090
03:11:07,819 --> 03:11:10,721
OPPORTUNITIES TO OFFER 

4091
03:11:10,721 --> 03:11:11,355
PREVENTION WORK IN THE COMMUNITY

4092
03:11:11,355 --> 03:11:16,994
THROUGH YOUR AGENCY AND THE 

4093
03:11:16,994 --> 03:11:17,395
MONEY ALLOTTED.

4094
03:11:17,395 --> 03:11:19,030
WE'RE HOPING TO -- YOU'RE DOING 

4095
03:11:19,030 --> 03:11:22,767
GREAT WORK AND KNOW THIS IS 

4096
03:11:22,767 --> 03:11:26,637
REALLY WHERE IT BEGINS AND THANK

4097
03:11:26,637 --> 03:11:29,740
YOU AND HOPE YOU CONTINUE TO 

4098
03:11:29,740 --> 03:11:35,046
HAVE THREES OPPORTUNITIES AND 

4099
03:11:35,046 --> 03:11:35,980
CONTINUE IN THE FUTURE.

4100
03:11:35,980 --> 03:11:38,749
ARE YOU PRETTY POSITIVE ABOUT 

4101
03:11:38,749 --> 03:11:49,293
THAT IN TERMS OF THOSE TYPES OF 

4102
03:11:51,462 --> 03:11:54,232
RO1s OR THOSE YOUR CONTINUING.

4103
03:11:54,232 --> 03:11:56,734
ARE THOSE AN OUTSTANDING 

4104
03:11:56,734 --> 03:11:57,068
ANNOUNCEMENT?

4105
03:11:57,068 --> 03:11:58,970
>> THE PREVENTION SERVICES
IS A 

4106
03:11:58,970 --> 03:12:00,204
STANDING ANNOUNCEMENT.

4107
03:12:00,204 --> 03:12:06,077
THE UG3, IH3 IS A ONE-TIME 

4108
03:12:06,077 --> 03:12:10,615
RECEIVE DATE IN 2019 BUT THE 

4109
03:12:10,615 --> 03:12:11,782
RESEARCH ANNOUNCEMENTS THE RO1 

4110
03:12:11,782 --> 03:12:15,586
HAS I WANT TO SAY MAYBE TWO MORE

4111
03:12:15,586 --> 03:12:17,755
RECEIVE DATES.

4112
03:12:17,755 --> 03:12:26,330
>> THANK YOU, VERY MUCH.

4113
03:12:26,330 --> 03:12:27,665
>> Director Volkow:
EVERYBODY 

4114
03:12:27,665 --> 03:12:29,367
COMPLAINS I'M TOO MUCH OF AN 

4115
03:12:29,367 --> 03:12:30,434
OPTIMIST BUT IN TERMS OF THE 

4116
03:12:30,434 --> 03:12:32,103
PRIORITY OF THE ADMINISTRATION 

4117
03:12:32,103 --> 03:12:35,740
TO IMPROVE HEALTH AND HOW 

4118
03:12:35,740 --> 03:12:38,609
DESPITE ALL THE BIG ADVANCES AND

4119
03:12:38,609 --> 03:12:41,612
THE LIFE EXPECTANCY OF AMERICANS

4120
03:12:41,612 --> 03:12:44,215
IS MUCH LOWER AND YOU HEARD THE 

4121
03:12:44,215 --> 03:12:44,815
HHS SECRETARY PRESENT.

4122
03:12:44,815 --> 03:12:47,752
I THINK WITHIN THAT CONTEXT IT'S

4123
03:12:47,752 --> 03:12:51,689
CLEAR WE CRUCIAL WE DO 

4124
03:12:51,689 --> 03:12:54,825
PREVENTION AND THE WHOLE CONCEPT

4125
03:12:54,825 --> 03:12:55,626
OF CHRONIC DISEASES.

4126
03:12:55,626 --> 03:12:59,030
YOU HAVE TO HAVE PREVENTION.

4127
03:12:59,030 --> 03:13:02,233
I'M OPTIMISTIC THERE'S 

4128
03:13:02,233 --> 03:13:04,702
REPRESENTATION RESEARCH NOT JUST

4129
03:13:04,702 --> 03:13:08,039
PREVENTION SCIENCE BUT ALSO FOR 

4130
03:13:08,039 --> 03:13:13,377
TRANSLATING THAT PREVENTION INTO

4131
03:13:13,377 --> 03:13:14,712
SUSTAINABLE INTERVENTION THAT 

4132
03:13:14,712 --> 03:13:18,249
WE'RE NAVIGATING.

4133
03:13:18,249 --> 03:13:21,252
IT'S THEY'RE NOT BEING TAKEN UP.

4134
03:13:21,252 --> 03:13:23,754
HOW DO WE DO THAT IN A MORE 

4135
03:13:23,754 --> 03:13:34,265
EFFECTIVE AND SUSTAINABLE WAY 

4136
03:13:37,168 --> 03:13:39,370
I'M OPTIMISTIC THAT IS SOMETHING

4137
03:13:39,370 --> 03:13:43,074
FOR WHICH RECEPTIVENESS.

4138
03:13:43,074 --> 03:13:43,941
>> OKAY.

4139
03:13:43,941 --> 03:13:46,744
I THINK THAT BRINGS US TO THE 

4140
03:13:46,744 --> 03:13:48,779
CONCLUSION OF OUR MEETING.

4141
03:13:48,779 --> 03:13:51,315
I DON'T TO THE, WALTER OR NORA 

4142
03:13:51,315 --> 03:13:52,750
IF YOU HAVE CONCLUDING TALKS 

4143
03:13:52,750 --> 03:13:54,018
ABOUT I TALK ABOUT OUR NEXT 

4144
03:13:54,018 --> 03:13:58,656
MEETING?

4145
03:13:58,656 --> 03:13:59,757
>> Director Volkow: WHAT
I'D 

4146
03:13:59,757 --> 03:14:01,325
LIKE TO SAY IS THANK EVERYONE 

4147
03:14:01,325 --> 03:14:02,760
FOR THEIR PARTICIPATION AND 

4148
03:14:02,760 --> 03:14:04,195
INTERESTING QUESTIONS AND THE 

4149
03:14:04,195 --> 03:14:06,764
PRESENTATIONS AND ALL THE WORK 

4150
03:14:06,764 --> 03:14:10,701
YOU'VE DONE BEHIND THE SCENES.

4151
03:14:10,701 --> 03:14:12,903
IT'S PART OF THE MDWG AND THE 

4152
03:14:12,903 --> 03:14:14,572
NIDA STAFF AND RECOGNIZING HOW 

4153
03:14:14,572 --> 03:14:17,742
IMPORTANT THAT WORK IS AND I'M 

4154
03:14:17,742 --> 03:14:24,649
VERY APPRECIATE IIVE WE SEE THE 

4155
03:14:24,649 --> 03:14:29,020
EFFORTS PAYS AND SEEING BIG 

4156
03:14:29,020 --> 03:14:32,923
ADVANCES AND FINALLY THERE'S A 

4157
03:14:32,923 --> 03:14:33,557
CRYSTALLIZATION OF THE WORKFORCE

4158
03:14:33,557 --> 03:14:35,292
BEHIND PAIN RESEARCH AND SCIENCE

4159
03:14:35,292 --> 03:14:37,962
AND THE RECOGNITION THAT THIS IS

4160
03:14:37,962 --> 03:14:41,766
AN AREA THAT DESERVES ATTENTION 

4161
03:14:41,766 --> 03:14:44,135
AND CRUCIAL FOR WELL BEING.

4162
03:14:44,135 --> 03:14:48,005
I'M GRATEFUL FOR WHAT YOU DO AND

4163
03:14:48,005 --> 03:14:50,741
GRATEFUL FOR THE PARTNERSHIP 

4164
03:14:50,741 --> 03:14:52,576
IT'S ENABLED US TO HAVE WITH 

4165
03:14:52,576 --> 03:14:54,812
NINDS AND THE OTHER INSTITUTES.

4166
03:14:54,812 --> 03:14:57,214
HAVING SAID THAT I WILL LET 

4167
03:14:57,214 --> 03:15:01,585
WALTER AND BEFORE I LET YOU GO 

4168
03:15:01,585 --> 03:15:03,721
SPEAK, WALTER, I LOVE THE 

4169
03:15:03,721 --> 03:15:08,659
NEURONS BEHIND YOU IN YOUR 

4170
03:15:08,659 --> 03:15:08,859
GLASS.

4171
03:15:08,859 --> 03:15:10,094
YOU HAVE NEURONS EVERYWHERE 

4172
03:15:10,094 --> 03:15:15,066
INSIDE AND OUTSIDE YOUR BRAIN.

4173
03:15:15,066 --> 03:15:17,735
>> Dr. Koroshetz:
SOMETIMES THEY

4174
03:15:17,735 --> 03:15:27,878
ESCAPE.

4175
03:15:28,312 --> 03:15:32,583
I FEEL EXHAUSTED LOOKING BACK AT

4176
03:15:32,583 --> 03:15:34,318
WHAT WE DID AND GREAT 

4177
03:15:34,318 --> 03:15:36,220
RECOMMENDATIONS AND YOU PAT 

4178
03:15:36,220 --> 03:15:37,722
YOURSELF ON THE BACK AND IT 

4179
03:15:37,722 --> 03:15:39,090
LASTS 30 SECONDS AND THEN YOU 

4180
03:15:39,090 --> 03:15:40,424
HAVE TO REALIZE, OKAY, WE HAVE 

4181
03:15:40,424 --> 03:15:41,859
TO GET TO WORK.

4182
03:15:41,859 --> 03:15:51,502
WE HAVE A LOT OF PROBLEMS.

4183
03:15:51,502 --> 03:15:54,271
THESE PROBLEMS ARE NOT THINGS WE

4184
03:15:54,271 --> 03:15:56,373
MADE UP AND NOT GOING AWAY 

4185
03:15:56,373 --> 03:15:58,042
UNLESS WE FIX THEM.

4186
03:15:58,042 --> 03:15:58,943
I APPRECIATE EVERYBODY'S EFFORTS

4187
03:15:58,943 --> 03:16:01,445
TO KEEP PUSHING THE ENVELOPE AND

4188
03:16:01,445 --> 03:16:09,286
SEE WHAT WE CAN DO TO SOLVE THE 

4189
03:16:09,286 --> 03:16:11,388
PROBLEM WE GOT ASSIGNED TO FIX.

4190
03:16:11,388 --> 03:16:15,493
THANKS EVERYBODY FOR YOUR HELP.

4191
03:16:15,493 --> 03:16:18,429
>> I'M NOT SURE IF I'M
GOING TO 

4192
03:16:18,429 --> 03:16:21,298
BE IN THE FIRST GROUP REPLACED 

4193
03:16:21,298 --> 03:16:23,901
BY NEW PEOPLE BUT JUST IN CASE 

4194
03:16:23,901 --> 03:16:25,369
THAT HAPPENS -- 

4195
03:16:25,369 --> 03:16:26,771
>> Dr. Koroshetz: WE
REPLACED 

4196
03:16:26,771 --> 03:16:36,981
HIM ALREADY.

4197
03:16:41,819 --> 03:16:43,587
>> THANK YOU SO EVERYONE
IN MY 

4198
03:16:43,587 --> 03:16:45,389
WORK THE LAST FEW YEARS.

4199
03:16:45,389 --> 03:16:47,858
I CONSIDER THIS ONE OF THE MOST 

4200
03:16:47,858 --> 03:16:49,794
IMPORTANT COMMITTEES I'VE WORKED

4201
03:16:49,794 --> 03:16:50,094
ON.

4202
03:16:50,094 --> 03:16:56,700
PROGRESS HAS BEEN REMARKABLE AND

4203
03:16:56,700 --> 03:16:58,736
I LOOK FORWARD TO CONTINUED 

4204
03:16:58,736 --> 03:16:59,937
SUCCESS AND I'M NOT GOING 

4205
03:16:59,937 --> 03:17:02,139
ANYWHERE AND YOU HAVE MY E-MAIL 

4206
03:17:02,139 --> 03:17:02,373
ADDRESS.

4207
03:17:02,373 --> 03:17:03,507
I'M NOT SHY, I THINK YOU KNOW 

4208
03:17:03,507 --> 03:17:05,209
THAT SO REACH OUT.

4209
03:17:05,209 --> 03:17:09,146
I LOOK FORWARD TO BUMPING 

4210
03:17:09,146 --> 03:17:10,114
EVERYBODY IN THE FUTURE.

4211
03:17:10,114 --> 03:17:11,015
TAKE CARE.

4212
03:17:11,015 --> 03:17:11,682
>> Dr. Koroshetz: WE'RE
ALL 

4213
03:17:11,682 --> 03:17:13,317
TOGETHER FOR THE NEXT MEETING.

4214
03:17:13,317 --> 03:17:14,385
>> IT'S APRIL 29.

4215
03:17:14,385 --> 03:17:15,953
I WANT TO TAKE A MOMENT AND MAKE

4216
03:17:15,953 --> 03:17:17,888
SURE EVERYBODY CAN PUT THAT ON 

4217
03:17:17,888 --> 03:17:18,355
YOUR CALENDAR.

4218
03:17:18,355 --> 03:17:21,125
WE'LL FOLLOW UP WITH THE 

4219
03:17:21,125 --> 03:17:21,458
CALENDAR.

4220
03:17:21,458 --> 03:17:24,395
ON THAT NOTE, IN ADDITION TO 

4221
03:17:24,395 --> 03:17:32,069
LINDA'S IMPENDING REQUIREMENT --

4222
03:17:32,069 --> 03:17:35,873
I WANT TO ACKNOWLEDGE THE 

4223
03:17:35,873 --> 03:17:36,774
RETIREMENT OF DOUG KRAMER AND 

4224
03:17:36,774 --> 03:17:38,475
FOR ALL THE WORK YOU HAVE DONE.

4225
03:17:38,475 --> 03:17:41,445
I WANT TO APPRECIATE THE WORK OF

4226
03:17:41,445 --> 03:17:43,247
LINDY WOODS TO MY LEFT FOR ALL 

4227
03:17:43,247 --> 03:17:47,852
OF HER AMAZING WORK MAKING SURE 

4228
03:17:47,852 --> 03:17:49,420
THIS MEETING KEPT ON KEEPING ON 

4229
03:17:49,420 --> 03:17:52,089
EVEN IN THE FACE OF SOME 

4230
03:17:52,089 --> 03:17:52,723
UNPRECEDENTED CHALLENGES OVER 

4231
03:17:52,723 --> 03:17:58,762
THE PAST FEW MONTHS AND ALL THE 

4232
03:17:58,762 --> 03:18:04,768
STAFF AT NIDA AND NINDS AND MAKE

4233
03:18:04,768 --> 03:18:06,637
IT POSSIBLE FOR US TO HEAR 

4234
03:18:06,637 --> 03:18:07,905
HELPFUL GUIDANCE AND INDIVIDUAL 

4235
03:18:07,905 --> 03:18:10,007
INPUT FROM MEMBERS.

4236
03:18:10,007 --> 03:18:11,442
THANK YOU ALL SO MUCH.

4237
03:18:11,442 --> 03:18:13,143
>> Dr. Koroshetz: CAN I
ADD ONE 

4238
03:18:13,143 --> 03:18:13,344
THING -- 

4239
03:18:15,412 --> 03:18:18,749
>> I LOOKED AT THAT THE
29th IS 

4240
03:18:18,749 --> 03:18:22,286
THE BEGINNING OF THE AMERICAN 

4241
03:18:22,286 --> 03:18:23,988
U.S. A.P.S. PAIN MEETING.

4242
03:18:23,988 --> 03:18:33,931
>> YES, WE ARE AWARE AND
IT IS 

4243
03:18:33,931 --> 03:18:34,765
UNFORTUNATE BUT WE'RE HOPING 

4244
03:18:34,765 --> 03:18:36,867
PEOPLE CAN FIT IT IN AS PEOPLE 

4245
03:18:36,867 --> 03:18:38,769
TRAVEL TO THEIR MEETING.

4246
03:18:38,769 --> 03:18:39,737
>> I'LL DO MY BEST.

4247
03:18:39,737 --> 03:18:43,173
>> WE BELIEVE IN YOU,
ALLAN.

4248
03:18:43,173 --> 03:18:46,744
>> THANKS.

4249
03:18:46,744 --> 03:18:50,915
>> THANK YOU ALL VERY
MUCH.

4250
03:18:50,915 --> 03:18:52,917
I LOOK FORWARD TO SEEING ALL OF 

4251
03:18:52,917 --> 03:18:53,884
YOU AT THE END OF APRIL.

4252
03:18:53,884 --> 03:19:03,928