1 00:00:10,360 --> 00:00:12,462 NOW I WANT TO THANK ALL OF THE 2 00:00:12,462 --> 00:00:13,730 MEMBERS FROM COUNCIL AND STAFF 3 00:00:13,730 --> 00:00:14,998 FROM NIDA FOR ALL OF THE GREAT 4 00:00:14,998 --> 00:00:16,766 WORK THAT THEY DO AND FOR THE 5 00:00:16,766 --> 00:00:18,001 TIME THAT YOU PUT INTO THIS 6 00:00:18,001 --> 00:00:18,334 MEETING. 7 00:00:18,334 --> 00:00:21,204 TODAY IS THE 147th MEETING OF 8 00:00:21,204 --> 00:00:23,539 THE NATIONAL ADVISORY COUNCIL ON 9 00:00:23,539 --> 00:00:27,910 DRUG ABUSE. 10 00:00:27,910 --> 00:00:29,412 TODAY IS THE TIME WE SAY 11 00:00:29,412 --> 00:00:31,014 GOOD-BYE TO SOME OF OUR COUNCIL 12 00:00:31,014 --> 00:00:32,148 MEMBERS, WHICH IS SOMETHING I 13 00:00:32,148 --> 00:00:33,683 REALLY, REALLY HATE TO DO 14 00:00:33,683 --> 00:00:35,985 BECAUSE I ACTUALLY GET 15 00:00:35,985 --> 00:00:36,986 CONDITIONED TO EVERYONE, AND 16 00:00:36,986 --> 00:00:38,388 COUNCIL THIS IS A PARTICULARLY 17 00:00:38,388 --> 00:00:39,355 STRONG PLACE TO CONDITION WITH 18 00:00:39,355 --> 00:00:39,956 OUR MEMBERS. 19 00:00:39,956 --> 00:00:42,792 WHO ARE WE LOSING TODAY? 20 00:00:42,792 --> 00:00:44,994 WE ARE LOSING ANNA ROTH 21 00:00:44,994 --> 00:00:51,668 CHILDRESS. 22 00:00:51,668 --> 00:00:53,303 >> I'LL STILL BE HERE IN SPIRIT. 23 00:00:53,303 --> 00:00:55,171 >> YES, ABSOLUTELY. 24 00:00:55,171 --> 00:00:56,272 YOU'LL BE HEAR IN SPIRIT. 25 00:00:56,272 --> 00:00:59,008 YOUR SPIRIT WILL BE ALL OVER THE 26 00:00:59,008 --> 00:00:59,976 PLACE. 27 00:00:59,976 --> 00:01:02,312 WE'RE ALSO LEARNING DANNY. 28 00:01:02,312 --> 00:01:07,116 WE'RE LOSING SHELLY GREENFIELD. 29 00:01:07,116 --> 00:01:11,187 WE'RE LOSING ANDRE, WHO I THINK 30 00:01:11,187 --> 00:01:13,489 IS IN THE CLOUD SOMEPLACE OVER 31 00:01:13,489 --> 00:01:14,390 THERE. 32 00:01:14,390 --> 00:01:16,959 WE ARE LOSING TRAVIS RYDER. 33 00:01:16,959 --> 00:01:19,262 I HOPE THAT IT'S A STRONG 34 00:01:19,262 --> 00:01:20,430 CONDITIONING SO YOU COME BACK 35 00:01:20,430 --> 00:01:23,866 AND STAY AROUND AND GIVE US 36 00:01:23,866 --> 00:01:25,501 PERSPECTIVE. 37 00:01:25,501 --> 00:01:31,741 ALSO, WE ARE LOSING RAJITA 38 00:01:31,741 --> 00:01:32,041 SINGH. 39 00:01:32,041 --> 00:01:35,611 AND FINALLY WE'RE LOSING MELISSA 40 00:01:35,611 --> 00:01:35,878 WALL. 41 00:01:35,878 --> 00:01:37,580 I THINK SHE MAY BE IN THE CLOUD. 42 00:01:37,580 --> 00:01:39,215 IN ORDER TO MEMORIALIZE THIS 43 00:01:39,215 --> 00:01:41,884 FOREVER, WE WANT TO TAKE A 44 00:01:41,884 --> 00:01:42,352 PICTURE. 45 00:01:42,352 --> 00:01:43,686 WHERE DO YOU WANT US? 46 00:01:43,686 --> 00:01:43,953 HERE? 47 00:01:43,953 --> 00:01:45,788 ALL OF THOSE MEMBERS THAT ARE 48 00:01:45,788 --> 00:01:47,657 LEAVING, PLEASE COME UP HERE SO 49 00:01:47,657 --> 00:01:52,729 WE CAN BE IMMORTALIZED. 50 00:02:40,209 --> 00:02:41,878 >> THOSE WHO HAVE THEIR NAME 51 00:02:41,878 --> 00:02:49,085 TAGS STILL ON. 52 00:02:49,085 --> 00:02:49,318 PERFECT. 53 00:02:49,318 --> 00:02:52,188 THANK YOU SO MUCH, EVERYONE. 54 00:02:52,188 --> 00:02:53,022 ONE, TWO, THREE. 55 00:02:53,022 --> 00:02:58,361 WE'RE GOING TO DO ONE MORE. 56 00:02:58,361 --> 00:03:08,638 ONE, TWO, THREE. 57 00:03:18,981 --> 00:03:22,685 >> NOW IT'S A PLEASURE FOR ME TO 58 00:03:22,685 --> 00:03:23,920 WELCOME THE NEW MEMBERS. 59 00:03:23,920 --> 00:03:26,923 THE FIRST MEMBER THAT I WANT TO 60 00:03:26,923 --> 00:03:33,129 WELCOME IS DR. CHRISTIANE 61 00:03:33,129 --> 00:03:37,767 DUARTE, WHO IS A PROFESSOR IN 62 00:03:37,767 --> 00:03:38,401 ADOLES 63 00:03:38,401 --> 00:03:41,103 ADOLESCENT PSYCHIATRY AT 64 00:03:41,103 --> 00:03:41,737 COLUMBIA UNIVERSITY. 65 00:03:41,737 --> 00:03:43,239 HER RESEARCH IS BASED ON 66 00:03:43,239 --> 00:03:44,941 POPULATION BASED STORIES ABOUT 67 00:03:44,941 --> 00:03:47,610 THE DEVELOPMENT OF MENTAL 68 00:03:47,610 --> 00:03:53,983 DISORDERS IN CHILDREN, ADD LESS 69 00:03:53,983 --> 00:03:54,350 LESSENTS. 70 00:03:54,350 --> 00:03:56,018 SHE'S A MEMBER OF THE ONLY 71 00:03:56,018 --> 00:03:57,687 MULTINATIONAL SOURCE OF 72 00:03:57,687 --> 00:03:59,021 INFORMATION ABOUT HOW MENTAL 73 00:03:59,021 --> 00:04:00,323 DISORDERS DEVELOP FROM CHILDHOOD 74 00:04:00,323 --> 00:04:06,395 TO ADULTHOOD IN A LATIN X GROUP 75 00:04:06,395 --> 00:04:08,197 OF PUERTO RICANS. 76 00:04:08,197 --> 00:04:09,799 SHE HAS PUBLISHED ARTICLES IN 77 00:04:09,799 --> 00:04:11,367 PUBLIC HEALTH AND PSYCHIATRIC 78 00:04:11,367 --> 00:04:12,101 JOURNALS. 79 00:04:12,101 --> 00:04:18,508 CHRISTIANE, WELCOME. 80 00:04:18,508 --> 00:04:20,610 ALSO A PLEASURE TO WELCOME MS. 81 00:04:20,610 --> 00:04:23,613 REGINA LABELLE. 82 00:04:23,613 --> 00:04:32,755 SHE'S A DISTINGUISH ED DIRECTOR 83 00:04:32,755 --> 00:04:35,658 AT THE O'NEILL INSTITUTE FOR 84 00:04:35,658 --> 00:04:38,427 NATIONAL AND GLOBAL HEALTH AT 85 00:04:38,427 --> 00:04:40,596 THE GEORGETOWN UNIVERSITY LAW 86 00:04:40,596 --> 00:04:40,930 CENTER. 87 00:04:40,930 --> 00:04:43,199 SHE LOOKS AT TREATMENT AND 88 00:04:43,199 --> 00:04:44,333 REDUCTION AND RECOVERY SUPPORT 89 00:04:44,333 --> 00:04:44,600 SERVICES. 90 00:04:44,600 --> 00:04:47,870 SHE WAS AN APPOINTEE IN THE 91 00:04:47,870 --> 00:04:48,871 BIDEN-HARRIS ADMINISTRATION AND 92 00:04:48,871 --> 00:04:51,407 SERVED AS ACTING DIRECTOR IN THE 93 00:04:51,407 --> 00:04:53,876 OFFICE OF THE NATIONAL CONTROL 94 00:04:53,876 --> 00:04:55,478 POLICY IN THE EXECUTIVE OFFICE 95 00:04:55,478 --> 00:04:56,712 OF THE PRESIDENT. 96 00:04:56,712 --> 00:04:57,213 REGINA, WELCOME. 97 00:04:57,213 --> 00:04:59,949 IT'S A PLEASURE TO HAVE YOU. 98 00:04:59,949 --> 00:05:02,718 THE OTHER PERSON I WANT TO 99 00:05:02,718 --> 00:05:04,020 INTRODUCE, AND I'M ACTUALLY 100 00:05:04,020 --> 00:05:05,321 WELCOMING HER VIRTUALLY. 101 00:05:05,321 --> 00:05:07,023 SHE'S SOMEPLACE IN THE CLOUD. 102 00:05:07,023 --> 00:05:09,825 LET ME SEE IF I CAN SEE HER. 103 00:05:09,825 --> 00:05:15,665 DR. ANGELA LAIRD, WHO IS A 104 00:05:15,665 --> 00:05:17,867 PROFESSOR AND DIRECTOR OF THE 105 00:05:17,867 --> 00:05:22,939 CENTER OF IMAGING SCIENCE AT 106 00:05:22,939 --> 00:05:23,973 FLORIDA INTERNATIONAL 107 00:05:23,973 --> 00:05:24,674 UNIVERSITY. 108 00:05:24,674 --> 00:05:27,543 SHE IS DIRECTOR OF INFORMMATICS 109 00:05:27,543 --> 00:05:28,744 AND CONNECTIVITY LABORATORY. 110 00:05:28,744 --> 00:05:31,414 HER RESEARCH USES FUNCTIONAL MRI 111 00:05:31,414 --> 00:05:33,115 TO UNDERSTAND LARGE SCALE 112 00:05:33,115 --> 00:05:35,151 NETWORKS IN THE HUMAN BRAIN. 113 00:05:35,151 --> 00:05:37,119 CURRENT PROJECTS EXAMINE CHANGES 114 00:05:37,119 --> 00:05:39,522 ASSOCIATED WITH ADOLESCENT 115 00:05:39,522 --> 00:05:41,857 DEVELOPMENT ON THE GRADUATE 116 00:05:41,857 --> 00:05:43,326 SCIENCE EDUCATION AND ADDICTION. 117 00:05:43,326 --> 00:05:46,362 ANGELA, WELCOME. 118 00:05:46,362 --> 00:05:48,230 THE FINAL NEW MEMBER, WHO I ALSO 119 00:05:48,230 --> 00:05:52,101 WANT TO WELCOME VIRTUALLY, IS 120 00:05:52,101 --> 00:05:55,271 DR. DEBORAH CHASSLER. 121 00:05:55,271 --> 00:05:56,739 SHE IS A SENIOR ACADEMIC 122 00:05:56,739 --> 00:05:58,641 RESEARCHER AND ASSOCIATE 123 00:05:58,641 --> 00:06:00,476 PROFESSOR AT THE BOSTON 124 00:06:00,476 --> 00:06:02,311 UNIVERSITY SCHOOL OF SOCIAL 125 00:06:02,311 --> 00:06:02,612 WORK. 126 00:06:02,612 --> 00:06:03,813 SHE'S THE INAUGURAL FACULTY 127 00:06:03,813 --> 00:06:04,480 FELLOW FOR THE OFFICE OF 128 00:06:04,480 --> 00:06:07,249 DIVERSITY AND INCLUSION. 129 00:06:07,249 --> 00:06:10,286 THE BROAD GOAL OF HER WORK IS TO 130 00:06:10,286 --> 00:06:11,654 INCREASE EQUITABLE ACCESS TO 131 00:06:11,654 --> 00:06:14,023 HARM REDUCTION AND TREATMENT 132 00:06:14,023 --> 00:06:18,961 OPTIONS AND ADDRESS 133 00:06:18,961 --> 00:06:20,463 DISPROPORTIONATELY EXPERIENCED 134 00:06:20,463 --> 00:06:21,297 HARMS OF SUBSTANCE DISORDER. 135 00:06:21,297 --> 00:06:27,336 MS. CHASSLER IS IN ENGAGED 136 00:06:27,336 --> 00:06:28,270 PARTNERSHIPS TO SUPPORT A 137 00:06:28,270 --> 00:06:29,372 COMMUNITY'S STATED NEEDS. 138 00:06:29,372 --> 00:06:30,706 I'M GOING TO ASK FOR THOSE 139 00:06:30,706 --> 00:06:32,908 MEMBERS WHO ARE HERE, IF YOU 140 00:06:32,908 --> 00:06:34,777 COULD ALSO NOW COME ALSO HERE SO 141 00:06:34,777 --> 00:06:45,154 WE CAN TAKE A PICTURE. 142 00:07:12,982 --> 00:07:14,150 NOW I HAVE TO READ THIS 143 00:07:14,150 --> 00:07:15,217 STATEMENT, THIS PARAGRAPH. 144 00:07:15,217 --> 00:07:16,285 THE GOVERNMENT IN THE SUNSHINE 145 00:07:16,285 --> 00:07:18,587 ACT AND THE FEDERAL ADVISORY 146 00:07:18,587 --> 00:07:20,256 COMMITTEE ACT REQUIRES THAT AS 147 00:07:20,256 --> 00:07:21,323 MANY ADVISORY COMMITTEE MEETINGS 148 00:07:21,323 --> 00:07:23,526 AS POSSIBLE BE OPEN TO THE 149 00:07:23,526 --> 00:07:23,759 PUBLIC. 150 00:07:23,759 --> 00:07:25,361 THIS INCLUDES MEETINGS OF THE 151 00:07:25,361 --> 00:07:26,362 NATIONAL ADVISORY COUNCIL ON 152 00:07:26,362 --> 00:07:27,329 DRUG ABUSE. 153 00:07:27,329 --> 00:07:28,964 TODAY'S MEETING IS OPEN TO THE 154 00:07:28,964 --> 00:07:31,901 PUBLIC AND IS BEING VIDEOCAST 155 00:07:31,901 --> 00:07:32,601 AND RECORDED. 156 00:07:32,601 --> 00:07:34,904 THE MINUTES OF THE MEETING WILL 157 00:07:34,904 --> 00:07:37,907 BE AVAILABLE ON THE NIDA HOME 158 00:07:37,907 --> 00:07:38,407 PAGE. 159 00:07:38,407 --> 00:07:39,709 RECORDINGS OF THE OPEN COUNCIL 160 00:07:39,709 --> 00:07:42,378 MEETINGS ARE POSTED ON THE NIH 161 00:07:42,378 --> 00:07:42,912 VIDEOCAST SITES. 162 00:07:42,912 --> 00:07:45,081 I'M GOING TO NOW ASK ALL OF YOU 163 00:07:45,081 --> 00:07:47,216 FOR COMMENTS OR CORRECTIONS TO 164 00:07:47,216 --> 00:07:49,518 THE MINUTES FROM THE FEBRUARY 20 165 00:07:49,518 --> 00:07:50,686 COUNCIL MEETING. 166 00:07:50,686 --> 00:07:53,422 A COPY OF THE MINUTES WAS MADE 167 00:07:53,422 --> 00:07:55,257 AVAILABLE UNDER ELECTRONIC 168 00:07:55,257 --> 00:07:57,893 COUNCIL BOOK UNDER THE NIDA 169 00:07:57,893 --> 00:08:00,362 CURRENT COUNCIL TAB. 170 00:08:00,362 --> 00:08:01,897 COMMENTS? 171 00:08:01,897 --> 00:08:03,065 CORRECTIONS? 172 00:08:03,065 --> 00:08:07,837 NOW I'M GOING TO -- I HAVE TO 173 00:08:07,837 --> 00:08:09,238 GET THAT. 174 00:08:09,238 --> 00:08:10,573 MOTION TO APPROVE? 175 00:08:10,573 --> 00:08:10,906 SECOND? 176 00:08:10,906 --> 00:08:12,408 ANYONE OPPOSED? 177 00:08:12,408 --> 00:08:12,708 OKAY. 178 00:08:12,708 --> 00:08:16,312 I'M GOING TO GET YOU THE FUTURE 179 00:08:16,312 --> 00:08:16,779 COUNCIL DATES. 180 00:08:16,779 --> 00:08:20,483 SEPTEMBER 11, 2024. 181 00:08:20,483 --> 00:08:26,255 FEBRUARY 4, 2025. 182 00:08:26,255 --> 00:08:28,357 MAY 13 AND 14, 2025. 183 00:08:28,357 --> 00:08:29,859 I HOPE IT'S NOT THE APA. 184 00:08:29,859 --> 00:08:39,168 WE WILL CHECK. 185 00:08:39,168 --> 00:08:42,938 LET'S BE SURE WE DON'T HAVE THE 186 00:08:42,938 --> 00:08:43,239 APA. 187 00:08:43,239 --> 00:08:45,775 I'M GOING TO NOW DO THE 188 00:08:45,775 --> 00:08:46,442 DIRECTOR'S REPORT. 189 00:08:46,442 --> 00:08:48,177 LET ME DO IT FROM UP HERE. 190 00:08:48,177 --> 00:08:50,546 LET ME GET MY GLASSES IN CASE I 191 00:08:50,546 --> 00:08:56,218 DON'T SEE SOMETHING. 192 00:08:56,218 --> 00:09:00,156 EVERY TIME I PRESENT AT COUNCIL, 193 00:09:00,156 --> 00:09:01,524 IT'S A GREAT OPPORTUNITY FOR ME 194 00:09:01,524 --> 00:09:02,925 TO LOOK AT WHAT HAS HAPPENED 195 00:09:02,925 --> 00:09:04,994 SINCE THE LAST TIME WE MET FOUR 196 00:09:04,994 --> 00:09:05,361 MONTHS AGO. 197 00:09:05,361 --> 00:09:07,663 I KNOW THAT I HAVE A RESTRICTIVE 198 00:09:07,663 --> 00:09:09,732 TIME AND I CANNOT PRESENT 199 00:09:09,732 --> 00:09:12,101 EVERYTHING THAT IS MERITORIOUS, 200 00:09:12,101 --> 00:09:12,968 SO I HAVE TO BE STRATEGIC, AND 201 00:09:12,968 --> 00:09:14,970 THE WAY THAT I DO IT IS SAY WHAT 202 00:09:14,970 --> 00:09:16,505 IS STRATEGIC TO ME IS AREAS 203 00:09:16,505 --> 00:09:18,307 WHERE I WANT MORE DIRECT INPUT, 204 00:09:18,307 --> 00:09:20,943 WHERE I WANT TO ALSO BE VERY 205 00:09:20,943 --> 00:09:23,245 AWARE OF SOME OF THE MORE 206 00:09:23,245 --> 00:09:24,847 CHALLENGING OR GAP AREAS WHERE 207 00:09:24,847 --> 00:09:26,982 HAVING AWARENESS OF OTHERS SO 208 00:09:26,982 --> 00:09:28,651 THAT THEY CAN CARRY THROUGH AND 209 00:09:28,651 --> 00:09:29,285 MAKE A DIFFERENCE. 210 00:09:29,285 --> 00:09:30,820 SO IT'S IN THIS CONTEXT THAT THE 211 00:09:30,820 --> 00:09:33,055 PRESENTATION AND THE TOPIC 212 00:09:33,055 --> 00:09:35,658 THAT'S I'M CHOOSING, WHY IT 213 00:09:35,658 --> 00:09:37,526 EXPLAINS THE TOPICS THAT I'M 214 00:09:37,526 --> 00:09:37,860 CHOOSING. 215 00:09:37,860 --> 00:09:39,695 I WANT TO START WITH ACTUALLY 216 00:09:39,695 --> 00:09:40,863 SOMETHING THAT IS VERY, VERY 217 00:09:40,863 --> 00:09:43,199 RELEVANT FOR ALL OF US THAT ARE 218 00:09:43,199 --> 00:09:45,367 IN THE RESEARCH WORLD, FOR ALL 219 00:09:45,367 --> 00:09:50,506 OF US THAT GET DEEP RUNS FOR NIH 220 00:09:50,506 --> 00:09:51,841 IN GENERAL, WHICH IS THE 221 00:09:51,841 --> 00:09:55,411 DECISION BY THE NIH TO INCREASE 222 00:09:55,411 --> 00:10:00,683 THE FUNDS TO PAY OUR POST DOCS 223 00:10:00,683 --> 00:10:02,218 AND PRE-DOCTORAL GRADUATES. 224 00:10:02,218 --> 00:10:03,085 THIS WAS OUR RECOMMENDATION FOR 225 00:10:03,085 --> 00:10:07,389 THE ADVISORY COUNCIL AT THE NIH, 226 00:10:07,389 --> 00:10:09,725 AND WE BASICALLY ARE FOLLOWING 227 00:10:09,725 --> 00:10:10,659 THEIR RECOMMENDATIONS. 228 00:10:10,659 --> 00:10:12,628 THE RECOMMENDATIONS OVERALL IN 229 00:10:12,628 --> 00:10:14,697 TERMS OF WHERE WE WILL BE 230 00:10:14,697 --> 00:10:15,998 INCREASING THE TOTAL SALARY WILL 231 00:10:15,998 --> 00:10:20,669 BE DONE OVER A PERIOD OF TWO TO 232 00:10:20,669 --> 00:10:22,004 THREE OR FOUR YEARS DEPENDING ON 233 00:10:22,004 --> 00:10:23,305 THE PROJECT. 234 00:10:23,305 --> 00:10:25,841 IT IS ACTUALLY GOING TO PERTAIN 235 00:10:25,841 --> 00:10:31,513 TO ALL OF THE PRE-DOCTORAL AND 236 00:10:31,513 --> 00:10:41,090 POST-DOCTORAL SCHOLARS OF N 237 00:10:41,090 --> 00:10:41,624 NIH-FUNDED INSTITUTIONS. 238 00:10:41,624 --> 00:10:43,492 IT APPLIES TO OVER 17,000 239 00:10:43,492 --> 00:10:45,427 RESEARCH TRAINEES. 240 00:10:45,427 --> 00:10:47,863 FOR PREDOCTORAL SCHOLARS, IT IS 241 00:10:47,863 --> 00:10:52,001 AN ESTIMATED 4% INCREASE, WHICH 242 00:10:52,001 --> 00:10:54,370 WILL BRING IT TO $28,224. 243 00:10:54,370 --> 00:10:57,172 FOR THE POSTDOCTORAL SCHOLARS, 244 00:10:57,172 --> 00:10:59,808 IT IS AN ESTIMATED 8% INCREASE 245 00:10:59,808 --> 00:11:03,545 WITH PAY STARTING AT $61,008 AND 246 00:11:03,545 --> 00:11:05,981 ADJUSTED BASED ON YEARS OF 247 00:11:05,981 --> 00:11:07,116 EXPERIENCE. 248 00:11:07,116 --> 00:11:09,118 ADDITIONALLY, THERE'S 249 00:11:09,118 --> 00:11:16,358 ELIGIBILITY FOR UP TO 2$200 FOR 250 00:11:16,358 --> 00:11:20,229 TRAINING AND $500 INCREASE FOR 251 00:11:20,229 --> 00:11:20,496 CHILDCARE. 252 00:11:20,496 --> 00:11:21,797 WE HAVE BEEN HEARING A LOT OF 253 00:11:21,797 --> 00:11:22,097 CONCERNS. 254 00:11:22,097 --> 00:11:23,966 A LOT OF PEOPLE FLYING AROUND ME 255 00:11:23,966 --> 00:11:25,868 IS THEY WANT TO GET RID OF THE 256 00:11:25,868 --> 00:11:27,136 LITTLE THING BELOW. 257 00:11:27,136 --> 00:11:29,538 I DON'T THINK IT'S SO BAD. 258 00:11:29,538 --> 00:11:30,973 I CERTAINLY TRY TO GET MY BRAIN 259 00:11:30,973 --> 00:11:33,142 TO IGNORE IT, BUT IF YOU ALL GET 260 00:11:33,142 --> 00:11:38,247 SO OBSESSED WITH IT -- NO, NO, 261 00:11:38,247 --> 00:11:39,515 I'M JUST ACTUALLY TRYING TO 262 00:11:39,515 --> 00:11:41,850 FIGURE OUT HOW TO DEAL WITH THIS 263 00:11:41,850 --> 00:11:42,217 THING. 264 00:11:42,217 --> 00:11:46,021 THERE'S A PROBLEM. 265 00:11:46,021 --> 00:11:49,224 MY VIEW IS, IF IT REALLY BOTHERS 266 00:11:49,224 --> 00:11:50,893 YOU A LOT, THEN WE CAN STOP. 267 00:11:50,893 --> 00:11:51,894 LET'S GO OTHERWISE. 268 00:11:51,894 --> 00:11:53,562 THIS IS ONE OF THE THINGS -- AND 269 00:11:53,562 --> 00:11:55,331 WE HAVE DISCUSSED IT IN PRIOR 270 00:11:55,331 --> 00:11:57,900 MEETINGS, THE NOTION THAT 271 00:11:57,900 --> 00:11:59,835 POSTDOCS DON'T FEEL THEY HAVE 272 00:11:59,835 --> 00:12:02,037 SUFFICIENT PAY IN ORDER TO MEET 273 00:12:02,037 --> 00:12:03,439 THEIR NEEDS. 274 00:12:03,439 --> 00:12:05,574 THEREFORE, WE WERE LOSING 275 00:12:05,574 --> 00:12:05,908 RESEARCHERS. 276 00:12:05,908 --> 00:12:10,746 IT HAS BEEN DIFFICULT TO RECRUIT 277 00:12:10,746 --> 00:12:13,482 POSTDOCS BECAUSE WE DON'T 278 00:12:13,482 --> 00:12:16,018 INCENTIVIZE IT ENORMOUSLY. 279 00:12:16,018 --> 00:12:18,487 THIS IS THE RECOMMENDATIONS, AND 280 00:12:18,487 --> 00:12:22,458 HOPEFULLY THIS WILL HELP US KEEP 281 00:12:22,458 --> 00:12:23,692 PEOPLE THAT ARE INTERESTED IN 282 00:12:23,692 --> 00:12:25,894 SCIENCE TO GO INTO RESEARCH 283 00:12:25,894 --> 00:12:26,128 CAREERS. 284 00:12:26,128 --> 00:12:28,630 THE OTHER THING THAT I WANT TO 285 00:12:28,630 --> 00:12:33,502 MAKE YOU AWARE OF RELATES TO ONE 286 00:12:33,502 --> 00:12:36,939 OF THE TWO PRIORITIES OF DR. 287 00:12:36,939 --> 00:12:41,310 MONICA BERTONOLLI WITH REGARD TO 288 00:12:41,310 --> 00:12:43,078 WHAT THE NIH WANTS TO 289 00:12:43,078 --> 00:12:43,379 ACCOMPLISH. 290 00:12:43,379 --> 00:12:44,747 I'VE SPOKEN ABOUT IT IN THE 291 00:12:44,747 --> 00:12:46,615 PAST, BUT ONE OF IT IS TO 292 00:12:46,615 --> 00:12:48,150 ESTABLISH A RESEARCH NETWORK IN 293 00:12:48,150 --> 00:12:49,084 PRIMARY CARE SETTINGS. 294 00:12:49,084 --> 00:12:52,054 WHY THIS IS RELEVANT, THIS IS 295 00:12:52,054 --> 00:12:54,690 INCREDIBLY RELEVANT ALSO AT 296 00:12:54,690 --> 00:12:55,924 NIDA, BUT IT IS ALSO VERY 297 00:12:55,924 --> 00:12:57,126 RELEVANT FOR ANY DISEASE 298 00:12:57,126 --> 00:12:57,826 CONDITION. 299 00:12:57,826 --> 00:12:59,661 IT STEMS FROM ONE OF THE 300 00:12:59,661 --> 00:13:01,730 SENSITIVITIES ABOUT THE WHOLE 301 00:13:01,730 --> 00:13:06,769 ISSUE IS THE RECOGNITION THAT 302 00:13:06,769 --> 00:13:07,536 HEALTHCARE AND THE HEALTH 303 00:13:07,536 --> 00:13:09,004 QUALITY AND THE HEALTH OF 304 00:13:09,004 --> 00:13:10,906 PEOPLE, PARTICULARLY OF 305 00:13:10,906 --> 00:13:12,374 UNDERSERVED AND UNDERREPRESENTED 306 00:13:12,374 --> 00:13:14,143 INDIVIDUALS, IS GOING DOWN. 307 00:13:14,143 --> 00:13:16,045 WE SAW THIS CLEARLY AND 308 00:13:16,045 --> 00:13:17,913 PAINFULLY DURING THE COVID 309 00:13:17,913 --> 00:13:18,180 PANDEMIC. 310 00:13:18,180 --> 00:13:20,716 PART OF IT REFLECTS THE FACT 311 00:13:20,716 --> 00:13:23,285 THAT THERE'S CERTAIN AREAS OF 312 00:13:23,285 --> 00:13:25,487 RESEARCH THAT ARE PRIORITIZED 313 00:13:25,487 --> 00:13:26,388 AND CERTAIN ENVIRONMENTS WHERE 314 00:13:26,388 --> 00:13:28,223 THAT RESEARCH IS DONE THAT DON'T 315 00:13:28,223 --> 00:13:29,892 NECESSARILY INCLUDE UNDERSERVED 316 00:13:29,892 --> 00:13:33,328 AND UNDERREPRESENTED PEOPLE. 317 00:13:33,328 --> 00:13:34,863 PRIMARY CARE IS THE MAIN SOURCE 318 00:13:34,863 --> 00:13:36,432 WE HAVE FOR GETTING CARE, AND 319 00:13:36,432 --> 00:13:38,200 IT'S THE ONE THAT'S MOST 320 00:13:38,200 --> 00:13:39,935 ACCESSIBLE TO ALL AMERICANS. 321 00:13:39,935 --> 00:13:41,870 SO IN A VERY BOLD MOVE THAT 322 00:13:41,870 --> 00:13:45,908 WOULD ACTUALLY TRY TO CHANGE 323 00:13:45,908 --> 00:13:47,976 THAT DISTINCTION BETWEEN THE 324 00:13:47,976 --> 00:13:49,311 SPECIALIZED CARE AND THE 325 00:13:49,311 --> 00:13:51,480 RESEARCH THAT'S DONE IN 326 00:13:51,480 --> 00:13:53,715 SPECIALIZED CENTERS, THIS 327 00:13:53,715 --> 00:13:55,084 NETWORK WILL ESTABLISH A PRIMARY 328 00:13:55,084 --> 00:13:57,653 CARE FOCUS CLINICAL RESEARCH 329 00:13:57,653 --> 00:14:00,823 NETWORK THAT WILL BE DISEASE 330 00:14:00,823 --> 00:14:02,925 AGNOSTIC, FACILITATING CLINICAL 331 00:14:02,925 --> 00:14:04,326 RESEARCH IN MISSION AREAS ACROSS 332 00:14:04,326 --> 00:14:06,462 ALL ICs. 333 00:14:06,462 --> 00:14:08,530 IT WILL INTEGRATE INNOVATIVE 334 00:14:08,530 --> 00:14:10,365 RESEARCH WITH ROUTINE CLINICAL 335 00:14:10,365 --> 00:14:11,400 CARE IN REAL WORLD SETTINGS. 336 00:14:11,400 --> 00:14:12,868 IN OTHER WORDS, IT WILL BRING US 337 00:14:12,868 --> 00:14:16,872 INTO THE FUTURE OF HOW CLINICAL 338 00:14:16,872 --> 00:14:18,607 RESEARCH SHOULD BE AT LEAST 339 00:14:18,607 --> 00:14:19,808 DIRECTLY BEING DONE. 340 00:14:19,808 --> 00:14:22,211 IT WILL CREATE A FOUNDATION FOR 341 00:14:22,211 --> 00:14:23,212 SUSTAINED ENGAGEMENT WITH 342 00:14:23,212 --> 00:14:24,313 COMMUNITIES UNDERREPRESENTED IN 343 00:14:24,313 --> 00:14:26,582 TYPICAL CLINICAL RESEARCH. 344 00:14:26,582 --> 00:14:27,983 WHAT IS THE ANTICIPATED BUDGET? 345 00:14:27,983 --> 00:14:30,619 AS YOU KNOW, THE BUDGET THIS 346 00:14:30,619 --> 00:14:32,955 YEAR HAS ACTUALLY BEEN QUITE 347 00:14:32,955 --> 00:14:33,522 CONSTRAINED. 348 00:14:33,522 --> 00:14:35,424 SO IT WILL BE START WITH FUNDS 349 00:14:35,424 --> 00:14:37,159 FROM THE OFFICE OF THE DIRECTOR 350 00:14:37,159 --> 00:14:41,697 AT $5 MILLION IN 2024, WITH A 351 00:14:41,697 --> 00:14:44,399 PLAN TO ESCALATE THEM TO $25 352 00:14:44,399 --> 00:14:46,468 MILLION IN 2025. 353 00:14:46,468 --> 00:14:50,439 FROM THERE, ANTICIPATE A RAMPING 354 00:14:50,439 --> 00:14:53,876 OF 50 MILLION TO $100 MILLION 355 00:14:53,876 --> 00:14:55,477 PER YEAR AFTER ASSESSING THE 356 00:14:55,477 --> 00:14:56,578 FEASIBILITY AND BUDGET 357 00:14:56,578 --> 00:14:56,912 REQUIREMENTS. 358 00:14:56,912 --> 00:14:58,113 WHAT IS THE TIMELINE? 359 00:14:58,113 --> 00:14:59,915 THE TIMELINE IS MOVING VERY, 360 00:14:59,915 --> 00:15:01,049 VERY FAST. 361 00:15:01,049 --> 00:15:02,184 IT'S TO GATHER FEEDBACK IN THE 362 00:15:02,184 --> 00:15:04,319 SPRING OF 2024, WHICH IS 363 00:15:04,319 --> 00:15:06,955 HAPPENING AS WE ARE DISCUSSING, 364 00:15:06,955 --> 00:15:09,024 INCLUDING THE PRESENTATION TO 365 00:15:09,024 --> 00:15:09,358 COUNCIL. 366 00:15:09,358 --> 00:15:12,561 A QUICK LAUNCH IN 2024 AND 367 00:15:12,561 --> 00:15:15,631 EXPANDING IN 2025 AND BEYOND. 368 00:15:15,631 --> 00:15:17,866 AS I THINK ABOUT IT, IT 369 00:15:17,866 --> 00:15:20,102 ULTIMATELY RESONATES WITH THAT 370 00:15:20,102 --> 00:15:21,904 INTEREST THAT WE HAVE IN THE 371 00:15:21,904 --> 00:15:23,872 CLINICAL RESEARCH IN NIDA BOTH 372 00:15:23,872 --> 00:15:26,341 FOR THE PREVENTION AND THE 373 00:15:26,341 --> 00:15:28,677 TREATMENT OF SUBSTANCE USE 374 00:15:28,677 --> 00:15:29,578 DISORDERS AND THE RECOGNITION 375 00:15:29,578 --> 00:15:32,447 THAT ACTIVE INVOLVEMENT OF 376 00:15:32,447 --> 00:15:36,084 PRIMARY CARE PHYSICIANS IN WAYS 377 00:15:36,084 --> 00:15:39,521 THAT CAN BE EFFECTIVE OR 378 00:15:39,521 --> 00:15:40,622 SIGNIFICANTLY HAVE A LARGE 379 00:15:40,622 --> 00:15:41,523 IMPACT IN CONTROLLING AND 380 00:15:41,523 --> 00:15:45,861 REDUCING THE TOLL OF ADDICTION 381 00:15:45,861 --> 00:15:46,528 IN OUR COUNTRY. 382 00:15:46,528 --> 00:15:48,697 SO I'M A VERY, VERY STRONG 383 00:15:48,697 --> 00:15:50,499 SUPPORTER OF THIS NETWORK, AND I 384 00:15:50,499 --> 00:15:52,601 THINK IT WILL BLEND VERY NICELY 385 00:15:52,601 --> 00:15:54,803 WITH MANY OF THE PROJECTS 386 00:15:54,803 --> 00:15:56,238 CURRENTLY BEING DONE ON THE 387 00:15:56,238 --> 00:15:58,640 CLINICAL TRIAL NETWORK THAT HAS 388 00:15:58,640 --> 00:16:00,275 EXTENSIVELY INCREASED THIS 389 00:16:00,275 --> 00:16:01,210 COLLABORATION WITH PRIMARY 390 00:16:01,210 --> 00:16:01,577 PHYSICIANS. 391 00:16:01,577 --> 00:16:03,011 I ALSO WANT YOU ALL TO BE AWARE 392 00:16:03,011 --> 00:16:05,581 THAT THIS YEAR IS THE TEN-YEAR 393 00:16:05,581 --> 00:16:07,816 CELEBRATION FOR THE BRAIN 394 00:16:07,816 --> 00:16:09,985 INITIATIVE, AND THE BRAIN HAS 395 00:16:09,985 --> 00:16:13,222 JUST BEEN PHENOMENAL IN ITS 396 00:16:13,222 --> 00:16:16,692 ABILITY TO UNCOVER SOME VERY 397 00:16:16,692 --> 00:16:19,962 BASIC PROPERTIES OF THE BRAIN IN 398 00:16:19,962 --> 00:16:21,730 RODENTS, IN THE BRAIN OF HUMAN 399 00:16:21,730 --> 00:16:23,899 PRIMATES, AND MORE RECENTLY ALSO 400 00:16:23,899 --> 00:16:25,567 OF THE BRAIN IN HUMANS. 401 00:16:25,567 --> 00:16:27,069 AS A RESULT OF THAT, WE HAVE 402 00:16:27,069 --> 00:16:29,438 COME TO REALIZE THAT THERE IS AN 403 00:16:29,438 --> 00:16:37,879 ENORMOUS DIVERSITY OF NEURONS, 404 00:16:37,879 --> 00:16:40,482 AND MICROBIAL AND ENDOTHELIAL 405 00:16:40,482 --> 00:16:41,450 CELLS IN THE BRAIN. 406 00:16:41,450 --> 00:16:42,484 THERE'S TREMENDOUS DIVERSITY IN 407 00:16:42,484 --> 00:16:44,686 EACH ONE OF THESE CELLS, AND BY 408 00:16:44,686 --> 00:16:45,320 CHARACTERIZING THESE SPECIFIC 409 00:16:45,320 --> 00:16:46,989 CELLS AND UNDERSTANDING WHAT ARE 410 00:16:46,989 --> 00:16:49,458 THE MOLECULAR SIGNATURES THAT 411 00:16:49,458 --> 00:16:51,793 THEY HAVE, THEN YOU CAN IDENTIFY 412 00:16:51,793 --> 00:16:53,962 THEM IN PSYCHIATRIC OR 413 00:16:53,962 --> 00:16:55,597 NEUROLOGICAL OR INCLUDING 414 00:16:55,597 --> 00:16:56,932 SUBSTANCE USE DISORDER 415 00:16:56,932 --> 00:16:58,634 CONDITIONS IN WAYS THAT CAN 416 00:16:58,634 --> 00:17:00,669 GUIDE US TO RECOGNIZE WHAT MAY 417 00:17:00,669 --> 00:17:03,972 BE MOLECULAR TARGETS THAT ARE 418 00:17:03,972 --> 00:17:05,207 IMPORTANT FOR TREATMENT 419 00:17:05,207 --> 00:17:07,409 DEVELOPMENT, BUT ALSO WHAT IS 420 00:17:07,409 --> 00:17:10,245 THE NEURAL CIRCUITRY IN A MUCH 421 00:17:10,245 --> 00:17:11,880 MORE SORT OF TAILORED AND 422 00:17:11,880 --> 00:17:14,116 SPECIFIC WAY. 423 00:17:14,116 --> 00:17:15,917 AS A RESULT OF THIS, THAT 424 00:17:15,917 --> 00:17:17,019 TEN-YEAR CELEBRATION, THAT WILL 425 00:17:17,019 --> 00:17:19,655 BE THE ANNUAL MEETING WHICH IS 426 00:17:19,655 --> 00:17:22,090 JUNE 16 AND JUNE 17, AND THERE 427 00:17:22,090 --> 00:17:25,794 WILL BE SORT OF A PANEL 428 00:17:25,794 --> 00:17:29,298 DISCUSSION WHERE THEY WILL HAVE, 429 00:17:29,298 --> 00:17:31,733 MY UNDERSTANDING IS DR. FRANCES 430 00:17:31,733 --> 00:17:33,302 COLLINS WILL BE THERE, WHO WAS 431 00:17:33,302 --> 00:17:35,904 ACTUALLY THE ONE THAT LAUNCHED 432 00:17:35,904 --> 00:17:37,806 THE B.R.A.I.N. TEN YEARS AGO. 433 00:17:37,806 --> 00:17:40,409 SO I ENCOURAGE YOU VERY MUCH TO 434 00:17:40,409 --> 00:17:41,009 REGISTER. 435 00:17:41,009 --> 00:17:42,778 IF YOU CAN MAKE IT IN PERSON, OR 436 00:17:42,778 --> 00:17:44,246 IF NOT, VIRTUALLY. 437 00:17:44,246 --> 00:17:46,882 NOW I WANT TO GET INTO THE 438 00:17:46,882 --> 00:17:48,383 ISSUES RELATED TO NIDA. 439 00:17:48,383 --> 00:17:54,756 THE BUDGET FOR 2024 IS THE SAME 440 00:17:54,756 --> 00:17:56,591 AS THE BUDGET FOR 2023. 441 00:17:56,591 --> 00:17:59,194 THIS ACTUALLY IS ZERO INCREASE, 442 00:17:59,194 --> 00:18:01,930 BUT THE REALITY IS BECAUSE OF 443 00:18:01,930 --> 00:18:05,334 INFLATIONARY COSTS, IT IS MORE 444 00:18:05,334 --> 00:18:07,235 COSTLY TO DO RESEARCH OVERALL, 445 00:18:07,235 --> 00:18:08,403 INCLUDING WHAT WE'RE NOW 446 00:18:08,403 --> 00:18:10,238 DISCUSSING, OF COURSE, WHICH IS 447 00:18:10,238 --> 00:18:11,940 VERY, VERY JUSTIFIED, INCREASING 448 00:18:11,940 --> 00:18:15,911 THE SALARIES OF POSTDOCS, THE 449 00:18:15,911 --> 00:18:17,546 COSTS ARE GOING UP. 450 00:18:17,546 --> 00:18:19,181 THAT MEANS WE HAVE LESS MONEY TO 451 00:18:19,181 --> 00:18:21,750 DO THE SAME SERIES OF 452 00:18:21,750 --> 00:18:25,887 PUBLICATION THAT'S WE HAVE, AND 453 00:18:25,887 --> 00:18:28,256 THIS MEANS AN OVERDOSE CRISIS AS 454 00:18:28,256 --> 00:18:30,092 WELL AS SOME VERY CHALLENGING 455 00:18:30,092 --> 00:18:31,660 COMPONENTS OF SUBSTANCE USE. 456 00:18:31,660 --> 00:18:32,894 NONETHELESS, WE RECOGNIZE THAT 457 00:18:32,894 --> 00:18:36,398 THE BUDGETS HAVE BEEN TIGHT 458 00:18:36,398 --> 00:18:39,968 ACROSS ALL OF THE AGENCIES, AND 459 00:18:39,968 --> 00:18:42,371 SOME OF THE AGENCIES THE BUDGETS 460 00:18:42,371 --> 00:18:43,739 HAVE GONE DOWN. 461 00:18:43,739 --> 00:18:47,275 THE NIH, THE BUDGET WAS NOT CUT 462 00:18:47,275 --> 00:18:48,677 DOWN EXCEPT FOR SOME SPECIFIC 463 00:18:48,677 --> 00:18:50,946 PROGRAMS LIKE B.R.A.I.N., BUT 464 00:18:50,946 --> 00:18:52,447 OTHERWISE, IT HAS REMAINED 465 00:18:52,447 --> 00:18:52,881 STABLE. 466 00:18:52,881 --> 00:18:55,083 TYPICALLY I'VE BEEN PRESENTING 467 00:18:55,083 --> 00:18:56,585 OUR BUDGETS OF NIDA IN TWO 468 00:18:56,585 --> 00:18:59,187 BUCKETS, THE BUCKET IS THAT IS 469 00:18:59,187 --> 00:19:03,158 UNDER THE HEADING OF BASE BUCKET 470 00:19:03,158 --> 00:19:05,460 AND THE BUCKET UNDER THE HEADING 471 00:19:05,460 --> 00:19:06,461 HEAL BUCKET. 472 00:19:06,461 --> 00:19:08,430 THE HEAL BUCKET WAS SPECIFICALLY 473 00:19:08,430 --> 00:19:10,365 AUTHORIZED BY CONGRESS IN ORDER 474 00:19:10,365 --> 00:19:12,601 TO ADDRESS THE URGENT NEEDS AND 475 00:19:12,601 --> 00:19:13,735 THE SCIENCE THAT IS REQUIRED TO 476 00:19:13,735 --> 00:19:14,536 ACCELERATE ADDRESSING THE 477 00:19:14,536 --> 00:19:20,142 OVERDOSE CRISIS. 478 00:19:20,142 --> 00:19:21,810 THAT BUDGET ALSO, NEITHER THE 479 00:19:21,810 --> 00:19:25,046 BASE NOR THE HEAL BUDGET 480 00:19:25,046 --> 00:19:28,116 INCREASED FOR 2024, SO IT IS A 481 00:19:28,116 --> 00:19:32,654 FLAT BUDGET, FOR A TOTAL OF $1.6 482 00:19:32,654 --> 00:19:32,888 MILLION. 483 00:19:32,888 --> 00:19:35,190 IN TERMS OF OUR ORGANIZATION, 484 00:19:35,190 --> 00:19:36,725 THERE ARE NEWS, AND I'M 485 00:19:36,725 --> 00:19:37,692 DELIGHTED TO ACTUALLY CONVEY 486 00:19:37,692 --> 00:19:41,897 THEM TO YOU, THAT WE NOW HAVE A 487 00:19:41,897 --> 00:19:45,367 FINAL PERMANENT DIRECTOR OF THE 488 00:19:45,367 --> 00:19:47,736 DIVISION OF THERAPEUTICS AND 489 00:19:47,736 --> 00:19:55,076 MEDICAL CONSEQUENCES. 490 00:19:55,076 --> 00:19:57,946 DR. MONTOYA, WHO I'M LOOKING AT 491 00:19:57,946 --> 00:19:59,714 HERE, WHO I DON'T NEED TO 492 00:19:59,714 --> 00:20:01,049 INTRODUCE AT ALL BECAUSE YOU ALL 493 00:20:01,049 --> 00:20:03,118 KNOW DR. MONTOYA, I KNOW FOR 494 00:20:03,118 --> 00:20:05,353 MANY, MANY YEARS, AND HE HAS 495 00:20:05,353 --> 00:20:08,390 BEEN ACTING DIRECTOR OF DTMC FOR 496 00:20:08,390 --> 00:20:10,892 A LONG TIME, AND BEFORE THAT, HE 497 00:20:10,892 --> 00:20:12,561 WAS A VERY ABLE DEPUTY DIRECTOR. 498 00:20:12,561 --> 00:20:14,596 IT'S A PLEASURE TO HAVE HIM 499 00:20:14,596 --> 00:20:17,632 FINALLY CONFIRMED, SO WELCOME. 500 00:20:17,632 --> 00:20:19,668 THE OTHER THING THAT I WANT TO 501 00:20:19,668 --> 00:20:21,870 GIVE YOU -- AND I'M GOING TO DO 502 00:20:21,870 --> 00:20:23,872 THEM SHORTLY BECAUSE TOMORROW WE 503 00:20:23,872 --> 00:20:27,442 HAVE THE COUNCIL FOCUS, AND 504 00:20:27,442 --> 00:20:29,311 YOU'RE GOING TO BE GETTING 505 00:20:29,311 --> 00:20:30,912 UPDATES ON THESE TWO EXTREMELY 506 00:20:30,912 --> 00:20:33,114 EXCITING PROJECTS, SOME OF THE 507 00:20:33,114 --> 00:20:35,617 MOST TRANSFORMATIVE WE HAVE HAD 508 00:20:35,617 --> 00:20:38,487 AT NIDA. 509 00:20:38,487 --> 00:20:41,890 ONE OF THEM IS THE ADOLESCENT 510 00:20:41,890 --> 00:20:43,291 BRAIN COGNITIVE DEVELOPMENT 511 00:20:43,291 --> 00:20:45,727 STUDY, THE ABCD, WHICH WAS 512 00:20:45,727 --> 00:20:46,528 STARTED IN SPRING. 513 00:20:46,528 --> 00:20:49,998 IT STARTED BY RECRUITING 9 TO 514 00:20:49,998 --> 00:20:50,332 10-YEAR-OLDS. 515 00:20:50,332 --> 00:20:55,670 THOSE 9 TO 10-YEAR-OLDS, THAT'S 516 00:20:55,670 --> 00:21:01,643 8 YEARS AGO, THEY'RE STARTING TO 517 00:21:01,643 --> 00:21:04,613 GROW UP INTO THE AGE OF USE OF 518 00:21:04,613 --> 00:21:04,880 SUBSTANCE. 519 00:21:04,880 --> 00:21:07,816 THAT STUDY WAS DONE WITH A 520 00:21:07,816 --> 00:21:10,151 PARTNERSHIP WITH NCI AND INH AND 521 00:21:10,151 --> 00:21:12,187 OTHER INSTITUTES THAT ARE, OF 522 00:21:12,187 --> 00:21:14,322 COURSE, VERY MUCH INVESTED INTO 523 00:21:14,322 --> 00:21:17,025 UNDERSTANDING HOW THE HUMAN 524 00:21:17,025 --> 00:21:21,263 BRAIN DEVELOPS IN THAT STAGE OF 525 00:21:21,263 --> 00:21:22,597 ADOLESCENCE AND TRANSITIONING 526 00:21:22,597 --> 00:21:23,598 INTO ADULTHOOD. 527 00:21:23,598 --> 00:21:26,268 THE STUDY STARTED AT AGE 9 TO 528 00:21:26,268 --> 00:21:27,769 10, NOT BECAUSE WE IGNORED THE 529 00:21:27,769 --> 00:21:29,404 IMPORTANCE OF INFANCY AND 530 00:21:29,404 --> 00:21:30,472 CHILDHOOD, BUT BECAUSE WE WANTED 531 00:21:30,472 --> 00:21:31,907 TO AT THAT TIME, AND WE STILL 532 00:21:31,907 --> 00:21:34,976 WANT TO, TO ADDRESS AN URGENT 533 00:21:34,976 --> 00:21:37,145 NEED, WHICH IS TO UNDERSTAND 534 00:21:37,145 --> 00:21:38,813 WHETHER EXPOSURE TO CANNABIS 535 00:21:38,813 --> 00:21:40,649 EARLY ON DURING ADOLESCENCE CAN 536 00:21:40,649 --> 00:21:43,051 HAVE NEGATIVE EFFECTS ON THE 537 00:21:43,051 --> 00:21:44,219 HUMAN BRAIN AFFECTING COGNITION 538 00:21:44,219 --> 00:21:46,254 OR INCREASING THE RISK FOR 539 00:21:46,254 --> 00:21:46,922 MENTAL DISORDERS. 540 00:21:46,922 --> 00:21:49,124 THESE TWO TOPICS HAVE BEEN 541 00:21:49,124 --> 00:21:51,393 EXTREMELY CONTROVERSIAL, AND THE 542 00:21:51,393 --> 00:21:56,865 DATA HAS BEEN DISMISSED BECAUSE 543 00:21:56,865 --> 00:21:58,133 OF THE COMPLAINT THAT THE STUDY 544 00:21:58,133 --> 00:22:01,202 THAT SHOWED INCREASED 545 00:22:01,202 --> 00:22:01,836 EDUCATIONAL ACHIEVEMENT IN 546 00:22:01,836 --> 00:22:03,505 INDIVIDUALS THAT SMOKED 547 00:22:03,505 --> 00:22:05,540 MARIJUANA DURING ADOLESCENT 548 00:22:05,540 --> 00:22:06,875 YEARS OR THOSE THAT ACTUALLY 549 00:22:06,875 --> 00:22:09,110 DROP OUT OF SCHOOL OR THOSE THAT 550 00:22:09,110 --> 00:22:11,780 DEVELOP PSYCHOSIS, CHRONIC 551 00:22:11,780 --> 00:22:13,715 PSYCHOSIS, THAT THERE WAS NO 552 00:22:13,715 --> 00:22:15,984 CONTROL FOR WHAT PREEXISTING 553 00:22:15,984 --> 00:22:17,686 CHANGES THEY MAY HAVE HAD THAT 554 00:22:17,686 --> 00:22:20,121 ACTUALLY MAY HAVE LED THEM TO 555 00:22:20,121 --> 00:22:24,092 SMOKE MARIJUANA, CREATING THESE 556 00:22:24,092 --> 00:22:24,426 DYSFUNCTIONS. 557 00:22:24,426 --> 00:22:29,898 SO THE ABCD WAS EMPOWERED IN 558 00:22:29,898 --> 00:22:31,733 ORDER TO BE ABLE TO ANSWER THAT 559 00:22:31,733 --> 00:22:33,835 QUESTION, TO OBTAIN INFORMATION 560 00:22:33,835 --> 00:22:35,270 BEFORE TEENAGERS START TO TAKE 561 00:22:35,270 --> 00:22:36,705 MARIJUANA, HOW THEIR BRAIN 562 00:22:36,705 --> 00:22:37,872 LOOKS, HOW THEIR COGNITIVE 563 00:22:37,872 --> 00:22:38,974 PERFORMANCE WAS, WHAT THEIR 564 00:22:38,974 --> 00:22:41,543 SOCIAL INTERACTIONS, AND TO 565 00:22:41,543 --> 00:22:43,144 FOLLOW THEM LONGITUDINALLY. 566 00:22:43,144 --> 00:22:44,846 THAT WAS SORT OF THE REASON WHY 567 00:22:44,846 --> 00:22:47,482 IT STARTED AT AGE 9 TO 10. 568 00:22:47,482 --> 00:22:49,651 IT ALSO BY CREATING -- BECAUSE 569 00:22:49,651 --> 00:22:52,187 AT THAT TIME WE REALIZED THERE 570 00:22:52,187 --> 00:22:53,588 WAS ALREADY PRECEDENCE OF LARGE 571 00:22:53,588 --> 00:22:54,656 STUDIES THAT WERE ABLE TO GATHER 572 00:22:54,656 --> 00:22:58,493 THE DATA AND MAKING IT OPENLY 573 00:22:58,493 --> 00:23:01,630 ACCESSIBLE TO EVERYONE IN A WAY 574 00:23:01,630 --> 00:23:03,231 THAT PROTECTED THE 575 00:23:03,231 --> 00:23:04,265 CONFIDENTIALITY OF THE 576 00:23:04,265 --> 00:23:06,201 PARTICIPANTS, BUT ALSO 577 00:23:06,201 --> 00:23:08,403 FACILITATED ACCESS TO THIS DATA 578 00:23:08,403 --> 00:23:11,406 TO EVERY RESEARCHER IN THE 579 00:23:11,406 --> 00:23:12,173 WORLD. 580 00:23:12,173 --> 00:23:15,110 IT'S OPEN FOR ANYONE THAT IS 581 00:23:15,110 --> 00:23:17,112 INTERESTED. 582 00:23:17,112 --> 00:23:18,713 AND VERY VISIONARY IN THE WAY 583 00:23:18,713 --> 00:23:21,483 THAT IT WAS NOT JUST FOCUSING ON 584 00:23:21,483 --> 00:23:27,222 HOW THE BRAIN DEVELOPS, HOW IT 585 00:23:27,222 --> 00:23:28,323 CHANGES, WHICH OF COURSE IS 586 00:23:28,323 --> 00:23:30,725 CRUCIAL, BUT IT WAS ALSO TO TRY 587 00:23:30,725 --> 00:23:34,529 TO UNDERSTAND HOW GENES 588 00:23:34,529 --> 00:23:36,931 INFLUENCE THAT DEVELOPMENT, AND 589 00:23:36,931 --> 00:23:38,767 TWO, HOW OUR ENVIRONMENTAL 590 00:23:38,767 --> 00:23:40,268 CONTEXT, AND IN PARTICULAR, THAT 591 00:23:40,268 --> 00:23:41,670 IS DRIVEN BY SOCIAL SITUATIONS, 592 00:23:41,670 --> 00:23:44,205 BY ECONOMIC SITUATIONS, BY 593 00:23:44,205 --> 00:23:44,839 DISCRIMINATION ULTIMATELY AFFECT 594 00:23:44,839 --> 00:23:49,577 THE HUMAN BRAIN. 595 00:23:49,577 --> 00:23:50,712 THIS WAS IN 2016. 596 00:23:50,712 --> 00:23:52,080 WE DID NOT KNOW COVID WAS GOING 597 00:23:52,080 --> 00:23:52,814 TO HIT. 598 00:23:52,814 --> 00:23:53,882 WE DID NOT KNOW THE STRESSES 599 00:23:53,882 --> 00:23:54,949 THAT WERE GOING TO HAPPEN. 600 00:23:54,949 --> 00:23:57,886 THE STUDY HAS BEEN EXTREMELY 601 00:23:57,886 --> 00:24:01,890 SUCCESSFUL IN RETAINING MOST OF 602 00:24:01,890 --> 00:24:02,991 THOSE CHILDREN THAT WERE 603 00:24:02,991 --> 00:24:04,426 RECRUITED, AND THAT'S SORT OF 604 00:24:04,426 --> 00:24:05,894 CLOSE TO 12,000 CHILDREN THAT 605 00:24:05,894 --> 00:24:08,897 WERE RECRUITED. 606 00:24:08,897 --> 00:24:10,965 THE OPEN ACCESS FORMAT WHERE THE 607 00:24:10,965 --> 00:24:13,835 DATA IS DEPOSITED -- IDEALLY, WE 608 00:24:13,835 --> 00:24:16,404 HAD ONE TO TWO DEPOSITED IN DATA 609 00:24:16,404 --> 00:24:17,806 THAT'S ACTUALLY GOOD QUALITY 610 00:24:17,806 --> 00:24:20,008 DATA, ON A YEARLY BASIS. 611 00:24:20,008 --> 00:24:22,143 THIS UNFORTUNATELY HAS HAD SOME 612 00:24:22,143 --> 00:24:26,815 OF CHALLENGES TO MAKE IT 613 00:24:26,815 --> 00:24:27,449 POSSIBLE. 614 00:24:27,449 --> 00:24:29,984 SO THERE HAS BEEN SOME DELAYS, 615 00:24:29,984 --> 00:24:32,153 UNFORTUNATELY, AS OF RECENTLY, 616 00:24:32,153 --> 00:24:34,756 ON THE DEPOSIT OF THE LATEST 617 00:24:34,756 --> 00:24:36,458 DATA, AND IN ORDER TO ADDRESS 618 00:24:36,458 --> 00:24:39,160 THAT, WE'VE MOVED THE REPOSITORY 619 00:24:39,160 --> 00:24:45,834 WHERE IT WAS, WHICH WAS A LESS 620 00:24:45,834 --> 00:24:47,602 FLEXIBLE SORT OF STRUCTURE WHICH 621 00:24:47,602 --> 00:24:50,004 WAS LOCATED AT THE NIMH, AND IT 622 00:24:50,004 --> 00:24:53,875 WAS WONDERFUL TO HAVE ALL OF 623 00:24:53,875 --> 00:24:54,275 THEIR SUPPORT. 624 00:24:54,275 --> 00:24:56,311 BUT HAVING THE FLEXIBILITY 625 00:24:56,311 --> 00:24:57,912 NECESSARY TO DEPOSIT THE DATA IN 626 00:24:57,912 --> 00:24:59,881 A FASTER WAY WAS CRUCIAL AS WELL 627 00:24:59,881 --> 00:25:02,383 AS TO HAVE THE FLEXIBILITY TO 628 00:25:02,383 --> 00:25:08,990 PRESENT THE DATA, TO GET ACCESS 629 00:25:08,990 --> 00:25:11,726 TO THAT DATA IN ITS ENTIRELY WAS 630 00:25:11,726 --> 00:25:12,026 FUNDAMENTAL. 631 00:25:12,026 --> 00:25:13,795 SO THIS FINALLY HAPPENED. 632 00:25:13,795 --> 00:25:19,234 I DO WANT TO ALSO THANK DR. NIJA 633 00:25:19,234 --> 00:25:20,902 DOWLING THAT IS SITTING OUT 634 00:25:20,902 --> 00:25:22,570 THERE BECAUSE IT IS HER 635 00:25:22,570 --> 00:25:24,539 PERSEVERANCE, WHEN THEY STARTED 636 00:25:24,539 --> 00:25:25,840 TO COMMENT ON THESE DIFFICULTIES 637 00:25:25,840 --> 00:25:27,275 AND REALIZED THIS WAS NOT GOING 638 00:25:27,275 --> 00:25:29,310 TO BE AN EASY LIFT. 639 00:25:29,310 --> 00:25:30,645 BUT HER PERSEVERANCE AND THE 640 00:25:30,645 --> 00:25:33,882 SUPPORT OF ALL OF HER TEAM, 641 00:25:33,882 --> 00:25:40,021 INCLUDING DR. SUSAN WEISS, WHO 642 00:25:40,021 --> 00:25:40,588 MADE THIS POSSIBLE. 643 00:25:40,588 --> 00:25:43,925 WHEN SHE TOLD ME, I WAS BEAMING. 644 00:25:43,925 --> 00:25:50,999 SUMMER 2024 IT'S HAPPENING. 645 00:25:50,999 --> 00:25:53,401 AS A RESULT, WE HOPE TO BE ABLE 646 00:25:53,401 --> 00:25:55,904 TO UPDATE AND DEPOSIT THE DATA 647 00:25:55,904 --> 00:25:57,772 IN A MORE TIMELY FASHION. 648 00:25:57,772 --> 00:25:59,641 DR. DOWLING AND HER TEAM ARE 649 00:25:59,641 --> 00:26:01,009 GOING TO BE GIVING US AN UPDATE 650 00:26:01,009 --> 00:26:02,177 OF WHERE WE ARE. 651 00:26:02,177 --> 00:26:04,112 JUST NOTICE HOW THIS OPEN 652 00:26:04,112 --> 00:26:05,613 PLATFORM HAS ENABLED RESEARCHERS 653 00:26:05,613 --> 00:26:16,090 TO JUMP IN RIGHT AWAY, NOT 654 00:26:16,925 --> 00:26:18,760 WAITING TO LOOK AT THE 655 00:26:18,760 --> 00:26:19,661 COMPLEXITY OF IT. 656 00:26:19,661 --> 00:26:23,731 IT'S NOT THAT ONE LOOKS AT THE 657 00:26:23,731 --> 00:26:24,933 BRAIN AND DETERMINES IF IT'S 658 00:26:24,933 --> 00:26:26,901 ASSOCIATED WITH THIS BEHAVIOR, 659 00:26:26,901 --> 00:26:29,771 IT'S THE ABILITY TO ENTER 660 00:26:29,771 --> 00:26:30,939 SCIENTIFIC DISCUSSION THAT'S ARE 661 00:26:30,939 --> 00:26:31,639 INCREDIBLY COMPLEX. 662 00:26:31,639 --> 00:26:33,408 THAT'S THE WAY THAT CERTAINLY 663 00:26:33,408 --> 00:26:33,875 THE BRAIN WORKS. 664 00:26:33,875 --> 00:26:35,877 IT'S NOT AN ISOLATED AREA OF THE 665 00:26:35,877 --> 00:26:36,211 BRAIN. 666 00:26:36,211 --> 00:26:38,079 IT'S NOT THAT ONE MEASURE IS 667 00:26:38,079 --> 00:26:39,280 ACTUALLY THE ULTIMATE REFLECTION 668 00:26:39,280 --> 00:26:40,682 OF WHAT THE BRAIN DOES. 669 00:26:40,682 --> 00:26:42,617 SO THIS IS WHAT IT HAS DONE. 670 00:26:42,617 --> 00:26:44,786 IT HAS ADVANCED ENORMOUSLY TO 671 00:26:44,786 --> 00:26:46,421 START WITH OUR UNDERSTANDING 672 00:26:46,421 --> 00:26:48,990 ABOUT HOW TO ANALYZE BRAIN 673 00:26:48,990 --> 00:26:56,231 IMAGES AND IT HAS LED TO NEW 674 00:26:56,231 --> 00:26:58,633 MODELS OF ANALYSIS THAT HAVE 675 00:26:58,633 --> 00:26:59,267 INSPIRED ARTIFICIAL INTELLIGENCE 676 00:26:59,267 --> 00:27:01,002 AND DEEP LEARNING MODELS. 677 00:27:01,002 --> 00:27:03,872 IT HAS ADVANCED OUR 678 00:27:03,872 --> 00:27:05,840 UNDERSTANDING ABOUT HOW SOCIAL 679 00:27:05,840 --> 00:27:06,541 ADVERSE ENVIRONMENTS INFLUENCES 680 00:27:06,541 --> 00:27:08,843 THE DEVELOPMENT OF THE BRAIN AND 681 00:27:08,843 --> 00:27:13,648 HOW ULTIMATELY TWO INSULTS IN 682 00:27:13,648 --> 00:27:14,382 THE ENVIRONMENT ARE RESPONSIBLE 683 00:27:14,382 --> 00:27:16,251 FOR AFFECTING THE BRAIN, SUCH AS 684 00:27:16,251 --> 00:27:16,985 THINGS THAT WE NORMALLY DO NOT 685 00:27:16,985 --> 00:27:22,657 THINK. 686 00:27:22,657 --> 00:27:24,158 IT HAS GIVEN THE OPPORTUNITY OF 687 00:27:24,158 --> 00:27:26,895 MANY RESEARCHERS COMING FROM 688 00:27:26,895 --> 00:27:28,029 UNDER REPRESENTED INSTITUTIONS 689 00:27:28,029 --> 00:27:30,365 TO BE ABLE TO HAVE ACCESS TO 690 00:27:30,365 --> 00:27:32,233 DATA THAT OTHERWISE WOULD ONLY 691 00:27:32,233 --> 00:27:33,668 BE AVAILABLE TO THE RICHEST 692 00:27:33,668 --> 00:27:35,303 SCHOOLS THAT HAVE ALL OF THE 693 00:27:35,303 --> 00:27:35,536 GRANTS. 694 00:27:35,536 --> 00:27:36,871 SO IT'S BEEN AN EXTRAORDINARY 695 00:27:36,871 --> 00:27:37,538 SUCCESS. 696 00:27:37,538 --> 00:27:39,073 AND BECAUSE OF THAT SUCCESS AND 697 00:27:39,073 --> 00:27:40,742 THE RECOGNITION THAT LIFE 698 00:27:40,742 --> 00:27:41,876 DOESN'T START WHEN YOU ARE 9 TO 699 00:27:41,876 --> 00:27:48,950 10, LAST YEAR WE STARTED THE 700 00:27:48,950 --> 00:27:50,985 HBCD IN AN UNOFFICIAL WAY. 701 00:27:50,985 --> 00:27:55,156 I THINK THE HBCD IS AIMING TO DO 702 00:27:55,156 --> 00:27:58,760 WHAT THE ABCD DID, EXCEPT OF 703 00:27:58,760 --> 00:28:00,428 COURSE LEARNING FROM THE LESSONS 704 00:28:00,428 --> 00:28:02,196 OF HOW TO DO THINGS BETTER. 705 00:28:02,196 --> 00:28:04,432 ONCE YOU'VE GONE THROUGH THAT, 706 00:28:04,432 --> 00:28:05,667 YOU DON'T REPEAT THE SAME 707 00:28:05,667 --> 00:28:07,402 MISTAKES, AND STARTING IN 708 00:28:07,402 --> 00:28:08,603 INFANCY, WITH THE IDEA ALSO OF 709 00:28:08,603 --> 00:28:10,672 FOLLOWING THIS COHORT FOR AT 710 00:28:10,672 --> 00:28:12,040 LEAST TEN YEARS. 711 00:28:12,040 --> 00:28:14,709 THE ISSUE THAT HAS BECOME MORE 712 00:28:14,709 --> 00:28:17,679 CHALLENGING FOR THE HBCD IS THE 713 00:28:17,679 --> 00:28:19,948 FACT THAT WE ARE ACTUALLY ONE TO 714 00:28:19,948 --> 00:28:21,883 RECRUIT AT LEAST 15% OF THE 715 00:28:21,883 --> 00:28:23,418 SAMPLE OF WOMEN THAT, WHEN THEY 716 00:28:23,418 --> 00:28:25,987 ARE PREGNANT, ARE GETTING 717 00:28:25,987 --> 00:28:33,461 EXPOSED TO OPIOIDS. 718 00:28:33,461 --> 00:28:34,996 THIS IS CRUCIAL. 719 00:28:34,996 --> 00:28:37,498 WE ARE ACTUALLY USING FUNDS THAT 720 00:28:37,498 --> 00:28:39,968 ARE ALLOCATED FOR HEAL BECAUSE 721 00:28:39,968 --> 00:28:41,736 WHAT WE ARE OBSERVING IS THAT 722 00:28:41,736 --> 00:28:43,304 ONE OF THE GROUPS THAT IS VERY 723 00:28:43,304 --> 00:28:44,739 NEGATIVELY AFFECTED DURING THE 724 00:28:44,739 --> 00:28:46,908 OVERDOSE CRISIS ARE PREGNANT 725 00:28:46,908 --> 00:28:48,476 WOMEN THAT HAVE AN OPIOID USE 726 00:28:48,476 --> 00:28:49,110 DISORDER. 727 00:28:49,110 --> 00:28:51,279 THEY'RE PROBABLY THE MOST 728 00:28:51,279 --> 00:28:52,013 STIGMATIZED OF THEM ALL. 729 00:28:52,013 --> 00:28:55,016 WE HAVE SEEN AN INCREASE IN THE 730 00:28:55,016 --> 00:28:57,151 MORTALITY OF THREEFOLD NOT JUST 731 00:28:57,151 --> 00:28:59,053 DURING PREGNANCY BUT ALSO 732 00:28:59,053 --> 00:29:00,555 TOWARDS THE END OF THEIR ONE 733 00:29:00,555 --> 00:29:01,889 YEAR FOLLOWING DELIVERY. 734 00:29:01,889 --> 00:29:05,526 AND PART OF IT REFLECTS MULTIPLE 735 00:29:05,526 --> 00:29:09,697 FACTORS THAT INCLUDE SOME OF THE 736 00:29:09,697 --> 00:29:11,232 VERY COMMUNITY PRACTICES THAT 737 00:29:11,232 --> 00:29:12,967 EXIST IN THE STATES FOR WOMEN 738 00:29:12,967 --> 00:29:16,504 THAT ARE PREGNANT AND ARE TAKING 739 00:29:16,504 --> 00:29:16,704 DRUGS. 740 00:29:16,704 --> 00:29:18,740 THAT CAN LAND THEM EITHER IN 741 00:29:18,740 --> 00:29:20,108 JAIL OR CAN LEAD THE CHILD 742 00:29:20,108 --> 00:29:21,876 WELFARE SYSTEM TO TAKE OVER 743 00:29:21,876 --> 00:29:22,477 THEIR CHILDREN. 744 00:29:22,477 --> 00:29:24,012 SO THEY DON'T SEEK TREATMENT. 745 00:29:24,012 --> 00:29:26,414 WHEN THEY SEEK TREATMENT, THE 746 00:29:26,414 --> 00:29:29,884 MAJORITY OF THE STATES IN THE 747 00:29:29,884 --> 00:29:35,356 UNITED STATES, THE DOCTOR HAS TO 748 00:29:35,356 --> 00:29:36,090 REPORT IT. 749 00:29:36,090 --> 00:29:38,793 WE'RE LOOKING AT THIS CONCEPT IN 750 00:29:38,793 --> 00:29:42,797 A VERY DIFFERENT CONTEXT WHERE 751 00:29:42,797 --> 00:29:44,699 WE SAY, IF I WERE A PREGNANT 752 00:29:44,699 --> 00:29:47,035 WOMAN THAT IS ADDICTED, I WOULD 753 00:29:47,035 --> 00:29:48,403 NOT GO TO TREATMENT BECAUSE I'M 754 00:29:48,403 --> 00:29:49,704 GOING TO BE PUT IN JAIL OR 755 00:29:49,704 --> 00:29:50,772 BASICALLY REPORTED. 756 00:29:50,772 --> 00:29:53,107 SO HOW DO WE GENERATE DATA THAT 757 00:29:53,107 --> 00:29:55,410 CAN INFORM OUR PRACTICES AND 758 00:29:55,410 --> 00:29:57,011 POLICIES THAT MAKE SENSE, THAT 759 00:29:57,011 --> 00:29:59,280 DON'T ACTUALLY ULTIMATELY MAKE 760 00:29:59,280 --> 00:30:01,816 THE OVERDOSE CRISIS WORSE? 761 00:30:01,816 --> 00:30:04,118 THE HBCD IS PREDICATED ON 762 00:30:04,118 --> 00:30:05,887 HELPING US UNDERSTAND THAT, 763 00:30:05,887 --> 00:30:07,688 HELPING US UNDERSTAND EXACTLY 764 00:30:07,688 --> 00:30:09,123 THE SAME QUESTIONS THAT WE'RE 765 00:30:09,123 --> 00:30:11,926 DOING, ASKING RIGHT NOW IN 766 00:30:11,926 --> 00:30:14,562 ADOLESCENCE, HOW ADVERSE 767 00:30:14,562 --> 00:30:15,630 CHILDHOOD EXPERIENCES AFFECT THE 768 00:30:15,630 --> 00:30:17,632 HUMAN BRAIN, WHAT ARE PRACTICES 769 00:30:17,632 --> 00:30:21,469 THAT WE KNOW RESULT IN 770 00:30:21,469 --> 00:30:22,737 RESILIENCE AND HOW DO WE LEARN 771 00:30:22,737 --> 00:30:23,204 FROM THEM? 772 00:30:23,204 --> 00:30:25,273 AND ULTIMATELY, HOW DO GENES 773 00:30:25,273 --> 00:30:28,076 INTERACT WITH ALL OF THESE 774 00:30:28,076 --> 00:30:28,342 PHENOMENA? 775 00:30:28,342 --> 00:30:29,911 ACTUALLY, I WANT TO THANK DR. 776 00:30:29,911 --> 00:30:32,146 COLE, WHO HAS BEEN THE ACTING 777 00:30:32,146 --> 00:30:35,049 DIRECTOR FOR THE HBCD ONCE 778 00:30:35,049 --> 00:30:38,986 MICHELLE FREUND LEFT FOR 779 00:30:38,986 --> 00:30:40,721 ACTUALLY TRANSITION INTO ANOTHER 780 00:30:40,721 --> 00:30:43,558 POSITION AT THE CHILD MIND 781 00:30:43,558 --> 00:30:50,832 INSTITUTE IN NEW YORK CITY. 782 00:30:50,832 --> 00:30:52,233 THIS IS THE TIME WHEN I GIVE YOU 783 00:30:52,233 --> 00:30:53,067 THE UPDATE. 784 00:30:53,067 --> 00:30:54,068 THIS IS THE REPORT OF THE 785 00:30:54,068 --> 00:30:56,170 OVERDOSE CRISIS. 786 00:30:56,170 --> 00:30:57,205 THIS IS SOMETHING THAT WE CANNOT 787 00:30:57,205 --> 00:30:58,172 TAKE OUR EYES OFF. 788 00:30:58,172 --> 00:31:00,541 THIS IS THE LATEST DATA. 789 00:31:00,541 --> 00:31:08,015 I GET IT FROM EMILE YA EVERY 790 00:31:08,015 --> 00:31:11,219 MONTH, AND IT REFLECTS THE 12 791 00:31:11,219 --> 00:31:13,454 MONTHS THAT END ON 2023. 792 00:31:13,454 --> 00:31:15,490 IT IS THE FIRST TIME -- YOU HEAR 793 00:31:15,490 --> 00:31:16,824 ME PRESENT THREE TIMES A YEAR 794 00:31:16,824 --> 00:31:19,193 THIS TABLE -- THE FIRST TIME 795 00:31:19,193 --> 00:31:21,729 I'VE PRESENTED WITH GREEN 796 00:31:21,729 --> 00:31:23,764 NUMBERS WITH THOSE MORTALITY 797 00:31:23,764 --> 00:31:25,833 DEATHS COMPARING THESE LAST 12 798 00:31:25,833 --> 00:31:28,736 MONTHS ENDING IN 11/2023, 799 00:31:28,736 --> 00:31:30,805 COMPARED TO THE LAST 12 MONTHS 800 00:31:30,805 --> 00:31:31,973 ENDING IN 11/2022. 801 00:31:31,973 --> 00:31:32,907 IT WENT DOWN. 802 00:31:32,907 --> 00:31:34,675 IT'S THE FIRST TIME IT WENT 803 00:31:34,675 --> 00:31:34,876 DOWN. 804 00:31:34,876 --> 00:31:39,747 IT'S NOT A GREAT DOWN, JUST 805 00:31:39,747 --> 00:31:42,683 0.49%, BUT BETTER THAN HAVING A 806 00:31:42,683 --> 00:31:43,384 RED NUMBER. 807 00:31:43,384 --> 00:31:45,086 IT'S INTERESTING. 808 00:31:45,086 --> 00:31:46,587 LAST NIGHT WHEN I WAS SORT OF 809 00:31:46,587 --> 00:31:50,224 THINKING, HOW CAN I NOT REJOICE? 810 00:31:50,224 --> 00:31:51,659 IT'S A TINY LITTLE NUMBER, BUT 811 00:31:51,659 --> 00:31:54,595 EVERY TIME I SEE A RED, A RED, A 812 00:31:54,595 --> 00:31:57,899 RED, AND WE'RE DOING ALL THESE 813 00:31:57,899 --> 00:31:58,199 ACTIVITIES. 814 00:31:58,199 --> 00:32:01,102 FIRST OF ALL, THERE'S ENORMOUS 815 00:32:01,102 --> 00:32:01,435 VARIATION. 816 00:32:01,435 --> 00:32:04,839 I DON'T WANT TO SAY THIS IS 817 00:32:04,839 --> 00:32:05,606 FACTUAL. 818 00:32:05,606 --> 00:32:12,013 WE'RE GOING TO SEE NEXT MONTH. 819 00:32:12,013 --> 00:32:15,049 WE WANT TO SEE IF THAT 820 00:32:15,049 --> 00:32:15,349 MAINTAINS. 821 00:32:15,349 --> 00:32:18,819 I CAN SAY DRAMATICALLY GOING 822 00:32:18,819 --> 00:32:21,189 DOWN IS OVERDOSE DEATHS FROM 823 00:32:21,189 --> 00:32:22,056 HEROIN. 824 00:32:22,056 --> 00:32:26,093 AND OVERDOSE DEATHS FROM OPIOIDS 825 00:32:26,093 --> 00:32:27,428 AND SYNTHETICS. 826 00:32:27,428 --> 00:32:28,796 THIS DOES REFLECT A CHANGE 827 00:32:28,796 --> 00:32:30,198 TOWARDS POLICIES AND PRACTICES. 828 00:32:30,198 --> 00:32:32,166 I WOULD SAY MORE PRACTICES AND 829 00:32:32,166 --> 00:32:34,368 GUIDELINES TO ACTUALLY BE MORE 830 00:32:34,368 --> 00:32:37,038 CAUTIOUS OF THE WAY THAT 831 00:32:37,038 --> 00:32:39,207 CLINICIANS ARE PRESCRIBING 832 00:32:39,207 --> 00:32:40,808 OPIOIDS FOR THE MACKMENT OF 833 00:32:40,808 --> 00:32:41,175 PAIN. 834 00:32:41,175 --> 00:32:43,344 IT'S NOT THAT THE PROBLEM IS 835 00:32:43,344 --> 00:32:43,678 SOLVED. 836 00:32:43,678 --> 00:32:45,513 THERE'S STILL OVER PRESCRIPTION 837 00:32:45,513 --> 00:32:46,447 OF OPIOID MEDICATIONS WHEN IT'S 838 00:32:46,447 --> 00:32:49,951 NOT NECESSARY, BUT I DO BELIEVE 839 00:32:49,951 --> 00:32:51,686 WE ARE TURNING INTO THE RIGHT 840 00:32:51,686 --> 00:32:51,986 DIRECTION. 841 00:32:51,986 --> 00:32:54,622 THEN YOU SEE A REDUCTION IN 842 00:32:54,622 --> 00:32:56,591 OVERDOSE MORTALITY FOR 843 00:32:56,591 --> 00:32:58,492 METHADONE, WHICH HAS MAINTAINED 844 00:32:58,492 --> 00:33:02,196 ITSELF VERY, VERY LOW, IT HASN'T 845 00:33:02,196 --> 00:33:05,633 CHANGED DESPITE IN THE PAST 846 00:33:05,633 --> 00:33:07,134 METHADONE HAS BEEN EXPANDED, 847 00:33:07,134 --> 00:33:09,637 WHICH LED TO THE FEAR THAT MAYBE 848 00:33:09,637 --> 00:33:11,105 THAT WOULD RESULT IN DIVERSION 849 00:33:11,105 --> 00:33:12,840 AND OVERDOSE, BUT NO, THAT 850 00:33:12,840 --> 00:33:13,774 DIDN'T HAPPEN. 851 00:33:13,774 --> 00:33:14,909 THEN WE HAVE THE RED NUMBERS TO 852 00:33:14,909 --> 00:33:16,611 THE RIGHT, AND THOSE ACTUALLY WE 853 00:33:16,611 --> 00:33:17,878 HAVE TO KEEP OUR EYES VERY 854 00:33:17,878 --> 00:33:19,714 CLOSELY INTO IT. 855 00:33:19,714 --> 00:33:24,585 SYNTHETIC OPIOIDS, PRIMARILY 856 00:33:24,585 --> 00:33:26,287 FENTANYL, IS CONTINUING TO GO 857 00:33:26,287 --> 00:33:26,554 UP. 858 00:33:26,554 --> 00:33:28,889 THE LARGER NUMBERS, IN TERMS OF 859 00:33:28,889 --> 00:33:32,627 OVERDOSE MORTALITY, ARE SEEN 860 00:33:32,627 --> 00:33:36,430 WITH COCAINE AND OTHER 861 00:33:36,430 --> 00:33:37,898 PSYCHO-STIMULANTS, WHICH MEANS 862 00:33:37,898 --> 00:33:40,735 METHAMPHETAMINE. 863 00:33:40,735 --> 00:33:44,405 BUT BY FAR THE DEATHS ARE 864 00:33:44,405 --> 00:33:44,672 FENTANYL. 865 00:33:44,672 --> 00:33:47,074 BUT COCAINE AND METHAMPHETAMINE, 866 00:33:47,074 --> 00:33:50,278 THE MAJORITY ALSO CONTAINS 867 00:33:50,278 --> 00:33:51,412 FENTANYL. 868 00:33:51,412 --> 00:33:54,015 IN REALITY, THOSE TO THE RIGHT 869 00:33:54,015 --> 00:33:55,549 PROJECT DRUG COMBINATIONS OF 870 00:33:55,549 --> 00:33:56,617 FENTANYL WITH STIMULANT DRUGS. 871 00:33:56,617 --> 00:33:58,119 THIS IS SOMETHING WE'VE BEEN 872 00:33:58,119 --> 00:33:59,120 SEEING NOW FOR SEVERAL YEARS, I 873 00:33:59,120 --> 00:34:05,893 WOULD SAY, THAT INCREASING LY 874 00:34:05,893 --> 00:34:08,129 THAT WAS INITIALLY PAIN 875 00:34:08,129 --> 00:34:08,863 MEDICATIONS TO HEROIN OVERDOSES 876 00:34:08,863 --> 00:34:10,298 TO FENTANYL AT THE BEGINNING 877 00:34:10,298 --> 00:34:13,801 INTO THE PERIOD OF 878 00:34:13,801 --> 00:34:14,168 POLYSUBSTANCES. 879 00:34:14,168 --> 00:34:15,703 THAT'S WHAT'S KILLING PEOPLE. 880 00:34:15,703 --> 00:34:17,605 THIS MAKES IT VERY CHALLENGING. 881 00:34:17,605 --> 00:34:19,740 I'M PRESENTING POLY SUBSTANCES 882 00:34:19,740 --> 00:34:20,875 FOR WHICH WE HAVE THE REPORT 883 00:34:20,875 --> 00:34:22,643 HERE, BUT WE KNOW THAT 15% OF 884 00:34:22,643 --> 00:34:27,648 THE OVERDOSES ARE IN FENTANYL, 885 00:34:27,648 --> 00:34:29,850 ARE ASSOCIATED WITH ALCOHOL. 886 00:34:29,850 --> 00:34:33,287 15% MORE OR LESS ALSO ASSOCIATED 887 00:34:33,287 --> 00:34:39,327 WITH BENZODIAZEPINES, AND 888 00:34:39,327 --> 00:34:39,560 OTHERS. 889 00:34:39,560 --> 00:34:42,196 SO IT IS POLY SUBSTANCE THAT NOW 890 00:34:42,196 --> 00:34:44,432 IS THE MAIN PRESENCE OVERALL IN 891 00:34:44,432 --> 00:34:47,935 THE PEOPLE THAT ARE ALSO TAKING 892 00:34:47,935 --> 00:34:55,509 DRUGS. 893 00:34:55,509 --> 00:34:56,977 NOW, IN THESE NUMBERS, AND WE 894 00:34:56,977 --> 00:34:59,013 KNOW THE MAIN FOCUS FOR THIS 895 00:34:59,013 --> 00:35:00,548 ADMINISTRATION WITH REGARD TO 896 00:35:00,548 --> 00:35:03,818 THE OVERDOSE CRISIS REMAINS ON 897 00:35:03,818 --> 00:35:04,952 IMPROVED PRESCRIPTION PRACTICES 898 00:35:04,952 --> 00:35:05,720 FOR PAIN. 899 00:35:05,720 --> 00:35:06,921 THAT'S ONE. 900 00:35:06,921 --> 00:35:08,989 NOW, THE MAIN DRIVER OF OVERDOSE 901 00:35:08,989 --> 00:35:10,758 DEATHS IS NOT PAIN. 902 00:35:10,758 --> 00:35:12,326 THE MAIN DRIVER OF THE OVERDOSES 903 00:35:12,326 --> 00:35:14,228 ARE BASICALLY PEOPLE TAKING 904 00:35:14,228 --> 00:35:16,530 SUBSTANCES, MISUSING SUBSTANCES. 905 00:35:16,530 --> 00:35:18,632 INITIALLY WHERE IT WAS SIMPLER 906 00:35:18,632 --> 00:35:21,469 BECAUSE PEOPLE THAT WERE HEROIN 907 00:35:21,469 --> 00:35:22,970 USERS OR WITH AN OPIOID USE 908 00:35:22,970 --> 00:35:24,171 DISORDER, THEN THERE THE 909 00:35:24,171 --> 00:35:25,272 STRATEGY IS GET THEM INTO 910 00:35:25,272 --> 00:35:27,408 TREATMENT WITH MEDICATIONS FOR 911 00:35:27,408 --> 00:35:28,642 OPIOID USE DISORDER BECAUSE THAT 912 00:35:28,642 --> 00:35:31,011 WILL PROTECT THEM FROM DYING. 913 00:35:31,011 --> 00:35:35,449 IT STILL HAS THE MOST 914 00:35:35,449 --> 00:35:36,417 CONSEQUENTIAL INTERVENTION WE 915 00:35:36,417 --> 00:35:38,953 CAN DO TO EXPAND TREATMENT FOR 916 00:35:38,953 --> 00:35:40,454 MEDICATIONS FOR OPIOID USE 917 00:35:40,454 --> 00:35:40,855 DISORDER. 918 00:35:40,855 --> 00:35:42,590 HOW SUCCESSFUL HAVE WE BEEN IN 919 00:35:42,590 --> 00:35:43,657 THAT? 920 00:35:43,657 --> 00:35:44,525 UNFORTUNATELY, NOT AS SUCCESSFUL 921 00:35:44,525 --> 00:35:45,659 AS WE WOULD WANT. 922 00:35:45,659 --> 00:35:47,495 THIS IS A PAPER THAT WAS PUBD 923 00:35:47,495 --> 00:35:49,964 RECENTLY, EVEN THOUGH THE DATA 924 00:35:49,964 --> 00:35:54,435 IS FROM 2021. 925 00:35:54,435 --> 00:35:55,970 IT IS SURVEYING THE NUMBER OF 926 00:35:55,970 --> 00:35:57,505 PEOPLE THAT HAVE AN OPIOID USE 927 00:35:57,505 --> 00:35:59,306 DISORDER, AND BASED ON THE 928 00:35:59,306 --> 00:36:00,474 ESTIMATED 2.5 MILLION PEOPLE, 929 00:36:00,474 --> 00:36:02,576 WHICH I ACTUALLY DON'T EVEN KNOW 930 00:36:02,576 --> 00:36:04,779 THE LEVEL OF ACCURACY OF THESE 931 00:36:04,779 --> 00:36:05,012 NUMBERS. 932 00:36:05,012 --> 00:36:05,913 ONE OF THE THINGS THAT ALWAYS 933 00:36:05,913 --> 00:36:07,915 HURTS MY BRAIN IN TRYING TO SAY 934 00:36:07,915 --> 00:36:09,383 WHAT REALLY IS THE NUMBER OF 935 00:36:09,383 --> 00:36:11,318 PEOPLE WITH AN OPIOID USE 936 00:36:11,318 --> 00:36:13,454 DISORDER IN OUR COUNTRY? 937 00:36:13,454 --> 00:36:15,256 LET'S BE CONSERVATIVE AND SAY 938 00:36:15,256 --> 00:36:18,325 IT'S 2.5 MILLION PEOPLE, OF 939 00:36:18,325 --> 00:36:21,929 WHICH 36% RECEIVED ANY 940 00:36:21,929 --> 00:36:22,263 TREATMENT. 941 00:36:22,263 --> 00:36:23,631 THAT DOESN'T MEAN QUALITY 942 00:36:23,631 --> 00:36:25,499 TREATMENT, ANY TREATMENT 943 00:36:25,499 --> 00:36:25,800 WHATSOEVER. 944 00:36:25,800 --> 00:36:31,005 AND MEDICINE-BASE D TREATMENT I 945 00:36:31,005 --> 00:36:38,946 ONLY 22%. 946 00:36:38,946 --> 00:36:41,081 I ASKED EMILY, AND I SAID TRY TO 947 00:36:41,081 --> 00:36:44,218 GET ME THE DATA ON PRESCRIPTIONS 948 00:36:44,218 --> 00:36:46,854 TO TRY TO GET A SENSE OF WHERE 949 00:36:46,854 --> 00:36:54,829 WE ARE WITH EXPANDING USE OF 950 00:36:54,829 --> 00:36:55,963 BUPRENORPHINE, AND YOU SEE WE 951 00:36:55,963 --> 00:37:01,335 HAVE IQVIA FROM 2017 TO 2020 WE 952 00:37:01,335 --> 00:37:04,872 HAVE A STIFFER INCREASE, AND 953 00:37:04,872 --> 00:37:06,807 THEN IT'S A LITTLE FLAT. 954 00:37:06,807 --> 00:37:09,577 THIS IS THROUGH RETAIL, SO IT 955 00:37:09,577 --> 00:37:11,378 MAY NOT NECESSARILY REPRESENT 956 00:37:11,378 --> 00:37:12,847 BUPRENORPHINE ALL OVER, BUT I DO 957 00:37:12,847 --> 00:37:14,381 THINK IT'S A GOOD REFLECTION. 958 00:37:14,381 --> 00:37:16,717 AND I DO BELIEVE WE NEED TO KEEP 959 00:37:16,717 --> 00:37:19,453 OUR EYES ON THAT ONE BECAUSE 960 00:37:19,453 --> 00:37:21,522 BUPRENORPHINE IS BY FAR THE 961 00:37:21,522 --> 00:37:24,592 MEDICATION THAT'S MOST WIDELY 962 00:37:24,592 --> 00:37:24,992 UTILIZED. 963 00:37:24,992 --> 00:37:28,329 HERE WE HAVE 800,000 PEOPLE. 964 00:37:28,329 --> 00:37:30,698 THIS IS THE TOTAL PATIENT 965 00:37:30,698 --> 00:37:31,031 TRACKER. 966 00:37:31,031 --> 00:37:34,301 SO 800,000 PEOPLE, CLOSE TO 967 00:37:34,301 --> 00:37:36,337 900,000 THAT ARE RECEIVING 968 00:37:36,337 --> 00:37:36,770 BUPRENORPHINE. 969 00:37:36,770 --> 00:37:39,640 THAT'S WHY I SAY WHAT IS 970 00:37:39,640 --> 00:37:41,442 REALLY -- AGAIN, WHEN I SEE 971 00:37:41,442 --> 00:37:43,410 NUMBERS LIKE THIS ONE, IT HURTS 972 00:37:43,410 --> 00:37:45,346 MY BRAIN BECAUSE I SAY, I JUST 973 00:37:45,346 --> 00:37:50,784 SAY THAT ONLY 22% RECEIVE 974 00:37:50,784 --> 00:37:55,823 MEDICATIONS, AND THEY ARE 2.2. 975 00:37:55,823 --> 00:37:57,892 THIS REPRESENTS THE 976 00:37:57,892 --> 00:37:58,826 UNCERTAINTIES IN TERMS OF THE 977 00:37:58,826 --> 00:38:00,127 NUMBERS OF WHAT WE HAVE. 978 00:38:00,127 --> 00:38:02,296 BE THAT AS IT MAY, I DO BELIEVE 979 00:38:02,296 --> 00:38:03,764 THAT THAT PLATEAUING THAT WE 980 00:38:03,764 --> 00:38:05,900 HAVE SEEN OVER THE PAST THREE 981 00:38:05,900 --> 00:38:06,500 YEARS, TO ME IS CERTAINLY 982 00:38:06,500 --> 00:38:08,602 CONCERNING. 983 00:38:08,602 --> 00:38:10,571 WE NEED TO UNDERSTAND WHY IS IT 984 00:38:10,571 --> 00:38:12,239 THAT WE HAVE NOT BEEN ABLE TO 985 00:38:12,239 --> 00:38:13,874 INCREASE IT FURTHER. 986 00:38:13,874 --> 00:38:18,746 ALSO CONSIDERING THE FACT THAT 987 00:38:18,746 --> 00:38:20,281 BASICALLY THE WAIVER WAS 988 00:38:20,281 --> 00:38:21,515 REMOVED, AND THIS WAS DONE IN AN 989 00:38:21,515 --> 00:38:24,084 ATTEMPT TO ACTUALLY INCREASE THE 990 00:38:24,084 --> 00:38:27,555 NUMBER OF POSITIONS THAT WOULD 991 00:38:27,555 --> 00:38:28,422 BE PRESCRIBING BUPRENORPHINE. 992 00:38:28,422 --> 00:38:31,058 THESE NUMBERS, IF I AM 993 00:38:31,058 --> 00:38:33,227 OBJECTIVE, DO NOT SEEM TO 994 00:38:33,227 --> 00:38:35,162 SUPPORT IN MY BRAIN THESE WILL 995 00:38:35,162 --> 00:38:35,796 BE CHANGED. 996 00:38:35,796 --> 00:38:36,830 I THINK THAT WE NEED TO 997 00:38:36,830 --> 00:38:41,802 UNDERSTAND WHY IT DIDN'T. 998 00:38:41,802 --> 00:38:42,770 THE OTHER IMPORTANT, CRUCIAL 999 00:38:42,770 --> 00:38:45,873 INTERVENTION IS THE ONE OF 1000 00:38:45,873 --> 00:38:49,643 EXPANDING INTERVENTION WITH 1001 00:38:49,643 --> 00:38:52,012 NALOXONE AND DOING IT TO ENSURE 1002 00:38:52,012 --> 00:38:53,080 THAT NALOXONE IS NOT JUST 1003 00:38:53,080 --> 00:38:55,049 DISTRIBUTED NO MATTER WHAT, BUT 1004 00:38:55,049 --> 00:38:57,351 WE ENSURE PEOPLE AT HIGHER RISK 1005 00:38:57,351 --> 00:38:59,587 HAVE ACCESS TO NALOXONE AT THE 1006 00:38:59,587 --> 00:39:00,354 CORRECT DOSES. 1007 00:39:00,354 --> 00:39:02,389 THESE, THE CURVES LOOK NICER TO 1008 00:39:02,389 --> 00:39:02,923 MY BRAIN. 1009 00:39:02,923 --> 00:39:04,725 I WAS HAPPIER WITH THESE CURVES. 1010 00:39:04,725 --> 00:39:06,527 IT DOES SEEM TO BE INCREASING. 1011 00:39:06,527 --> 00:39:08,295 THAT'S THE RED ONE, WHICH IS THE 1012 00:39:08,295 --> 00:39:10,798 MONTHLY DATA, AND YOU CAN 1013 00:39:10,798 --> 00:39:13,334 AVERAGE IT IN THE ORANGE ROLLING 1014 00:39:13,334 --> 00:39:14,401 THREE MONTHS AVERAGE. 1015 00:39:14,401 --> 00:39:16,770 YOU CAN SEE THERE IS AN INCREASE 1016 00:39:16,770 --> 00:39:20,741 IN THE AVERAGE FOR DISPENSING OF 1017 00:39:20,741 --> 00:39:24,912 NALOX 1018 00:39:24,912 --> 00:39:26,313 NALOXONE, AND THIS IS 1019 00:39:26,313 --> 00:39:27,448 PREDOMINANTLY FROM PHARMACIES. 1020 00:39:27,448 --> 00:39:30,451 THE PURPLE ONE, WHICH IS NOT 1021 00:39:30,451 --> 00:39:32,586 INCREASING AS MUCH, IS 1022 00:39:32,586 --> 00:39:32,920 NON-PHARMACY. 1023 00:39:32,920 --> 00:39:34,521 BUT IT IS OVERALL GOING IN THE 1024 00:39:34,521 --> 00:39:35,389 RIGHT DIRECTION. 1025 00:39:35,389 --> 00:39:38,225 I THINK THAT THE SUCCESS IN THE 1026 00:39:38,225 --> 00:39:40,961 DISTRIBUTION OF NALOXONE MAY BE 1027 00:39:40,961 --> 00:39:42,129 ACCOUNTING IN PART FOR WHY WE'RE 1028 00:39:42,129 --> 00:39:43,364 SEEING, AT LEAST IN CERTAIN 1029 00:39:43,364 --> 00:39:45,265 GROUPS, A REDUCTION IN THE 1030 00:39:45,265 --> 00:39:47,401 OVERDOSE MORTALITY. 1031 00:39:47,401 --> 00:39:49,169 IT'S ALSO AND PERHAPS -- AND 1032 00:39:49,169 --> 00:39:51,271 THIS THOUGHT JUST JUMPED INTO MY 1033 00:39:51,271 --> 00:39:53,641 BRAIN, AND YOU HEARD ME DISCUSS 1034 00:39:53,641 --> 00:39:59,246 IT, ONE OF THE REASONS WHY EVEN 1035 00:39:59,246 --> 00:40:00,748 THOUGH WE HAVE SEEN THE 1036 00:40:00,748 --> 00:40:01,582 INCREASES IN NALOXONE THAT MAY 1037 00:40:01,582 --> 00:40:03,417 BE REDUCING PERHAPS THE 1038 00:40:03,417 --> 00:40:05,252 OVERDOSES, BUT WE'RE NOT SEEING 1039 00:40:05,252 --> 00:40:05,886 INCREASES IN BUPRENORPHINE 1040 00:40:05,886 --> 00:40:07,388 BECAUSE WE'RE SEEING PEOPLE THAT 1041 00:40:07,388 --> 00:40:09,757 DON'T HAVE AN OPIOID USE 1042 00:40:09,757 --> 00:40:11,225 DISORDER DYING FROM AN OVERDOSE. 1043 00:40:11,225 --> 00:40:12,226 WHO ARE THOSE PEOPLE? 1044 00:40:12,226 --> 00:40:14,528 PEOPLE THAT ARE COCAINE USERS. 1045 00:40:14,528 --> 00:40:16,730 PEOPLE THAT ARE METHAMPHETAMINE 1046 00:40:16,730 --> 00:40:18,032 USERS. 1047 00:40:18,032 --> 00:40:19,566 OCCASIONAL USERS THAT GET A PILL 1048 00:40:19,566 --> 00:40:23,404 ON THE INTERNET AND IT CONTAINS 1049 00:40:23,404 --> 00:40:24,338 FENTANYL, AND THEY ARE DYING. 1050 00:40:24,338 --> 00:40:25,873 THESE PEOPLE, BUPRENORPHINE WILL 1051 00:40:25,873 --> 00:40:26,740 NOT HELP. 1052 00:40:26,740 --> 00:40:27,441 ON THE OTHER HAND, NALOXONE WILL 1053 00:40:27,441 --> 00:40:29,243 SAVE THEIR LIVES. 1054 00:40:29,243 --> 00:40:31,145 THIS IS ACTUALLY AN ASPECT THAT 1055 00:40:31,145 --> 00:40:32,246 CAN HELP US UNDERSTAND SOME OF 1056 00:40:32,246 --> 00:40:34,114 THESE DYNAMICS. 1057 00:40:34,114 --> 00:40:36,684 NOW, WHAT ARE SOME OF THE 1058 00:40:36,684 --> 00:40:37,351 INTERVENTION THAT'S HAVE BEEN 1059 00:40:37,351 --> 00:40:43,957 DONE FROM RESEARCHERS AT NIDA IN 1060 00:40:43,957 --> 00:40:45,993 ORDER TO ENHANCE ACCESS TO 1061 00:40:45,993 --> 00:40:48,562 MEDICATIONS FOR THOSE WITH 1062 00:40:48,562 --> 00:40:50,698 OPIOID USE DISORDERS AND EXPAND 1063 00:40:50,698 --> 00:40:52,666 ACCESS TO THOSE IN OPIOID USE 1064 00:40:52,666 --> 00:40:53,834 DISORDER TREATMENT AND EXPAND 1065 00:40:53,834 --> 00:40:54,768 USE OF NALOXONE. 1066 00:40:54,768 --> 00:40:56,503 WELL, YOU HEARD ME PRESENT. 1067 00:40:56,503 --> 00:40:58,105 TAKE ADVANTAGE OF THE HEALTHCARE 1068 00:40:58,105 --> 00:40:58,539 SYSTEM. 1069 00:40:58,539 --> 00:41:00,441 LET'S PERMEATE IT. 1070 00:41:00,441 --> 00:41:01,308 SECOND, LET'S TAKE ADVANTAGE OF 1071 00:41:01,308 --> 00:41:02,509 THE JUSTICE SETTINGS. 1072 00:41:02,509 --> 00:41:03,410 LET'S PERMEATE IT. 1073 00:41:03,410 --> 00:41:03,911 AND LET'S GET INTO THE 1074 00:41:03,911 --> 00:41:08,482 COMMUNITIES. 1075 00:41:08,482 --> 00:41:09,283 LET'S LEARN FROM WHAT THE 1076 00:41:09,283 --> 00:41:10,751 COMMUNITY ARE DOING. 1077 00:41:10,751 --> 00:41:13,821 WE HAVE BEEN VERY LUCKY TO HAVE 1078 00:41:13,821 --> 00:41:16,423 THE CLINICAL TRIAL NETWORK ABLY 1079 00:41:16,423 --> 00:41:20,894 LED BY DR. BETTY TYE, WHO 1080 00:41:20,894 --> 00:41:22,796 THROUGH THE CLINICAL TRIAL 1081 00:41:22,796 --> 00:41:24,498 NETWORK, THE INVESTIGATORS HAVE 1082 00:41:24,498 --> 00:41:26,800 BEEN ABLE TO FORM STRONG 1083 00:41:26,800 --> 00:41:27,534 COLLABORATIONS WITH HEALTHCARE 1084 00:41:27,534 --> 00:41:27,768 SYSTEMS. 1085 00:41:27,768 --> 00:41:29,937 WHETHER IT'S SPECIALIZING IN 1086 00:41:29,937 --> 00:41:31,939 TREATMENT LIKE THE EMERGENCY 1087 00:41:31,939 --> 00:41:33,574 DEPARTMENT OR PRIMARY CARE 1088 00:41:33,574 --> 00:41:35,409 PHYSICIANS TO ENGAGE THEM INTO 1089 00:41:35,409 --> 00:41:36,410 MODELS OF CARE THAT SHOW THAT 1090 00:41:36,410 --> 00:41:37,845 THE PROPER SCREENING AND 1091 00:41:37,845 --> 00:41:39,346 TREATMENT OF INDIVIDUALS WITH 1092 00:41:39,346 --> 00:41:41,548 OPIOID USE DISORDER CAN BE DONE 1093 00:41:41,548 --> 00:41:44,251 IN THESE SETTINGS. 1094 00:41:44,251 --> 00:41:46,720 THIS HAS QUITE DRAMATICALLY 1095 00:41:46,720 --> 00:41:47,688 CHANGED THE PRACTICE. 1096 00:41:47,688 --> 00:41:49,490 HAS IT CHANGED IT AT THE LEVEL 1097 00:41:49,490 --> 00:41:50,457 THAT I WANT? 1098 00:41:50,457 --> 00:41:50,791 NO. 1099 00:41:50,791 --> 00:41:53,160 BUT IT HAS BEEN VERY, VERY 1100 00:41:53,160 --> 00:41:53,527 CONSEQUENTIAL. 1101 00:41:53,527 --> 00:41:55,229 FOR EXAMPLE, NOW WE HAVE 1102 00:41:55,229 --> 00:41:56,497 MULTIPLE EMERGENCY DEPARTMENTS 1103 00:41:56,497 --> 00:41:57,598 ACROSS THE UNITED STATES THAT 1104 00:41:57,598 --> 00:42:00,667 ACTUALLY ARE IMPLEMENTED WHILE 1105 00:42:00,667 --> 00:42:05,606 DR. GAIL DENOFRE SHOWED THROUGH 1106 00:42:05,606 --> 00:42:07,908 THE CLINICAL TRIALS NETWORK THAT 1107 00:42:07,908 --> 00:42:09,109 ISSUING BUPRENORPHINE IN THE 1108 00:42:09,109 --> 00:42:09,843 EMERGENCY DEPARTMENT 1109 00:42:09,843 --> 00:42:11,211 SIGNIFICANTLY IMPROVED THE 1110 00:42:11,211 --> 00:42:13,447 LIKELIHOOD THAT PATIENT WILL 1111 00:42:13,447 --> 00:42:15,282 STAY IN TREATMENT FOR MEDICATION 1112 00:42:15,282 --> 00:42:17,451 FOR OPIOID USE DISORDER. 1113 00:42:17,451 --> 00:42:19,787 THIS IN THEORY HAS BEEN 1114 00:42:19,787 --> 00:42:20,687 FACILITATED BY DEVELOPMENT 1115 00:42:20,687 --> 00:42:22,156 THAT'S HAVE BEEN ACCELERATED 1116 00:42:22,156 --> 00:42:24,324 THROUGH THE DIVISION OF 1117 00:42:24,324 --> 00:42:26,493 THERAPEUTICS, OF FACILITATING 1118 00:42:26,493 --> 00:42:28,061 THE DEVELOPMENT OF EXTENDED 1119 00:42:28,061 --> 00:42:28,562 RELEASE FORMULATIONS OF 1120 00:42:28,562 --> 00:42:35,736 BUPRENORPHINE. 1121 00:42:35,736 --> 00:42:37,037 AGAIN, IT'S ALWAYS THIS FINDING 1122 00:42:37,037 --> 00:42:39,406 OF, YES, WE HAVE INNOVATION, BUT 1123 00:42:39,406 --> 00:42:40,974 WE FIND OUT IT CANNOT 1124 00:42:40,974 --> 00:42:41,742 NECESSARILY BE IMPLEMENTED 1125 00:42:41,742 --> 00:42:42,843 BECAUSE THERE'S NOT COVERAGE BY 1126 00:42:42,843 --> 00:42:43,410 THE INSURANCE. 1127 00:42:43,410 --> 00:42:45,646 OR THE PHARMACY MAY NOT CARRY. 1128 00:42:45,646 --> 00:42:47,347 SO AS A RESULT OF THAT, NOW THAT 1129 00:42:47,347 --> 00:42:48,382 WE HAVE THE OPPORTUNITY OF 1130 00:42:48,382 --> 00:42:51,485 HAVING THESE EXTENDED RELEASE 1131 00:42:51,485 --> 00:42:52,686 FORMULATIONS, WE ARE FINDING 1132 00:42:52,686 --> 00:42:57,891 OURSELVES SITTING IN 1133 00:42:57,891 --> 00:42:58,559 CIRCUMSTANCES THAT THEY CANNOT 1134 00:42:58,559 --> 00:43:00,727 BE IMPLEMENTED BECAUSE OF THESE 1135 00:43:00,727 --> 00:43:01,128 OBSTACLES. 1136 00:43:01,128 --> 00:43:02,563 AGAIN, THIS IS WHERE THE 1137 00:43:02,563 --> 00:43:03,931 CLINICAL TRIAL NETWORK COMES 1138 00:43:03,931 --> 00:43:04,998 INTO PLAY TO TRY TO UNDERSTAND 1139 00:43:04,998 --> 00:43:09,036 WHAT IS THE DATA AND TO WORK 1140 00:43:09,036 --> 00:43:10,337 THROUGH WHAT ARE THE POLICIES 1141 00:43:10,337 --> 00:43:11,572 THAT NEED TO CHANGE IN ORDER FOR 1142 00:43:11,572 --> 00:43:12,673 THIS TO HAPPEN? 1143 00:43:12,673 --> 00:43:13,774 ALSO VERY NOVEL APPROACHES LIKE 1144 00:43:13,774 --> 00:43:16,710 THE PHARMACY, DELIVERY OF 1145 00:43:16,710 --> 00:43:19,179 MEDICATIONS FOR OPIOID USE 1146 00:43:19,179 --> 00:43:20,581 DISORDER FOR WHICH RESEARCH HAS 1147 00:43:20,581 --> 00:43:22,549 SHOWN, INCLUDING JOHNS HOPKINS, 1148 00:43:22,549 --> 00:43:25,385 THAT THE DELIVERY OF PHARMACY, 1149 00:43:25,385 --> 00:43:27,120 WHETHER METHADONE OR 1150 00:43:27,120 --> 00:43:29,456 BUPRENORPHINE, ACTUALLY BY THE 1151 00:43:29,456 --> 00:43:31,592 PHARMACIST IS PROVIDING AS GOOD 1152 00:43:31,592 --> 00:43:33,060 OUTCOMES AS THOSE WHEN THEY GO 1153 00:43:33,060 --> 00:43:35,495 TO A METHADONE CLINIC. 1154 00:43:35,495 --> 00:43:37,598 BUT WE HAVE PRACTICES THAT ARE 1155 00:43:37,598 --> 00:43:38,665 VERY INFLEXIBLE. 1156 00:43:38,665 --> 00:43:40,300 IT HAS BEEN VERY DIFFICULT TO 1157 00:43:40,300 --> 00:43:42,236 CHANGE THAT. 1158 00:43:42,236 --> 00:43:43,971 UNFORTUNATELY, THE ONES THAT 1159 00:43:43,971 --> 00:43:44,972 HAVE SUFFERED ARE THE PATIENTS 1160 00:43:44,972 --> 00:43:46,573 BECAUSE THE PATIENTS ARE THE 1161 00:43:46,573 --> 00:43:48,542 ONES THAT CAN ONLY GET THEIR 1162 00:43:48,542 --> 00:43:50,811 METHADONE IN A METHADONE CLINIC, 1163 00:43:50,811 --> 00:43:52,579 AND THERE MAY NOT BE ANY 1164 00:43:52,579 --> 00:43:53,981 METHADONE CLINIC NEARBY. 1165 00:43:53,981 --> 00:43:55,916 SO WHAT ARE THEY SUPPOSED TO DO? 1166 00:43:55,916 --> 00:43:57,918 WHY IS IT THAT WE CANNOT HAVE 1167 00:43:57,918 --> 00:43:59,987 BOTH, METHADONE CLINICS WHERE 1168 00:43:59,987 --> 00:44:01,521 FOR PATIENTS THAT ACTUALLY DO 1169 00:44:01,521 --> 00:44:03,724 BENEFIT AND WANT TO ATTEND THE 1170 00:44:03,724 --> 00:44:05,459 METHADONE CLINIC, BUT ALSO 1171 00:44:05,459 --> 00:44:07,494 PHARMACY DELIVERY THAT WILL 1172 00:44:07,494 --> 00:44:08,629 ACTUALLY ALLOW FOR PATIENTS THAT 1173 00:44:08,629 --> 00:44:10,163 OTHERWISE WOULD NOT BE ABLE TO 1174 00:44:10,163 --> 00:44:11,665 GET INTO A METHADONE CLINIC 1175 00:44:11,665 --> 00:44:13,500 BECAUSE IT'S NOT THERE OR DON'T 1176 00:44:13,500 --> 00:44:16,637 WANT TO GO TO A METHADONE 1177 00:44:16,637 --> 00:44:19,573 CLINIC. 1178 00:44:19,573 --> 00:44:22,376 SIMILARLY, MOBILE DELIVERY OF 1179 00:44:22,376 --> 00:44:24,811 MOUD HAS PROVED TO BE VERY 1180 00:44:24,811 --> 00:44:25,746 HELPFUL IN SETTINGS THAT ARE 1181 00:44:25,746 --> 00:44:27,547 DIFFICULT TO REACH, WHERE THERE 1182 00:44:27,547 --> 00:44:30,150 MAY NOT BE A NEARBY PHARMACY, 1183 00:44:30,150 --> 00:44:32,886 LIKE RURAL AREAS. 1184 00:44:32,886 --> 00:44:34,588 AND WE HAVE INCREASED OUR 1185 00:44:34,588 --> 00:44:37,124 UNDERSTANDING OF HOW TO OPTIMAL 1186 00:44:37,124 --> 00:44:41,461 LY USE TELEHEALTH FOR THE MOUD 1187 00:44:41,461 --> 00:44:43,030 TREATMENT AND CARE. 1188 00:44:43,030 --> 00:44:46,433 IT WAS HELPFUL DURING THE COVID 1189 00:44:46,433 --> 00:44:46,700 PANDEMIC. 1190 00:44:46,700 --> 00:44:50,804 IT ALLOWED PHYSICIANS TO 1191 00:44:50,804 --> 00:44:51,438 ADMINISTER BUPRENORPHINE WITHOUT 1192 00:44:51,438 --> 00:44:53,240 THE PATIENT HAVING TO COME IN. 1193 00:44:53,240 --> 00:44:54,708 THAT SAVED THE DAY BECAUSE WITH 1194 00:44:54,708 --> 00:44:56,610 THE ADDITIONAL CHALLENGES WE 1195 00:44:56,610 --> 00:44:58,312 WOULD HAVE SEEN MORE OVERDOSES 1196 00:44:58,312 --> 00:44:59,246 THAN WE OBSERVED THE FIRST TWO 1197 00:44:59,246 --> 00:45:05,419 YEARS OF THE PANDEMIC. 1198 00:45:05,419 --> 00:45:08,889 JUST AS COMMUNITY OPIOID ABUSE 1199 00:45:08,889 --> 00:45:09,890 NETWORK, WHICH WAS OUR 1200 00:45:09,890 --> 00:45:11,191 PENETRATION INTO THE JUSTICE 1201 00:45:11,191 --> 00:45:15,228 SETTING, AND THIS HAS BEEN VERY, 1202 00:45:15,228 --> 00:45:19,299 VERY ABLY LED BY DR. WILEY AND 1203 00:45:19,299 --> 00:45:20,467 DR. CARLOS BLANCO AND 1204 00:45:20,467 --> 00:45:21,835 RECOGNIZING THIS IS A NUMBER 1205 00:45:21,835 --> 00:45:24,571 WHERE YOU SAY WHY ARE WE 1206 00:45:24,571 --> 00:45:26,239 ALLOWING SYSTEMS LIKE THIS? 1207 00:45:26,239 --> 00:45:27,908 25% OF PEOPLE THAT DIE FROM AN 1208 00:45:27,908 --> 00:45:29,676 OVERDOSE HAVE PASSED THROUGH A 1209 00:45:29,676 --> 00:45:31,111 JUSTICE SETTING IN THE PAST 1210 00:45:31,111 --> 00:45:33,180 YEAR, WHICH MEANS THAT, IF WE 1211 00:45:33,180 --> 00:45:35,749 HAD INTERVENED IN THE JUSTICE 1212 00:45:35,749 --> 00:45:39,152 SETTING TO ENSURE THAT THEY -- 1213 00:45:39,152 --> 00:45:41,455 THEY ARE A CAPTIVE AUDIENCE. 1214 00:45:41,455 --> 00:45:43,223 WHY DON'T WE INITIATE TREATMENT? 1215 00:45:43,223 --> 00:45:46,827 WHY DON'T WE ENGAGE THEM INTO 1216 00:45:46,827 --> 00:45:48,328 PROGRESS BEFORE THEY ARE 1217 00:45:48,328 --> 00:45:48,595 RELEASED. 1218 00:45:48,595 --> 00:45:51,999 ALL OF THAT CAN MAKE A LARGE 1219 00:45:51,999 --> 00:45:55,035 IMPACT ON DECREASING FATALITY 1220 00:45:55,035 --> 00:45:58,305 FROM OVERDOSES, AND DECREASING 1221 00:45:58,305 --> 00:45:58,705 RE-INCARCERATION. 1222 00:45:58,705 --> 00:46:00,941 BUT IT IS IN MANY INSTANCES, OF 1223 00:46:00,941 --> 00:46:02,376 COURSE, YOU CAN SHOW THE DATA. 1224 00:46:02,376 --> 00:46:04,077 IT DOESN'T CHANGE A CULTURE. 1225 00:46:04,077 --> 00:46:05,212 HOW DO YOU CHANGE PRACTICE? 1226 00:46:05,212 --> 00:46:08,348 I THINK THIS IS WHERE JCOIN 1227 00:46:08,348 --> 00:46:10,083 COMES INTO PLAY AND HAS BEEN SO 1228 00:46:10,083 --> 00:46:12,285 SUCCESSFUL BECAUSE WHAT YOU NEED 1229 00:46:12,285 --> 00:46:13,854 TO DO SO BRING TOGETHER TWO 1230 00:46:13,854 --> 00:46:15,389 FIELDS THAT NORMALLY DON'T PLAY 1231 00:46:15,389 --> 00:46:16,356 WITH ONE ANOTHER. 1232 00:46:16,356 --> 00:46:19,459 SO WE ARE AN AGENCY FROM HHS, 1233 00:46:19,459 --> 00:46:19,760 HEALTH. 1234 00:46:19,760 --> 00:46:21,895 WE DON'T INTERACT WE MUCH WITH 1235 00:46:21,895 --> 00:46:28,335 JUSTICE. 1236 00:46:28,335 --> 00:46:31,171 AND YET JUSTICE HAS TO DEAL WITH 1237 00:46:31,171 --> 00:46:33,874 MANY OF THE PEOPLE SUFFERING 1238 00:46:33,874 --> 00:46:36,610 FROM OPIOID USE DISORDER. 1239 00:46:36,610 --> 00:46:37,778 THAT'S WHAT JCOIN HAS BEEN ABLE 1240 00:46:37,778 --> 00:46:39,913 TO DO, VERY, VERY SUCCESSFUL. 1241 00:46:39,913 --> 00:46:40,947 CREATING PARTNERSHIPS WHERE 1242 00:46:40,947 --> 00:46:42,682 RESEARCH IS DONE BY PEOPLE FROM 1243 00:46:42,682 --> 00:46:43,350 BOTH THE JUSTICE SIDE AND THE 1244 00:46:43,350 --> 00:46:44,885 HEALTHCARE SIDE, FROM THE 1245 00:46:44,885 --> 00:46:47,054 RESEARCH SIDE, FROM INDIVIDUALS 1246 00:46:47,054 --> 00:46:52,626 WITH L.E.A.P. AND LIVING 1247 00:46:52,626 --> 00:46:53,593 EXPERIENCES, AND BRINGING THEM 1248 00:46:53,593 --> 00:46:55,195 TOGETHER AND SHOWING IT MAKES A 1249 00:46:55,195 --> 00:46:56,997 BIG IMPACT IN IMPROVING THE 1250 00:46:56,997 --> 00:46:58,899 OUTCOMES, AND ALSO BUILDING 1251 00:46:58,899 --> 00:47:00,033 CAPACITY SO THE PEOPLE THERE IN 1252 00:47:00,033 --> 00:47:01,334 THE JUSTICE SETTING CAN BE 1253 00:47:01,334 --> 00:47:02,202 INVOLVED WITH RESEARCH BECAUSE 1254 00:47:02,202 --> 00:47:03,136 THEY ARE THE ONES OUT THERE IN 1255 00:47:03,136 --> 00:47:06,473 THE TRENCHES. 1256 00:47:06,473 --> 00:47:08,608 AND MAY BE ABLE TO DO THINGS 1257 00:47:08,608 --> 00:47:10,177 THAT OTHERWISE WE CANNOT THINK 1258 00:47:10,177 --> 00:47:10,444 OF. 1259 00:47:10,444 --> 00:47:13,580 HAS BEEN VERY, VERY SUCCESSFUL. 1260 00:47:13,580 --> 00:47:15,816 AND IT STARTED, ACTUALLY, JUST 1261 00:47:15,816 --> 00:47:17,384 LIKE I WAS SAYING IN TERMS OF 1262 00:47:17,384 --> 00:47:19,553 HEALTHCARE, WE'RE NOW STARTING 1263 00:47:19,553 --> 00:47:20,954 TO SEE MORE HEALTHCARE SYSTEMS 1264 00:47:20,954 --> 00:47:23,457 INVOLVED WITH THE SCREENING AND 1265 00:47:23,457 --> 00:47:24,658 TREATMENT OF PEOPLE WITH 1266 00:47:24,658 --> 00:47:26,159 SUBSTANCE USE DISORDER. 1267 00:47:26,159 --> 00:47:28,628 THAT'S IN BIG MEASURE TO ALL OF 1268 00:47:28,628 --> 00:47:33,400 THE WORK WITH CTM, SIMILARLY IN 1269 00:47:33,400 --> 00:47:34,968 THE JUSTICE SETTINGS WE'RE 1270 00:47:34,968 --> 00:47:36,636 SEEING, STILL SLOWLY, BUT 1271 00:47:36,636 --> 00:47:37,737 INCREASES IN THE NUMBER OF JAILS 1272 00:47:37,737 --> 00:47:39,873 AND PRISONS THAT ARE NOW 1273 00:47:39,873 --> 00:47:44,111 PROVIDING ACCESS TO MEDICATIONS 1274 00:47:44,111 --> 00:47:44,778 FOR OPIOID USE DISORDER. 1275 00:47:44,778 --> 00:47:47,681 IT HAS ALSO BEEN REINFORCING TO 1276 00:47:47,681 --> 00:47:48,582 SEE THE WILLINGNESS TO CHANGE 1277 00:47:48,582 --> 00:47:50,584 SOME OF THE POLICIES THAT WILL 1278 00:47:50,584 --> 00:47:53,386 ALLOW A PERSON THAT IS 1279 00:47:53,386 --> 00:47:58,592 INCARCERATED TO HAVE COVER 1280 00:47:58,592 --> 00:48:00,527 INSURANCE ONCE THEY GO INTO THE 1281 00:48:00,527 --> 00:48:00,794 COMMUNITY. 1282 00:48:00,794 --> 00:48:02,362 THIS HELPS BY BRINGING TOGETHER 1283 00:48:02,362 --> 00:48:03,096 PEOPLE AND UNDERSTANDING WHERE 1284 00:48:03,096 --> 00:48:04,364 EACH ARE COMING FROM AND SHOWING 1285 00:48:04,364 --> 00:48:05,132 THEIR RESULTS. 1286 00:48:05,132 --> 00:48:05,899 THIS IS THE SECOND ONE OF OUR 1287 00:48:05,899 --> 00:48:09,202 ENDEAVORS. 1288 00:48:09,202 --> 00:48:10,270 THE THIRD ENDEAVOR THAT WE'VE 1289 00:48:10,270 --> 00:48:11,905 DONE IS THAT ONE OF MAXIMIZING 1290 00:48:11,905 --> 00:48:12,372 THE KNOWLEDGE. 1291 00:48:12,372 --> 00:48:14,407 HOW DO WE MAXIMIZE THE KNOWLEDGE 1292 00:48:14,407 --> 00:48:16,643 THAT'S COMING FROM THE 1293 00:48:16,643 --> 00:48:16,943 COMMUNITIES? 1294 00:48:16,943 --> 00:48:17,878 PARTICULARLY THOSE THAT HAVE 1295 00:48:17,878 --> 00:48:20,213 BEEN MOST AFFECTED BY THE 1296 00:48:20,213 --> 00:48:21,248 OVERDOSE CRISIS. 1297 00:48:21,248 --> 00:48:23,350 BOTH URBAN AND RURAL. 1298 00:48:23,350 --> 00:48:25,719 THAT'S WHY WE LAUNCHED THE 1299 00:48:25,719 --> 00:48:27,554 HEALING COMMUNITIES STUDY, WHICH 1300 00:48:27,554 --> 00:48:32,325 WAS ACTUALLY LAUNCHED IN 2019, 1301 00:48:32,325 --> 00:48:34,528 2018, 2019, AROUND THAT TIME. 1302 00:48:34,528 --> 00:48:35,629 SELECTED FOR STATES THAT HAVE 1303 00:48:35,629 --> 00:48:37,864 SOME OF THE HIGHEST RATES OF 1304 00:48:37,864 --> 00:48:40,167 OVERDOSES, FOR A TOTAL OF 67 1305 00:48:40,167 --> 00:48:40,867 COMMUNITIES. 1306 00:48:40,867 --> 00:48:42,736 IT WAS A CLOSELY RANDOMIZED 1307 00:48:42,736 --> 00:48:44,137 PROJECT, WHERE HALF OF THE 1308 00:48:44,137 --> 00:48:46,273 COMMUNITIES WERE RANDOMIZED TO 1309 00:48:46,273 --> 00:48:50,443 GET THE INTERVENTION, AND THEY 1310 00:48:50,443 --> 00:48:50,911 WERE TREATED. 1311 00:48:50,911 --> 00:48:52,179 AND THE OTHER HALF OF THE 1312 00:48:52,179 --> 00:48:54,147 COMMUNITIES WERE USED AS 1313 00:48:54,147 --> 00:48:55,448 CONTROLS, BASICALLY PRACTICES AS 1314 00:48:55,448 --> 00:48:57,884 USUAL, WAVE 2. 1315 00:48:57,884 --> 00:48:59,886 THE IMPLEMENTATION IN BASICALLY 1316 00:48:59,886 --> 00:49:01,688 FOCUSING ON INCREASING NALOXONE 1317 00:49:01,688 --> 00:49:03,690 DISTRIBUTION, INCREASING ACCESS 1318 00:49:03,690 --> 00:49:06,526 AND UTILIZATION OF MEDICATIONS 1319 00:49:06,526 --> 00:49:09,863 FOR OPIOID USE DISORDER, AND 1320 00:49:09,863 --> 00:49:16,336 INCREASED HIGH -- DECREASE HIGH 1321 00:49:16,336 --> 00:49:18,972 RISK OPIOID PRESCRIPTIONS. 1322 00:49:18,972 --> 00:49:21,474 AND BRINGING TOGETHER 1323 00:49:21,474 --> 00:49:22,509 HEALTHCARE, JUSTICE, THE 1324 00:49:22,509 --> 00:49:24,010 COMMUNITY AND THE STATE AND 1325 00:49:24,010 --> 00:49:25,879 ENABLE THE COLLECTION OF DATA 1326 00:49:25,879 --> 00:49:27,547 THAT COULD BE PROVIDED TO THE 1327 00:49:27,547 --> 00:49:29,616 COMMUNITIES RAPIDLY IN A WAY 1328 00:49:29,616 --> 00:49:33,553 THAT THEY COULD UTILIZE THE DATA 1329 00:49:33,553 --> 00:49:37,190 TO TAILOR THEIR INTERVENTIONED 1330 00:49:37,190 --> 00:49:37,958 AND UNDERSTAND WHETHER THEY WERE 1331 00:49:37,958 --> 00:49:38,925 WORKING OR NOT. 1332 00:49:38,925 --> 00:49:41,895 THAT STUDY HAS COME TO 1333 00:49:41,895 --> 00:49:43,930 COMPLETION. 1334 00:49:43,930 --> 00:49:46,866 DESPITE THE FACT THAT ACTUALLY 1335 00:49:46,866 --> 00:49:49,603 COVID HIT IN 2020 WHEN THE STUDY 1336 00:49:49,603 --> 00:49:51,271 WAS INITIATING ITS 1337 00:49:51,271 --> 00:49:52,105 IMPLEMENTATION. 1338 00:49:52,105 --> 00:49:53,907 IN JANUARY 2020 THE HEALING 1339 00:49:53,907 --> 00:49:57,310 COMMUNITY STUDY STARTED THE 1340 00:49:57,310 --> 00:50:00,013 IMPLEMENTATION, AND IN MARCH 1341 00:50:00,013 --> 00:50:03,083 2020, THE COUNTRY CLOSED. 1342 00:50:03,083 --> 00:50:05,085 HERE WUF IT. 1343 00:50:05,085 --> 00:50:08,321 IT'S ONE OF THE MOST 1344 00:50:08,321 --> 00:50:10,056 UNPREDICTABLE EVENTS AND MOST 1345 00:50:10,056 --> 00:50:11,625 STRESSFUL THAT WE ALL EVER 1346 00:50:11,625 --> 00:50:14,728 EXPERIENCED AMIDST THAT 1347 00:50:14,728 --> 00:50:16,196 DEPLOYMENT OF THIS EXTREMELY 1348 00:50:16,196 --> 00:50:17,597 AMBITIOUS STUDY. 1349 00:50:17,597 --> 00:50:20,367 THE GOAL OF THE STORY WAS BY 1350 00:50:20,367 --> 00:50:22,202 DOING THESE INTERVENTIONS, THERE 1351 00:50:22,202 --> 00:50:23,470 WOULD BE A SIGNIFICANT REDUCTION 1352 00:50:23,470 --> 00:50:25,205 IN OVERDOSE MORTALITY, THAT 1353 00:50:25,205 --> 00:50:26,506 THERE WOULD BE A SIGNIFICANT 1354 00:50:26,506 --> 00:50:27,974 INCREASE IN NALOXONE 1355 00:50:27,974 --> 00:50:29,276 PRESCRIPTIONS, A SIGNIFICANT 1356 00:50:29,276 --> 00:50:29,843 INCREASE IN BUPRENORPHINE 1357 00:50:29,843 --> 00:50:31,578 INITIATION AND RETENTION, AND 1358 00:50:31,578 --> 00:50:33,346 THAT THERE WOULD BE A REDUCTION 1359 00:50:33,346 --> 00:50:39,586 IN OVERDOSE MENTALITY. 1360 00:50:39,586 --> 00:50:42,122 -- MORTALITY. 1361 00:50:42,122 --> 00:50:43,957 THE RESULTS ARE UNDER REVIEW, 1362 00:50:43,957 --> 00:50:45,558 AND DR. CHANDLER HAS BEEN THE 1363 00:50:45,558 --> 00:50:47,460 PERSON AT NIDA IN THIS PROGRAM 1364 00:50:47,460 --> 00:50:49,062 FROM ITS INCEPTION, AND SHE HAS 1365 00:50:49,062 --> 00:50:49,963 BEEN MAKING THIS HAPPEN. 1366 00:50:49,963 --> 00:50:52,499 THIS IS THE DATA. 1367 00:50:52,499 --> 00:50:56,970 IT SHOWS THAT OVERALL THERE WAS 1368 00:50:56,970 --> 00:50:58,872 IN WAVE 1 -- AGAIN, THOSE ARE 1369 00:50:58,872 --> 00:51:00,106 THE ONES THAT HAD THE 1370 00:51:00,106 --> 00:51:02,709 INTERVENTION, AND ON WAVE 2, 1371 00:51:02,709 --> 00:51:04,010 THOSE ARE THE ONES THAT WERE 1372 00:51:04,010 --> 00:51:05,078 CONTROLS, AND YOU HAVE THE RATE 1373 00:51:05,078 --> 00:51:07,013 OF OVERDOSES PER 100,000. 1374 00:51:07,013 --> 00:51:10,083 ONE OF THEM WAS 47.2 FOR WAVE 1 1375 00:51:10,083 --> 00:51:12,018 AND 51.7 FOR WAVE 2. 1376 00:51:12,018 --> 00:51:13,887 THIS IS A 9% REDUCTION, BUT IT'S 1377 00:51:13,887 --> 00:51:19,259 NOT SIGNIFICANT. 1378 00:51:19,259 --> 00:51:21,161 I THINK THAT, AS I THINK ABOUT 1379 00:51:21,161 --> 00:51:24,631 ALL OF THIS AND SAY, WELL, 1380 00:51:24,631 --> 00:51:26,433 SIGNIFICANCE IS A SPECIFIC 1381 00:51:26,433 --> 00:51:28,568 CONCEPT, AND WE NEED TO 1382 00:51:28,568 --> 00:51:29,836 UNDERSTAND WHAT IT'S TELLING US. 1383 00:51:29,836 --> 00:51:32,472 WOULD WE HAVE BEEN ELATED TO SEE 1384 00:51:32,472 --> 00:51:34,507 A 9% REDUCTION? 1385 00:51:34,507 --> 00:51:34,741 CORRECT. 1386 00:51:34,741 --> 00:51:36,242 BUT IN MANY INSTANCES WHERE WE 1387 00:51:36,242 --> 00:51:38,812 TRY TO AIM AND SAY, WELL, WHAT 1388 00:51:38,812 --> 00:51:40,980 IS IT I WOULD LIKE TO ACHIEVE, 1389 00:51:40,980 --> 00:51:43,683 WE AIM FOR THE SKY BECAUSE WE 1390 00:51:43,683 --> 00:51:44,050 WANT THAT. 1391 00:51:44,050 --> 00:51:45,885 BUT ALSO IT RISKS THAT CREATION 1392 00:51:45,885 --> 00:51:49,989 OF EXPECTATION THAT'S ARE NOT 1393 00:51:49,989 --> 00:51:50,690 NECESSARILY IN THE CONTROL OF 1394 00:51:50,690 --> 00:51:52,425 THINGS THAT CAN HAPPEN, LIKE THE 1395 00:51:52,425 --> 00:51:54,060 COVID PANDEMICS. 1396 00:51:54,060 --> 00:51:55,562 WELL, WHAT CAN WE UNDERSTAND 1397 00:51:55,562 --> 00:52:02,702 WITH THE 9% REDUCTION, LOOK AT 1398 00:52:02,702 --> 00:52:03,570 THE DIFFERENT FOUR STATES. 1399 00:52:03,570 --> 00:52:06,106 WHAT I SEE IS DECREASING IN 1400 00:52:06,106 --> 00:52:06,906 OVERDOSES IN MASSACHUSETTS, NEW 1401 00:52:06,906 --> 00:52:08,375 YORK, AND OHIO, BUT YOU'RE NOT 1402 00:52:08,375 --> 00:52:10,310 SEEING THE DECREASES IN OVERDOSE 1403 00:52:10,310 --> 00:52:11,845 INS KENTUCKY, AND THIS SURPRISED 1404 00:52:11,845 --> 00:52:13,847 ME ABSOLUTELY, BECAUSE ONE OF 1405 00:52:13,847 --> 00:52:15,648 THE THINGS THAT I'VE BEEN TO 1406 00:52:15,648 --> 00:52:18,017 KENTUCKY MANY, MANY TIMES, AND 1407 00:52:18,017 --> 00:52:21,388 YOU HAVE THE UNIVERSITY OF 1408 00:52:21,388 --> 00:52:21,988 KENTU 1409 00:52:21,988 --> 00:52:23,256 KENTUCKY, AND THAT'S ACTUALLY 1410 00:52:23,256 --> 00:52:25,425 ONE OF THE MOST COMMITTED PLACES 1411 00:52:25,425 --> 00:52:27,961 TO ADVANCE THE SCIENCE OF 1412 00:52:27,961 --> 00:52:30,697 ADDICTION, AND THE STATE ALSO 1413 00:52:30,697 --> 00:52:33,066 HAS BEEN VERY PROACTIVE IN 1414 00:52:33,066 --> 00:52:35,402 PROVIDING THE RESOURCES FOR 1415 00:52:35,402 --> 00:52:39,205 TREATING PEOPLE WITH OPIOID USE 1416 00:52:39,205 --> 00:52:41,441 DISORDER, FOR GIVING SUCCESS TO 1417 00:52:41,441 --> 00:52:41,875 MEDICATIONS. 1418 00:52:41,875 --> 00:52:42,942 SO I WAS SUSPECTING KENTUCKY 1419 00:52:42,942 --> 00:52:44,511 WOULD HAVE THE LARGEST EFFECT. 1420 00:52:44,511 --> 00:52:46,312 THEN IT OCCURRED TO ME MAYBE 1421 00:52:46,312 --> 00:52:49,149 WHAT HAPPENS IS IN THE WAVE 2, 1422 00:52:49,149 --> 00:52:52,585 THEY HAVE ALSO VERY SERIOUS -- 1423 00:52:52,585 --> 00:52:53,953 AS I SAY, KENTUCKY HAS BEEN 1424 00:52:53,953 --> 00:52:57,424 NUMBER ONE, ALONG WITH WEST 1425 00:52:57,424 --> 00:53:02,996 VIRGINIA, IN OVERDOSE DECREASE 1426 00:53:02,996 --> 00:53:04,998 IN ABSOLUTE TERMS BECAUSE OF THE 1427 00:53:04,998 --> 00:53:07,133 SIGNIFICANCE OF THE CRISIS, BUT 1428 00:53:07,133 --> 00:53:08,802 THEY ALSO HAVE HAD A VERY, VERY 1429 00:53:08,802 --> 00:53:13,173 PROACTIVE TREATMENT OF PEOPLE. 1430 00:53:13,173 --> 00:53:14,741 THE QUESTION THAT MAKES ME THINK 1431 00:53:14,741 --> 00:53:17,177 IS WERE THE WAVE 2 INDIVIDUALS 1432 00:53:17,177 --> 00:53:18,978 GETTING THAT SUPPORT ALREADY SO 1433 00:53:18,978 --> 00:53:21,181 THAT THE WAVE 1 DIDN'T REALLY 1434 00:53:21,181 --> 00:53:23,116 ADD VERY MUCH MORE THAN WHAT'S 1435 00:53:23,116 --> 00:53:24,717 ALREADY THERE IN KENTUCKY? 1436 00:53:24,717 --> 00:53:27,053 THIS IS SOMETHING, AS WE GO 1437 00:53:27,053 --> 00:53:28,154 ALONG, WE'LL BE ABLE TO 1438 00:53:28,154 --> 00:53:30,223 UNDERSTAND IF THAT IS THE CASE. 1439 00:53:30,223 --> 00:53:32,559 MEANWHILE, THIS IS NOT THE MAIN 1440 00:53:32,559 --> 00:53:34,027 OUTCOME, BUT WHEN THEY LOOK AT 1441 00:53:34,027 --> 00:53:35,628 THE OVERDOSE DEATHS ASSOCIATED 1442 00:53:35,628 --> 00:53:38,198 WITH OPIOIDS PLUS 1443 00:53:38,198 --> 00:53:39,833 PSYCHOSTIMULANTS, AND THAT 1444 00:53:39,833 --> 00:53:41,868 PSYCHOSTIMULANT THERE 1445 00:53:41,868 --> 00:53:42,735 PREDOMINANTLY REFLECTS 1446 00:53:42,735 --> 00:53:43,736 METHAMPHETAMINE, THERE THEY DID 1447 00:53:43,736 --> 00:53:45,872 SEE A SIGNIFICANT REDUCTION IN 1448 00:53:45,872 --> 00:53:49,843 WAVE 1. 1449 00:53:49,843 --> 00:53:51,544 I WAS TRYING TO THINK ABOUT IT, 1450 00:53:51,544 --> 00:53:52,946 WHAT DOES THAT MEAN? 1451 00:53:52,946 --> 00:53:55,648 WHY ARE WE NOT SEEING IT SO MUCH 1452 00:53:55,648 --> 00:53:58,518 IN THE OPIOID OVERDOSE INS 1453 00:53:58,518 --> 00:54:00,086 GENERAL BUT IN THE COMBINATION? 1454 00:54:00,086 --> 00:54:02,622 IT SORT OF ACTUALLY MAKES ME 1455 00:54:02,622 --> 00:54:03,690 WONDER IF THIS SIGNIFICANT 1456 00:54:03,690 --> 00:54:05,558 REDUCTION MAY REFLECT, IN FACT, 1457 00:54:05,558 --> 00:54:06,960 THAT IN THIS POPULATION WHERE 1458 00:54:06,960 --> 00:54:10,029 THEY DO NOT HAVE AN OPIOID USE 1459 00:54:10,029 --> 00:54:12,365 DISORDER PERCENT NECESSARILY, I 1460 00:54:12,365 --> 00:54:13,867 EXPANDED THE ACCESS OF NALOXONE 1461 00:54:13,867 --> 00:54:19,506 HAS A LARGER IMPACT BY ITSELF. 1462 00:54:19,506 --> 00:54:22,041 THEY ARE ANALYZING THE DATA. 1463 00:54:22,041 --> 00:54:23,877 THIS HAS NOT BEEN REPORTED. 1464 00:54:23,877 --> 00:54:26,579 REGARDLESS OF ALL OF THESE, WE 1465 00:54:26,579 --> 00:54:28,548 KNOW THAT 525 OVERDOSE DEATHS 1466 00:54:28,548 --> 00:54:30,383 WERE AVERTED IN WAVE 1. 1467 00:54:30,383 --> 00:54:32,352 WE ALSO NEED TO RECOGNIZE THAT, 1468 00:54:32,352 --> 00:54:34,521 WHEN WE WERE INITIATING THE 1469 00:54:34,521 --> 00:54:36,556 STUDY, I WAS AFRAID. 1470 00:54:36,556 --> 00:54:43,129 I REMEMBER DISCUSSING TO AMIR AL 1471 00:54:43,129 --> 00:54:44,864 GARRAR, THE SECRETARY OF HEALTH, 1472 00:54:44,864 --> 00:54:47,300 WHERE I SAID I'M HESITANT TO PUT 1473 00:54:47,300 --> 00:54:52,205 IN THE REDUCTION OF THE NUMBER 1474 00:54:52,205 --> 00:54:54,707 OF OVERDOSES BECAUSE WHAT IF 1475 00:54:54,707 --> 00:54:56,109 METHAMPHETAMINE EXPANDS IN THE 1476 00:54:56,109 --> 00:54:56,643 RURAL AREAS? 1477 00:54:56,643 --> 00:54:58,444 AND METHAMPHETAMINE DID EXPAND, 1478 00:54:58,444 --> 00:54:59,712 AND FENTANYL EXPANDED MUCH MORE 1479 00:54:59,712 --> 00:55:01,848 THAN WE THOUGHT, BUT I DID NOT 1480 00:55:01,848 --> 00:55:02,982 KNOW ABOUT COVID. 1481 00:55:02,982 --> 00:55:04,951 COVID, THE MORTALITY OF 1482 00:55:04,951 --> 00:55:06,185 OVERDOSES DURING THE COVID 1483 00:55:06,185 --> 00:55:08,488 PANDEMIC DURING THE FIRST TWO 1484 00:55:08,488 --> 00:55:13,860 YEARS WAS 45% INCREASE. 1485 00:55:13,860 --> 00:55:16,629 TODAY I PRESENT A 0.5% DECREASE. 1486 00:55:16,629 --> 00:55:18,064 DURING THE COVID PANDEMIC, IT 1487 00:55:18,064 --> 00:55:20,400 WAS A 45% INCREASE, AND THAT WAS 1488 00:55:20,400 --> 00:55:20,700 DEVASTATING. 1489 00:55:20,700 --> 00:55:22,235 I THINK THE LESSONS LEARNED IN 1490 00:55:22,235 --> 00:55:24,003 ALL OF THIS IS, OF COURSE, WHEN 1491 00:55:24,003 --> 00:55:26,039 YOU HAVE A STRUCTURE, YOU CAN 1492 00:55:26,039 --> 00:55:28,074 PLAN ON THAT RESEARCH, IT IS SO 1493 00:55:28,074 --> 00:55:29,776 VERY IMPORTANT TO HAVE THE 1494 00:55:29,776 --> 00:55:31,444 COMMUNITIES INVOLVED. 1495 00:55:31,444 --> 00:55:37,984 IN THIS CASE, DESPITE THE 1496 00:55:37,984 --> 00:55:44,691 CHALLENGES, THE STUDY 1497 00:55:44,691 --> 00:55:49,829 CONTINUED, AND WE ACHIEVED BASIC 1498 00:55:49,829 --> 00:55:53,266 DECREASES. 1499 00:55:53,266 --> 00:55:56,669 BUT AS WE LEARN IN GREATER DEPTH 1500 00:55:56,669 --> 00:55:58,171 WHAT IS THE DIFFERENCE BETWEEN 1501 00:55:58,171 --> 00:55:59,872 THE STATES AND URBAN AND RURAL, 1502 00:55:59,872 --> 00:56:02,408 WE MAY HAVE A BETTER 1503 00:56:02,408 --> 00:56:03,443 UNDERSTANDING OF -- WE LEARN 1504 00:56:03,443 --> 00:56:05,878 FROM THIS ONE THAT WE CAN APPLY 1505 00:56:05,878 --> 00:56:07,246 INTO OTHER PROGRAMS SO THAT WE 1506 00:56:07,246 --> 00:56:14,120 CAN TRANSLATE THESE FINDINGS. 1507 00:56:14,120 --> 00:56:15,455 AMONG THE ISSUES TOO THAT WE 1508 00:56:15,455 --> 00:56:17,523 HAVE SORT OF SEEN, I MENTIONED 1509 00:56:17,523 --> 00:56:18,858 INITIALLY, WHEN YOU HAVE AN 1510 00:56:18,858 --> 00:56:21,227 OVERDOSE WITH MULTIPLE DRUGS ON 1511 00:56:21,227 --> 00:56:23,363 BOARD, IT IS MUCH HARDER TO 1512 00:56:23,363 --> 00:56:25,331 REVERT THE OVERDOSE. 1513 00:56:25,331 --> 00:56:30,269 YOU NEED TO GIVE FENTANYL -- YOU 1514 00:56:30,269 --> 00:56:31,537 NEED TO GIVE NALOXONE BECAUSE 1515 00:56:31,537 --> 00:56:32,672 THAT WILL REVERSE THE OVERDOSE 1516 00:56:32,672 --> 00:56:33,640 FOR FENTANYL. 1517 00:56:33,640 --> 00:56:34,540 IF YOU HAVE A METHAMPHETAMINE 1518 00:56:34,540 --> 00:56:36,376 AND YOU HAVE AN ARRYTHMIA, THAT 1519 00:56:36,376 --> 00:56:36,976 MAY NOT NECESSARILY SAVE THE 1520 00:56:36,976 --> 00:56:40,046 PERSON. 1521 00:56:40,046 --> 00:56:40,880 MEANWHILE, WE'RE ALSO SEEING 1522 00:56:40,880 --> 00:56:42,849 IT'S NOT JUST COCAINE, IT'S NOT 1523 00:56:42,849 --> 00:56:43,783 JUST METHAMPHETAMINE. 1524 00:56:43,783 --> 00:56:45,685 AS OF RECENTLY, THERE'S BEEN 1525 00:56:45,685 --> 00:56:49,989 ACTUALLY A LOT OF CONCERN THAT 1526 00:56:49,989 --> 00:56:52,191 XYLAZINE IS CONTAMINATING THE 1527 00:56:52,191 --> 00:56:54,394 DRUGS, ILLICIT DRUGS, AND THAT 1528 00:56:54,394 --> 00:56:55,795 APPROXIMATELY 12% OF PEOPLE THAT 1529 00:56:55,795 --> 00:56:59,032 ARE OVERDOSING WITH FENTANYL 1530 00:56:59,032 --> 00:57:01,567 HAVE IN OUR COUNTRY XYLAZINE. 1531 00:57:01,567 --> 00:57:05,705 XYLAZINE EXACERBATES THE 1532 00:57:05,705 --> 00:57:13,112 HYPERTENSIVE AND HYPOTOXIC 1533 00:57:13,112 --> 00:57:13,579 EFFECTS. 1534 00:57:13,579 --> 00:57:16,983 SO IT'S MUCH MORE LONG LASTING. 1535 00:57:16,983 --> 00:57:20,119 IF YOU GIVE NALOXONE, WHICH YOU 1536 00:57:20,119 --> 00:57:21,854 SHOULD GIVE, IT WILL BLUNT THE 1537 00:57:21,854 --> 00:57:22,955 PRESENT EFFECT OF THE OPIOID, 1538 00:57:22,955 --> 00:57:25,925 BUT IT WILL NOT COUNTERACT THE 1539 00:57:25,925 --> 00:57:28,327 DECREASE IN OXYGENATION 1540 00:57:28,327 --> 00:57:33,232 ASSOCIATED WITH XYLAZINE AS AN 1541 00:57:33,232 --> 00:57:40,339 ALPHA 2 ANERGENIC. 1542 00:57:40,339 --> 00:57:43,643 SO THEY NEED TO TRY TO DECIDE 1543 00:57:43,643 --> 00:57:45,445 WHAT ARE THE RECOMMENDATIONS TO 1544 00:57:45,445 --> 00:57:46,446 TREAT PEOPLE WHO COME WITH 1545 00:57:46,446 --> 00:57:48,848 COMBINED OVERDOSES OF THESE TWO 1546 00:57:48,848 --> 00:57:49,182 DRUGS. 1547 00:57:49,182 --> 00:57:50,850 THEY ALSO IDENTIFY SOME VERY 1548 00:57:50,850 --> 00:57:51,584 SIGNIFICANT AREAS OF RESEARCH 1549 00:57:51,584 --> 00:57:53,352 THAT I'M THROWING AT YOU, WHICH 1550 00:57:53,352 --> 00:57:56,989 IS WE NEED TO UNDERSTAND BETTER 1551 00:57:56,989 --> 00:58:00,126 THE FENTANYL-XYLAZINE OVERDOSES. 1552 00:58:00,126 --> 00:58:01,861 ARE PEOPLE TAKING LESS FENTANYL 1553 00:58:01,861 --> 00:58:03,663 WHEN THEY HAVE XYLAZINE, WHICH 1554 00:58:03,663 --> 00:58:05,732 HAS BEEN TAINTED BY SOME 1555 00:58:05,732 --> 00:58:05,998 FINDINGS? 1556 00:58:05,998 --> 00:58:08,334 AND ARE THERE SOME PEOPLE WHO DO 1557 00:58:08,334 --> 00:58:09,936 BETTER OR MUCH WORSE, AND THOSE 1558 00:58:09,936 --> 00:58:13,039 THAT SURVIVE, DO THEY HAVE MORE 1559 00:58:13,039 --> 00:58:13,439 NARROW TOXICITY? 1560 00:58:13,439 --> 00:58:17,810 WE HAVE ABSOLUTELY NO IDEA. 1561 00:58:17,810 --> 00:58:24,951 XYLAZINE PRODUCES PROBLEMS THAT, 1562 00:58:24,951 --> 00:58:27,687 WHEN YOU'RE GOING THROUGH 1563 00:58:27,687 --> 00:58:28,888 WITHDRAWAL, THEY HAVE THE 1564 00:58:28,888 --> 00:58:30,156 WITHDRAWAL FROM THE NALOXONE 1565 00:58:30,156 --> 00:58:32,325 PRECIPITATING THE OPIOID, BUT 1566 00:58:32,325 --> 00:58:35,228 ALSO THE WITHDRAWAL PRECIPITATED 1567 00:58:35,228 --> 00:58:37,864 BY HAVING THE LACK OF XYLAZINE. 1568 00:58:37,864 --> 00:58:38,998 THE MANIFESTATIONS, WHICH YOU'VE 1569 00:58:38,998 --> 00:58:40,867 PROBABLY SEEN IN THE NEWSPAPERS, 1570 00:58:40,867 --> 00:58:43,302 ARE NOT YOUR TYPICAL SORT OF 1571 00:58:43,302 --> 00:58:45,338 INFECTIOUS ULCER THAT IS BROUGHT 1572 00:58:45,338 --> 00:58:47,273 BY INJECTING INFECTED SUBSTANCES 1573 00:58:47,273 --> 00:58:49,609 INTO THE SKIN, AND UNDERSTANDING 1574 00:58:49,609 --> 00:58:52,311 HOW TO OPTIMALLY TREAT THEM. 1575 00:58:52,311 --> 00:58:54,781 IMPORTANTLY, HOW DO WE RAMP OUT 1576 00:58:54,781 --> 00:58:57,884 ACCESS TO INFORMATION THAT GIVES 1577 00:58:57,884 --> 00:59:01,721 US TIMELY DATA ON EXPOSURE TO 1578 00:59:01,721 --> 00:59:03,122 XYLAZINE THAT WE CURRENTLY DO 1579 00:59:03,122 --> 00:59:04,857 NOT HAVE, WHICH IS CRUCIAL AND 1580 00:59:04,857 --> 00:59:05,158 FUNDAMENTAL. 1581 00:59:05,158 --> 00:59:07,560 WE DO REQUIRE, IF WE DO NOT HAVE 1582 00:59:07,560 --> 00:59:08,828 ACCESS, TO UNDERSTANDING WHAT IS 1583 00:59:08,828 --> 00:59:10,830 IT THAT PEOPLE WHO END UP IN AN 1584 00:59:10,830 --> 00:59:12,098 EMERGENCY DEPARTMENT OR A 1585 00:59:12,098 --> 00:59:14,433 TREATMENT PROGRAM, WHAT ARE THEY 1586 00:59:14,433 --> 00:59:14,667 TAKING? 1587 00:59:14,667 --> 00:59:17,103 WE BASICALLY ARE OPERATING IN 1588 00:59:17,103 --> 00:59:19,639 THE DARK. 1589 00:59:19,639 --> 00:59:22,108 SO ONE OF THE PRIORITIES OF NIDA 1590 00:59:22,108 --> 00:59:26,312 THROUGH THE PROGRAM WAS TO 1591 00:59:26,312 --> 00:59:28,214 FACILITATE THE APPROVAL AND 1592 00:59:28,214 --> 00:59:29,115 DEVELOPMENT OF FENTANYL TEST 1593 00:59:29,115 --> 00:59:31,651 STRIP THAT WOULD BE APPROVED BY 1594 00:59:31,651 --> 00:59:32,285 THE FDA. 1595 00:59:32,285 --> 00:59:34,253 FENTANYL TEST STRIPS ARE OUT 1596 00:59:34,253 --> 00:59:34,453 THERE. 1597 00:59:34,453 --> 00:59:36,756 THEY COST BETWEEN $1 AND $2, YOU 1598 00:59:36,756 --> 00:59:37,590 CAN BUY THEM. 1599 00:59:37,590 --> 00:59:39,158 BECAUSE THEY ARE NOT FDA 1600 00:59:39,158 --> 00:59:40,426 APPROVED, THEY CANNOT BE USED IN 1601 00:59:40,426 --> 00:59:42,094 THE TREATMENT. 1602 00:59:42,094 --> 00:59:43,563 ONE OF THE THINGS THAT NATIONAL 1603 00:59:43,563 --> 00:59:44,797 INSTITUTE ON DRUG ABUSE 1604 00:59:44,797 --> 00:59:45,531 ADDRESSED HERE AT COUNCIL FOR 1605 00:59:45,531 --> 00:59:47,333 MANY OF YOU, THE DESPERATION 1606 00:59:47,333 --> 00:59:48,601 THAT YOU DON'T HAVE ACCESS. 1607 00:59:48,601 --> 00:59:50,570 YOU DON'T KNOW IF THE PATIENTS 1608 00:59:50,570 --> 00:59:51,404 IN THE EMERGENCY DEPARTMENT 1609 00:59:51,404 --> 00:59:53,105 COMING THERE HAVE FENTANYL OR 1610 00:59:53,105 --> 00:59:54,707 NOT BECAUSE YOU CANNOT MEASURE T 1611 00:59:54,707 --> 00:59:56,676 IT'S NOT THAT YOU DON'T HAVE 1612 00:59:56,676 --> 00:59:59,312 MASS SPECTOMETRY. 1613 00:59:59,312 --> 01:00:00,513 THAT MAY TAKE SEVERAL DAYS. 1614 01:00:00,513 --> 01:00:01,881 YOU NEED THE INFORMATION RIGHT 1615 01:00:01,881 --> 01:00:02,582 THERE. 1616 01:00:02,582 --> 01:00:05,318 THROUGH A GRANT FUNDED THROUGH 1617 01:00:05,318 --> 01:00:08,087 OTP, I AM VERY DELIGHTED TO 1618 01:00:08,087 --> 01:00:09,889 BASICALLY REPORT THAT THE 1619 01:00:09,889 --> 01:00:12,158 STENOSIS, A COMPANY THAT FUNDED 1620 01:00:12,158 --> 01:00:18,831 THROUGH THE OPTIQ PROGRAM FROM 1621 01:00:18,831 --> 01:00:21,000 NIDA GOT A BREAKTHROUGH ON 1622 01:00:21,000 --> 01:00:22,768 OCTOBER 5, 2023. 1623 01:00:22,768 --> 01:00:25,838 AND LESS THAN ONE YEAR LATER, 1624 01:00:25,838 --> 01:00:30,443 ACTUALLY GOT FDA 510 (K) 1625 01:00:30,443 --> 01:00:32,178 APPROVAL, MARCH 28, 2024. 1626 01:00:32,178 --> 01:00:33,813 THESE PRODUCTS ARE GOING TO BE 1627 01:00:33,813 --> 01:00:35,681 SOON AVAILABLE SO THAT 1628 01:00:35,681 --> 01:00:37,416 CLINICIANS CAN UTILIZE THEM, AND 1629 01:00:37,416 --> 01:00:40,620 THEY CAN BE USED TO MONITOR 1630 01:00:40,620 --> 01:00:46,325 ACTUALLY HOW THE PHYSICIANS KNOW 1631 01:00:46,325 --> 01:00:47,260 WHAT THEY ARE TAKING. 1632 01:00:47,260 --> 01:00:48,961 THE LAST PART, COMMENTS THAT I 1633 01:00:48,961 --> 01:00:50,663 WANTED TO SAY ARE JUST GIVE YOU 1634 01:00:50,663 --> 01:00:53,499 AN UPDATE ON SOMETHING THAT HAS 1635 01:00:53,499 --> 01:00:55,101 BEEN CONCERNING, AND I'VE BEEN 1636 01:00:55,101 --> 01:00:56,168 PRESENTING, WHICH IS THE NOTION 1637 01:00:56,168 --> 01:00:57,904 THAT, YES, WE'RE SEEING SOME 1638 01:00:57,904 --> 01:01:00,506 REDUCTION IN OVERDOSES, AND YOU 1639 01:01:00,506 --> 01:01:03,809 CAN SEE THE WHITE GROUP IN THE 1640 01:01:03,809 --> 01:01:05,111 UNITED STATES, WHICH IS THE 1641 01:01:05,111 --> 01:01:06,812 MINORITY, IS SHOWING A 1642 01:01:06,812 --> 01:01:08,915 REDUCTION, 35.4 DEATHS PER 1643 01:01:08,915 --> 01:01:09,148 100,000. 1644 01:01:09,148 --> 01:01:09,916 THAT GOES IN THE RIGHT 1645 01:01:09,916 --> 01:01:11,450 DIRECTION, IS GOING DOWN. 1646 01:01:11,450 --> 01:01:13,619 BUT LOOK AT THE AMERICAN 1647 01:01:13,619 --> 01:01:15,421 INDIAN/ALASKA NATIVE, LOOK AT 1648 01:01:15,421 --> 01:01:16,355 THE BLACK PEOPLE. 1649 01:01:16,355 --> 01:01:18,024 THERE THE NUMBERS ARE STEEPLY 1650 01:01:18,024 --> 01:01:19,125 GOING UP. 1651 01:01:19,125 --> 01:01:21,894 THAT'S 0.5% IS NOT TOUCHING 1652 01:01:21,894 --> 01:01:23,863 THEM. 1653 01:01:23,863 --> 01:01:25,731 IT'S ACTUALLY POINTING THE 1654 01:01:25,731 --> 01:01:28,301 FINGER IN TERMS OF WHAT ARE THE 1655 01:01:28,301 --> 01:01:29,168 RESEARCH PROJECTS? 1656 01:01:29,168 --> 01:01:30,069 WHAT ARE THE NEEDS? 1657 01:01:30,069 --> 01:01:32,038 HOW CAN WE USE SCIENCE TO 1658 01:01:32,038 --> 01:01:33,873 ADVANCE HOW WE CAN IMPROVE THE 1659 01:01:33,873 --> 01:01:40,179 OUTCOMES IN THESE POPULATIONS? 1660 01:01:40,179 --> 01:01:42,782 YOU HAVE HEARD ME PRESENT ON THE 1661 01:01:42,782 --> 01:01:44,150 PROGRAM, WHICH IS BASICALLY 1662 01:01:44,150 --> 01:01:45,351 INTENDED TO DRIVE 1663 01:01:45,351 --> 01:01:48,120 INFRASTRUCTURE, TO DRIVE SOME 1664 01:01:48,120 --> 01:01:50,690 NATIVE AMERICAN SERVING 1665 01:01:50,690 --> 01:01:51,490 ORGANIZATIONS SO THEY CAN DO 1666 01:01:51,490 --> 01:01:53,159 RESEARCH THAT THEY PRIORITIZE IN 1667 01:01:53,159 --> 01:01:55,628 ORDER TO ADDRESS THE HORRIFIC 1668 01:01:55,628 --> 01:01:58,798 OVERDOSE MORTALITY THAT THEY ARE 1669 01:01:58,798 --> 01:02:01,200 ACTUALLY EXPERIENCING. 1670 01:02:01,200 --> 01:02:04,003 THE PROJECT ARE ORGANIZED IN TWO 1671 01:02:04,003 --> 01:02:04,370 PHASES. 1672 01:02:04,370 --> 01:02:05,905 PHASE 1, WHICH IS THE FIRST TWO 1673 01:02:05,905 --> 01:02:07,106 YEARS, WHICH ACTUALLY THE GRANTS 1674 01:02:07,106 --> 01:02:09,008 ARE GOING TO BE RELEASED SOON. 1675 01:02:09,008 --> 01:02:11,210 THEN IN ORDER TO GIVE THEM THE 1676 01:02:11,210 --> 01:02:14,046 TIME TO CREATE NETWORKS TO SHOW 1677 01:02:14,046 --> 01:02:15,047 VISIBILITY, THEY'RE GOING TO THE 1678 01:02:15,047 --> 01:02:15,982 NEXT STEP. 1679 01:02:15,982 --> 01:02:17,750 WHERE ARE WE WITH THIS PROJECT? 1680 01:02:17,750 --> 01:02:25,257 AS I SAY, IT WAS THE OPPORTUNITY 1681 01:02:25,257 --> 01:02:28,327 ANNOUNCEMENT WAS RELEASED IN 1682 01:02:28,327 --> 01:02:29,862 JUNE OF 2023. 1683 01:02:29,862 --> 01:02:31,564 THE APPLICATIONS WERE DUE ON 1684 01:02:31,564 --> 01:02:32,765 NOVEMBER OF 2024. 1685 01:02:32,765 --> 01:02:34,300 THEY WERE REVIEWED THIS 1686 01:02:34,300 --> 01:02:35,434 FEBRUARY, AND WE ARE EXPECTING 1687 01:02:35,434 --> 01:02:40,606 TO GIVE THE AWARD ON JUNE 24. 1688 01:02:40,606 --> 01:02:43,609 DR. KATHY ETTES, WHO HAS BEEN 1689 01:02:43,609 --> 01:02:45,411 BASICALLY SPEAR HEADING THIS 1690 01:02:45,411 --> 01:02:47,413 PROJECT AND HAS BEEN RELENTLESS 1691 01:02:47,413 --> 01:02:49,749 WILL BE GIVING YOU AN UPDATE 1692 01:02:49,749 --> 01:02:51,450 ONCE WE HAVE SPECIFIC 1693 01:02:51,450 --> 01:02:52,885 INFORMATION IN TERMS OF WHAT ARE 1694 01:02:52,885 --> 01:02:54,787 GOING TO BE THE SITES THAT HAVE 1695 01:02:54,787 --> 01:02:56,188 BEEN SELECTED AND WHAT ARE THE 1696 01:02:56,188 --> 01:02:57,723 PROJECTS GOING TO COVER? 1697 01:02:57,723 --> 01:03:00,159 IT IS VERY EXCITING, VERY, VERY 1698 01:03:00,159 --> 01:03:00,426 AMBITIOUS. 1699 01:03:00,426 --> 01:03:01,894 IT'S ONE OF THOSE INSTANCES 1700 01:03:01,894 --> 01:03:03,763 WHERE WE HAVE FAILED AT THE NIH 1701 01:03:03,763 --> 01:03:12,238 TO REALLY EXPAND ON THE NUMBER 1702 01:03:12,238 --> 01:03:13,939 OF OVERDOSE THAT'S ARE NATIVE 1703 01:03:13,939 --> 01:03:14,440 AMERICAN. 1704 01:03:14,440 --> 01:03:16,842 WE HAVE A DEVASTATING CRISIS. 1705 01:03:16,842 --> 01:03:18,144 AS I HAVE BEEN THINKING HOW TO 1706 01:03:18,144 --> 01:03:20,112 MOVE IT FORWARD, I WAS THINKING 1707 01:03:20,112 --> 01:03:23,082 THIS, IF WE CAN SEE GROUPS THAT 1708 01:03:23,082 --> 01:03:24,884 ACTUALLY UNDERSTAND THIS CULTURE 1709 01:03:24,884 --> 01:03:25,885 SO THAT THEY CAN TAKE ADVANTAGE 1710 01:03:25,885 --> 01:03:29,588 OF THE TREMENDOUS NUMBER OF 1711 01:03:29,588 --> 01:03:30,723 RESILIENCE THAT EXISTS IN THESE 1712 01:03:30,723 --> 01:03:31,991 COMMUNITIES, AND DESPITE THAT 1713 01:03:31,991 --> 01:03:32,725 RESILIENCE, THEY ARE SUFFERING 1714 01:03:32,725 --> 01:03:33,893 SO MUCH, WE CAN LEARN TO 1715 01:03:33,893 --> 01:03:40,800 UNDERSTAND THAT. 1716 01:03:40,800 --> 01:03:42,668 BASICALLY, WE CAN FACILITATE 1717 01:03:42,668 --> 01:03:44,403 COMING UP WITH SOLUTIONS THAT 1718 01:03:44,403 --> 01:03:46,939 SPEAK TO THEM AND NOT JUST 1719 01:03:46,939 --> 01:03:51,777 IMPOSING WESTERN CULTURE. 1720 01:03:51,777 --> 01:03:55,981 THEN IN THE FIELD OF 1721 01:03:55,981 --> 01:03:57,616 INTERVENTIONS, I BASICALLY SAID 1722 01:03:57,616 --> 01:03:59,218 WE'RE VERY AWARE THAT PEOPLE ARE 1723 01:03:59,218 --> 01:04:02,555 DYING FROM POLY SUBSTANCES. 1724 01:04:02,555 --> 01:04:05,891 SO WE'RE LOOKING AT INTRODUCING 1725 01:04:05,891 --> 01:04:06,959 THERAPEUTICS THAT ADDRESS NOT 1726 01:04:06,959 --> 01:04:09,061 JUST ONE, ALCOHOL, NICOTINE, BUT 1727 01:04:09,061 --> 01:04:15,334 TO ACTUALLY TARGET THE COMMON 1728 01:04:15,334 --> 01:04:16,669 ADDICTION SUBSTANCES IN GENERAL. 1729 01:04:16,669 --> 01:04:18,370 THE GENES THAT MAKE YOU 1730 01:04:18,370 --> 01:04:20,005 VULNERABLE, MOST OF THEM MAKE 1731 01:04:20,005 --> 01:04:21,207 YOU VULNERABLE IN GENERAL, NOT 1732 01:04:21,207 --> 01:04:23,175 JUST ONE OR THE OTHER. 1733 01:04:23,175 --> 01:04:24,710 SIMILARLY, THE NEUROCIRCUITRY 1734 01:04:24,710 --> 01:04:27,146 THAT IS IMPLICATE NORTHBOUND 1735 01:04:27,146 --> 01:04:30,716 ADDICT 1736 01:04:30,716 --> 01:04:32,952 ADDICTION THAT IS NOT JUST FOR 1737 01:04:32,952 --> 01:04:34,253 CANNABIS OR ALCOHOL, ET CETERA. 1738 01:04:34,253 --> 01:04:35,754 LOOKING AT THE KNOWLEDGE AND 1739 01:04:35,754 --> 01:04:37,890 EXPANDING INTO TREATMENT THAT'S 1740 01:04:37,890 --> 01:04:39,859 GO AFTER THAT. 1741 01:04:39,859 --> 01:04:41,861 SIMILARLY, WE NEED TO DEVELOP 1742 01:04:41,861 --> 01:04:44,029 AND EXPAND RESEARCH ON OVERDOSE 1743 01:04:44,029 --> 01:04:44,897 REVERSAL AGENTS THAT ARE NOT 1744 01:04:44,897 --> 01:04:52,571 JUST LIMITED TO ACTUALLY OPIOID 1745 01:04:52,571 --> 01:04:55,941 RECEPTOR AND ANTAGONISTS, BUT 1746 01:04:55,941 --> 01:04:59,078 ALSO LOOKING AT MONOCLONAL 1747 01:04:59,078 --> 01:05:00,379 ANTIBODIES THAT MAY BE ABLE TO 1748 01:05:00,379 --> 01:05:02,581 HELP IN WHAT WE CURRENTLY HAVE, 1749 01:05:02,581 --> 01:05:06,852 NOT JUST LIMITED TO THE OPIOID 1750 01:05:06,852 --> 01:05:09,822 ANTAGONIST OR RESPIRATORY 1751 01:05:09,822 --> 01:05:10,122 STIMULATION. 1752 01:05:10,122 --> 01:05:12,057 THIS IS MY FINAL SLIDE IN TERMS 1753 01:05:12,057 --> 01:05:12,658 OF SCIENCE. 1754 01:05:12,658 --> 01:05:14,693 THIS JUST GETS YOU AN IDEA OF 1755 01:05:14,693 --> 01:05:16,095 SOME OF THE ISSUES THAT WE 1756 01:05:16,095 --> 01:05:16,362 FACED. 1757 01:05:16,362 --> 01:05:17,963 I THINK, BECAUSE THIS IS AN OPEN 1758 01:05:17,963 --> 01:05:19,765 SESSION, I WANT TO HIGHLIGHT 1759 01:05:19,765 --> 01:05:22,601 WHERE THE ISSUES THAT ARE 1760 01:05:22,601 --> 01:05:29,074 ACTUALLY IN MY BRAIN SEEM TO 1761 01:05:29,074 --> 01:05:30,109 KEEP AND ARE ACTUALLY NECESSARY. 1762 01:05:30,109 --> 01:05:32,077 I'VE HEARD FROM ALL OF YOU, AND 1763 01:05:32,077 --> 01:05:34,413 AT THE APA, THIS WAS SOMETHING 1764 01:05:34,413 --> 01:05:35,214 THAT WAS ALSO DISCUSSED. 1765 01:05:35,214 --> 01:05:37,116 TREATMENT IS MUCH HARDER WITH 1766 01:05:37,116 --> 01:05:39,185 PEOPLE WITH POLY SUBSTANCES. 1767 01:05:39,185 --> 01:05:43,622 IT'S MUCH HARDER TO INITIATE ON 1768 01:05:43,622 --> 01:05:45,090 MEDICATIONS FOR OPIOID USE 1769 01:05:45,090 --> 01:05:45,391 DISORDER. 1770 01:05:45,391 --> 01:05:47,660 MUCH HARDER FOR BUPRENORPHINE 1771 01:05:47,660 --> 01:05:49,628 AND METHADONE ALSO. 1772 01:05:49,628 --> 01:05:50,796 WE ACTUALLY DON'T KNOW WHAT ARE 1773 01:05:50,796 --> 01:05:52,932 THE CORRECT DOSES AND WE DON'T 1774 01:05:52,932 --> 01:05:54,066 KNOW THE LONG TERM OUTCOMES. 1775 01:05:54,066 --> 01:05:56,335 THIS, I THINK, IS A HUGE GAP IN 1776 01:05:56,335 --> 01:05:57,269 THE FIELD. 1777 01:05:57,269 --> 01:05:58,337 WE NEED TO START TO FOLLOW OUR 1778 01:05:58,337 --> 01:06:00,773 PATIENTS FOR A LONGER PERIOD OF 1779 01:06:00,773 --> 01:06:02,041 TIME BECAUSE WITHOUT THAT 1780 01:06:02,041 --> 01:06:04,343 INFORMATION WE'RE MISSING THE 1781 01:06:04,343 --> 01:06:06,078 LINK OF WHAT IS IT, WHAT ARE 1782 01:06:06,078 --> 01:06:07,680 FACTORS THAT MAY BE DETERMINING 1783 01:06:07,680 --> 01:06:09,281 RECOVERY. 1784 01:06:09,281 --> 01:06:13,519 AGAIN, WE NEED TO PROGRESS THE 1785 01:06:13,519 --> 01:06:17,623 HARD TO REACH POPULATIONS. 1786 01:06:17,623 --> 01:06:20,893 AMERICAN INDIANS/ALASKAN 1787 01:06:20,893 --> 01:06:22,361 NATIVES, BLACK AMERICANS, RURAL, 1788 01:06:22,361 --> 01:06:24,029 HOMELESS, PREGNANT WOMEN. 1789 01:06:24,029 --> 01:06:25,598 THESE ARE NEGLECTED GROUPS. 1790 01:06:25,598 --> 01:06:28,133 WE NEED TO ADDRESS THE OTHER 1791 01:06:28,133 --> 01:06:29,768 REALITY THAT MOST INDIVIDUALS 1792 01:06:29,768 --> 01:06:34,473 WITH SUBSTANCE USE DISORDER HAVE 1793 01:06:34,473 --> 01:06:36,508 COMORBID MEDICAL CONDITIONS, AND 1794 01:06:36,508 --> 01:06:37,610 PARTICULARLY COMORBID 1795 01:06:37,610 --> 01:06:39,712 PSYCHIATRIC CONDITIONS THAT, IF 1796 01:06:39,712 --> 01:06:41,680 THEY ARE NOT DEALT WITH THEY ARE 1797 01:06:41,680 --> 01:06:43,349 VERY UNLIKELY TO ACHIEVE 1798 01:06:43,349 --> 01:06:43,649 RECOVERY. 1799 01:06:43,649 --> 01:06:45,351 WE NEED TO UNDERSTAND THAT NOT 1800 01:06:45,351 --> 01:06:48,354 EVERYBODY IS READY TO GO INTO 1801 01:06:48,354 --> 01:06:50,289 TREATM 1802 01:06:50,289 --> 01:06:52,358 TREATMENT, AND THAT RIGHT NOW 1803 01:06:52,358 --> 01:06:54,260 LEAVING THEM UNPROTECTED IS VERY 1804 01:06:54,260 --> 01:06:55,327 DANGEROUS BECAUSE OF THE HIGH 1805 01:06:55,327 --> 01:06:56,495 RISK OF OVERDOSES. 1806 01:06:56,495 --> 01:06:59,164 THIS IS AGAIN WHERE WE NEED TO 1807 01:06:59,164 --> 01:07:00,566 UNDERSTAND WHAT AREAS OF 1808 01:07:00,566 --> 01:07:02,368 RESEARCH IN NOVEL HARM REDUCTION 1809 01:07:02,368 --> 01:07:04,803 PRACTICES CAN IMPROVE THE 1810 01:07:04,803 --> 01:07:06,305 SURVIVAL OF THESE PEOPLE. 1811 01:07:06,305 --> 01:07:08,274 SIMILARLY, WE NEED TO HAVE A 1812 01:07:08,274 --> 01:07:10,609 MUCH BETTER ACCESS TO DATA, 1813 01:07:10,609 --> 01:07:12,044 TIMELY DATA OF THE DRUGS THAT 1814 01:07:12,044 --> 01:07:14,079 ARE HITTING IN THE COMMUNITIES, 1815 01:07:14,079 --> 01:07:16,548 AND THIS IS ACTUALLY I'M 1816 01:07:16,548 --> 01:07:18,784 PRESENTING XYLAZINE, BUT IT'S 1817 01:07:18,784 --> 01:07:21,020 NOT GOING TO END IN XYLAZINE. 1818 01:07:21,020 --> 01:07:23,055 SOME PLACES ARE SEEING AN 1819 01:07:23,055 --> 01:07:24,423 INCREASE IN THE EXPOSURE WITH 1820 01:07:24,423 --> 01:07:24,757 TYLENOL. 1821 01:07:24,757 --> 01:07:26,025 THERE ARE COMBINATIONS THAT ARE 1822 01:07:26,025 --> 01:07:28,961 NOT NECESSARILY EVEN OF DRUGS 1823 01:07:28,961 --> 01:07:30,195 BUT CAN HAVE CONSEQUENCES. 1824 01:07:30,195 --> 01:07:32,798 IT'S ALSO, I THINK, HIGHLIGHTS 1825 01:07:32,798 --> 01:07:35,100 HOW CRUCIAL, EVEN THOUGH IT'S 1826 01:07:35,100 --> 01:07:37,770 NOT -- IT DOESN'T ATTRACT OR 1827 01:07:37,770 --> 01:07:39,805 MESMERIZE THE SAME WAY THAT 1828 01:07:39,805 --> 01:07:40,906 TREATMENTS, PREVENTION IS 1829 01:07:40,906 --> 01:07:41,206 NONETHELESS. 1830 01:07:41,206 --> 01:07:44,743 WE NEED TO MODIFY AND REALLY PUT 1831 01:07:44,743 --> 01:07:47,212 NOT JUST THE SCIENCE, THE 1832 01:07:47,212 --> 01:07:53,185 SCIENCE, BUT ALSO A MODEL THAT 1833 01:07:53,185 --> 01:07:55,187 COULD MAKE THE PREVENTION AND 1834 01:07:55,187 --> 01:07:57,189 INTERVENTIONS WORK AND SUSTAIN. 1835 01:07:57,189 --> 01:08:00,993 I WANT TO BE VERY GRATEFUL TO 1836 01:08:00,993 --> 01:08:06,365 DR. AMY GOLSTON, WHO HAS BEEN A 1837 01:08:06,365 --> 01:08:09,601 LEADER AT PREVENTION OF OVERDOSE 1838 01:08:09,601 --> 01:08:10,135 AT NIDA. 1839 01:08:10,135 --> 01:08:12,771 AND ALSO JUST LOOKING AT GENETIC 1840 01:08:12,771 --> 01:08:14,473 AND BIOLOGICAL COMPONENTS, BUT 1841 01:08:14,473 --> 01:08:16,208 IF IT'S FED BY INEQUALITIES AND 1842 01:08:16,208 --> 01:08:18,110 ECONOMIC DEPRIVATION THAT WE SEE 1843 01:08:18,110 --> 01:08:18,911 ACROSS THE COUNTRY. 1844 01:08:18,911 --> 01:08:20,479 IF WE WANT TO PREVENT AND 1845 01:08:20,479 --> 01:08:23,615 PROTECT PEOPLE, WE WANT TO 1846 01:08:23,615 --> 01:08:24,883 PROVIDE RESILIENCE, WE NEED TO 1847 01:08:24,883 --> 01:08:26,618 ADDRESS IN A WAY THAT IS 1848 01:08:26,618 --> 01:08:27,820 SUSTAINABLE, THOSE SOCIAL 1849 01:08:27,820 --> 01:08:29,121 DETERMINANTS OF HEALTH THAT ARE 1850 01:08:29,121 --> 01:08:30,089 MAKING SO MANY PEOPLE 1851 01:08:30,089 --> 01:08:32,391 VULNERABLE. 1852 01:08:32,391 --> 01:08:35,194 I ALSO WANT TO BRAG, WE ARE 1853 01:08:35,194 --> 01:08:37,463 GOING TO BE 50 YEARS OLD. 1854 01:08:37,463 --> 01:08:39,665 WE HAVE OUR ANNIVERSARY ON MAY 1855 01:08:39,665 --> 01:08:39,965 14th. 1856 01:08:39,965 --> 01:08:42,267 EVERYONE IS INVITED. 1857 01:08:42,267 --> 01:08:46,004 THERE WILL BE A PANEL A SET OF 1858 01:08:46,004 --> 01:08:48,440 PANELISTS TO AGAIN TRY TO PUSH 1859 01:08:48,440 --> 01:08:51,877 THE ENVELOPE. 1860 01:08:51,877 --> 01:08:53,712 WE'VE DONE ALL OF THESE OVER 50 1861 01:08:53,712 --> 01:08:53,912 YEARS. 1862 01:08:53,912 --> 01:08:55,080 WE HAVE A LOT OF CHALLENGES. 1863 01:08:55,080 --> 01:08:56,315 WHAT DO WE WANT? 1864 01:08:56,315 --> 01:08:57,416 WE HAVE GREAT OPPORTUNITIES. 1865 01:08:57,416 --> 01:09:00,018 WHAT ARE THE THINGS, WE NEED TO 1866 01:09:00,018 --> 01:09:01,453 KEEP CLOSE, CLOSE EYES BECAUSE 1867 01:09:01,453 --> 01:09:02,921 THEY ARE THE HARDEST ONES TO 1868 01:09:02,921 --> 01:09:03,355 ADDRESS. 1869 01:09:03,355 --> 01:09:05,391 THAT MEANS WE JUST NEED TO PUT 1870 01:09:05,391 --> 01:09:05,891 MORE ENERGY. 1871 01:09:05,891 --> 01:09:07,926 AND JUST ALSO I WANT TO SAY 1872 01:09:07,926 --> 01:09:11,230 GOOD-BYE TO ALL OF THE MEMBERS, 1873 01:09:11,230 --> 01:09:12,297 AT LEAST FOR THE COUNCIL ITSELF, 1874 01:09:12,297 --> 01:09:13,699 AND THANK YOU FOR ALL OF YOUR 1875 01:09:13,699 --> 01:09:14,032 CONTRIBUTIONS. 1876 01:09:14,032 --> 01:09:15,234 AND I WANT TO WELCOME THE NEW 1877 01:09:15,234 --> 01:09:15,534 MEMBERS. 1878 01:09:15,534 --> 01:09:17,870 WITH THAT, I WANT TO THANK YOU 1879 01:09:17,870 --> 01:09:28,213 FOR YOUR ATTENTION. 1880 01:09:33,152 --> 01:09:34,787 THIS IS THE POINT WHERE WE HAVE 1881 01:09:34,787 --> 01:09:45,130 TIME FOR QUESTIONS. 1882 01:09:52,771 --> 01:09:54,206 >> THANK YOU FOR THAT LOVELY 1883 01:09:54,206 --> 01:09:54,406 TALK. 1884 01:09:54,406 --> 01:09:57,476 I WANT TO ECHO THE IMPORTANCE OF 1885 01:09:57,476 --> 01:10:04,817 INCREASING -- THAT'S BEEN VERY 1886 01:10:04,817 --> 01:10:07,553 ENCOURAGING TO OUR TRAINEES. 1887 01:10:07,553 --> 01:10:10,122 NIDA HAS BEEN ORGANIZING THESE 1888 01:10:10,122 --> 01:10:11,390 MEETINGS OF DIRECTORS WHERE WE 1889 01:10:11,390 --> 01:10:14,159 KIND OF CO-MENTOR EACH OTHER. 1890 01:10:14,159 --> 01:10:17,362 I'LL SPEAK FOR OUR TEAM, WE 1891 01:10:17,362 --> 01:10:18,797 LEARN A LOT FROM EACH OTHER. 1892 01:10:18,797 --> 01:10:20,799 YOU CAN DO THAT SOMETIMES AT 1893 01:10:20,799 --> 01:10:22,234 CONFERENCES, BUT TO HAVE A 1894 01:10:22,234 --> 01:10:23,569 DEDICATED TIME TO BE ABLE TO DO 1895 01:10:23,569 --> 01:10:24,803 THAT, THAT'S EXTREMELY HELPFUL. 1896 01:10:24,803 --> 01:10:25,871 THANK YOU SO MUCH FOR BEING 1897 01:10:25,871 --> 01:10:26,805 THERE FOR US. 1898 01:10:26,805 --> 01:10:28,073 THE OTHER COMMENT I HAD, AND 1899 01:10:28,073 --> 01:10:30,375 MAYBE IT'S A QUESTION, IS WHAT 1900 01:10:30,375 --> 01:10:32,644 NIDA MIGHT BE ABLE TO DO TO 1901 01:10:32,644 --> 01:10:34,012 ENCOURAGE AND PROMOTE 1902 01:10:34,012 --> 01:10:37,783 RESPONSIBLE USE OF AI AND 1903 01:10:37,783 --> 01:10:38,450 MACHINE LEARNING. 1904 01:10:38,450 --> 01:10:40,052 I THINK, WITH ALL THE DATA WE'RE 1905 01:10:40,052 --> 01:10:42,488 ABLE TO GET OUT THERE, ONE OF 1906 01:10:42,488 --> 01:10:44,590 THE CHALLENGES WE'RE INCURRING 1907 01:10:44,590 --> 01:10:47,226 IS HOW MACHINE LEARNING 1908 01:10:47,226 --> 01:10:48,961 ALGORITHMS, DEEP LEARNING, CAN 1909 01:10:48,961 --> 01:10:51,263 ACTUALLY BE IMPLEMENTED IN A WAY 1910 01:10:51,263 --> 01:10:52,264 THAT'S NOT GIVING US THE BEST 1911 01:10:52,264 --> 01:10:53,599 USE OF DATA. 1912 01:10:53,599 --> 01:10:55,200 I WONDER IF THERE ARE CHECKS AND 1913 01:10:55,200 --> 01:10:56,568 BALANCES OR TRAINING 1914 01:10:56,568 --> 01:10:57,603 OPPORTUNITIES, SOMETHING THAT 1915 01:10:57,603 --> 01:10:59,304 THE AGENCY COULD SUPPORT TO 1916 01:10:59,304 --> 01:11:01,507 ENSURE THAT AI IS USED IN 1917 01:11:01,507 --> 01:11:02,074 ADDICTION RESEARCH. 1918 01:11:02,074 --> 01:11:03,942 >> AND THE ANSWER IS YES, OF 1919 01:11:03,942 --> 01:11:04,243 COURSE. 1920 01:11:04,243 --> 01:11:05,978 THIS IS ONE OF THE ISSUES THAT 1921 01:11:05,978 --> 01:11:12,384 WE'VE DISCUSSED AT LENGTH. 1922 01:11:12,384 --> 01:11:14,586 IT PERTAINS NOT JUST TO NIDA. 1923 01:11:14,586 --> 01:11:16,688 IT PERTAINS TO THE WHOLE OF NIH. 1924 01:11:16,688 --> 01:11:18,924 HOW DO WE ENSURE THE DATA IS 1925 01:11:18,924 --> 01:11:21,193 PROPERLY UTILIZED? 1926 01:11:21,193 --> 01:11:22,528 BECAUSE OTHERWISE YOU END UP 1927 01:11:22,528 --> 01:11:23,195 WHERE IT CONTRIBUTES. 1928 01:11:23,195 --> 01:11:24,997 PEOPLE HAVE WRITTEN ABOUT IN OUR 1929 01:11:24,997 --> 01:11:27,399 CASE IT'S ALSO VERY CHALLENGING 1930 01:11:27,399 --> 01:11:28,967 BECAUSE WE'RE DEALING WITH A 1931 01:11:28,967 --> 01:11:31,169 DISEASE THAT IS HIGHLY 1932 01:11:31,169 --> 01:11:31,470 STIGMATIZED. 1933 01:11:31,470 --> 01:11:33,872 IT'S AN ILLEGAL ACTIVITY IN SOME 1934 01:11:33,872 --> 01:11:37,576 PLACES. 1935 01:11:37,576 --> 01:11:39,144 RIGHT NOW WITH AI, I SUSPECT 1936 01:11:39,144 --> 01:11:41,880 SOME OF THESE LEARNING MODELS 1937 01:11:41,880 --> 01:11:43,815 AND GENERATIVE MODELS YOU CAN 1938 01:11:43,815 --> 01:11:45,884 PROBABLY OBTAIN INFORMATION OF 1939 01:11:45,884 --> 01:11:53,525 OUR PARTICIPANTS. 1940 01:11:53,525 --> 01:11:54,960 THE ASPECT OF CONFIDENTIALITY, 1941 01:11:54,960 --> 01:11:57,563 THE ASPECT OF DATA EQUALITY, THE 1942 01:11:57,563 --> 01:12:00,399 ASPECT OF DATA EQUITY IS 1943 01:12:00,399 --> 01:12:03,669 CRUCIAL. 1944 01:12:03,669 --> 01:12:05,437 IT'S NOT LIKE WE HAVE A SIMPLE 1945 01:12:05,437 --> 01:12:05,704 SOLUTION. 1946 01:12:05,704 --> 01:12:16,048 THE NIH HAS A GROUP. 1947 01:12:16,448 --> 01:12:17,983 TO TRY TO ALSO LEARN WHAT 1948 01:12:17,983 --> 01:12:19,551 PRACTICES MAY BE UTILIZED IN 1949 01:12:19,551 --> 01:12:19,918 OTHER PLACES. 1950 01:12:19,918 --> 01:12:21,587 IF WE DON'T SOLVE IT, THEN WE 1951 01:12:21,587 --> 01:12:24,423 COULD DO A LOT OF HARM. 1952 01:12:24,423 --> 01:12:32,631 I'M VERY AWARE. 1953 01:12:32,631 --> 01:12:33,865 I THINK IT'S AN EXTRAORDINARY 1954 01:12:33,865 --> 01:12:34,800 OPPORTUNITY WHAT THESE LARGE 1955 01:12:34,800 --> 01:12:36,868 DATABASES ARE GIVING US. 1956 01:12:36,868 --> 01:12:40,939 BUT SPEAKING OF THE ABCD AND 1957 01:12:40,939 --> 01:12:42,107 HBCD, IT COMES WITH 1958 01:12:42,107 --> 01:12:42,474 RESPONSIBILITY. 1959 01:12:42,474 --> 01:12:43,508 IT HAS MANY NUANCES. 1960 01:12:43,508 --> 01:12:45,043 JUST SORT OF SPEAKING IN GENERAL 1961 01:12:45,043 --> 01:12:45,243 TERMS. 1962 01:12:45,243 --> 01:12:47,879 YES, ABSOLUTELY. 1963 01:12:47,879 --> 01:12:50,115 IT IS ONE OF THE THINGS THAT I 1964 01:12:50,115 --> 01:12:52,284 ALSO BUG WILSON, I SAY, WILSON, 1965 01:12:52,284 --> 01:12:53,885 WE NEED TO ENSURE WE ARE 1966 01:12:53,885 --> 01:12:56,221 TRAINING THE SCIENTISTS ON DATA. 1967 01:12:56,221 --> 01:12:57,055 WE BASICALLY CANNOT AFFORD NOT 1968 01:12:57,055 --> 01:13:01,560 TO. 1969 01:13:01,560 --> 01:13:02,427 HE ALWAYS SAYS, YES, NORA, WE 1970 01:13:02,427 --> 01:13:05,263 ARE. 1971 01:13:05,263 --> 01:13:07,532 WE ARE OF COURSE TAKING 1972 01:13:07,532 --> 01:13:08,734 ADVANTAGE OF CORPORATE PROGRAMS 1973 01:13:08,734 --> 01:13:11,136 FOR LEARNING AND TRAINING THAT 1974 01:13:11,136 --> 01:13:15,140 ARE GIVEN ACROSS THE WHOLE NIH, 1975 01:13:15,140 --> 01:13:16,908 BUT IF YOU HAVE SUGGESTIONS, 1976 01:13:16,908 --> 01:13:17,943 PLEASE COME TO US. 1977 01:13:17,943 --> 01:13:20,078 THIS DATA WORLD IS NEW TO ALL OF 1978 01:13:20,078 --> 01:13:20,245 US. 1979 01:13:20,245 --> 01:13:20,779 WE'RE ALL LEARNING IN THE 1980 01:13:20,779 --> 01:13:30,922 PROCESS. 1981 01:13:34,860 --> 01:13:37,295 >> THANKS FOR AN INCREDIBLE 1982 01:13:37,295 --> 01:13:38,096 PRESENTATION AS ALWAYS. 1983 01:13:38,096 --> 01:13:39,398 THERE'S ONE COMMENT I WANT TO 1984 01:13:39,398 --> 01:13:41,533 MAKE ABOUT THE EFFORTS TO EXPAND 1985 01:13:41,533 --> 01:13:42,234 ACCESS TO NALOXONE. 1986 01:13:42,234 --> 01:13:45,070 WHEN I WAS CHECKING INTO MY 1987 01:13:45,070 --> 01:13:46,705 MARRIOTT HOTEL FOR THIS TRIP, I 1988 01:13:46,705 --> 01:13:48,306 WAS LOOKING FOR A PLACE TO BUY 1989 01:13:48,306 --> 01:13:49,374 TOOTHPASTE, AND I COULDN'T 1990 01:13:49,374 --> 01:13:50,776 BECAUSE I FORGOT TO BUY 1991 01:13:50,776 --> 01:13:51,076 TOOTHPASTE. 1992 01:13:51,076 --> 01:13:53,378 I WENT TO THE VENDING MACHINE IN 1993 01:13:53,378 --> 01:13:56,481 THE LOBBY, AND YOU CAN BUY 1994 01:13:56,481 --> 01:13:58,483 NALOXONE IN THE VENDING MACHINE. 1995 01:13:58,483 --> 01:13:59,918 SO YOUR EFFORTS ARE WORKING. 1996 01:13:59,918 --> 01:14:01,153 I APPLAUD YOU. 1997 01:14:01,153 --> 01:14:02,721 I DON'T KNOW HOW MUCH IT COSTS, 1998 01:14:02,721 --> 01:14:03,922 BUT IT'S THERE. 1999 01:14:03,922 --> 01:14:04,956 >> NO, THAT'S WONDERFUL. 2000 01:14:04,956 --> 01:14:05,624 I DIDN'T KNOW. 2001 01:14:05,624 --> 01:14:07,025 I'LL GO AND TAKE A PICTURE. 2002 01:14:07,025 --> 01:14:08,126 >> I'LL TAKE A PICTURE FOR YOU 2003 01:14:08,126 --> 01:14:11,496 AND SEND IT. 2004 01:14:11,496 --> 01:14:13,999 >> THIS IS ALWAYS MY FAVORITE 2005 01:14:13,999 --> 01:14:14,199 PART. 2006 01:14:14,199 --> 01:14:15,967 I FEEL I HAVE TO TRIAGE WHAT 2007 01:14:15,967 --> 01:14:17,002 QUESTIONS I WANT TO ASK YOU. 2008 01:14:17,002 --> 01:14:18,804 I WAS REALLY INTERESTED TO SEE 2009 01:14:18,804 --> 01:14:20,672 THAT THERE IS THE EARLY DATA 2010 01:14:20,672 --> 01:14:22,240 COMING IN FROM THE HBCD. 2011 01:14:22,240 --> 01:14:25,043 I WAS ON THE EARLY PLANNING 2012 01:14:25,043 --> 01:14:26,011 GRANTS, THINKING ABOUT THE 2013 01:14:26,011 --> 01:14:27,179 ISSUES WITH THIS. 2014 01:14:27,179 --> 01:14:29,514 ONE OF THE THINGS I CONTINUED TO 2015 01:14:29,514 --> 01:14:32,951 THINK ABOUT IS, AS THE STATE 2016 01:14:32,951 --> 01:14:35,787 LAWS GOVERNING WE PRODUCTION OR 2017 01:14:35,787 --> 01:14:38,156 COSTS TO ALLAY THE RISKS OF 2018 01:14:38,156 --> 01:14:39,725 THESE WOMEN WHO ARE PREGNANT AND 2019 01:14:39,725 --> 01:14:40,425 USING DRUGS. 2020 01:14:40,425 --> 01:14:43,261 THE THING I WAS WONDERING IS 2021 01:14:43,261 --> 01:14:45,163 HAVE THERE BEEN ANY CONCERNS SO 2022 01:14:45,163 --> 01:14:49,835 FAR, CLOSE CALLS, REPORTS, LAW 2023 01:14:49,835 --> 01:14:51,303 ENFORCEMENT INVOLVEMENT, SOCIAL 2024 01:14:51,303 --> 01:14:54,072 SERVICES INVOLVEMENT FOR ANY OF 2025 01:14:54,072 --> 01:14:55,707 THESE WOMEN WHO ARE BEING 2026 01:14:55,707 --> 01:14:57,509 ENROLLED IN THIS STUDY AND USING 2027 01:14:57,509 --> 01:14:59,978 DRUGS WHILE THEY ARE PREGNANT? 2028 01:14:59,978 --> 01:15:03,281 >> I WILL ALLOW ED TO RESPOND TO 2029 01:15:03,281 --> 01:15:03,448 IT. 2030 01:15:03,448 --> 01:15:05,083 THIS WAS ONE OF OUR BIG, BIG 2031 01:15:05,083 --> 01:15:06,284 CONCERNS, AND THEY ADDRESSED IT, 2032 01:15:06,284 --> 01:15:08,353 I THINK, IN A PRETTY IMPRESSIVE 2033 01:15:08,353 --> 01:15:08,520 WAY. 2034 01:15:08,520 --> 01:15:11,656 >> I'M NOT AWARE OF ANYTHING 2035 01:15:11,656 --> 01:15:12,724 DIRECTLY, BUT WE'VE SPENT MANY, 2036 01:15:12,724 --> 01:15:14,259 MANY MONTHS AND A LOT OF 2037 01:15:14,259 --> 01:15:16,595 DISCUSSIONS ABOUT HOW TO AVOID 2038 01:15:16,595 --> 01:15:17,362 THIS PROBLEM. 2039 01:15:17,362 --> 01:15:18,930 WE DON'T WANT ANYBODY THAT'S 2040 01:15:18,930 --> 01:15:21,133 RECRUITED INTO THE STUDY TO BE 2041 01:15:21,133 --> 01:15:24,402 PUT IN JEOPARDY BECAUSE OF THEIR 2042 01:15:24,402 --> 01:15:26,538 PARTICIPATION. 2043 01:15:26,538 --> 01:15:29,241 THE PROCESSES THAT WE USE ARE 2044 01:15:29,241 --> 01:15:33,678 SUCH THAT PEOPLE WHO ARE AT THE 2045 01:15:33,678 --> 01:15:36,815 SITE ARE NOT GIVEN THE DATA FROM 2046 01:15:36,815 --> 01:15:38,049 THE PARTICIPANTS ABOUT WHAT 2047 01:15:38,049 --> 01:15:39,584 THEIR DRUG USE IS. 2048 01:15:39,584 --> 01:15:41,720 IT GOES THROUGH THE REPOSITORY, 2049 01:15:41,720 --> 01:15:43,155 AND THEY'RE GIVEN FEEDBACK IN 2050 01:15:43,155 --> 01:15:44,256 GENERAL ABOUT WHAT PARTICIPANTS 2051 01:15:44,256 --> 01:15:46,324 THEY NEED TO BE RECRUITING. 2052 01:15:46,324 --> 01:15:48,160 THE WHOLE POINT IS TO NOT PUT 2053 01:15:48,160 --> 01:15:49,661 THEM IN A SITUATION WHERE THEY 2054 01:15:49,661 --> 01:15:50,562 HAVE TO REPORT SOMETHING WHERE 2055 01:15:50,562 --> 01:15:53,231 THEY'RE GOING TO PUT SOMEONE IN 2056 01:15:53,231 --> 01:15:53,498 JEOPARDY. 2057 01:15:53,498 --> 01:15:54,399 RATHER EVERYBODY IS GIVEN 2058 01:15:54,399 --> 01:15:56,001 INFORMATION ABOUT A HEALTHY 2059 01:15:56,001 --> 01:16:00,405 PREGNANCY AND RESOURCE THAT'S 2060 01:16:00,405 --> 01:16:02,374 THEY CAN USE TO TRY TO GET HELP 2061 01:16:02,374 --> 01:16:03,608 IF THEY WANT TO. 2062 01:16:03,608 --> 01:16:06,411 WE HAVE PEER NAVIGATORS ALSO AT 2063 01:16:06,411 --> 01:16:07,546 EVERY SINGLE SITE. 2064 01:16:07,546 --> 01:16:08,647 THERE ARE PEOPLE THERE THAT CAN 2065 01:16:08,647 --> 01:16:10,215 HELP THEM COME UP WITH RESOURCES 2066 01:16:10,215 --> 01:16:12,417 IF THEY'RE INTERESTED. 2067 01:16:12,417 --> 01:16:14,186 WE REALLY WENT TO GREAT LENGTHS 2068 01:16:14,186 --> 01:16:15,587 NOT TO HAVE THE INDIVIDUAL DATA 2069 01:16:15,587 --> 01:16:17,856 AVAILABLE TO PEOPLE AT THE 2070 01:16:17,856 --> 01:16:22,994 SITES. 2071 01:16:22,994 --> 01:16:25,864 >> IS THERE LIKE A PLAN FOR 2072 01:16:25,864 --> 01:16:28,533 REPORTING SHOULD SOMETHING 2073 01:16:28,533 --> 01:16:28,767 HAPPEN? 2074 01:16:28,767 --> 01:16:30,836 IS THIS ONE OF THE STOPPAGE 2075 01:16:30,836 --> 01:16:31,136 CRITERIA? 2076 01:16:31,136 --> 01:16:32,337 I CAN JUST IMAGINE THIS BEING 2077 01:16:32,337 --> 01:16:35,073 LIKE A REALLY BIG DEAL IF 2078 01:16:35,073 --> 01:16:36,374 SOMETHING LIKE THIS WERE TO 2079 01:16:36,374 --> 01:16:36,608 HAPPEN? 2080 01:16:36,608 --> 01:16:38,376 >> I THINK WE'RE TRYING TO THINK 2081 01:16:38,376 --> 01:16:39,477 ABOUT WE HAVE AN OBSERVATIONAL 2082 01:16:39,477 --> 01:16:42,514 STUDY MONITORING BOARD, AND WE 2083 01:16:42,514 --> 01:16:45,250 HAVE A BIOMEDICAL UNIT AND A LOT 2084 01:16:45,250 --> 01:16:46,685 OF DIFFERENT GROUPS WE CONSULT 2085 01:16:46,685 --> 01:16:46,885 WITH. 2086 01:16:46,885 --> 01:16:48,220 I THINK RIGHT NOW WHAT WE'RE 2087 01:16:48,220 --> 01:16:50,689 TRYING TO DEAL WITH IS THAT 2088 01:16:50,689 --> 01:16:55,627 WE'VE HAD SOME POSITIVE FENTANYL 2089 01:16:55,627 --> 01:17:00,532 REPORTS. 2090 01:17:00,532 --> 01:17:01,867 NOT WHAT WE'VE GOTTEN IN TERMS 2091 01:17:01,867 --> 01:17:03,702 OF WHAT PEOPLE ARE REPORTING, 2092 01:17:03,702 --> 01:17:04,903 AND WE'VE BEEN STRUGGLING WITH 2093 01:17:04,903 --> 01:17:06,438 THAT PEOPLE BECAUSE WE DON'T GET 2094 01:17:06,438 --> 01:17:08,773 THE BIOSPECIMENS IMMEDIATELY. 2095 01:17:08,773 --> 01:17:09,774 THOSE ANALYSES DON'T COME IN 2096 01:17:09,774 --> 01:17:10,742 IMMEDIATELY WHEN SOMEBODY IS 2097 01:17:10,742 --> 01:17:11,109 THERE. 2098 01:17:11,109 --> 01:17:12,911 WE DON'T KNOW THE PERSON KNEW 2099 01:17:12,911 --> 01:17:13,812 THEY WERE BEING EXPOSED. 2100 01:17:13,812 --> 01:17:15,380 IF WE START GETTING INTO THIS 2101 01:17:15,380 --> 01:17:17,215 INDIVIDUAL LEVEL DATA, THEN 2102 01:17:17,215 --> 01:17:17,816 WE'RE GOING TO RUN INTO THOSE 2103 01:17:17,816 --> 01:17:20,385 PROBLEMS. 2104 01:17:20,385 --> 01:17:22,187 ALL OF THESE ISSUES, I THINK, 2105 01:17:22,187 --> 01:17:24,289 ARE GOING TO KEEP -- THEY'RE ON 2106 01:17:24,289 --> 01:17:26,591 EVERYBODY'S RADAR, AND WE'RE 2107 01:17:26,591 --> 01:17:29,127 TRYING TO HAVE THE ACTIVE 2108 01:17:29,127 --> 01:17:29,961 DISCUSSIONS TO FIGURE WHAT THE 2109 01:17:29,961 --> 01:17:31,263 MOST EFFECTIVE SOLUTIONS ARE. 2110 01:17:31,263 --> 01:17:33,265 AT THIS POINT AT THE VERY LEAST, 2111 01:17:33,265 --> 01:17:35,634 IT'S MAKING SURE PEOPLE ARE 2112 01:17:35,634 --> 01:17:37,869 AWARE THAT FENTANYL IS IN THE 2113 01:17:37,869 --> 01:17:39,638 DRUG SUPPLY AND ADDING THAT TO 2114 01:17:39,638 --> 01:17:40,672 THE HEALTHY PREGNANCY 2115 01:17:40,672 --> 01:17:43,174 INFORMATION WE GIVE, AND WE'RE 2116 01:17:43,174 --> 01:17:46,511 DEVELOPING A SPECIFIC FLIER 2117 01:17:46,511 --> 01:17:46,878 ABOUT FENTANYL. 2118 01:17:46,878 --> 01:17:48,179 IT'S VERY CHALLENGING FOR THAT 2119 01:17:48,179 --> 01:17:49,814 REASON BECAUSE YOU'RE REALLY 2120 01:17:49,814 --> 01:17:51,616 BALANCING TWO DIFFERENT SETS OF 2121 01:17:51,616 --> 01:17:53,318 FORMS, WHICH CAN BE EQUALLY -- 2122 01:17:53,318 --> 01:17:55,086 AND WE HAVE A CRISIS 2123 01:17:55,086 --> 01:17:56,187 COMMUNICATIONS TEAM TO DEAL WITH 2124 01:17:56,187 --> 01:17:57,188 IT BECAUSE WE RECOGNIZE THAT 2125 01:17:57,188 --> 01:17:59,124 THINGS ARE GOING TO HAPPEN AND 2126 01:17:59,124 --> 01:18:01,159 THAT WE'RE GOING TO NEED TO BE 2127 01:18:01,159 --> 01:18:03,695 ABLE TO ADDRESS THEM AS BEST WE 2128 01:18:03,695 --> 01:18:03,995 CAN. 2129 01:18:03,995 --> 01:18:06,965 >> IS THE ETHICS TEAM INVOLVED? 2130 01:18:06,965 --> 01:18:09,067 >> YES, SHE'S IN THE WORK GROUP 2131 01:18:09,067 --> 01:18:10,735 THAT'S SORT OF LEADING THE LEGAL 2132 01:18:10,735 --> 01:18:12,904 AND ETHICAL CONSIDERATIONS. 2133 01:18:12,904 --> 01:18:16,274 BUT THEN THE OSMB, THEY WORK 2134 01:18:16,274 --> 01:18:16,541 SEPARATE. 2135 01:18:16,541 --> 01:18:17,976 THEY ARE A VERY ACTIVE GROUP. 2136 01:18:17,976 --> 01:18:19,077 THEY WERE NOT HAPPY WITH JUST 2137 01:18:19,077 --> 01:18:20,245 TWO MEETINGS A YEAR. 2138 01:18:20,245 --> 01:18:21,913 THEY WANT FOUR MEETINGS A YEAR. 2139 01:18:21,913 --> 01:18:23,481 WE'RE VERY INTERESTED IN REALLY 2140 01:18:23,481 --> 01:18:24,950 BEING INVOLVED IN HELPING US 2141 01:18:24,950 --> 01:18:25,884 WORK THROUGH SOME OF THESE 2142 01:18:25,884 --> 01:18:33,491 TRICKY THINGS. 2143 01:18:33,491 --> 01:18:35,327 >> THANK YOU, NORA, FOR THAT 2144 01:18:35,327 --> 01:18:36,962 REALLY WONDERFUL PRESENTATION. 2145 01:18:36,962 --> 01:18:39,831 SO MANY IMPORTANT NUGGETS YOU 2146 01:18:39,831 --> 01:18:40,198 TOUCHED ON. 2147 01:18:40,198 --> 01:18:42,600 I WANT TO SECOND THE POINT ABOUT 2148 01:18:42,600 --> 01:18:45,270 THE TRAINING AND THE T-32s. 2149 01:18:45,270 --> 01:18:46,805 THAT'S VERY, VERY HELPFUL. 2150 01:18:46,805 --> 01:18:49,274 I HOPE THAT WILL IMPACT THE 2151 01:18:49,274 --> 01:18:54,112 CURRENT CURRENT RENEWALS AND 2152 01:18:54,112 --> 01:18:54,713 GRANTS AS WELL. 2153 01:18:54,713 --> 01:18:56,348 THE TWO THINGS I WANTED TO POINT 2154 01:18:56,348 --> 01:18:58,416 OUT AND MAKE THE COMMENT AND ASK 2155 01:18:58,416 --> 01:19:00,452 A QUESTION ABOUT WAS FIRST ON 2156 01:19:00,452 --> 01:19:04,990 THE THERAPEUTICS FOR POLY 2157 01:19:04,990 --> 01:19:06,658 SUBSTANCES, AND WE'VE KNOWN FOR 2158 01:19:06,658 --> 01:19:07,659 SO LONG THERE ARE GATEWAY DRUGS 2159 01:19:07,659 --> 01:19:08,893 THAT ARE COMMONLY USED. 2160 01:19:08,893 --> 01:19:10,729 I WANT TO COMMEND YOU ON REALLY 2161 01:19:10,729 --> 01:19:11,696 MOVING IN THAT DIRECTION. 2162 01:19:11,696 --> 01:19:14,899 IT'S REALLY NEEDED, THE OVERDOSE 2163 01:19:14,899 --> 01:19:17,202 PREVENTION, BUT REALLY 2164 01:19:17,202 --> 01:19:19,738 PREVENTION OF DEVELOPING EVEN 2165 01:19:19,738 --> 01:19:22,941 SEVERE SUBSTANCE USE DISORDER, 2166 01:19:22,941 --> 01:19:24,275 POLY SUBSTANCE USE DISORDER. 2167 01:19:24,275 --> 01:19:26,044 BUT THE QUESTION ABOUT 2168 01:19:26,044 --> 01:19:27,746 PREVENTION, AND I WONDER IF 2169 01:19:27,746 --> 01:19:29,247 THERE WAS ANY EFFORTS ON THE 2170 01:19:29,247 --> 01:19:32,017 PREVENTATIVE SIDE OF POLY 2171 01:19:32,017 --> 01:19:33,418 SUBSTANCE USE. 2172 01:19:33,418 --> 01:19:35,487 OF COURSE PSYCHOSOCIAL 2173 01:19:35,487 --> 01:19:37,689 INTERVENTION BUT EVEN 2174 01:19:37,689 --> 01:19:39,891 THERAPEUTICS BECAUSE THEY'RE 2175 01:19:39,891 --> 01:19:41,326 ALREADY EXPOSED TO ALCOHOL AND 2176 01:19:41,326 --> 01:19:42,427 NICOTINE AND MARIJUANA, AND IN 2177 01:19:42,427 --> 01:19:44,396 OUR HANDS, WE'RE LOOKING AT VERY 2178 01:19:44,396 --> 01:19:45,864 HIGH LEVELS OF SOCIAL 2179 01:19:45,864 --> 01:19:46,831 DETERMINANTS OF HEALTH AND 2180 01:19:46,831 --> 01:19:48,500 TRAUMA LEVELS IN THAT EARLY 2181 01:19:48,500 --> 01:19:49,667 CONTEXT. 2182 01:19:49,667 --> 01:19:52,137 JUST WANTED TO ASK ABOUT 2183 01:19:52,137 --> 01:19:53,938 THERAPEUTICS AND SORT OF 2184 01:19:53,938 --> 01:19:54,572 PREVENTING MORE SEVERE SUBSTANCE 2185 01:19:54,572 --> 01:20:00,812 USE. 2186 01:20:00,812 --> 01:20:01,346 THAT'S ONE. 2187 01:20:01,346 --> 01:20:02,680 IT TIES TO THE OTHER THING THAT 2188 01:20:02,680 --> 01:20:04,082 SEEMED REALLY EXCITING COMING 2189 01:20:04,082 --> 01:20:06,985 FROM THE NIH DIRECTOR'S OFFICE, 2190 01:20:06,985 --> 01:20:08,887 THIS PRIMARY CARE CLINICAL 2191 01:20:08,887 --> 01:20:09,320 SERVICE INITIATIVE. 2192 01:20:09,320 --> 01:20:13,258 I WONDER IF YOU COULD EXPAND ON 2193 01:20:13,258 --> 01:20:14,492 HOW NIDA WOULD INTERFACE WITH 2194 01:20:14,492 --> 01:20:14,959 THAT. 2195 01:20:14,959 --> 01:20:17,829 I KNOW IT'S EARLY DAYS AND NOT 2196 01:20:17,829 --> 01:20:19,697 MUCH FROM THE COMMON FUND, BUT 2197 01:20:19,697 --> 01:20:20,799 NEXT YEAR THERE WILL BE MORE. 2198 01:20:20,799 --> 01:20:23,301 IT SEEMS LIKE IT'S SUCH AN 2199 01:20:23,301 --> 01:20:24,235 OPPORTUNITY FOR OUR AFFECTED 2200 01:20:24,235 --> 01:20:26,905 GROUPS AND FAMILIES WHO ARE NOT 2201 01:20:26,905 --> 01:20:29,240 GOING INTO INITIAL TREATMENT BUT 2202 01:20:29,240 --> 01:20:30,442 THEY ARE SHOWING UP IN PRIMARY 2203 01:20:30,442 --> 01:20:30,642 CARE. 2204 01:20:30,642 --> 01:20:31,876 YOU ALSO ALLUDED TO THAT. 2205 01:20:31,876 --> 01:20:33,845 IF THERE'S A PLACE FOR US TO 2206 01:20:33,845 --> 01:20:35,947 REALLY GET IN ON THE PREVENTION 2207 01:20:35,947 --> 01:20:36,481 SIDE THERE TOO. 2208 01:20:36,481 --> 01:20:41,119 JUST YOUR THOUGHTS ON THAT. 2209 01:20:41,119 --> 01:20:43,154 >> IN FACT, ONE OF THE THINGS I 2210 01:20:43,154 --> 01:20:44,489 LOVED ABOUT THE PRIMARY CARE 2211 01:20:44,489 --> 01:20:45,323 RESEARCH NETWORK, MANY THINGS, 2212 01:20:45,323 --> 01:20:47,058 BUT ONE OF THE THEM IS THE 2213 01:20:47,058 --> 01:20:48,693 OPPORTUNITY TO DO RESEARCH ON 2214 01:20:48,693 --> 01:20:48,993 PREVENTION. 2215 01:20:48,993 --> 01:20:50,428 THAT IS WHERE YOU'LL BE ABLE TO 2216 01:20:50,428 --> 01:20:51,763 FIND PEOPLE IN THE EARLY STAGES 2217 01:20:51,763 --> 01:20:52,730 AND ACTUALLY DO NOT 2218 01:20:52,730 --> 01:20:54,399 AINTERVENTION THAT WILL PREVENT 2219 01:20:54,399 --> 01:20:55,667 THE ESCALATION INTO GREATER 2220 01:20:55,667 --> 01:20:56,868 SEVERITY. 2221 01:20:56,868 --> 01:21:01,272 THAT IS THE SPACE THAT WE WE'VE 2222 01:21:01,272 --> 01:21:02,640 ACTUALLY NOT PROPERLY TACKLES, 2223 01:21:02,640 --> 01:21:05,009 AND I THINK IT GIVES US -- IF 2224 01:21:05,009 --> 01:21:07,412 WE'RE GOING TO MAKE AN IMPACT, 2225 01:21:07,412 --> 01:21:09,981 IT HAS TO BE IN THE PRIMARY CARE 2226 01:21:09,981 --> 01:21:13,084 SETTINGS BECAUSE, IF WE GO TO 2227 01:21:13,084 --> 01:21:13,885 SPECIALIZED, IT'S ALREADY TOO 2228 01:21:13,885 --> 01:21:18,723 LATE. 2229 01:21:18,723 --> 01:21:20,024 THAT WOULD BE ONE OF THE 2230 01:21:20,024 --> 01:21:22,127 PROJECTS I WOULD LOVE TO DO. 2231 01:21:22,127 --> 01:21:24,496 IT'S AN AREA WE NEED TO ADVANCE 2232 01:21:24,496 --> 01:21:25,630 AS THERE'S A TREMENDOUS GAP. 2233 01:21:25,630 --> 01:21:28,666 THE PRIMARY CARE NETWORK WOULD 2234 01:21:28,666 --> 01:21:30,735 BE PERFECT IS FOR DEVELOPMENT 2235 01:21:30,735 --> 01:21:33,404 RESEARCH AND TREATMENT OF 2236 01:21:33,404 --> 01:21:34,339 ADOLESCENTS WITH MILD OPIOID USE 2237 01:21:34,339 --> 01:21:37,475 DISORDER OR EVEN WITH A MOTHER 2238 01:21:37,475 --> 01:21:37,909 OPIOID USE DISORDER. 2239 01:21:37,909 --> 01:21:39,711 PRIMARY CARE NETWORK, SAY, FOR 2240 01:21:39,711 --> 01:21:41,646 EXAMPLE, ALSO FOR DEVELOPMENT OF 2241 01:21:41,646 --> 01:21:43,882 INTERVENTIONS FOR THERAPEUTICS 2242 01:21:43,882 --> 01:21:50,488 OF NICOTINE ADDICTION. 2243 01:21:50,488 --> 01:21:52,257 WE HAVE NOTHING RIGHT NOW IN 2244 01:21:52,257 --> 01:21:53,558 ADOLESCENTS. 2245 01:21:53,558 --> 01:21:55,827 BEING ABLE TO HAVE THAT 2246 01:21:55,827 --> 01:21:56,528 INFRASTRUCTURE AND THE 2247 01:21:56,528 --> 01:21:57,662 OPPORTUNITY TO SCREEN PROPERLY 2248 01:21:57,662 --> 01:22:00,165 AND TO IDENTIFY THEM, TO START 2249 01:22:00,165 --> 01:22:02,300 TO PAY ATTENTION TO 2250 01:22:02,300 --> 01:22:03,234 CO-MORBIDITIES THAT CAN LEAD YOU 2251 01:22:03,234 --> 01:22:05,036 TO DETERMINE THIS IS A HIGHER OR 2252 01:22:05,036 --> 01:22:05,870 LOWER RISK. 2253 01:22:05,870 --> 01:22:07,972 THIS PRIMARY CARE NETWORK, 2254 01:22:07,972 --> 01:22:10,475 RESEARCH NETWORK, THE OTHER 2255 01:22:10,475 --> 01:22:19,984 GIGANTIC MAJOR PRIORITY FOR DR. 2256 01:22:19,984 --> 01:22:21,920 BERTONOLLI IS TO COLLECT THE 2257 01:22:21,920 --> 01:22:23,588 DATA FOR AN ORGANIZATION OF 2258 01:22:23,588 --> 01:22:23,988 HEALTH NETWORKS. 2259 01:22:23,988 --> 01:22:27,492 SO IF YOU HAVE A PRIMARY CARE 2260 01:22:27,492 --> 01:22:29,060 NETWORK FOR RESEARCH AND BETTER 2261 01:22:29,060 --> 01:22:31,029 IN PRACTICE THAT IS COLLECTING 2262 01:22:31,029 --> 01:22:32,096 DATA, YOU CAN THEN SEE THE 2263 01:22:32,096 --> 01:22:33,198 OPPORTUNITY OF REALLY 2264 01:22:33,198 --> 01:22:35,266 UNDERSTANDING HOW THESE POLY 2265 01:22:35,266 --> 01:22:37,335 SUBSTANCES MAY BE PLAYING OUT 2266 01:22:37,335 --> 01:22:45,376 AND HOW THEY CHANGE AND THE 2267 01:22:45,376 --> 01:22:45,944 DIFFERENT TRAJECTORIES ON 2268 01:22:45,944 --> 01:22:47,145 DIFFERENT PEOPLE FOR WHICH WE 2269 01:22:47,145 --> 01:22:48,146 DON'T HAVE KNOWLEDGE. 2270 01:22:48,146 --> 01:22:49,347 IN MY BRAIN, I SAID THIS WOULD 2271 01:22:49,347 --> 01:22:50,248 BE WONDERFUL. 2272 01:22:50,248 --> 01:22:52,016 WITH RESPECT, IT WOULD BE AN 2273 01:22:52,016 --> 01:22:53,384 OPPORTUNITY FOR US TO EXPAND 2274 01:22:53,384 --> 01:22:54,619 SOME OF THE THINGS THAT THE 2275 01:22:54,619 --> 01:22:57,322 CLINICAL TRIALS NETWORK IS 2276 01:22:57,322 --> 01:22:57,622 DOING. 2277 01:22:57,622 --> 01:23:00,592 THE CLINICAL TRIALS NETWORK IS 2278 01:23:00,592 --> 01:23:01,859 NECESSARY IN THE WAY IT IS NOT 2279 01:23:01,859 --> 01:23:02,660 AN ETHICS AGENCY. 2280 01:23:02,660 --> 01:23:05,263 IT BASICALLY, DEPENDING ON THE 2281 01:23:05,263 --> 01:23:07,332 PROJECT, IT REACHES OUT TO 2282 01:23:07,332 --> 01:23:09,033 PRIMARY CARE PHYSICIANS OR TO 2283 01:23:09,033 --> 01:23:10,902 SPECIALISTS IN ORDER TO DEPLOY 2284 01:23:10,902 --> 01:23:11,302 THE PROJECTS. 2285 01:23:11,302 --> 01:23:12,904 WE COULD RELY MORE ON PRIMARY 2286 01:23:12,904 --> 01:23:15,540 CARE PHYSICIANS, WHICH ARE THE 2287 01:23:15,540 --> 01:23:17,609 FIRST LINE OF TREATMENT FOR 2288 01:23:17,609 --> 01:23:19,344 ANYONE IN THE UNITED STATES. 2289 01:23:19,344 --> 01:23:21,879 SORT OF WHY IT'S SO VERY, VERY 2290 01:23:21,879 --> 01:23:26,684 CONSEQUENCE. 2291 01:23:26,684 --> 01:23:30,555 >> THANK YOU. 2292 01:23:30,555 --> 01:23:33,057 THAT WAS AN INSPIRING TALK. 2293 01:23:33,057 --> 01:23:36,160 I ALSO GOT -- I WASN'T ABLE TO 2294 01:23:36,160 --> 01:23:39,597 ATTEND YOUR KEYNOTE LECTURE AT 2295 01:23:39,597 --> 01:23:40,198 THE AMERICAN PSYCHIATRIC 2296 01:23:40,198 --> 01:23:42,467 ASSOCIATION, BUT I GOT SOME 2297 01:23:42,467 --> 01:23:44,202 INDICATION FROM SUSAN ABOUT 2298 01:23:44,202 --> 01:23:45,870 YOU'RE REALLY FOREGROUNDING 2299 01:23:45,870 --> 01:23:47,272 SOCIAL DETERMINANTS, AND I GOT 2300 01:23:47,272 --> 01:23:48,673 SOME HINTS OF THAT FROM YOUR 2301 01:23:48,673 --> 01:23:49,540 PRESENTATION TODAY. 2302 01:23:49,540 --> 01:23:51,309 I DID NOTICE ON THE SLIDE ABOUT 2303 01:23:51,309 --> 01:23:52,310 CHALLENGES AT THE BOTTOM OF THE 2304 01:23:52,310 --> 01:23:54,646 LIST, WHERE PREVENTION ACROSS 2305 01:23:54,646 --> 01:23:55,680 THE LANDSCAPE AND SOCIAL 2306 01:23:55,680 --> 01:23:57,181 DETERMINANTS OF HEALTH, AND IT 2307 01:23:57,181 --> 01:24:00,718 SEEMS THAT THOSE TWO THEMES 2308 01:24:00,718 --> 01:24:03,421 REALLY RUN THROUGH ALL OF THE 2309 01:24:03,421 --> 01:24:04,656 OTHER CHALLENGES AT THE TOP OF 2310 01:24:04,656 --> 01:24:06,557 THE LIST, THEY'RE KIND OF 2311 01:24:06,557 --> 01:24:07,058 FOUNDATIONAL. 2312 01:24:07,058 --> 01:24:09,093 I AM VERY INTERESTED IN YOUR 2313 01:24:09,093 --> 01:24:14,699 THINKING ABOUT A THROUGH GOING 2314 01:24:14,699 --> 01:24:16,367 SYSTEMATIC AND DELIBERATE 2315 01:24:16,367 --> 01:24:17,802 APPROACH TO THE SOCIAL 2316 01:24:17,802 --> 01:24:19,504 DETERMINANTS AGENDA AT NIDA 2317 01:24:19,504 --> 01:24:21,739 WITH, OF COURSE, SOCIAL 2318 01:24:21,739 --> 01:24:22,874 DETERMINANTS BEING 2319 01:24:22,874 --> 01:24:23,508 DISPROPORTIONATE DRIVERS OF 2320 01:24:23,508 --> 01:24:26,210 OUTCOMES, BAR NONE, AND ALSO 2321 01:24:26,210 --> 01:24:33,318 VERY EFFECTIVE AND COMPREHENSIVE 2322 01:24:33,318 --> 01:24:35,386 INFLUENCES ON PRIMARY, 2323 01:24:35,386 --> 01:24:37,221 SECONDARY, AND TERTIARY 2324 01:24:37,221 --> 01:24:37,555 PREVENTION. 2325 01:24:37,555 --> 01:24:40,158 ADDRESSING SOCIAL DETERMINANTS, 2326 01:24:40,158 --> 01:24:41,826 YOU INFLUENCE INITIATION OF DRUG 2327 01:24:41,826 --> 01:24:42,193 USE. 2328 01:24:42,193 --> 01:24:43,628 YOU INFLUENCE TREATMENT ACCESS 2329 01:24:43,628 --> 01:24:45,163 AND OUTCOMES. 2330 01:24:45,163 --> 01:24:46,297 YOU INFLUENCE OVERDOSE RATES. 2331 01:24:46,297 --> 01:24:48,666 AND THE EFFECTIVENESS OF HARM 2332 01:24:48,666 --> 01:24:52,637 REDUCTION APREEPROAAPPROACHES. 2333 01:24:52,637 --> 01:24:53,871 AND YOU ALSO AFFECT MANY 2334 01:24:53,871 --> 01:24:54,806 DIFFERENT CHRONIC CONDITIONS 2335 01:24:54,806 --> 01:24:56,207 WITH ONE INTERVENTION. 2336 01:24:56,207 --> 01:24:59,711 ALSO, IF WE LOOK 2337 01:24:59,711 --> 01:25:00,511 INTERNATIONALLY, INDUSTRIALIZED 2338 01:25:00,511 --> 01:25:02,447 PEER COUNTRIES DO MUCH BETTER 2339 01:25:02,447 --> 01:25:04,615 THAN WE DO WITH SOCIAL 2340 01:25:04,615 --> 01:25:05,550 DETERMINANTS APPROACHES, 2341 01:25:05,550 --> 01:25:07,485 INCLUDING PRIMARY PREVENTION 2342 01:25:07,485 --> 01:25:07,785 APPROACHES. 2343 01:25:07,785 --> 01:25:09,053 THAT'S ONE PLACE WHERE WE REALLY 2344 01:25:09,053 --> 01:25:09,854 STAND OUT. 2345 01:25:09,854 --> 01:25:12,490 WE HAVE THE WORST HEALTHY 2346 01:25:12,490 --> 01:25:14,959 OUTCOMES, INCLUDING SUBSTANCE 2347 01:25:14,959 --> 01:25:19,430 USE DISORDER, HEALTH OUTCOMES OF 2348 01:25:19,430 --> 01:25:21,866 INDUSTRIALIZED COUNTRIES, AND WE 2349 01:25:21,866 --> 01:25:23,334 HAVE THE WORST SOCIAL 2350 01:25:23,334 --> 01:25:24,902 DETERMINANT APPROACHES. 2351 01:25:24,902 --> 01:25:30,675 SO IT WAS INTERESTING ON THE ICD 2352 01:25:30,675 --> 01:25:32,410 STUDY AND THE WINDOW THEY GIVE 2353 01:25:32,410 --> 01:25:33,911 US ON NOT ONLY A HEALTH SCIENCE 2354 01:25:33,911 --> 01:25:36,247 AS APPROACH THAT LOOKS AT SOCIAL 2355 01:25:36,247 --> 01:25:37,215 DETERMINANTS, BUT A NEUROSCIENCE 2356 01:25:37,215 --> 01:25:38,883 AGENDA THAT LOOKS AT THE 2357 01:25:38,883 --> 01:25:41,886 UNDERLYING MECHANISMS BY WHICH 2358 01:25:41,886 --> 01:25:44,188 SOCIAL EXPOSURES INFLUENCE BRAIN 2359 01:25:44,188 --> 01:25:44,455 BIOLOGY. 2360 01:25:44,455 --> 01:25:45,757 THAT'S AN APPROACH THAT IS 2361 01:25:45,757 --> 01:25:47,959 INTRIGUING TO ME, AND ONE OF MY 2362 01:25:47,959 --> 01:25:48,893 COLLEAGUES AT UCLA JUST GOT 2363 01:25:48,893 --> 01:25:50,461 MAJOR FUNDING FROM DANA 2364 01:25:50,461 --> 01:25:51,696 FOUNDATION TO START A 2365 01:25:51,696 --> 01:25:53,765 NEUROSCIENCE AND SOCIETY CENTER 2366 01:25:53,765 --> 01:25:56,234 THAT BOTH RETHINKS NEUROSCIENCE 2367 01:25:56,234 --> 01:25:57,969 METHODOLOGY AND IS DEVELOPING A 2368 01:25:57,969 --> 01:26:01,472 COMMUNITY PARTICIPATORY 2369 01:26:01,472 --> 01:26:01,806 NEUROSCIENCE. 2370 01:26:01,806 --> 01:26:03,775 SO THE COMMUNITY MEMBERS FROM 2371 01:26:03,775 --> 01:26:05,143 AREAS LIKE SOUTH L.A. IN THE 2372 01:26:05,143 --> 01:26:06,244 COUNTRY THAT HAVE NOT BEEN WELL 2373 01:26:06,244 --> 01:26:08,212 SERVED AND INTEGRATED INTO THE 2374 01:26:08,212 --> 01:26:09,714 NEUROSCIENCE AGENDA ACTUALLY 2375 01:26:09,714 --> 01:26:10,581 HELP TO DECIDE THE RESEARCH 2376 01:26:10,581 --> 01:26:11,816 QUESTIONS THAT WE'RE GOING TO 2377 01:26:11,816 --> 01:26:12,049 PURSUE. 2378 01:26:12,049 --> 01:26:13,885 IT PROBABLY WOULDN'T BE 2379 01:26:13,885 --> 01:26:14,819 SURPRISING THAT LEARN THAT THOSE 2380 01:26:14,819 --> 01:26:16,754 QUESTIONS THAT REALLY DO LOOK AT 2381 01:26:16,754 --> 01:26:18,823 TOXIC SOCIAL EXPOSURES AND THEIR 2382 01:26:18,823 --> 01:26:19,791 INFLUENCE ON BRAIN DEVELOPMENT 2383 01:26:19,791 --> 01:26:22,960 AND LEARNING, FOR EXAMPLE, AND 2384 01:26:22,960 --> 01:26:24,695 MULTIGENERATIONAL EFFECTS ARE 2385 01:26:24,695 --> 01:26:25,730 COMING TO THE FORE. 2386 01:26:25,730 --> 01:26:27,265 THE INITIAL PILOT STUDY HAD TO 2387 01:26:27,265 --> 01:26:30,701 DO WITH THE IMPACT OF LOW FLYING 2388 01:26:30,701 --> 01:26:32,236 LAW ENFORCEMENT SHERIFF'S 2389 01:26:32,236 --> 01:26:33,237 HELICOPTERS ON SLEEP DISRUPTION 2390 01:26:33,237 --> 01:26:35,139 LATE AT NIGHT, EARLY IN THE 2391 01:26:35,139 --> 01:26:36,741 MORNING AS THEY TARGET SOUTH 2392 01:26:36,741 --> 01:26:39,444 L.A. NEIGHBORHOODS. 2393 01:26:39,444 --> 01:26:41,245 AND THE IMPACT ON BRAIN 2394 01:26:41,245 --> 01:26:42,780 DEVELOPMENT AND LEARNING ON 2395 01:26:42,780 --> 01:26:45,283 LOCAL CHILDREN, WHICH WE'RE NOW 2396 01:26:45,283 --> 01:26:55,793 MODELING IN THE LAB AND WITH 2397 01:26:56,060 --> 01:26:56,294 DROSOPHILA. 2398 01:26:56,294 --> 01:26:58,663 IT HAD PROFOUND SCIENTIFIC 2399 01:26:58,663 --> 01:27:00,998 IMPLICATIONS AS WELL AS POLICY 2400 01:27:00,998 --> 01:27:01,666 IMPLICATIONS. 2401 01:27:01,666 --> 01:27:03,134 THIS IS WHERE NEUROSCIENCE COULD 2402 01:27:03,134 --> 01:27:05,903 BE LEADING THE WAY AND LOOKING 2403 01:27:05,903 --> 01:27:10,842 AT EPIGENETICS, THE MICROBIOME, 2404 01:27:10,842 --> 01:27:13,010 EMERGING LIFE SCIENCE MODELS 2405 01:27:13,010 --> 01:27:14,245 THAT WE'RE BEHIND IN 2406 01:27:14,245 --> 01:27:15,346 NEUROPSYCHIATRY AND KIND OF 2407 01:27:15,346 --> 01:27:15,847 TAPPING INTO. 2408 01:27:15,847 --> 01:27:17,048 SO ALL OF THESE THINGS ARE 2409 01:27:17,048 --> 01:27:18,349 HAPPENING AT ONCE. 2410 01:27:18,349 --> 01:27:21,219 I WANT TO KNOW IN YOUR MIND WHAT 2411 01:27:21,219 --> 01:27:22,753 WOULD BE A SYSTEMATIC AND KIND 2412 01:27:22,753 --> 01:27:24,989 OF VERY RIGOROUS APPROACH TO 2413 01:27:24,989 --> 01:27:27,091 MAKING SURE THAT WE'RE 2414 01:27:27,091 --> 01:27:28,459 APPROACHING SOCIAL DETERMINANTS 2415 01:27:28,459 --> 01:27:29,794 IN THE MOST EFFECTIVE WAY 2416 01:27:29,794 --> 01:27:31,329 POSSIBLE AND THAT WE HAVE THE 2417 01:27:31,329 --> 01:27:33,197 RIGHT PEOPLE AROUND THE TABLE, 2418 01:27:33,197 --> 01:27:36,234 SOCIAL SCIENTISTS, THOSE THAT 2419 01:27:36,234 --> 01:27:37,034 REALLY SPECIALIZE IN MODELING 2420 01:27:37,034 --> 01:27:39,103 AND MEASURING THE SOCIAL, AS 2421 01:27:39,103 --> 01:27:41,105 WELL AS, FOR EXAMPLE, COMMUNITY 2422 01:27:41,105 --> 01:27:43,508 PARTNERS, PEOPLE FROM MULTIPLE 2423 01:27:43,508 --> 01:27:45,209 SECTORS THAT WOULD HAVE TO BE 2424 01:27:45,209 --> 01:27:48,079 INVOLVED IN ANY KIND OF 2425 01:27:48,079 --> 01:27:49,780 IMPLEMENTATION FROM HOUSING TO 2426 01:27:49,780 --> 01:27:56,153 LAW ENFORCEMENT TO EDUCATION. 2427 01:27:56,153 --> 01:27:58,356 >> I WOULD SAY IT'S EVIDENT THAT 2428 01:27:58,356 --> 01:27:59,857 THIS IS A KEY COMPONENT ON 2429 01:27:59,857 --> 01:28:00,825 EVERYTHING THAT WE DO. 2430 01:28:00,825 --> 01:28:02,460 WHAT ARE THE SOCIAL DETERMINANTS 2431 01:28:02,460 --> 01:28:05,897 FOR PREVENTION, FOR TREATMENT, 2432 01:28:05,897 --> 01:28:08,099 FOR RECOVERY, FOR OVERDOSE 2433 01:28:08,099 --> 01:28:08,466 DEATHS? 2434 01:28:08,466 --> 01:28:09,967 THEY ARE FUNDAMENTAL. 2435 01:28:09,967 --> 01:28:11,502 I ACTUALLY -- SO LIKE IN THE 2436 01:28:11,502 --> 01:28:13,905 PAST, I MEAN, YOU DO A CLINICAL 2437 01:28:13,905 --> 01:28:15,206 TRIAL AND YOU SEE SOME PATIENTS 2438 01:28:15,206 --> 01:28:16,674 RESPONDED YES OR NO AND WE LOOK 2439 01:28:16,674 --> 01:28:19,176 AT THE GENETICS TO TRY TO SEE IF 2440 01:28:19,176 --> 01:28:20,211 THAT EXPLAINS IT. 2441 01:28:20,211 --> 01:28:21,712 THAT'S THE CONSENSUS OF THE 2442 01:28:21,712 --> 01:28:22,446 PERSON. 2443 01:28:22,446 --> 01:28:23,915 PROBABLY HAD A MUCH HIGHER 2444 01:28:23,915 --> 01:28:25,349 IMPACT ON WHETHER THEY RESPONDED 2445 01:28:25,349 --> 01:28:25,950 OR NOT. 2446 01:28:25,950 --> 01:28:27,418 THEY'VE BEEN NEGLECTED. 2447 01:28:27,418 --> 01:28:28,920 NOW WE DON'T NEGLECT THEM 2448 01:28:28,920 --> 01:28:29,186 ANYMORE. 2449 01:28:29,186 --> 01:28:30,421 SO THROUGHOUT ALL OF THE WORK 2450 01:28:30,421 --> 01:28:32,089 THAT WE'RE DOING, WE'RE 2451 01:28:32,089 --> 01:28:33,291 EMPHASIZING THAT WE ARE 2452 01:28:33,291 --> 01:28:36,394 COLLECTING DATA RELATED TO THE 2453 01:28:36,394 --> 01:28:37,328 SOCIAL DETERMINANTS OF HEALTH. 2454 01:28:37,328 --> 01:28:39,697 OF COURSE, AS WE GO ALONG, WE 2455 01:28:39,697 --> 01:28:42,333 LEARN NEW THINGS AND HOW TO DO 2456 01:28:42,333 --> 01:28:44,368 IT OPTIMALLY. 2457 01:28:44,368 --> 01:28:45,670 ALSO WE HAVE TO -- BECAUSE AT 2458 01:28:45,670 --> 01:28:48,839 THE ESSENCE OF ALL OF THIS, OUR 2459 01:28:48,839 --> 01:28:50,741 STRUCTURAL SYSTEMS THAT HAVE 2460 01:28:50,741 --> 01:28:53,244 CREATE 2461 01:28:53,244 --> 01:28:55,246 CREATED TREMENDOUS INEQUALITY. 2462 01:28:55,246 --> 01:28:57,815 WE DON'T NEED TO DISCOVER THE 2463 01:28:57,815 --> 01:29:00,351 WATER TO KNOW THAT IS THE CASE. 2464 01:29:00,351 --> 01:29:01,919 THE QUESTION IS WHAT IS THE DATA 2465 01:29:01,919 --> 01:29:03,321 THAT WILL HELP US CHANGE IT? 2466 01:29:03,321 --> 01:29:05,523 THAT'S THE WAY I VIEW ALL OF 2467 01:29:05,523 --> 01:29:06,657 THESE ISSUES. 2468 01:29:06,657 --> 01:29:08,859 WHAT INFORMATION CAN CHANGE 2469 01:29:08,859 --> 01:29:19,236 POLICIES SO THAT 2470 01:29:24,775 --> 01:29:25,042 TRAJECTORIES. 2471 01:29:25,042 --> 01:29:26,043 BECAUSE IN THE PAST WHERE YOU 2472 01:29:26,043 --> 01:29:29,914 WERE SEEING, FOR EXAMPLE, THE 2473 01:29:29,914 --> 01:29:32,283 LOWER PERFORMANCE AMONG CHILDREN 2474 01:29:32,283 --> 01:29:33,217 OF UNDERREPRESENTED GROUPS. 2475 01:29:33,217 --> 01:29:36,253 AND SORT OF THIS WAS TO ME TO 2476 01:29:36,253 --> 01:29:36,887 JUSTIFY WHY THERE ARE PEOPLE 2477 01:29:36,887 --> 01:29:39,423 WITH PRIVILEGE AND OTHERS NOT. 2478 01:29:39,423 --> 01:29:43,027 AND NOW THAT WHAT WE CAN SHOW IS 2479 01:29:43,027 --> 01:29:44,895 THAT IS ACCOUNTED BY THE FACT 2480 01:29:44,895 --> 01:29:47,965 THAT THERE ARE FACTORS RELATED 2481 01:29:47,965 --> 01:29:52,236 TO POVERTY, TO DISCRIMINATION, 2482 01:29:52,236 --> 01:29:53,304 THAT IS DIRECTLY RESPONSIBLE TO 2483 01:29:53,304 --> 01:29:54,271 CHANGING THE BRAIN. 2484 01:29:54,271 --> 01:29:56,874 THAT IS HARDER TO PUT UNDER THE 2485 01:29:56,874 --> 01:29:57,208 ROCK. 2486 01:29:57,208 --> 01:29:59,910 THIS IS WHY ALSO WE'RE VERY 2487 01:29:59,910 --> 01:30:00,478 EXCITED. 2488 01:30:00,478 --> 01:30:01,779 BECAUSE THAT'S EARLY ON YOU ARE 2489 01:30:01,779 --> 01:30:03,648 LIKELY TO HAVE A GREATER IMPACT. 2490 01:30:03,648 --> 01:30:08,486 THE ABCD HAS BEEN ILLUMINATING 2491 01:30:08,486 --> 01:30:13,758 ALREADY. 2492 01:30:13,758 --> 01:30:17,662 MOVE THE CULTURE THAT HAD 2493 01:30:17,662 --> 01:30:20,731 CREATED SYSTEMS THAT ARE REALLY 2494 01:30:20,731 --> 01:30:23,768 TREAT PEOPLE DIFFERENT. 2495 01:30:23,768 --> 01:30:26,937 SORT OF AGAIN, HOW DO YOU CHANGE 2496 01:30:26,937 --> 01:30:27,672 CULTURE? 2497 01:30:27,672 --> 01:30:28,673 CHANGING THE JUSTICE SYSTEM. 2498 01:30:28,673 --> 01:30:32,410 CHANGING THE SYSTEM THAT IS SO 2499 01:30:32,410 --> 01:30:32,810 UNEQUAL. 2500 01:30:32,810 --> 01:30:34,045 IN OUR MISSION. 2501 01:30:34,045 --> 01:30:36,681 IN THE MISSION OF SCIENCE AND 2502 01:30:36,681 --> 01:30:36,847 SO. 2503 01:30:36,847 --> 01:30:39,216 SO THAT'S WHERE WE HAVE TO BE, 2504 01:30:39,216 --> 01:30:41,252 AGAIN, STRATEGIC. 2505 01:30:41,252 --> 01:30:42,486 AND I THINK THERE IS GETTING 2506 01:30:42,486 --> 01:30:43,754 NERVOUS. 2507 01:30:43,754 --> 01:30:44,989 THE TIME IS PAST. 2508 01:30:44,989 --> 01:30:47,825 AM I READING YOUR NONVERBAL 2509 01:30:47,825 --> 01:30:49,060 BEHAVIOR PROPERLY? 2510 01:30:49,060 --> 01:30:52,563 YES, IT'S 2:31. 2511 01:30:52,563 --> 01:30:54,932 I THINK THAT -- YEAH. 2512 01:30:54,932 --> 01:30:57,668 >> IT'S ON OPPORTUNITY FOR 2513 01:30:57,668 --> 01:30:59,336 SOCIAL SCIENTIST. 2514 01:30:59,336 --> 01:31:00,671 >> I THINK THIS IS A QUICK 2515 01:31:00,671 --> 01:31:01,272 COMMENT ACTUALLY. 2516 01:31:01,272 --> 01:31:03,841 I REALLY APPRECIATED WHAT THE 2517 01:31:03,841 --> 01:31:05,910 DOCTOR JUST SAID AND THE 2518 01:31:05,910 --> 01:31:06,711 COMPLEXITY WHICH WITH YOU 2519 01:31:06,711 --> 01:31:09,914 DESCRIBED THE INITIATIVES THAT 2520 01:31:09,914 --> 01:31:10,981 YOU'RE SEEING. 2521 01:31:10,981 --> 01:31:13,350 I WAS JUST THINKING ONE THING 2522 01:31:13,350 --> 01:31:15,319 THAT YOU MAY ALREADY BE DOING AT 2523 01:31:15,319 --> 01:31:17,788 NIDA, BUT IF NOT, IT MIGHT BE 2524 01:31:17,788 --> 01:31:20,624 GOOD TO TRACK ACROSS GOING 2525 01:31:20,624 --> 01:31:22,026 FORWARD THE NEXT SEVERAL YEARS 2526 01:31:22,026 --> 01:31:25,096 AMONGST ALL THE FUNDED GRANTS. 2527 01:31:25,096 --> 01:31:27,264 WHICH ONES ARE TAKING INTO 2528 01:31:27,264 --> 01:31:28,833 ACCOUNT THE SOCIAL DETERMINANTS 2529 01:31:28,833 --> 01:31:30,634 OF HEALTH ACROSS ALL THE 2530 01:31:30,634 --> 01:31:32,236 DIFFERENT TYPES OF FUNDING 2531 01:31:32,236 --> 01:31:33,804 MECHANISMS. 2532 01:31:33,804 --> 01:31:36,440 AND THEN TO BEGIN TO DEMONSTRATE 2533 01:31:36,440 --> 01:31:37,308 THAT GOING FORWARD, JUST BECAUSE 2534 01:31:37,308 --> 01:31:39,410 IT'S A WAY OF TRACKING THROUGH 2535 01:31:39,410 --> 01:31:40,845 EVERYTHING THAT'S GETTING FUNDED 2536 01:31:40,845 --> 01:31:44,181 FROM BASIC TO TRANSLATIONAL TO 2537 01:31:44,181 --> 01:31:45,015 POPULATION-BASED, ET CETERA, 2538 01:31:45,015 --> 01:31:45,783 SCIENCE. 2539 01:31:45,783 --> 01:31:49,153 AND I THINK THAT MIGHT BE VERY 2540 01:31:49,153 --> 01:31:50,821 INFORMATIVE AS TO HOW WE'RE 2541 01:31:50,821 --> 01:31:52,890 DOING YEAR TO YEAR GOING FORWARD 2542 01:31:52,890 --> 01:31:54,725 GIVEN THAT EVERYBODY IS IN FULL 2543 01:31:54,725 --> 01:31:55,426 AGREEMENT OF HOW IMPORTANT THAT 2544 01:31:55,426 --> 01:31:55,826 IS. 2545 01:31:55,826 --> 01:31:56,761 JUST A COMMENT AND A THOUGHT. 2546 01:31:56,761 --> 01:31:58,162 >> YEAH. 2547 01:31:58,162 --> 01:31:59,663 AND IT'S A GREAT SUGGESTION. 2548 01:31:59,663 --> 01:32:04,068 AND I WOULD BRING IT UP TO THE 2549 01:32:04,068 --> 01:32:05,569 WHOLE NIH. 2550 01:32:05,569 --> 01:32:07,905 I THINK THE SOCIAL DETERMINANTS 2551 01:32:07,905 --> 01:32:08,572 OF HEALTH. 2552 01:32:08,572 --> 01:32:09,607 WIDE VARIETY OF THINGS. 2553 01:32:09,607 --> 01:32:12,543 COMING UP WITH A STANDARDIZED 2554 01:32:12,543 --> 01:32:14,845 METRIC THAT CAN BE FOLLOW-UP 2555 01:32:14,845 --> 01:32:15,079 EASILY. 2556 01:32:15,079 --> 01:32:19,517 I MEAN, RIGHT NOW IF YOU 2557 01:32:19,517 --> 01:32:21,285 EXPLICITLY SAY THIS IS SOCIAL 2558 01:32:21,285 --> 01:32:22,686 DETERMINANTS, WE WANT TO GO 2559 01:32:22,686 --> 01:32:23,621 BEYOND THAT. 2560 01:32:23,621 --> 01:32:26,957 I WANT CLINICAL TRIALS TO 2561 01:32:26,957 --> 01:32:28,192 DETERMINE SOCIAL DETERMINANTS OF 2562 01:32:28,192 --> 01:32:29,126 HEALTH. 2563 01:32:29,126 --> 01:32:32,396 YES, YOU WANT ME TO JUMP INTO 2564 01:32:32,396 --> 01:32:40,237 THE NEXT TOPIC? 2565 01:32:40,237 --> 01:32:50,681 I'M GOING TO GO UP THERE. 2566 01:33:03,994 --> 01:33:06,363 AND IT IS A PLEASURE FOR ME NOW 2567 01:33:06,363 --> 01:33:10,568 TO GET INTO GETTING THE LIFETIME 2568 01:33:10,568 --> 01:33:13,671 ACHIEVEMENT AWARD TO WILLIAM 2569 01:33:13,671 --> 01:33:15,906 DEWY WHICH ANYONE WHO HAS BEEN 2570 01:33:15,906 --> 01:33:18,309 DOING RESEARCH IN THE SUBSTANCE 2571 01:33:18,309 --> 01:33:18,776 USE FIELD. 2572 01:33:18,776 --> 01:33:22,046 YOU DON'T NEED AN INTRODUCTION. 2573 01:33:22,046 --> 01:33:24,882 BUT I WANT TO GO OVER SOME OF 2574 01:33:24,882 --> 01:33:26,584 HIS ACHIEVEMENTS, WHICH IS IT'S 2575 01:33:26,584 --> 01:33:27,017 EXTRAORDINARY. 2576 01:33:27,017 --> 01:33:29,887 THIS IS A TOKEN FOR EVERYTHING 2577 01:33:29,887 --> 01:33:31,822 THAT HE HAS GIVEN US AND HAS 2578 01:33:31,822 --> 01:33:33,057 GIVEN THE FIELD. 2579 01:33:33,057 --> 01:33:34,658 SO IT IS AN HONOR AND MY 2580 01:33:34,658 --> 01:33:36,427 PRIVILEGE TO BE ABLE TO DO THIS. 2581 01:33:36,427 --> 01:33:38,662 AND IT'S ALSO AN HONOR TO SEE 2582 01:33:38,662 --> 01:33:40,664 YOU HERE WITH ALL OF YOUR 2583 01:33:40,664 --> 01:33:40,898 FAMILY. 2584 01:33:40,898 --> 01:33:44,301 YOUR WIFE WHO I HEARD A LOT, 2585 01:33:44,301 --> 01:33:47,872 EVERY TIME THAT BILL AND I MET. 2586 01:33:47,872 --> 01:33:49,607 AND SPEAKS ABOUT HIS WIFE. 2587 01:33:49,607 --> 01:33:51,342 AND HIS CHILDREN. 2588 01:33:51,342 --> 01:33:53,644 SO I KNOW THAT HE'S VERY VERY 2589 01:33:53,644 --> 01:33:54,979 DEVOTED TO HIS FAMILY. 2590 01:33:54,979 --> 01:33:57,514 JUST LIKE HE'S DEVOTED TO 2591 01:33:57,514 --> 01:33:59,016 SCIENCE AND TO HIS STUDENTS AND 2592 01:33:59,016 --> 01:34:02,753 TO ADDICTION. 2593 01:34:02,753 --> 01:34:07,024 SO I CAN SAY THAT HE IS NOT JUST 2594 01:34:07,024 --> 01:34:09,894 A COLLEAGUE, HE'S ALSO I VALUE 2595 01:34:09,894 --> 01:34:11,862 HIM VERY MUCH AS A FRIEND. 2596 01:34:11,862 --> 01:34:14,531 AND I VALUE HIS OUTSTANDING 2597 01:34:14,531 --> 01:34:16,133 CONTRIBUTIONS TO THE FIELD. 2598 01:34:16,133 --> 01:34:17,902 HIS COMMITMENT TO SUBSTANCE USE 2599 01:34:17,902 --> 01:34:19,536 AND TO THE PEOPLE THAT SUFFERING 2600 01:34:19,536 --> 01:34:21,906 FROM ADDICTION, HIS COMMITMENT 2601 01:34:21,906 --> 01:34:25,476 TO THE STUDENTS, AND FROM 2602 01:34:25,476 --> 01:34:27,645 INSPIRING THROUGHOUT HIS STELLAR 2603 01:34:27,645 --> 01:34:28,212 CAREER. 2604 01:34:28,212 --> 01:34:32,783 HE BEGAN HIS CAREER 50 YEARS AGO 2605 01:34:32,783 --> 01:34:35,085 IN ASSOCIATION WITH VIRGINIA 2606 01:34:35,085 --> 01:34:35,986 COMMONWEALTH UNIVERSITY. 2607 01:34:35,986 --> 01:34:38,055 AND THAT WAS IN 1972 WHERE HE 2608 01:34:38,055 --> 01:34:42,359 WAS RECRUITED AS ON SOCIETY 2609 01:34:42,359 --> 01:34:43,961 PROFESSOR OF PHARMACOLOGY. 2610 01:34:43,961 --> 01:34:45,896 FOUR YEARS LATER, HE WAS 2611 01:34:45,896 --> 01:34:53,804 PROMOTED TO PROFESSOR AND -- 2612 01:34:53,804 --> 01:34:56,173 OVER THE FOLLOWING YEARS, HE 2613 01:34:56,173 --> 01:35:01,612 TOOK ON KEY LEADERSHIP ROLES OF 2614 01:35:01,612 --> 01:35:02,846 INCREASING INSTITUTIONAL 2615 01:35:02,846 --> 01:35:07,518 VISIBILITY IN VARIOUS RESEARCH. 2616 01:35:07,518 --> 01:35:11,555 IN 2008, HE WAS NAMED A 2617 01:35:11,555 --> 01:35:12,823 PROFESSOR AND CHAIR OF THE 2618 01:35:12,823 --> 01:35:15,960 DEPARTMENT OF PHARMACOLOGY AND 2619 01:35:15,960 --> 01:35:16,260 TOXICOLOGY. 2620 01:35:16,260 --> 01:35:17,895 AND A POSITION HE HELD WITH 2621 01:35:17,895 --> 01:35:21,398 DISTINCTION UP TO THIS DAY. 2622 01:35:21,398 --> 01:35:24,735 UP TO 400 SCIENTIFIC 2623 01:35:24,735 --> 01:35:25,135 PUBLICATIONS. 2624 01:35:25,135 --> 01:35:28,605 AND CONTRIBUTIONS THAT REFLECT 2625 01:35:28,605 --> 01:35:29,673 HIS LIFELONG INTEREST IN 2626 01:35:29,673 --> 01:35:32,242 UNDERSTANDING HOW ADDICTIVE 2627 01:35:32,242 --> 01:35:34,278 DRUGS IN GENERAL WORK. 2628 01:35:34,278 --> 01:35:38,515 IN THIS CONTEXT, HIS FOCUS HAS 2629 01:35:38,515 --> 01:35:42,252 BEEN THE -- UNDERLYING THE 2630 01:35:42,252 --> 01:35:44,788 TOLERANCE, DEPENDANCE. 2631 01:35:44,788 --> 01:35:47,558 USING MULTIPLE INVESTIGATIONAL 2632 01:35:47,558 --> 01:35:49,793 TOOLS AND APPROACHES THAT 2633 01:35:49,793 --> 01:35:52,663 INCLUDES NEUROCHEMISTRY, 2634 01:35:52,663 --> 01:35:53,864 PHARMACOLOGY, AND BEHAVIORAL 2635 01:35:53,864 --> 01:35:54,131 RESEARCH. 2636 01:35:54,131 --> 01:35:56,934 AS I SAID AT THE BEGINNING, HIS 2637 01:35:56,934 --> 01:35:58,769 CONTRIBUTIONS GO WELL BEYOND HIS 2638 01:35:58,769 --> 01:36:00,504 SCHOLARLY WORK. 2639 01:36:00,504 --> 01:36:03,507 HE HAS BEEN AMONG THE SUPPORTS. 2640 01:36:03,507 --> 01:36:06,076 20 YEARS AGO, HE CREATED THE 2641 01:36:06,076 --> 01:36:06,977 FRIENDS OF NIDA. 2642 01:36:06,977 --> 01:36:09,580 AND SERVE AS ITS CHAIRMAN UNTIL 2643 01:36:09,580 --> 01:36:10,781 THIS YEAR. 2644 01:36:10,781 --> 01:36:12,950 UNDER HIS LEADERSHIP, THE 2645 01:36:12,950 --> 01:36:16,186 FRIENDS OF NIDA COALITION 2646 01:36:16,186 --> 01:36:18,956 LEVERAGED THE POWER OF THOSE 2647 01:36:18,956 --> 01:36:19,757 ORGANIZATIONS INCLUDING 2648 01:36:19,757 --> 01:36:21,525 SCIENTIFIC AND PROFESSIONAL 2649 01:36:21,525 --> 01:36:24,028 SOCIETIES, PATIENT GROUPS, 2650 01:36:24,028 --> 01:36:24,862 COMMUNITY ORGANIZATIONS AND 2651 01:36:24,862 --> 01:36:25,195 OTHERS. 2652 01:36:25,195 --> 01:36:28,499 POLICY MAKERS AND THE PUBLIC ON 2653 01:36:28,499 --> 01:36:31,535 THE VALUE OF ADDICTION RESEARCH 2654 01:36:31,535 --> 01:36:33,771 THROUGH EDUCATION AND ADVOCACY. 2655 01:36:33,771 --> 01:36:35,239 HIS WORK HAS BEEN INSTRUMENTAL 2656 01:36:35,239 --> 01:36:38,642 IN RAISING THE PROFILE OF AND 2657 01:36:38,642 --> 01:36:42,379 BOLLSTERING THE SUPPORT OF NIDA 2658 01:36:42,379 --> 01:36:44,848 ON CAPITOL HILL. 2659 01:36:44,848 --> 01:36:46,850 PERHAPS THE GREATEST MARK IS THE 2660 01:36:46,850 --> 01:36:49,253 LIFELONG COMMITMENT TO RESEARCH 2661 01:36:49,253 --> 01:36:49,520 TRAINING. 2662 01:36:49,520 --> 01:36:51,455 BILL IS THE REGIONAL AND CURRENT 2663 01:36:51,455 --> 01:36:53,891 PI OF THE TRAINING IN 2664 01:36:53,891 --> 01:36:58,028 PHARMACOLOGY OF ABUSED DRUG. 2665 01:36:58,028 --> 01:37:01,231 TWO GRANTS FUNDED UNINTERPRETED 2666 01:37:01,231 --> 01:37:02,599 SINCE 1986. 2667 01:37:02,599 --> 01:37:05,602 THIS ENDISCOVER HAS BEEN A 2668 01:37:05,602 --> 01:37:09,473 SOURCE OF INSPIRATION AND A 2669 01:37:09,473 --> 01:37:11,742 NURTURING SPACE, SO THEY CAN 2670 01:37:11,742 --> 01:37:16,013 TAKE RISK, PURSUE THEIR IDEAS, 2671 01:37:16,013 --> 01:37:17,881 AND IN THE ACADEMIC OR OTHER 2672 01:37:17,881 --> 01:37:18,148 PURSUITS. 2673 01:37:18,148 --> 01:37:21,452 THE PROGRAM THAT HE CREATED AND 2674 01:37:21,452 --> 01:37:23,987 SO LOVINGLY NURTURED HAS SPAWNED 2675 01:37:23,987 --> 01:37:26,223 A MULTI-GENERATIONAL FAMILY OF 2676 01:37:26,223 --> 01:37:26,523 SCIENTISTS. 2677 01:37:26,523 --> 01:37:29,726 A RARE ENVIRONMENT AND 2678 01:37:29,726 --> 01:37:30,160 ACHIEVEMENT INDEED. 2679 01:37:30,160 --> 01:37:32,763 NOT SURPRISINGLY, BILL'S 2680 01:37:32,763 --> 01:37:33,630 MULTIFACETED WORK RECEIVED 2681 01:37:33,630 --> 01:37:36,967 ACCOLADES AND HONORS THROUGH THE 2682 01:37:36,967 --> 01:37:37,167 YEARS. 2683 01:37:37,167 --> 01:37:41,672 LIKE THE 2009 AWARD FROM CPDD. 2684 01:37:41,672 --> 01:37:42,873 THE 2003 LIFETIME ACHIEVEMENT IN 2685 01:37:42,873 --> 01:37:45,442 SCIENCE AWARD FROM THE 2686 01:37:45,442 --> 01:37:47,211 COMMONWEALTH OF VIRGINIA. 2687 01:37:47,211 --> 01:37:49,680 THE 2006 PUBLIC SERVICE AWARD 2688 01:37:49,680 --> 01:37:50,714 FROM NIDA. 2689 01:37:50,714 --> 01:37:54,618 THE 2012 PRESIDENTIAL MEDALLION. 2690 01:37:54,618 --> 01:37:57,688 AND THE 2013 AWARD, JUST TO NAME 2691 01:37:57,688 --> 01:37:59,957 A FEW. 2692 01:37:59,957 --> 01:38:03,794 IN HONORING WILLIAM WITH THE 2693 01:38:03,794 --> 01:38:05,195 NIDA LIFETIME SCIENTIFIC 2694 01:38:05,195 --> 01:38:06,730 ACHIEVEMENT AWARD, WE NOT ONLY 2695 01:38:06,730 --> 01:38:08,132 RECOGNIZE HIS MANY CONTRIBUTIONS 2696 01:38:08,132 --> 01:38:09,700 TO SCIENCE AND TRAINING OF 2697 01:38:09,700 --> 01:38:11,668 FUTURE GENERATIONS TO HAVE 2698 01:38:11,668 --> 01:38:13,570 SCIENTISTS BUT PAY TRIBUTE TO 2699 01:38:13,570 --> 01:38:15,772 THE ENDURING POWER OF HUMAN 2700 01:38:15,772 --> 01:38:18,075 CURIOSITY, GOOD CITIZENSHIP, AND 2701 01:38:18,075 --> 01:38:19,843 UNWAIVERING SUPPORT OF 2702 01:38:19,843 --> 01:38:23,480 COLLEAGUES AND TRAINEES. 2703 01:38:23,480 --> 01:38:26,216 JOIN ME IN CONGRATULATING HIM ON 2704 01:38:26,216 --> 01:38:29,953 THIS WELL DESERVED HONOR. 2705 01:38:29,953 --> 01:38:36,426 EXPRESSING OUR DEEP SKWUS EST 2706 01:38:36,426 --> 01:38:37,561 GRATITUDE. 2707 01:38:37,561 --> 01:38:47,971 BILL, THANKS VERY MUCH. 2708 01:39:04,855 --> 01:39:05,889 >> ALL RIGHT, THANK YOU VERY 2709 01:39:05,889 --> 01:39:06,790 MUCH FOR THIS. 2710 01:39:06,790 --> 01:39:08,892 I REALLY VERY MUCH APPRECIATE 2711 01:39:08,892 --> 01:39:09,059 IT. 2712 01:39:09,059 --> 01:39:11,261 YOU KNOW, JUST TO BE A SCIENTIST 2713 01:39:11,261 --> 01:39:15,265 IS AN AMAZING WAY TO SPEND YOUR 2714 01:39:15,265 --> 01:39:15,766 LIFE. 2715 01:39:15,766 --> 01:39:17,668 I DON'T THINK ANY OF US DO 2716 01:39:17,668 --> 01:39:19,269 THINGS INDIVIDUALLY IN THIS 2717 01:39:19,269 --> 01:39:19,536 BUSINESS. 2718 01:39:19,536 --> 01:39:20,704 I THINK WE DO THINGS TOGETHER. 2719 01:39:20,704 --> 01:39:22,406 WE RELY ON THE LITERATURE AND 2720 01:39:22,406 --> 01:39:25,042 OUR LEAGUES, OUR FACULTY 2721 01:39:25,042 --> 01:39:26,076 MEMBERS, STUDENTS. 2722 01:39:26,076 --> 01:39:27,611 WE RELY ON GROUPS OF PEOPLE. 2723 01:39:27,611 --> 01:39:29,179 AND I THANK YOU FOR THIS. 2724 01:39:29,179 --> 01:39:30,914 AND I THANK YOU FOR TWO SPECIFIC 2725 01:39:30,914 --> 01:39:31,315 GROUPS. 2726 01:39:31,315 --> 01:39:36,186 ONE IS SITTING RIGHT OVER THERE. 2727 01:39:36,186 --> 01:39:37,721 THAT'S THE GROUP. 2728 01:39:37,721 --> 01:39:41,024 THAT WIFE OF MINE AND THOSE 2729 01:39:41,024 --> 01:39:41,291 CHILDREN. 2730 01:39:41,291 --> 01:39:43,193 AND THEIR SPOUSES, 2731 01:39:43,193 --> 01:39:43,527 GRANDCHILDREN. 2732 01:39:43,527 --> 01:39:44,828 THEY MADE MY LIFE BETTER. 2733 01:39:44,828 --> 01:39:47,698 IT WAS EASY TO WORK. 2734 01:39:47,698 --> 01:39:50,801 I DO THIS JOB, ANYTHING THAT YOU 2735 01:39:50,801 --> 01:39:53,003 DO, HELPS THE HEALTH OF A HUMAN 2736 01:39:53,003 --> 01:39:53,203 BEING. 2737 01:39:53,203 --> 01:39:56,106 WHAT'S A BETTER REASON FOR BEING 2738 01:39:56,106 --> 01:39:57,874 ON THIS EARTH? 2739 01:39:57,874 --> 01:39:59,543 YOU SAVE THEIR LIFE BECAUSE YOU 2740 01:39:59,543 --> 01:40:01,111 HAVE SOME IDEA THAT OTHERS COME 2741 01:40:01,111 --> 01:40:03,180 OUT AND BUILD ON IT. 2742 01:40:03,180 --> 01:40:04,681 WE DON'T DO IT ALONE. 2743 01:40:04,681 --> 01:40:07,351 TOGETHER WE'RE GOING TO STOP 2744 01:40:07,351 --> 01:40:07,851 THIS. 2745 01:40:07,851 --> 01:40:09,886 100,000 PEOPLE DYING A YEAR. 2746 01:40:09,886 --> 01:40:12,256 THIS IS RIDICULOUS. 2747 01:40:12,256 --> 01:40:13,490 AND YOU ARE SMARTER. 2748 01:40:13,490 --> 01:40:17,094 WE ARE ALL SMARTER. 2749 01:40:17,094 --> 01:40:18,929 PEOPLE SAID I SHOULD RETIRE. 2750 01:40:18,929 --> 01:40:20,897 HOW DO YOU RETIRE FROM THIS? 2751 01:40:20,897 --> 01:40:24,534 YOU KNOW WHEN YOU RETIRE? 2752 01:40:24,534 --> 01:40:26,303 WHEN THIS NUMBER IS ZERO. 2753 01:40:26,303 --> 01:40:32,409 WE HAVE TO CONVINCE CONGRESS. 2754 01:40:32,409 --> 01:40:33,377 BUT THAT BUDGET DIDN'T CHANGE. 2755 01:40:33,377 --> 01:40:35,045 THAT WAS FRUSTRATING. 2756 01:40:35,045 --> 01:40:37,014 MORE AND MORE PEOPLE ARE DYING. 2757 01:40:37,014 --> 01:40:38,448 WE NEED TO STOP THAT. 2758 01:40:38,448 --> 01:40:41,685 IT'S GOING TO TAKE SCIENCE. 2759 01:40:41,685 --> 01:40:45,055 THINGS DON'T HAPPEN BY CHANCE. 2760 01:40:45,055 --> 01:40:46,356 BUT, YOU KNOW. 2761 01:40:46,356 --> 01:40:48,025 I SEE SO MANY FRIENDS IN THIS 2762 01:40:48,025 --> 01:40:48,258 ROOM. 2763 01:40:48,258 --> 01:40:50,060 I SEE THEIR FAMILY OVER THERE. 2764 01:40:50,060 --> 01:40:53,363 I GOTTEN TO KNOW NORA WELL. 2765 01:40:53,363 --> 01:40:55,866 AND OTHERS OF YOU. 2766 01:40:55,866 --> 01:40:57,501 I CAN SAY THANK YOU VERY MUCH. 2767 01:40:57,501 --> 01:41:01,171 ON BEHALF OF THOSE TWO GROUPS. 2768 01:41:01,171 --> 01:41:11,348 THANK YOU. 2769 01:42:54,217 --> 01:42:55,318 >> OKAY. 2770 01:42:55,318 --> 01:42:57,888 SO WE NOW HAVE A BREAK UNTIL 2771 01:42:57,888 --> 01:42:58,422 WHEN? 2772 01:42:58,422 --> 01:43:00,791 >> UNTIL 3 O'CLOCK. 2773 01:43:00,791 --> 01:43:01,792 >> YOU HAVE 15 MINUTES. 2774 01:43:01,792 --> 01:43:05,162 THANKS VERY MUCH, EVERYBODY. 2775 01:44:47,224 --> 01:44:53,663 >> HELLO. 2776 01:44:53,663 --> 01:44:55,766 ALREADY 3 O'CLOCK IN THE 2777 01:44:55,766 --> 01:44:56,033 AFTERNOON. 2778 01:44:56,033 --> 01:44:59,002 AND IT'S A PLEASURE FOR ME TO 2779 01:44:59,002 --> 01:45:03,073 INTRODUCE THE NEXT SPEAKER. 2780 01:45:03,073 --> 01:45:04,708 WHICHEVER WAY YOU WANT. 2781 01:45:04,708 --> 01:45:06,643 YOU CAN GO OVER HERE OR THERE. 2782 01:45:06,643 --> 01:45:08,278 WHO IS A DIRECTOR OF THE 2783 01:45:08,278 --> 01:45:10,347 DIVISION OF NEUROSCIENCE AND 2784 01:45:10,347 --> 01:45:10,647 BEHAVIOR. 2785 01:45:10,647 --> 01:45:12,816 AND SHE WILL BE GIVING US AN 2786 01:45:12,816 --> 01:45:15,519 ESSAY ON THE PORTFOLIO ON THE 2787 01:45:15,519 --> 01:45:16,053 SCIENTIFIC QUESTIONS AND 2788 01:45:16,053 --> 01:45:17,754 FINDINGS. 2789 01:45:17,754 --> 01:45:18,655 >> OKAY. 2790 01:45:18,655 --> 01:45:19,456 THIS IS ON NOW. 2791 01:45:19,456 --> 01:45:20,757 THANK YOU VERY MUCH. 2792 01:45:20,757 --> 01:45:23,060 IT'S REALLY A PRIVILEGE TO BE 2793 01:45:23,060 --> 01:45:24,928 ABLE TO GIVE YOU AN UPDATE FROM 2794 01:45:24,928 --> 01:45:29,032 THE DIVISION OF NEUROSCIENCE AND 2795 01:45:29,032 --> 01:45:29,299 BEHAVIOR. 2796 01:45:29,299 --> 01:45:31,802 AND IT'S OUR 50TH ANNIVERSARY. 2797 01:45:31,802 --> 01:45:34,471 AND OVER THE LAST 50 YEARS, NIDA 2798 01:45:34,471 --> 01:45:36,173 HAS SUPPORTED BASIC RESEARCH 2799 01:45:36,173 --> 01:45:38,775 THAT'S LED TO A NUMBER OF 2800 01:45:38,775 --> 01:45:40,544 TRANSFORMATIVE DISCOVERIES. 2801 01:45:40,544 --> 01:45:44,448 THESE HAVE ALLOWED US TO ADVANCE 2802 01:45:44,448 --> 01:45:45,849 OUR KNOWLEDGE IN THE 2803 01:45:45,849 --> 01:45:49,286 NEUROBIOLOGY OF MOTIVATED 2804 01:45:49,286 --> 01:45:52,456 BEHAVIOR AND OF EXECUTIVE 2805 01:45:52,456 --> 01:45:54,558 FUNCTION LIKE DECISION MAKING. 2806 01:45:54,558 --> 01:45:58,128 AND HAVE CHARACTERIZED THE 2807 01:45:58,128 --> 01:45:59,529 PHARMACOLOGY MECHANISMS OF MANY 2808 01:45:59,529 --> 01:45:59,863 DRUGS. 2809 01:45:59,863 --> 01:46:03,767 AND THIS HAS LED TO ADVANCES IN 2810 01:46:03,767 --> 01:46:05,368 MEDICATION DEVELOPMENT, 2811 01:46:05,368 --> 01:46:07,304 PARTICULARLY IN THE TREATMENT OF 2812 01:46:07,304 --> 01:46:09,473 OVERDOSE, AND IN THE TREATMENT 2813 01:46:09,473 --> 01:46:09,940 OF WITHDRAWAL. 2814 01:46:09,940 --> 01:46:14,811 AND IMPORTANTLY, ALL OF THIS 2815 01:46:14,811 --> 01:46:17,547 SUPPORT OF BASIC RESEARCH HAS 2816 01:46:17,547 --> 01:46:19,149 BEGUN TO CHANGE OUR PERSPECTIVE 2817 01:46:19,149 --> 01:46:22,252 OF ADDICTION FROM BEING A 2818 01:46:22,252 --> 01:46:23,487 DEVIANT BEHAVIOR TO BEING A 2819 01:46:23,487 --> 01:46:23,987 HEALTH CONDITION. 2820 01:46:23,987 --> 01:46:29,092 BUT WE STILL HAVE A WAYS TO GO. 2821 01:46:29,092 --> 01:46:32,195 AND BASIC RESEARCH IS TASKED 2822 01:46:32,195 --> 01:46:34,197 WITH DEALING WITH MANY OF THE 2823 01:46:34,197 --> 01:46:36,433 CHALLENGES, CURRENT CHALLENGES 2824 01:46:36,433 --> 01:46:38,068 OF SUBSTANCE USE DISORDER. 2825 01:46:38,068 --> 01:46:40,670 MANY THAT WE TALKED ABOUT TODAY. 2826 01:46:40,670 --> 01:46:42,572 SO WE STILL HAVE THIS RAGING 2827 01:46:42,572 --> 01:46:44,307 OVERDOSE CRISIS. 2828 01:46:44,307 --> 01:46:47,878 WE ARE TRYING TO NAVIGATE A VERY 2829 01:46:47,878 --> 01:46:49,613 COMPLEX LANDSCAPE OF POLY 2830 01:46:49,613 --> 01:46:50,413 SUBSTANCE USE. 2831 01:46:50,413 --> 01:46:51,781 WE RECOGNIZE THAT DRUG USE 2832 01:46:51,781 --> 01:46:55,085 REALLY IS A TRAJECTORY THAT IT'S 2833 01:46:55,085 --> 01:46:57,020 COMPOSED OF MANY DIFFERENT 2834 01:46:57,020 --> 01:47:00,323 STAGES THAT ARE CHARACTERIZED BY 2835 01:47:00,323 --> 01:47:01,925 DIFFERENT COGNITIVE PROCESSES 2836 01:47:01,925 --> 01:47:06,963 AND UNDERLYING THESE PROCESSES 2837 01:47:06,963 --> 01:47:08,064 ARE SUBSTRAITS. 2838 01:47:08,064 --> 01:47:10,500 AND WE NEED TO UNDERSTAND THE 2839 01:47:10,500 --> 01:47:12,435 MECHANISM OF TRANSITIONS FROM 2840 01:47:12,435 --> 01:47:15,539 ONE STATE TO ANOTHER. 2841 01:47:15,539 --> 01:47:17,908 WE RECOGNIZE THAT SUBSTANCE USE 2842 01:47:17,908 --> 01:47:19,910 DISORDER IS PART OF SOMETHING 2843 01:47:19,910 --> 01:47:22,679 BIGGER; PART OF A COMPLEX 2844 01:47:22,679 --> 01:47:23,813 MORBILITY. 2845 01:47:23,813 --> 01:47:29,219 IT'S MORBID WITH PAIN, WITH 2846 01:47:29,219 --> 01:47:32,455 SLEEP DISORDERS, AND MENTAL 2847 01:47:32,455 --> 01:47:34,391 HEALTH DISORDERS. 2848 01:47:34,391 --> 01:47:35,492 THERE MAY BE A BROADER NETWORK 2849 01:47:35,492 --> 01:47:37,694 THAT SUBSERVES ALL OF THESE 2850 01:47:37,694 --> 01:47:38,195 DISORDERS. 2851 01:47:38,195 --> 01:47:39,996 AND WE NEED TO TARGET THESE 2852 01:47:39,996 --> 01:47:41,431 BROADER NETWORK IF WE'RE GOING 2853 01:47:41,431 --> 01:47:42,132 TO TREAT IT. 2854 01:47:42,132 --> 01:47:45,435 IT'S COMPLICATED BY OTHER 2855 01:47:45,435 --> 01:47:46,503 CONDITIONS: PREGNANCY, 2856 01:47:46,503 --> 01:47:46,803 INFLECTION. 2857 01:47:46,803 --> 01:47:48,438 AND ONE OF THE MAJOR QUESTIONS 2858 01:47:48,438 --> 01:47:52,442 THAT WE'RE TRYING TO ADDRESS IS 2859 01:47:52,442 --> 01:47:55,979 WHAT'S THE BASIS FOR INDIVIDUAL 2860 01:47:55,979 --> 01:47:57,080 VARIABILITY IN THE RISK TO 2861 01:47:57,080 --> 01:47:58,381 DEVELOP SUBSTANCE USE DISORDERS? 2862 01:47:58,381 --> 01:48:00,750 THERE ARE DETERMINANTS: GENETIC 2863 01:48:00,750 --> 01:48:03,853 DETERMINANTS, SEX IS A 2864 01:48:03,853 --> 01:48:06,456 DETERMINANT, ENVIRONMENTAL 2865 01:48:06,456 --> 01:48:07,357 DETERMINANTS, AND ENVIRONMENT. 2866 01:48:07,357 --> 01:48:09,593 HOW DO ALL THESE FACTORS 2867 01:48:09,593 --> 01:48:12,762 INTERACT TO DETERMINE THE RISK 2868 01:48:12,762 --> 01:48:15,765 TO DEVELOP SUBSTANCE USE 2869 01:48:15,765 --> 01:48:16,032 DISORDER. 2870 01:48:16,032 --> 01:48:18,468 I WANT TO GIVE YOU HIGHLIGHTS OF 2871 01:48:18,468 --> 01:48:20,237 REPRESENTATIVE RESEARCH THAT 2872 01:48:20,237 --> 01:48:21,438 WERE SUPPORTING THAT ADDRESSES 2873 01:48:21,438 --> 01:48:23,406 EACH OF THESE CHALLENGES. 2874 01:48:23,406 --> 01:48:25,275 AND FIRST TO SHOW YOU THE 2875 01:48:25,275 --> 01:48:27,544 ORGANIZATION OF DMV. 2876 01:48:27,544 --> 01:48:30,380 SO IT'S LEADERSHIP LEVEL. 2877 01:48:30,380 --> 01:48:32,449 MYSELF AND COULDN'T DO THIS 2878 01:48:32,449 --> 01:48:38,855 WITHOUT THE ASSISTANCE OF ROGER 2879 01:48:38,855 --> 01:48:39,723 LITTLE. 2880 01:48:39,723 --> 01:48:41,925 ORGANIZED INTO FOUR SCIENTIFIC 2881 01:48:41,925 --> 01:48:42,459 BRANCHES. 2882 01:48:42,459 --> 01:48:46,062 THEY ARE INTEGRATED AND WORK 2883 01:48:46,062 --> 01:48:49,299 TOGETHER. 2884 01:48:49,299 --> 01:48:53,370 BONNIE, JONATHAN IS THE CHIEF OF 2885 01:48:53,370 --> 01:48:55,672 GENETICS. 2886 01:48:55,672 --> 01:48:57,674 TRISTA IS THE CHIEF OF A BRANCH. 2887 01:48:57,674 --> 01:49:00,510 AND SAM IS THE CHIEF OF 2888 01:49:00,510 --> 01:49:03,580 CHEMISTRY, PHYSIOLOGY BRANCH. 2889 01:49:03,580 --> 01:49:06,916 AND THEN WE HAVE NHIB RESEARCH 2890 01:49:06,916 --> 01:49:08,451 PORTFOLIO THAT CUTS ACROSS THE 2891 01:49:08,451 --> 01:49:08,718 BRANCHES. 2892 01:49:08,718 --> 01:49:09,986 I WON'T BE ABLE TO TELL YOU 2893 01:49:09,986 --> 01:49:12,856 ABOUT THE RESEARCH TODAY. 2894 01:49:12,856 --> 01:49:15,392 WE WORK WITH PEOPLE TO 2895 01:49:15,392 --> 01:49:16,693 ADMINISTER THAT RESEARCH 2896 01:49:16,693 --> 01:49:16,960 PORTFOLIO. 2897 01:49:16,960 --> 01:49:18,495 AND THEN CUTTING ACROSS THE 2898 01:49:18,495 --> 01:49:21,631 BRANCHES, WE HAVE A PORTFOLIO OR 2899 01:49:21,631 --> 01:49:22,866 PROGRAM IN DATA SCIENCE AND 2900 01:49:22,866 --> 01:49:28,438 THAT'S HEADED UP BY SUSAN 2901 01:49:28,438 --> 01:49:34,010 WRIGHT. 2902 01:49:34,010 --> 01:49:36,346 SO ADDRESSING THE OVERDOSE 2903 01:49:36,346 --> 01:49:37,280 CRISIS. 2904 01:49:37,280 --> 01:49:39,349 ONE OF THE MAJOR PROGRAMS THAT 2905 01:49:39,349 --> 01:49:42,519 WE HAVE IS DIRECTED BY MURRAY IN 2906 01:49:42,519 --> 01:49:43,887 THE CHEMISTRY PHARMACOLOGY 2907 01:49:43,887 --> 01:49:44,220 BRANCH. 2908 01:49:44,220 --> 01:49:45,588 AND THIS IS THE CHEMICAL COUNTER 2909 01:49:45,588 --> 01:49:46,990 MEASURES RESEARCH PROGRAM. 2910 01:49:46,990 --> 01:49:48,892 SO THIS IS A PROGRAM THAT WE 2911 01:49:48,892 --> 01:49:53,163 HAVE IN COLLABORATION WITH 2912 01:49:53,163 --> 01:49:53,363 NIAID. 2913 01:49:53,363 --> 01:49:56,066 AND IT'S REALLY TO SORT OF 2914 01:49:56,066 --> 01:49:59,602 ADDRESS OR TO IDENTIFY COUNTER 2915 01:49:59,602 --> 01:50:01,404 MEASURES TO AGENTS THAT COULD BE 2916 01:50:01,404 --> 01:50:02,972 USED AS WEAPONS AGAINST THE 2917 01:50:02,972 --> 01:50:04,140 POPULATION. 2918 01:50:04,140 --> 01:50:10,447 AND ON THAT LIST IS -- THIS 2919 01:50:10,447 --> 01:50:13,717 PROGRAM ALLOWED US TO FUND 2920 01:50:13,717 --> 01:50:15,585 RESEARCH THAT'S REALLY TRYING TO 2921 01:50:15,585 --> 01:50:19,122 GET AT THE BASIS OF THE 2922 01:50:19,122 --> 01:50:21,324 NEUROBIOLOGY OF THE TOXICITY DUE 2923 01:50:21,324 --> 01:50:23,626 TO THESE AGENTS. 2924 01:50:23,626 --> 01:50:27,330 IT ALSO SUPPORTS RESEARCH FOR 2925 01:50:27,330 --> 01:50:30,400 USING METHODS FOR SCREENING 2926 01:50:30,400 --> 01:50:32,869 COMPOUNDS THAT WOULD COUNTER ACT 2927 01:50:32,869 --> 01:50:33,770 THESE. 2928 01:50:33,770 --> 01:50:35,939 TO STIMULATE RESPIRATION, 2929 01:50:35,939 --> 01:50:39,075 CHEMICALS AND DEVICES, TO CHANGE 2930 01:50:39,075 --> 01:50:42,145 THE FORMULATION OF CHEMICALS 2931 01:50:42,145 --> 01:50:44,247 THAT THEY HAVE A LONGER DURATION 2932 01:50:44,247 --> 01:50:45,615 OF ACTION. 2933 01:50:45,615 --> 01:50:48,051 AND THIS PROGRAM HAS ALSO 2934 01:50:48,051 --> 01:50:49,986 SUPPORTED THE DEVELOPMENT OF 2935 01:50:49,986 --> 01:50:51,321 IMMUNE THERAPIES OR EARLY 2936 01:50:51,321 --> 01:50:52,956 RESEARCH IN IMMUNE THERAPIES 2937 01:50:52,956 --> 01:50:55,258 LIKE VACCINES AND ANTIBODIES. 2938 01:50:55,258 --> 01:50:58,061 AND THIS PROGRAM SUPPORTED SOME 2939 01:50:58,061 --> 01:51:00,430 OF THE EARLY WORK ON ANTIBODIES 2940 01:51:00,430 --> 01:51:02,499 THAT LED UP TO THE ONES THAT ARE 2941 01:51:02,499 --> 01:51:04,234 IN CLINICAL TRIALS TODAY. 2942 01:51:04,234 --> 01:51:07,103 AND IT'S ALSO SUPPORTED WORK ON 2943 01:51:07,103 --> 01:51:12,842 AGENTS THAT ARE SEQUESTER. 2944 01:51:12,842 --> 01:51:14,577 AND DRIVE THEM TO PATHWAYS. 2945 01:51:14,577 --> 01:51:17,414 AND WE SUPPORTED THROUGH THIS 2946 01:51:17,414 --> 01:51:18,047 PROGRAM SOME OF THE EARLY 2947 01:51:18,047 --> 01:51:20,016 RESEARCH THAT LED TO ONE OF 2948 01:51:20,016 --> 01:51:20,650 THESE THAT'S NOW IN CLINICAL 2949 01:51:20,650 --> 01:51:25,188 TRIAL. 2950 01:51:25,188 --> 01:51:27,590 SO I THINK ONE REALLY GOOD 2951 01:51:27,590 --> 01:51:29,559 REPRESENTATIVE EXAMPLE OF HOW 2952 01:51:29,559 --> 01:51:31,060 THE BASIC RESEARCH WE SUPPORT 2953 01:51:31,060 --> 01:51:36,433 HAS REALLY ADVANCED SCIENCES IN 2954 01:51:36,433 --> 01:51:40,537 THE STRUCTURES OF RECEPTORS AS 2955 01:51:40,537 --> 01:51:43,506 WELL AS RECEPTORS THAT DRUGS OF 2956 01:51:43,506 --> 01:51:45,375 ABUSE INTERACT WITH. 2957 01:51:45,375 --> 01:51:47,143 AT THE ATOMIC LEVEL. 2958 01:51:47,143 --> 01:51:50,880 THIS CAME IN ADVANCES. 2959 01:51:50,880 --> 01:51:52,649 AND IT'S NOT JUST THE STRUCTURE 2960 01:51:52,649 --> 01:51:56,453 THE RECEPTOR, BUT REALLY THE 2961 01:51:56,453 --> 01:51:58,455 STRUCTURAL DYNAMICS OF THE 2962 01:51:58,455 --> 01:51:58,721 RECEPTOR. 2963 01:51:58,721 --> 01:52:04,494 HOW THE RECEPTOR CHANGE THE -- 2964 01:52:04,494 --> 01:52:07,197 MODULATORS AND SO ON. 2965 01:52:07,197 --> 01:52:08,765 AND THIS INFORMATION HAS BEEN 2966 01:52:08,765 --> 01:52:12,135 VERY IMPACTFUL BECAUSE IT'S 2967 01:52:12,135 --> 01:52:14,170 ALLOWED FOR HIGH THROUGH-PUT 2968 01:52:14,170 --> 01:52:15,872 COMPUTATIONAL SCREENING OF THESE 2969 01:52:15,872 --> 01:52:18,007 VERY LARGE CHEMICAL LIBRARIES TO 2970 01:52:18,007 --> 01:52:21,444 IDENTIFY OPTIMAL COMPOUNDS. 2971 01:52:21,444 --> 01:52:23,413 ONE OF THE CHALLENGES THAT COMES 2972 01:52:23,413 --> 01:52:24,981 WITH THIS IS THAT THE CHEMICAL 2973 01:52:24,981 --> 01:52:27,083 SPACE BECOMES SO LARGE THAT IT 2974 01:52:27,083 --> 01:52:29,519 TAKES A LOT OF RESOURCES TO 2975 01:52:29,519 --> 01:52:31,688 SCREEN THIS SPACE, IT TAKES A 2976 01:52:31,688 --> 01:52:33,022 LOT OF TIME TO SCREEN THIS 2977 01:52:33,022 --> 01:52:33,490 SPACE. 2978 01:52:33,490 --> 01:52:37,026 SO WE ARE ALSO SUPPORTING WORK 2979 01:52:37,026 --> 01:52:40,530 THAT IS IDENTIFYING NEW METHODS 2980 01:52:40,530 --> 01:52:41,998 TO OPTIMIZE THESE SCREENING 2981 01:52:41,998 --> 01:52:42,298 APPROACHES. 2982 01:52:42,298 --> 01:52:45,468 SO ONE EXAMPLE OF THESE IS 2983 01:52:45,468 --> 01:52:46,936 FRAGMENT-BASED APPROACH FROM THE 2984 01:52:46,936 --> 01:52:51,074 LAB WHICH HAS GONE ON TO 2985 01:52:51,074 --> 01:52:51,875 IDENTIFY RECEPTORS. 2986 01:52:51,875 --> 01:52:55,411 ANOTHER APPROACH IS TO USE 2987 01:52:55,411 --> 01:53:05,955 GENERATIVE DEEP LEARNING MODELS. 2988 01:53:06,189 --> 01:53:06,422 A 2989 01:53:06,422 --> 01:53:09,526 SO WE HAVE A LARGE GENETICS 2990 01:53:09,526 --> 01:53:11,561 PROGRAM THAT'S HEADED UP BY 2991 01:53:11,561 --> 01:53:12,795 JONATHAN, WHO IS THE CHIEF. 2992 01:53:12,795 --> 01:53:15,498 AND WE HAVE A HUMAN GENETICS 2993 01:53:15,498 --> 01:53:15,732 PROGRAM. 2994 01:53:15,732 --> 01:53:17,433 AND COMPLEMENTARY TO THAT IS THE 2995 01:53:17,433 --> 01:53:18,868 ANIMAL GENETIC PROGRAM. 2996 01:53:18,868 --> 01:53:21,704 THE HUMAN GENETICS PROGRAM 2997 01:53:21,704 --> 01:53:24,440 SUPPORTS A NUMBER OF STUDIES 2998 01:53:24,440 --> 01:53:26,509 DESIGNED TO IDENTIFY THE GENETIC 2999 01:53:26,509 --> 01:53:29,512 VARIANCE THROUGH THE BASIS OF 3000 01:53:29,512 --> 01:53:30,380 DEVELOPMENT OF SUBSTANCE USE 3001 01:53:30,380 --> 01:53:30,780 DISORDER. 3002 01:53:30,780 --> 01:53:34,450 AND SENSITIVITY TO TOXICITIES OF 3003 01:53:34,450 --> 01:53:36,686 ABUSED DRUGS. 3004 01:53:36,686 --> 01:53:40,123 ONE OF THE CHALLENGES IN THESE 3005 01:53:40,123 --> 01:53:44,460 GWAS STUDIES, YOU IDENTIFY 3006 01:53:44,460 --> 01:53:50,500 VARIANTS IN NONCODING REGENTS. 3007 01:53:50,500 --> 01:53:54,404 WE ARE LOOKING AT THE 3D 3008 01:53:54,404 --> 01:53:55,738 ARCHITECTURE TO ASSIGN THE 3009 01:53:55,738 --> 01:53:58,474 VARIANT TO THE GENE THAT IT 3010 01:53:58,474 --> 01:53:59,075 REGULATES. 3011 01:53:59,075 --> 01:54:00,910 AND IN THIS WAY ARE IDENTIFYING 3012 01:54:00,910 --> 01:54:02,478 NEW RISK GENES AND MAPPING THESE 3013 01:54:02,478 --> 01:54:04,981 OUT IN THE BRAIN. 3014 01:54:04,981 --> 01:54:08,551 ANOTHER CHALLENGE OF THESE GWAS 3015 01:54:08,551 --> 01:54:09,752 STUDIES IS THAT TO HAVE ENOUGH 3016 01:54:09,752 --> 01:54:12,188 POWER IT REALLY TAKES A LARGE 3017 01:54:12,188 --> 01:54:15,658 POPULATION, A DIVERSE POPULATION 3018 01:54:15,658 --> 01:54:18,528 ANCESTRY SO THE RESULTS AREN'T 3019 01:54:18,528 --> 01:54:18,895 BIASSED. 3020 01:54:18,895 --> 01:54:20,430 AND THIS CAN BE CHALLENGING TO 3021 01:54:20,430 --> 01:54:22,031 GET AND VERY COSTLY. 3022 01:54:22,031 --> 01:54:25,201 SO WE HAVE BEEN SUPPORTING 3023 01:54:25,201 --> 01:54:31,474 RESEARCH THAT IS APPLYING 3024 01:54:31,474 --> 01:54:31,808 COMPUTATIONAL. 3025 01:54:31,808 --> 01:54:35,912 AND AN EXAMPLE OF THIS IS WORK 3026 01:54:35,912 --> 01:54:40,750 FROM ALEX ANDER. 3027 01:54:40,750 --> 01:54:42,318 APPLYING THIS TO EXISTING DATA 3028 01:54:42,318 --> 01:54:43,620 SETS. 3029 01:54:43,620 --> 01:54:46,489 AND FROM THIS HE HAS IDENTIFIED 3030 01:54:46,489 --> 01:54:48,458 AN ADDICTION RISK FACTOR WHICH 3031 01:54:48,458 --> 01:54:53,029 BASICALLY IS THE SHARED GENETIC 3032 01:54:53,029 --> 01:54:56,032 ARCHITECTURE ACROSS OPIOID USE 3033 01:54:56,032 --> 01:54:58,601 DISORDER, NICOTINE USE DISORDER, 3034 01:54:58,601 --> 01:55:00,703 AND CANNABIS USE DISORDER. 3035 01:55:00,703 --> 01:55:04,340 THIS RISK FACTOR SHARES GENETIC 3036 01:55:04,340 --> 01:55:07,210 LIABILITY WITH CERTAIN FEATURES 3037 01:55:07,210 --> 01:55:08,144 OF INDIVIDUALS WITH SUBSTANCE 3038 01:55:08,144 --> 01:55:09,245 USE DISORDER. 3039 01:55:09,245 --> 01:55:11,280 SO RISK TAKING BEHAVIOR, 3040 01:55:11,280 --> 01:55:16,452 NEGATIVE AFFECT, AND IMPAIRMENTS 3041 01:55:16,452 --> 01:55:19,155 IN EXECUTIVE FUNCTION. 3042 01:55:19,155 --> 01:55:22,225 SO GENETICS IS INTIMATELY LINKED 3043 01:55:22,225 --> 01:55:24,427 TO DEVELOPMENT AND DEVELOPMENT 3044 01:55:24,427 --> 01:55:28,231 IS AN IMPORTANT DETERMINANT OF 3045 01:55:28,231 --> 01:55:28,931 DEVELOPING RISK FOR SUBSTANCE 3046 01:55:28,931 --> 01:55:30,333 USE DISORDER. 3047 01:55:30,333 --> 01:55:33,036 WE KNOW THAT THERE ARE CRITICAL 3048 01:55:33,036 --> 01:55:35,505 WINDOWS OF DEVELOPMENT WHEN 3049 01:55:35,505 --> 01:55:39,142 CELLS ARE BORN, MIGRATE, WHEN 3050 01:55:39,142 --> 01:55:40,443 THEY FORM CONNECTIONS, AND WHEN 3051 01:55:40,443 --> 01:55:42,378 THE CONNECTIONS ARE PRUNED. 3052 01:55:42,378 --> 01:55:46,482 AND THIS REALLY REQUIRES A VERY 3053 01:55:46,482 --> 01:55:49,052 PRECISE GENETIC PROGRAMMING AND 3054 01:55:49,052 --> 01:55:52,455 EXPOSURE TO DRUGS AT THESE 3055 01:55:52,455 --> 01:55:54,257 DIFFERENT WINDOWS OF DEVELOPMENT 3056 01:55:54,257 --> 01:55:57,727 THROUGH EPI-GENETIC AFFECTS 3057 01:55:57,727 --> 01:55:58,528 INTERFERE WITH THAT PROGRAMMING 3058 01:55:58,528 --> 01:56:01,030 AND CAUSE A RESHAPING OF 3059 01:56:01,030 --> 01:56:02,398 CIRCUITS OR A DISRUPTION OF THE 3060 01:56:02,398 --> 01:56:05,201 FORMATION OF CIRCUITS. 3061 01:56:05,201 --> 01:56:07,770 AND THAT CAN HAVE LONG-TERM 3062 01:56:07,770 --> 01:56:10,506 EFFECTS ON BEHAVIOR THAT LAST 3063 01:56:10,506 --> 01:56:12,108 INTO ADULTHOOD. 3064 01:56:12,108 --> 01:56:15,578 SO WE SUPPORT A LOT OF RESEARCH 3065 01:56:15,578 --> 01:56:16,312 THAT IS FOCUSED ON DETERMINING 3066 01:56:16,312 --> 01:56:18,648 OR IDENTIFYING THE EFFECTS AND 3067 01:56:18,648 --> 01:56:20,349 THE MECHANISMS BY WHICH EXPOSURE 3068 01:56:20,349 --> 01:56:23,352 TO DRUGS DURING THESE DIFFERENT 3069 01:56:23,352 --> 01:56:25,054 WINDOWS ALTERS THESE 3070 01:56:25,054 --> 01:56:25,755 DEVELOPMENTAL PROCESSES. 3071 01:56:25,755 --> 01:56:27,924 AND YOU KNOW, RECENTLY THERE'S A 3072 01:56:27,924 --> 01:56:29,659 LOT OF ATTENTION THAT'S BEEN 3073 01:56:29,659 --> 01:56:32,228 GIVEN PARTICULARITY TO CANNABIS 3074 01:56:32,228 --> 01:56:34,497 BECAUSE OF GREATER EXPOSURE TO 3075 01:56:34,497 --> 01:56:36,165 CANNABIS. 3076 01:56:36,165 --> 01:56:37,567 GREATER AVAILABILITY TO TAKE 3077 01:56:37,567 --> 01:56:37,834 CANNABIS. 3078 01:56:37,834 --> 01:56:41,204 AND TO PURCHASE THIS. 3079 01:56:41,204 --> 01:56:44,240 AND GREATER USE BY INDIVIDUALS 3080 01:56:44,240 --> 01:56:45,308 THAT ARE IN THESE PARTICULAR 3081 01:56:45,308 --> 01:56:48,778 DEVELOPMENTAL WINDOWS SUCH AS 3082 01:56:48,778 --> 01:56:54,383 PREGNANCY AND ADOLESCENCE. 3083 01:56:54,383 --> 01:57:00,356 LIKE DRUGS, ADVERSE EVENTS 3084 01:57:00,356 --> 01:57:03,126 DURING PARTICULAR CRITICAL 3085 01:57:03,126 --> 01:57:04,627 WINDOWS OF DEVELOPMENT CAN ALSO 3086 01:57:04,627 --> 01:57:06,162 CHANGE THE DEVELOPMENT OF THE 3087 01:57:06,162 --> 01:57:07,764 BRAIN AND THEN HAVE LONG-TERM 3088 01:57:07,764 --> 01:57:10,500 EFFECTS ON BEHAVIOR. 3089 01:57:10,500 --> 01:57:16,439 AND YOU HEARD FROM THE DOCTOR 3090 01:57:16,439 --> 01:57:19,742 TODAY TWO STUDIES ON BRAIN 3091 01:57:19,742 --> 01:57:20,042 DEVELOPMENT. 3092 01:57:20,042 --> 01:57:21,911 AND YOU WILL HEAR TOMORROW IN 3093 01:57:21,911 --> 01:57:23,012 THE DETAILS OF THAT. 3094 01:57:23,012 --> 01:57:24,947 AND COLLEAGUES THAT DIRECT THAT 3095 01:57:24,947 --> 01:57:25,948 PROGRAM. 3096 01:57:25,948 --> 01:57:29,252 THE ABCD PROGRAM AND HBCD 3097 01:57:29,252 --> 01:57:29,919 PROGRAM. 3098 01:57:29,919 --> 01:57:32,455 AND THESE PROGRAMS THEY ARE 3099 01:57:32,455 --> 01:57:34,123 OBSERVATIONAL STUDIES, THEY ARE 3100 01:57:34,123 --> 01:57:36,659 COLLECTING DATA ON BRAIN IMAGES, 3101 01:57:36,659 --> 01:57:40,263 BIO SAMPLES, GENETICS, 3102 01:57:40,263 --> 01:57:42,832 NEUROCOGNITIVE FUNCTION, AND 3103 01:57:42,832 --> 01:57:44,433 SOCIO ENVIRONMENTAL FACTORS. 3104 01:57:44,433 --> 01:57:48,604 AND TRYING TO DETERMINE HOW THEY 3105 01:57:48,604 --> 01:57:51,107 INTERACT TO SHAPE THE TRAJECTORY 3106 01:57:51,107 --> 01:57:51,908 OF MENTAL HEALTH. 3107 01:57:51,908 --> 01:57:54,677 WE'RE EXCITED FOR A NUMBER OF 3108 01:57:54,677 --> 01:57:55,311 REASONS. 3109 01:57:55,311 --> 01:57:56,779 WE'LL BE GETTING DATA. 3110 01:57:56,779 --> 01:58:00,449 AND THESE STUDIES ARE GOING TO 3111 01:58:00,449 --> 01:58:03,219 GENERATE HYPOTHESIS THAT CAN BE 3112 01:58:03,219 --> 01:58:05,521 BACK TRANSLATED. 3113 01:58:05,521 --> 01:58:08,457 AND SO WE'LL BE ABLE TO TEST 3114 01:58:08,457 --> 01:58:10,126 THESE HYPOTHESIS, FOR EXAMPLE, 3115 01:58:10,126 --> 01:58:13,062 IN RODENT MODELS TO DETERMINE 3116 01:58:13,062 --> 01:58:16,499 HOW CHANGES IN SOCIAL OR 3117 01:58:16,499 --> 01:58:18,467 ENVIRONMENTAL FACTORS INFLUENCE 3118 01:58:18,467 --> 01:58:19,135 THE DEVELOPMENT OF BRAIN. 3119 01:58:19,135 --> 01:58:23,306 AND HOW THIS CHANGES THE 3120 01:58:23,306 --> 01:58:25,908 TRAJECTORY TO BIAS TOWARDS 3121 01:58:25,908 --> 01:58:27,343 RESILIENCE OR VULNERABILITY TO A 3122 01:58:27,343 --> 01:58:28,311 SUBSTANCE USE DISORDER. 3123 01:58:28,311 --> 01:58:29,979 AND A NEW PROGRAM THAT WE HAVE 3124 01:58:29,979 --> 01:58:32,448 THAT'S SUPPORTING THIS RESEARCH 3125 01:58:32,448 --> 01:58:35,685 IS THE TRANSLATING SOCIO 3126 01:58:35,685 --> 01:58:38,754 ENVIRONMENTAL INFLUENCES ON 3127 01:58:38,754 --> 01:58:39,956 NEUROCOGNITIVE DEVELOPMENT OR 3128 01:58:39,956 --> 01:58:41,891 RISK. 3129 01:58:41,891 --> 01:58:44,427 DEVELOPING BY HOLLY MOORE OF THE 3130 01:58:44,427 --> 01:58:44,894 BEHAVIORAL COGNITIVE 3131 01:58:44,894 --> 01:58:50,433 NEUROSCIENCE BRANCH. 3132 01:58:50,433 --> 01:58:52,301 ONE QUESTION THAT WE'RE TRYING 3133 01:58:52,301 --> 01:58:53,836 TO ANSWER THAT KIND OF GOES 3134 01:58:53,836 --> 01:58:56,272 ACROSS ALL OF THE BRANCHES IS 3135 01:58:56,272 --> 01:59:00,076 WHAT IS THE BASIS OR WHAT'S THE 3136 01:59:00,076 --> 01:59:02,345 MECHANISM OF TRANSITION FROM IN 3137 01:59:02,345 --> 01:59:04,313 THESE DIFFERENT STAGES THROUGH 3138 01:59:04,313 --> 01:59:06,515 THE TRAJECTORY OF DRUG USE FROM 3139 01:59:06,515 --> 01:59:08,251 THE CELLULAR TO THE CIRCUIT TO 3140 01:59:08,251 --> 01:59:11,153 THE NETWORK TO THE BEHAVIORAL 3141 01:59:11,153 --> 01:59:11,420 LEVEL? 3142 01:59:11,420 --> 01:59:13,923 AND AT THE CELLULAR LEVEL, THE 3143 01:59:13,923 --> 01:59:15,191 MOST AMBITIOUS PROGRAM WE HAVE 3144 01:59:15,191 --> 01:59:17,326 IS THE SCORCH PROGRAM THAT WAS 3145 01:59:17,326 --> 01:59:20,062 DEVELOPED BY JOHN. 3146 01:59:20,062 --> 01:59:22,498 AND THIS PROGRAM IS SUPPORTING 3147 01:59:22,498 --> 01:59:24,433 WORK THAT'S DOING SINGLE CELL 3148 01:59:24,433 --> 01:59:27,470 AND SINGLE NUCLEUS PROFILING AND 3149 01:59:27,470 --> 01:59:29,238 GETTING THE PROFILING AND THE 3150 01:59:29,238 --> 01:59:32,308 EPI GENETIC PROFILE OF 3151 01:59:32,308 --> 01:59:34,477 INDIVIDUAL CELLS THAT ARE IN 3152 01:59:34,477 --> 01:59:35,411 BRAIN REGIONS THAT HAVE BEEN 3153 01:59:35,411 --> 01:59:36,012 ASSOCIATED WITH SUBSTANCE USE 3154 01:59:36,012 --> 01:59:38,147 DISORDER. 3155 01:59:38,147 --> 01:59:39,081 AND DOING THIS IN THREE 3156 01:59:39,081 --> 01:59:40,016 DIFFERENT SPECIES. 3157 01:59:40,016 --> 01:59:44,921 SO IN THE MOUTH, IN THE NONHUMAN 3158 01:59:44,921 --> 01:59:48,457 PRIMATE, AND IN HUMAN 3159 01:59:48,457 --> 01:59:48,758 POSTMORTEM. 3160 01:59:48,758 --> 01:59:50,793 WE'LL HAVE AN ATLAS. 3161 01:59:50,793 --> 01:59:52,995 LAYERED ON TOP OF THIS IS THE 3162 01:59:52,995 --> 01:59:54,196 CONDITION OF HIV. 3163 01:59:54,196 --> 01:59:56,432 SO IN THE CONTEXT OF HIV AND IN 3164 01:59:56,432 --> 01:59:58,467 THE PRESENCE OF HIV OR IN THE 3165 01:59:58,467 --> 01:59:59,835 ABSENCE OF HIV. 3166 01:59:59,835 --> 02:00:02,638 SO WE CAN BEGIN TO UNDERSTAND AT 3167 02:00:02,638 --> 02:00:06,575 THE CELLULAR LEVEL THE 3168 02:00:06,575 --> 02:00:07,443 COMORBILITY BETWEEN HIV AND 3169 02:00:07,443 --> 02:00:08,411 SUBSTANCE USE DISORDER. 3170 02:00:08,411 --> 02:00:09,578 AT THIS POINT WE ARE NOW 3171 02:00:09,578 --> 02:00:11,647 SUPPORTING 15 DATA GENERATING 3172 02:00:11,647 --> 02:00:12,448 CENTERS. 3173 02:00:12,448 --> 02:00:13,749 AGAIN, LOOKING AT DIFFERENT 3174 02:00:13,749 --> 02:00:15,418 SPECIES AND AT DIFFERENT STAGES 3175 02:00:15,418 --> 02:00:16,719 OF THAT TRAJECTORY. 3176 02:00:16,719 --> 02:00:20,456 DATA IS GOING INTO THE SCORCH 3177 02:00:20,456 --> 02:00:22,491 DATA COORDINATING CENTER. 3178 02:00:22,491 --> 02:00:23,926 AND THAT DATA IS GOING TO BE 3179 02:00:23,926 --> 02:00:24,994 AVAILABLE FOR USE BY THE 3180 02:00:24,994 --> 02:00:29,498 SCIENTIFIC COMMUNITY. 3181 02:00:29,498 --> 02:00:31,233 SO THAT'S AT THE CELLULAR LEVEL. 3182 02:00:31,233 --> 02:00:33,903 BUT BUILDING FUNCTIONALITY ON TO 3183 02:00:33,903 --> 02:00:42,411 SCORCH IS OUR NEW PROGRAM, THE 3184 02:00:42,411 --> 02:00:42,778 NEXTUS PROGRAM. 3185 02:00:42,778 --> 02:00:46,482 THE IDEA HERE IS TO IDENTIFY 3186 02:00:46,482 --> 02:00:48,985 NEURAL ENSEMBLES THAT BECAME 3187 02:00:48,985 --> 02:00:52,688 ENGAGED DURING THESE STAGES OF 3188 02:00:52,688 --> 02:00:53,322 OPIOID USE. 3189 02:00:53,322 --> 02:00:55,391 IT'S IDENTIFICATION OF THOSE 3190 02:00:55,391 --> 02:00:58,361 CELLS, IDENTIFICATION OF THEIR 3191 02:00:58,361 --> 02:00:59,528 MOLECULAR PROFILE, 3192 02:00:59,528 --> 02:01:01,197 IDENTIFICATION OF THEIR SPATIAL 3193 02:01:01,197 --> 02:01:03,899 LOCALIZATION IN BRAIN, THEIR 3194 02:01:03,899 --> 02:01:06,736 ACTIVITY, AND THEIR 3195 02:01:06,736 --> 02:01:07,069 CONNECTIVITY. 3196 02:01:07,069 --> 02:01:09,238 AND THE PRIMARY GOAL OF THIS, 3197 02:01:09,238 --> 02:01:11,140 THE GOAL IS TO REALLY TRY TO 3198 02:01:11,140 --> 02:01:13,209 UNDERSTAND THE MECHANISMS BY 3199 02:01:13,209 --> 02:01:15,745 WHICH CELLS BECOME RECRUITED 3200 02:01:15,745 --> 02:01:20,916 INTO ENSEMBLES THAT ENCODE FOR 3201 02:01:20,916 --> 02:01:23,419 ADDICTIVE-RELATED 3202 02:01:23,419 --> 02:01:23,786 NEUROBEHAVIORS. 3203 02:01:23,786 --> 02:01:25,388 AND THIS REALLY JUST STARTED. 3204 02:01:25,388 --> 02:01:27,490 WE JUST STARTED FUNDING THE 3205 02:01:27,490 --> 02:01:29,592 FIRST COHORT. 3206 02:01:29,592 --> 02:01:32,428 AND AT THE END OF THIS MONTH 3207 02:01:32,428 --> 02:01:35,398 WE'RE HAVING A MEETING OF THE 3208 02:01:35,398 --> 02:01:40,536 COLLABTORY OR ALL THE PROGRAMS 3209 02:01:40,536 --> 02:01:41,137 COLLABORATING ON THIS PROJECT. 3210 02:01:41,137 --> 02:01:43,105 GOING FROM CELLS TO CIRCUITS TO 3211 02:01:43,105 --> 02:01:43,372 BEHAVIOR. 3212 02:01:43,372 --> 02:01:46,475 I WANT TO GIVE A SHOUT OUT TO 3213 02:01:46,475 --> 02:01:48,411 HOLLY MOORE AT THE BEHAVIORAL 3214 02:01:48,411 --> 02:01:49,779 COGNITIVE NEUROSCIENCE BRANCH. 3215 02:01:49,779 --> 02:01:51,147 SHE DEVELOPED THIS PROGRAM 3216 02:01:51,147 --> 02:01:54,483 THAT'S REALLY A PART OF A LARGER 3217 02:01:54,483 --> 02:01:57,620 BRAIN INITIATIVE PROGRAM. 3218 02:01:57,620 --> 02:02:03,692 IT'S THE BDQS. 3219 02:02:03,692 --> 02:02:07,563 THE GOAL OF THIS PROGRAM IS TO 3220 02:02:07,563 --> 02:02:09,031 BE ABLE TO QUANTITIFY BEHAVIOR 3221 02:02:09,031 --> 02:02:11,133 AT A HIGH RESOLUTION OF ANIMALS 3222 02:02:11,133 --> 02:02:14,703 THAT ARE IN A NATURAL SOCIAL AND 3223 02:02:14,703 --> 02:02:15,271 PHYSICAL ENVIRONMENT. 3224 02:02:15,271 --> 02:02:17,339 AND SO SYNCHRONIZE THIS WITH 3225 02:02:17,339 --> 02:02:19,308 NEURAL ACTIVITY. 3226 02:02:19,308 --> 02:02:21,243 SO WE CAN BEGIN TO UNDERSTAND 3227 02:02:21,243 --> 02:02:23,579 THE NEURAL CODE OF BEHAVIORS. 3228 02:02:23,579 --> 02:02:26,582 THIS SHOWS ONE EXAMPLE PROJECT. 3229 02:02:26,582 --> 02:02:37,126 THEY ARE LOOKING AT A COHORT OF 3230 02:02:38,661 --> 02:02:39,128 GERBLES. 3231 02:02:39,128 --> 02:02:41,097 THEY ARE SOCIAL AND VOCAL 3232 02:02:41,097 --> 02:02:42,832 ANIMALS. 3233 02:02:42,832 --> 02:02:46,268 FOLLOWING MOTOR ACTIVITY, VOCAL 3234 02:02:46,268 --> 02:02:46,669 SKW 3235 02:02:46,669 --> 02:02:46,902 IZATION. 3236 02:02:46,902 --> 02:02:48,237 AND RECORDING. 3237 02:02:48,237 --> 02:02:50,906 AND WE CAN GET THE NEURAL 3238 02:02:50,906 --> 02:02:52,308 ENCODING OF THE COMMUNICATIVE 3239 02:02:52,308 --> 02:02:53,776 BEHAVIOR AND MOTOR BEHAVIOR. 3240 02:02:53,776 --> 02:02:55,878 SO THIS ALONG WITH THE SCORCH 3241 02:02:55,878 --> 02:02:58,514 PROGRAM AND THE NEXUS PROGRAM 3242 02:02:58,514 --> 02:03:00,449 ARE GOING TO BE GENERATING VAST 3243 02:03:00,449 --> 02:03:02,318 AMOUNTS OF DATA THAT ARE GOING 3244 02:03:02,318 --> 02:03:03,419 TO BE AVAILABLE TO THE 3245 02:03:03,419 --> 02:03:09,425 SCIENTIFIC COMMUNITY TO MINE. 3246 02:03:09,425 --> 02:03:13,295 ONE OF OUR GOALS IS TO BE ABLE 3247 02:03:13,295 --> 02:03:17,666 TO IDENTIFY BRAIN SIGNATURES OF 3248 02:03:17,666 --> 02:03:18,033 CRAVING. 3249 02:03:18,033 --> 02:03:19,768 CRAVING HAS BEEN ASSOCIATED WITH 3250 02:03:19,768 --> 02:03:21,604 RELAPSE, HIGHLY ASSOCIATED WITH 3251 02:03:21,604 --> 02:03:23,372 CONTINUED DRUG USE. 3252 02:03:23,372 --> 02:03:26,775 AND SO OUR BEHAVIORAL COGNITIVE 3253 02:03:26,775 --> 02:03:28,611 NEUROSCIENCE BRANCH IS 3254 02:03:28,611 --> 02:03:32,448 SUPPORTING RESEARCH THAT IS 3255 02:03:32,448 --> 02:03:33,516 APPLYING COMPUTATIONAL 3256 02:03:33,516 --> 02:03:36,452 APPROACHES ACROSS DIFFERENT 3257 02:03:36,452 --> 02:03:38,254 IMAGES FORMATS TO IDENTIFY 3258 02:03:38,254 --> 02:03:39,722 NEUROBIOLOGY SIGNATURES OF 3259 02:03:39,722 --> 02:03:40,122 CRAVING. 3260 02:03:40,122 --> 02:03:41,924 THIS IS JUST ONE EXAMPLE. 3261 02:03:41,924 --> 02:03:45,027 APPLYING MACHINE LEARNING TO MRI 3262 02:03:45,027 --> 02:03:45,261 STUDIES. 3263 02:03:45,261 --> 02:03:48,631 WHICH INDIVIDUALS WERE EXPOSED 3264 02:03:48,631 --> 02:03:51,700 TO FOOD OR DIFFERENT ABUSED 3265 02:03:51,700 --> 02:03:52,001 SUBSTANCES. 3266 02:03:52,001 --> 02:03:55,304 FROM THIS THEY WERE ABLE TO GET 3267 02:03:55,304 --> 02:03:58,474 A NEUROBIOLOGICAL CRAVING 3268 02:03:58,474 --> 02:04:00,075 SIGNATURES THAT DISTINGUISHED 3269 02:04:00,075 --> 02:04:03,312 DRUG USERS FROM NONUSERS. 3270 02:04:03,312 --> 02:04:05,681 THIS BRANCH HAS BEEN SUPPORTING 3271 02:04:05,681 --> 02:04:08,450 RESEARCH THAT IS APPLYING 3272 02:04:08,450 --> 02:04:12,221 COMPUTATIONAL APPROACHES TO 3273 02:04:12,221 --> 02:04:13,689 PREDICT TREATMENT OUTCOMES. 3274 02:04:13,689 --> 02:04:18,160 AN EXAMPLE IS USING MODELLING 3275 02:04:18,160 --> 02:04:19,361 AND IN THIS CASE THIS IS WHERE 3276 02:04:19,361 --> 02:04:24,533 FROM LICHENSTEIN. 3277 02:04:24,533 --> 02:04:27,336 LOOKING AT COCAINE USERS AND 3278 02:04:27,336 --> 02:04:29,071 CANNABIS USERS, AND SHOWING THEY 3279 02:04:29,071 --> 02:04:30,639 WENT USE THIS TO ACTUALLY 3280 02:04:30,639 --> 02:04:33,108 PREDICT TREATMENT OUTCOMES. 3281 02:04:33,108 --> 02:04:36,212 AND IMPORTANTLY THAT'S AN 3282 02:04:36,212 --> 02:04:36,912 ASSOCIATED WITH THE OUTCOME IS 3283 02:04:36,912 --> 02:04:38,747 REALLY DRUG-SPECIFIC. 3284 02:04:38,747 --> 02:04:41,550 IT'S DIFFERENT FROM COCAINE, FOR 3285 02:04:41,550 --> 02:04:43,852 EXAMPLE, THAN CANNABIS. ONE OF 3286 02:04:43,852 --> 02:04:46,722 THE GOALS OF GENERATING THESE 3287 02:04:46,722 --> 02:04:47,923 DATA IS THAT WE CAN THEN BE ABLE 3288 02:04:47,923 --> 02:04:52,127 TO USE THESE TYPES OF SIGNATURES 3289 02:04:52,127 --> 02:04:55,564 TO GUIDE NEUROMODULATION STUDIES 3290 02:04:55,564 --> 02:04:58,067 THAT THEN CAN CHANGE THESE 3291 02:04:58,067 --> 02:05:00,269 CIRCUITS AND PREVENT RELAPSE OR 3292 02:05:00,269 --> 02:05:03,539 TO SHAPE THE CIRCUITS TO BIAS 3293 02:05:03,539 --> 02:05:06,942 THEM TOWARDS BETTER OUTCOMES. 3294 02:05:06,942 --> 02:05:10,079 SO JOHN HAS BEEN DEVELOPING A 3295 02:05:10,079 --> 02:05:13,015 PROGRAM IN A PORTFOLIO IN 3296 02:05:13,015 --> 02:05:13,382 NEUROMODULATION. 3297 02:05:13,382 --> 02:05:15,417 TO DO THIS HE'S PUT OUT A COUPLE 3298 02:05:15,417 --> 02:05:18,520 OF RFAS ON THIS. 3299 02:05:18,520 --> 02:05:22,491 THE MOST RECENT ONE IS TO 3300 02:05:22,491 --> 02:05:24,193 CHARACTERIZE USING 3301 02:05:24,193 --> 02:05:26,328 NEUROMODULATION TO CHARACTERIZE 3302 02:05:26,328 --> 02:05:28,130 A CONTINUUM BETWEEN SUBSTANCE 3303 02:05:28,130 --> 02:05:29,665 USE AND MENTAL HEALTH DISORDERS. 3304 02:05:29,665 --> 02:05:31,133 AND THIS GOES BACK TO WHAT I WAS 3305 02:05:31,133 --> 02:05:33,602 SAYING EARLIER IN THE TALK ABOUT 3306 02:05:33,602 --> 02:05:35,604 THE IMPORTANCE OF REALLY 3307 02:05:35,604 --> 02:05:38,207 TARGETING A BROADER CIRCUIT THAT 3308 02:05:38,207 --> 02:05:40,109 IS ADDRESSING THE COMORBILITY 3309 02:05:40,109 --> 02:05:41,510 BETWEEN MENTAL HEALTH DISORDERS 3310 02:05:41,510 --> 02:05:47,249 AND SUBSTANCE USE DISORDERS. 3311 02:05:47,249 --> 02:05:52,955 AND FINALLY, THE OTHER THING 3312 02:05:52,955 --> 02:05:54,056 COMORBILITY THAT WE'VE PUT A LOT 3313 02:05:54,056 --> 02:05:57,793 OF FOCUS ON RECENTLY IS THAT 3314 02:05:57,793 --> 02:06:00,429 BETWEEN SLEEP DISORDERS AND 3315 02:06:00,429 --> 02:06:01,230 ADDICTION. 3316 02:06:01,230 --> 02:06:04,433 WE KNOW THAT THERE IS AN 3317 02:06:04,433 --> 02:06:05,734 INTERSECTION BETWEEN SLEEP AND 3318 02:06:05,734 --> 02:06:06,068 ADDICTION. 3319 02:06:06,068 --> 02:06:08,637 THAT DRUGS THAT ARE ABUSED CAN 3320 02:06:08,637 --> 02:06:10,272 INTERFERE WITH SLEEP. 3321 02:06:10,272 --> 02:06:12,374 SLEEP DISORDERS CAN MAINTAIN 3322 02:06:12,374 --> 02:06:14,977 DRUG USE, CAN DRIVE DRUG USE, 3323 02:06:14,977 --> 02:06:17,680 CAN PRECIPITATE RELAPSE IN 3324 02:06:17,680 --> 02:06:20,482 INDIVIDUALS THAT ARE UNDERGOING 3325 02:06:20,482 --> 02:06:21,884 TREATMENT. 3326 02:06:21,884 --> 02:06:23,052 AND BASIC RESEARCH THAT WE'VE 3327 02:06:23,052 --> 02:06:27,856 SUPPORTED IS BEGINNING TO 3328 02:06:27,856 --> 02:06:30,626 UNCOVER SOME OF THE NEURO -- 3329 02:06:30,626 --> 02:06:31,193 SUBSTRAITS. 3330 02:06:31,193 --> 02:06:35,464 AND ONE OF THE SUBSTRAITS HAS 3331 02:06:35,464 --> 02:06:39,968 BEEN IDENTIFIED AS THE SYSTEM. 3332 02:06:39,968 --> 02:06:45,741 ONE PIECE OF EVIDENCE IS IN 3333 02:06:45,741 --> 02:06:47,476 POSTMORTEM. 3334 02:06:47,476 --> 02:06:51,947 IT'S A LARGE INCREASE IN 3335 02:06:51,947 --> 02:06:52,181 NEURONS. 3336 02:06:52,181 --> 02:06:56,051 AROUSAL RELATED PEPTIDE. 3337 02:06:56,051 --> 02:06:59,288 THIS WORK INSPIRED THE 3338 02:06:59,288 --> 02:07:01,056 HYPOTHESIS THAT AGENTS THAT 3339 02:07:01,056 --> 02:07:03,225 INTERFERE WITH IT MIGHT BE 3340 02:07:03,225 --> 02:07:06,195 USEFUL IN TREATING SUBSTANCE USE 3341 02:07:06,195 --> 02:07:06,862 DISORDER. 3342 02:07:06,862 --> 02:07:10,566 AND WE NOW HAVE DTMC IS 3343 02:07:10,566 --> 02:07:13,268 SUPPORTING WORK ON THE USE OF IT 3344 02:07:13,268 --> 02:07:16,438 FOR TREATMENT OF SUBSTANCE USE 3345 02:07:16,438 --> 02:07:20,142 DISORDER. 3346 02:07:20,142 --> 02:07:24,079 AND FINALLY I WANT TO GIVE A 3347 02:07:24,079 --> 02:07:27,516 SHOUT OUT. 3348 02:07:27,516 --> 02:07:28,517 JUST DEVELOPED THIS 3349 02:07:28,517 --> 02:07:31,687 COLLABORATIVE PROGRAM. 3350 02:07:31,687 --> 02:07:32,421 OPIOID USE AND SLEEP 3351 02:07:32,421 --> 02:07:32,955 INTERSECTION STUDY. 3352 02:07:32,955 --> 02:07:35,657 THIS IS A HEAL-SUPPORTED STUDY. 3353 02:07:35,657 --> 02:07:38,260 WHERE WE'RE TRYING TO USE 3354 02:07:38,260 --> 02:07:41,296 SLEEP-BASED PREDICTORS OF OPIOID 3355 02:07:41,296 --> 02:07:42,931 USE DISORDER MEDICATION 3356 02:07:42,931 --> 02:07:44,633 TREATMENT RESPONSE. 3357 02:07:44,633 --> 02:07:48,137 SO BASICALLY WE'RE FUNDING FOUR 3358 02:07:48,137 --> 02:07:49,838 DIFFERENT CLINICAL CENTERS. 3359 02:07:49,838 --> 02:07:54,376 EACH IS TESTING THEIR OWN 3360 02:07:54,376 --> 02:07:56,111 HYPOTHESIS THAT IS LINKING SLEEP 3361 02:07:56,111 --> 02:07:59,748 TO OPIOID USE DISORDER. 3362 02:07:59,748 --> 02:08:01,183 THEY ARE GENERATING DATA THAT'S 3363 02:08:01,183 --> 02:08:02,518 GOING TO THE COORDINATING CENTER 3364 02:08:02,518 --> 02:08:04,820 AND PARTICULARLY EEG DATA. 3365 02:08:04,820 --> 02:08:07,189 AND WE'RE HOPING TO GET OUT OF 3366 02:08:07,189 --> 02:08:10,526 THAT SIGNALS THAT CAN BE USED TO 3367 02:08:10,526 --> 02:08:13,629 PREDICT TREATMENT RESPONSE. 3368 02:08:13,629 --> 02:08:16,098 SO THROUGH THE YEARS, WE REALLY 3369 02:08:16,098 --> 02:08:20,102 BEEN NAVIGATING A VERY 3370 02:08:20,102 --> 02:08:22,104 EVER-CHANGING LANDSCAPE THAT 3371 02:08:22,104 --> 02:08:24,373 EACH LANDSCAPE HAS ITS OWN 3372 02:08:24,373 --> 02:08:24,973 CHALLENGES. 3373 02:08:24,973 --> 02:08:27,309 THROUGH THIS WE HAVE BEEN 3374 02:08:27,309 --> 02:08:28,544 ADVANCING FUNDAMENTAL BRAIN 3375 02:08:28,544 --> 02:08:33,682 SCIENCE, ADVANCING PHARMACOLOGY 3376 02:08:33,682 --> 02:08:39,188 TO NEW THERAPEUTIC TARGETS AND 3377 02:08:39,188 --> 02:08:39,421 PROBES. 3378 02:08:39,421 --> 02:08:46,528 AND ELUCIDATING BIOLOGICAL AND 3379 02:08:46,528 --> 02:08:49,798 SOCIO ENVIRONMENTAL 3380 02:08:49,798 --> 02:08:51,834 INTERACTIONS. 3381 02:08:51,834 --> 02:08:53,135 SO THANK YOU. 3382 02:08:53,135 --> 02:08:55,003 AND THANKS FOR YOUR ATTENTION. 3383 02:08:55,003 --> 02:09:05,547 I'M READY TO TAKE ANY QUESTIONS. 3384 02:09:06,748 --> 02:09:10,519 >> I HAVE A COUPLE QUESTIONS. 3385 02:09:10,519 --> 02:09:12,488 THE FIRST IS YOU WERE TALKING 3386 02:09:12,488 --> 02:09:13,856 ABOUT SLEEP. 3387 02:09:13,856 --> 02:09:15,858 BASICALLY IT'S A PREDICTOR. 3388 02:09:15,858 --> 02:09:17,059 PREDICTOR OF OPIOID USE 3389 02:09:17,059 --> 02:09:17,493 DISORDER. 3390 02:09:17,493 --> 02:09:19,495 I'M WONDERING IF ANY RESEARCH 3391 02:09:19,495 --> 02:09:22,097 HAS BEEN DONE ON WE KNOW THAT 3392 02:09:22,097 --> 02:09:25,934 PEOPLE WHO ARE EXPERIENCING 3393 02:09:25,934 --> 02:09:27,903 HOMELESSNESS OFTEN USE METH TO 3394 02:09:27,903 --> 02:09:32,641 STAY AWAKE WHEN IT'S DANGEROUS. 3395 02:09:32,641 --> 02:09:35,210 I WAS CURIOUS IF THERE WAS ANY 3396 02:09:35,210 --> 02:09:37,246 RESEARCH BEING DONE IN THAT 3397 02:09:37,246 --> 02:09:37,546 REGARD. 3398 02:09:37,546 --> 02:09:38,547 >> YEAH. 3399 02:09:38,547 --> 02:09:40,549 NOT PARTICULARLY IN THIS STUDY 3400 02:09:40,549 --> 02:09:43,685 RELATED TO SLEEP. 3401 02:09:43,685 --> 02:09:46,355 YOU KNOW, THROUGH SOME OF OUR 3402 02:09:46,355 --> 02:09:48,423 STUDIES WE'RE LOOKING AT 3403 02:09:48,423 --> 02:09:50,259 POTENTIALS TO PREVENT OVERDOSE 3404 02:09:50,259 --> 02:09:51,527 DUE TO THAT COMBINATION. 3405 02:09:51,527 --> 02:09:55,297 BUT NO, IT'S A REALLY GOOD POINT 3406 02:09:55,297 --> 02:09:56,732 THERE THAT THEY ARE TRYING TO 3407 02:09:56,732 --> 02:09:58,000 COUNTER ACT EACH OTHER. 3408 02:09:58,000 --> 02:10:01,003 AND THAT MAY BE PART OF THE 3409 02:10:01,003 --> 02:10:04,473 DRIVE FOR THAT POLY SUBSTANCE 3410 02:10:04,473 --> 02:10:04,640 USE. 3411 02:10:04,640 --> 02:10:08,443 >> MY SECOND QUESTION, IS 3412 02:10:08,443 --> 02:10:10,779 THERE ANY RESEARCH GOING ON ON 3413 02:10:10,779 --> 02:10:15,551 GAMING AND THE OVERLAY BETWEEN 3414 02:10:15,551 --> 02:10:19,788 GAMBLING USE DISORDER, GAMBLE 3415 02:10:19,788 --> 02:10:22,257 DISORDER AND SUBSTANCE USE 3416 02:10:22,257 --> 02:10:22,524 DISORDER. 3417 02:10:22,524 --> 02:10:23,158 >> I HAVE GIVEN A LOT OF 3418 02:10:23,158 --> 02:10:25,060 THOUGHT TO THAT, PARTICULARLY I 3419 02:10:25,060 --> 02:10:26,361 WAS THINKING OF SOCIAL 3420 02:10:26,361 --> 02:10:29,331 DETERMINANTS OF HEALTH. 3421 02:10:29,331 --> 02:10:30,999 IF YOU EVENED EVERYTHING OUT, 3422 02:10:30,999 --> 02:10:33,201 WOULD THERE STILL BE ADDICTION? 3423 02:10:33,201 --> 02:10:35,203 AND I THOUGHT TO MYSELF, 3424 02:10:35,203 --> 02:10:36,972 GAMBLING ADDICTION. 3425 02:10:36,972 --> 02:10:39,308 THAT'S SOMETHING THAT'S VERY 3426 02:10:39,308 --> 02:10:42,444 DIFFERENT AND IT'S A VERY 3427 02:10:42,444 --> 02:10:44,212 DIFFERENT SOCIAL ENVIRONMENTAL 3428 02:10:44,212 --> 02:10:45,213 FACTOR THERE. 3429 02:10:45,213 --> 02:10:47,149 AND SO WE ARE NOT -- I DON'T 3430 02:10:47,149 --> 02:10:48,250 THINK WE HAVE ANYTHING IN OUR 3431 02:10:48,250 --> 02:10:51,520 PORTFOLIO THAT'S INVESTIGATING 3432 02:10:51,520 --> 02:10:52,554 THAT, BUT IT'S REALLY IMPORTANT 3433 02:10:52,554 --> 02:10:54,690 BECAUSE -- IT'S SORT OF A 3434 02:10:54,690 --> 02:10:56,325 CONTROL IN SOME WAYS. 3435 02:10:56,325 --> 02:10:58,260 BECAUSE YOU STILL HAVE AN 3436 02:10:58,260 --> 02:10:58,961 ADDICTION BUT IT'S REALLY 3437 02:10:58,961 --> 02:11:00,429 DIFFERENT FACTORS THAT ARE 3438 02:11:00,429 --> 02:11:00,829 DRIVING IT. 3439 02:11:00,829 --> 02:11:01,964 >> NO, WE HAVE. 3440 02:11:01,964 --> 02:11:04,266 AND THROUGH THE ABCD STUDY. 3441 02:11:04,266 --> 02:11:05,567 AND IN FACT, ONE OF THE MORE 3442 02:11:05,567 --> 02:11:06,835 CHALLENGING ISSUES AS YOU KNOW 3443 02:11:06,835 --> 02:11:09,104 IS THE CONCERNS THAT PEOPLE HAVE 3444 02:11:09,104 --> 02:11:13,542 THAT THE OVERRELIANCE ON THE 3445 02:11:13,542 --> 02:11:17,012 DEVICES INCLUDING VIDEOGAME, 3446 02:11:17,012 --> 02:11:17,813 AMONGTILY YOUNG BOYS IS 3447 02:11:17,813 --> 02:11:20,349 CONTRIBUTING. 3448 02:11:20,349 --> 02:11:22,150 AN AREA THAT I ALSO -- AND I'M 3449 02:11:22,150 --> 02:11:25,821 GLAD YOU BRING IT UP. 3450 02:11:25,821 --> 02:11:28,423 WE DO NOT HAVE GRANTS RIGHT NOW 3451 02:11:28,423 --> 02:11:31,259 IN GAMBLING ADDICTION. 3452 02:11:31,259 --> 02:11:37,432 BUT IT HAS ME EXTRAORDINARILY 3453 02:11:37,432 --> 02:11:38,066 WORRIED. 3454 02:11:38,066 --> 02:11:40,102 BUT THE LEVEL OF ACCESS TO 3455 02:11:40,102 --> 02:11:41,403 GAMBLING RIGHT NOW IS ALL OVER 3456 02:11:41,403 --> 02:11:42,371 THE PLACE. 3457 02:11:42,371 --> 02:11:47,376 AND WHICH CAN LEAD TO VERY 3458 02:11:47,376 --> 02:11:48,343 DEVASTATING CONSEQUENCES. 3459 02:11:48,343 --> 02:11:49,645 IS BEING NEGLECTED. 3460 02:11:49,645 --> 02:11:52,648 NO ONE IS KEEPING EYES ON THAT 3461 02:11:52,648 --> 02:11:53,248 POLICY. 3462 02:11:53,248 --> 02:11:55,617 THE WORLD HEALTH ORGANIZATION 3463 02:11:55,617 --> 02:11:56,818 HAS RECOGNIZED IT ALREADY. 3464 02:11:56,818 --> 02:11:57,953 MUCH MORE AHEAD OF US. 3465 02:11:57,953 --> 02:12:02,090 AND I WISH -- IF OUR BUDGET WERE 3466 02:12:02,090 --> 02:12:02,824 BETTER WE WOULD. 3467 02:12:02,824 --> 02:12:04,559 GUESS WHAT? 3468 02:12:04,559 --> 02:12:07,362 IT'S THE SAME. 3469 02:12:07,362 --> 02:12:08,897 AND WHEN WE'RE DISCUSSING THIS 3470 02:12:08,897 --> 02:12:13,735 ISSUE OF IDENTIFYING MOLECULES 3471 02:12:13,735 --> 02:12:17,639 THAT CAN IDENTIFY -- THAT HYPER 3472 02:12:17,639 --> 02:12:19,541 ACTIVATION THAT YOU GET WHEN YOU 3473 02:12:19,541 --> 02:12:20,342 ARE OBSESSED ABOUT SOMETHING. 3474 02:12:20,342 --> 02:12:21,810 I BET YOU THAT'S EXACTLY THE 3475 02:12:21,810 --> 02:12:23,378 SAME THING IN GAMBLING. 3476 02:12:23,378 --> 02:12:25,213 AND PEOPLE HAVE COMMENTED. 3477 02:12:25,213 --> 02:12:27,616 WE ARE NOT FUNDING IT DIRECTLY 3478 02:12:27,616 --> 02:12:28,784 IN THE BIG MEASURE JUST BECAUSE 3479 02:12:28,784 --> 02:12:30,986 OF LACK OF FUNDING, BUT WE ARE 3480 02:12:30,986 --> 02:12:35,257 KEEPING AN EYE WITH THE ABCD. 3481 02:12:35,257 --> 02:12:38,293 IT WILL BE PART OF THE HBCD. 3482 02:12:38,293 --> 02:12:39,861 YEAH, WE NEED TO DO IT. 3483 02:12:39,861 --> 02:12:41,563 AND I'M GLAD YOU BROUGHT IT UP. 3484 02:12:41,563 --> 02:12:43,498 WE NEED TO MAKE PEOPLE AWARE 3485 02:12:43,498 --> 02:12:46,635 THIS IS AN ISSUE THAT WE CAN NOT 3486 02:12:46,635 --> 02:12:47,069 NEGLECT. 3487 02:12:47,069 --> 02:12:48,970 ONE OR TWO YEARS FROM NOW, WE 3488 02:12:48,970 --> 02:12:51,139 HAVE A SERIOUS PROBLEM. 3489 02:12:51,139 --> 02:12:52,507 >> THERE IS LEGISLATION ON 3490 02:12:52,507 --> 02:12:58,246 CAPITOL HILL THAT WOULD ERECT 3491 02:12:58,246 --> 02:13:00,449 THE GAMBLING PROCEEDS THAT GOES 3492 02:13:00,449 --> 02:13:03,185 TO THE FEDERAL GOVERNMENT TO 3493 02:13:03,185 --> 02:13:04,853 DEDICATE IT TO RESEARCH AND WORK 3494 02:13:04,853 --> 02:13:05,220 FORCE. 3495 02:13:05,220 --> 02:13:07,789 BUT, YOU KNOW, WE'LL SEE IF 3496 02:13:07,789 --> 02:13:08,924 ANYTHING PASSES. 3497 02:13:08,924 --> 02:13:11,526 >> BUT I THINK THAT WHAT WOULD 3498 02:13:11,526 --> 02:13:13,929 BE INTERESTING TOO IS TO HAVE 3499 02:13:13,929 --> 02:13:14,730 CERTAIN REGULATORY PROCESSES 3500 02:13:14,730 --> 02:13:16,531 ESTABLISHED FROM THE BEGINNING, 3501 02:13:16,531 --> 02:13:18,100 BECAUSE NOW YOU CAN -- I MEAN, 3502 02:13:18,100 --> 02:13:20,435 ANYONE CAN GAMBLE IN THEIR CELL 3503 02:13:20,435 --> 02:13:22,871 PHONES. 3504 02:13:22,871 --> 02:13:27,109 AND NOW IT MIGHT BE WITH 3505 02:13:27,109 --> 02:13:27,776 ARTIFICIAL INTELLIGENCE, 3506 02:13:27,776 --> 02:13:30,712 GENERATE A 3507 02:13:33,348 --> 02:13:36,284 IT COULD GET MUCH WORSE OUT OF 3508 02:13:36,284 --> 02:13:37,586 CONTROL WHAT WE'RE GETTING RIGHT 3509 02:13:37,586 --> 02:13:38,019 NOW. 3510 02:13:38,019 --> 02:13:41,189 SPEAKING ABOUT IT, AND AGAIN, WE 3511 02:13:41,189 --> 02:13:44,392 NEED TO KEEP OUR EYES ON THESE 3512 02:13:44,392 --> 02:13:45,193 THAT WE HAVE. 3513 02:13:45,193 --> 02:13:47,362 BUT IN TERMS OF SPEAKING, I 3514 02:13:47,362 --> 02:13:49,331 MEAN, THIS IS REWARDING, AND 3515 02:13:49,331 --> 02:13:50,565 IT'S THE SAME CIRCUIT AND IT'S 3516 02:13:50,565 --> 02:13:58,039 THE SAME PROCESS. 3517 02:13:58,039 --> 02:14:01,476 >> SO YOU MENTIONED IN YOUR 3518 02:14:01,476 --> 02:14:04,012 PRESENTATION, WHICH I THOUGHT 3519 02:14:04,012 --> 02:14:07,182 WAS GREAT THE CHALLENGE OF 3520 02:14:07,182 --> 02:14:09,451 GENETIC STUDIES WHEN YOU HAVE 3521 02:14:09,451 --> 02:14:13,388 NOT DIVERSE ENOUGH ANCESTRY AND 3522 02:14:13,388 --> 02:14:14,923 HOW THIS IS IMPORTANT. 3523 02:14:14,923 --> 02:14:16,858 AND IF I UNDERSTOOD YOU WELL YOU 3524 02:14:16,858 --> 02:14:18,326 WERE SHOWING US THE DIFFERENT 3525 02:14:18,326 --> 02:14:19,060 METHODOLOGIES WE COULD USE IN 3526 02:14:19,060 --> 02:14:22,664 ORDER TO OPTIMIZE SO THAT YOU 3527 02:14:22,664 --> 02:14:25,700 DON'T NEED AS LARGE SAMPLES SO 3528 02:14:25,700 --> 02:14:26,535 CAN YOU DO YOUR INVESTIGATION. 3529 02:14:26,535 --> 02:14:28,570 SO MY QUESTION IS, WHAT ARE WE 3530 02:14:28,570 --> 02:14:32,107 DOING IN TERMS OF ACTUALLY 3531 02:14:32,107 --> 02:14:33,608 DIVERSIFYING THE SAMPLES OF THE 3532 02:14:33,608 --> 02:14:36,678 PEOPLE WHO ARE PART OF THE STUDY 3533 02:14:36,678 --> 02:14:39,548 SO THAT WE ACTUALLY HAVE -- 3534 02:14:39,548 --> 02:14:43,018 >> WE DO HAVE -- SOME OF THE 3535 02:14:43,018 --> 02:14:45,053 MORE RECENT STUDIES THAT WE ARE 3536 02:14:45,053 --> 02:14:46,488 SUPPORTING ARE LOOKING AT A 3537 02:14:46,488 --> 02:14:52,127 BROADER AND MORE DIVERSE 3538 02:14:52,127 --> 02:14:52,394 ANCESTRY. 3539 02:14:52,394 --> 02:14:52,794 >> THAT'S GREAT. 3540 02:14:52,794 --> 02:14:55,497 >> WE RECOGNIZE THAT'S A 3541 02:14:55,497 --> 02:14:56,131 PROBLEM. 3542 02:14:56,131 --> 02:14:59,334 SHAKING THEIR HEADS THERE 3543 02:14:59,334 --> 02:15:00,235 BECAUSE, YEAH. 3544 02:15:00,235 --> 02:15:04,339 >> I'LL JUST ADD TO THAT THAT I 3545 02:15:04,339 --> 02:15:05,874 THINK THAT IS THE GAP AND THAT 3546 02:15:05,874 --> 02:15:08,009 WE HAVE TO FILL THAT GAP QUICKLY 3547 02:15:08,009 --> 02:15:10,178 OR OTHERWISE WE'RE NOT DOING 3548 02:15:10,178 --> 02:15:11,046 EQUITABLE RESEARCH. 3549 02:15:11,046 --> 02:15:12,814 THAT'S A PRIORITY FOR EVERYBODY 3550 02:15:12,814 --> 02:15:14,282 IN THE FIELD. 3551 02:15:14,282 --> 02:15:16,418 WE APPRECIATE NIDA'S SUPPORT AND 3552 02:15:16,418 --> 02:15:18,153 GETTING OUR SAMPLES UP TO 3553 02:15:18,153 --> 02:15:19,754 RESPOND TO EVERYBODY IN THE 3554 02:15:19,754 --> 02:15:21,223 POPULATION BECAUSE THIS IS GOING 3555 02:15:21,223 --> 02:15:24,559 TO MOVE TOWARDS DRUG REPURPOSING 3556 02:15:24,559 --> 02:15:27,796 AND POLY WORKFORCE RETENTION AND 3557 02:15:27,796 --> 02:15:30,632 WE CAN'T DO IT JUST IN ONE 3558 02:15:30,632 --> 02:15:32,300 GROUP, MOVING ACROSS ALL GROUPS. 3559 02:15:32,300 --> 02:15:33,902 I HAD A QUICK QUESTION. 3560 02:15:33,902 --> 02:15:37,372 AND THAT HAD TO DO WITH 3561 02:15:37,372 --> 02:15:38,640 COMORBIDITIES WITH OTHER MENTAL 3562 02:15:38,640 --> 02:15:39,174 HEALTH CONDITIONS. 3563 02:15:39,174 --> 02:15:41,443 ONE OF THE THINGS WE WANTED TO 3564 02:15:41,443 --> 02:15:43,979 DO OBVIOUSLY IN ADDITION TO ALL 3565 02:15:43,979 --> 02:15:45,113 THE SUBSTANCE USE DISORDERS 3566 02:15:45,113 --> 02:15:47,515 SHARING GENETIC UNDERPINNINGS WE 3567 02:15:47,515 --> 02:15:49,150 SHARED FACTORS, SHARED GENETIC 3568 02:15:49,150 --> 02:15:50,518 FACTORS AND DEPRESSION AND 3569 02:15:50,518 --> 02:15:52,354 ANXIETY ALL OF THEM. 3570 02:15:52,354 --> 02:15:54,256 THEY TEND TO CLING TOGETHER BUT 3571 02:15:54,256 --> 02:15:56,258 THEY ALSO HAVE GENETIC 3572 02:15:56,258 --> 02:15:56,591 CORRELATIONS. 3573 02:15:56,591 --> 02:15:59,194 THIS PROBABLY HAPPENS IN ALL THE 3574 02:15:59,194 --> 02:16:00,095 POSTMORTEM SINGLE CELL DATA 3575 02:16:00,095 --> 02:16:01,263 THAT'S COMING OUT. 3576 02:16:01,263 --> 02:16:02,364 THAT'S SOMETHING THAT I'VE 3577 02:16:02,364 --> 02:16:04,833 ALWAYS WONDERED, I DON'T KNOW IF 3578 02:16:04,833 --> 02:16:07,469 THERE'S EFFORTS TO DISENTANGLE 3579 02:16:07,469 --> 02:16:10,205 THAT BECAUSE IN SOME WAYS FOR 3580 02:16:10,205 --> 02:16:11,306 SUBSTANCE USE DISORDERS I THINK 3581 02:16:11,306 --> 02:16:12,941 PARTICULARLY CHALLENGING THAT WE 3582 02:16:12,941 --> 02:16:15,310 ARE BOTH A CAUSE AND A 3583 02:16:15,310 --> 02:16:17,045 CONSEQUENCE, LOOKING AT GENE 3584 02:16:17,045 --> 02:16:18,346 EXPRESSION CHANGES THAT BECAUSE 3585 02:16:18,346 --> 02:16:20,348 IT'S SUBSTANCE USE DISORDER IS 3586 02:16:20,348 --> 02:16:22,083 THAT BECAUSE BENEATH BTL YOU 3587 02:16:22,083 --> 02:16:24,219 BRING WITH IT THE FACT THAT AN 3588 02:16:24,219 --> 02:16:27,289 INDIVIDUAL WHO POTENTIALLY DIES 3589 02:16:27,289 --> 02:16:30,959 FROM AN OPIOID OVERDOSE OR 3590 02:16:30,959 --> 02:16:33,328 DEPRESSION, PTSD, ARE YOU SEEING 3591 02:16:33,328 --> 02:16:35,697 CONDITIONS THAT ARE CARRY OVERS, 3592 02:16:35,697 --> 02:16:39,234 OPPORTUNITIES TO PRIORITIZE THE 3593 02:16:39,234 --> 02:16:41,636 DISENTANGL 3594 02:16:41,636 --> 02:16:42,003 DISENTANGLEMENT. 3595 02:16:42,003 --> 02:16:43,138 >> THAT'S AN EXCELLENT POINT, 3596 02:16:43,138 --> 02:16:48,143 TO BE ABLE TO DISENTANGLE. 3597 02:16:48,143 --> 02:16:51,579 WE HAVE POSTMORTEM TISSUE, WE'RE 3598 02:16:51,579 --> 02:16:53,848 GETTING MULTIPLE RECORDS OF THAT 3599 02:16:53,848 --> 02:16:55,450 IN THESE STUDIES AND THAT YES 3600 02:16:55,450 --> 02:16:58,186 IT'S AN IMPORTANT THING LIKE YOU 3601 02:16:58,186 --> 02:17:05,827 SAY TO DISENTANGLE. 3602 02:17:05,827 --> 02:17:06,294 THANKS FOR THE GREAT 3603 02:17:06,294 --> 02:17:10,532 PRESENTATION JUST AS A FOLLOW ON 3604 02:17:10,532 --> 02:17:12,167 TO WHAT WAS ASKED, I ASSUME THAT 3605 02:17:12,167 --> 02:17:14,069 THIS IS THE ANSWER TO THIS IS 3606 02:17:14,069 --> 02:17:15,337 YES BUT WOULD LOVE TO HEAR A 3607 02:17:15,337 --> 02:17:16,838 LITTLE MORE ABOUT HOW YOU 3608 02:17:16,838 --> 02:17:23,678 ACCOUNT FOR SEX DIFFERENCES AS 3609 02:17:23,678 --> 02:17:25,981 YOU'RE LOOKING ACROSS ALL THE 3610 02:17:25,981 --> 02:17:27,349 STUDIES BECAUSE I THINK THERE'S 3611 02:17:27,349 --> 02:17:30,352 SOME FUNDAMENTAL BIOLOGICAL AND 3612 02:17:30,352 --> 02:17:31,519 ENVIRONMENTAL INTERACTIONS BY 3613 02:17:31,519 --> 02:17:33,888 SEX AND GENDER, WONDERING WHAT 3614 02:17:33,888 --> 02:17:35,657 THE PROCESS IS AND THE FRAME 3615 02:17:35,657 --> 02:17:37,559 THAT YOU USE FOR THIS. 3616 02:17:37,559 --> 02:17:40,562 >> WELL, I THINK IN ALL OF THE 3617 02:17:40,562 --> 02:17:44,432 GENETIC SEGMENTS, SCORCH STUDY, 3618 02:17:44,432 --> 02:17:47,702 THAT'S ALL -- SEX AS A 3619 02:17:47,702 --> 02:17:49,637 BIOLOGICAL VARIABLE IS BEING 3620 02:17:49,637 --> 02:17:51,506 CONSIDERED AND REALLY IN ALL OF 3621 02:17:51,506 --> 02:17:54,676 THE ANIMAL STUDIES NOW, THIS 3622 02:17:54,676 --> 02:17:57,746 IS -- YOU REALLY CAN'T EVEN 3623 02:17:57,746 --> 02:17:58,813 PUBLISH WITHOUT CONSIDERING 3624 02:17:58,813 --> 02:17:59,347 THAT. 3625 02:17:59,347 --> 02:18:02,117 AND WHAT'S GREAT ABOUT THAT IS 3626 02:18:02,117 --> 02:18:04,619 THAT YOU OFTEN -- IT OFTEN LEADS 3627 02:18:04,619 --> 02:18:06,087 YOU TO NEW HYPOTHESES BECAUSE 3628 02:18:06,087 --> 02:18:07,288 YOU FIND DIFFERENCES AND THEN 3629 02:18:07,288 --> 02:18:09,557 THAT TELLS YOU SOMETHING ABOUT 3630 02:18:09,557 --> 02:18:10,692 THE PROCESS. 3631 02:18:10,692 --> 02:18:15,997 SO THIS IS CLEARLY IN OUR RADAR, 3632 02:18:15,997 --> 02:18:17,999 AND SOMETHING THAT WE'RE 3633 02:18:17,999 --> 02:18:26,074 SUPPORTING AND ENCOURAGING. 3634 02:18:26,074 --> 02:18:27,809 ARE THERE ANY QUESTIONS FROM 3635 02:18:27,809 --> 02:18:28,543 PEOPLE IN THE CLOUD? 3636 02:18:28,543 --> 02:18:31,913 I'M LOOKING AND I'M NOT SEEING 3637 02:18:31,913 --> 02:18:42,223 ANY HANDS RAISED. 3638 02:18:49,464 --> 02:18:51,332 THANK YOU VERY MUCH. 3639 02:18:51,332 --> 02:18:51,800 THAT WAS A WONDERFUL 3640 02:18:51,800 --> 02:18:59,340 PRESENTATION. 3641 02:18:59,340 --> 02:19:02,677 NOW 3:35, WE'RE GOING TO GO INTO 3642 02:19:02,677 --> 02:19:05,246 THE PRESENTATION OF THE NEW 3643 02:19:05,246 --> 02:19:05,513 CONCEPTS. 3644 02:19:05,513 --> 02:19:07,115 AND THE FIRST FOR CLEARANCE, AND 3645 02:19:07,115 --> 02:19:10,285 THE FIRST ONE IS GOING TO BE 3646 02:19:10,285 --> 02:19:15,690 PRESENTED BY DR. TISHA WYLIE 3647 02:19:15,690 --> 02:19:18,793 PREVENTION RESEARCH AND ENGAGING 3648 02:19:18,793 --> 02:19:22,997 LOVED ONES AND RECOVERY AND 3649 02:19:22,997 --> 02:19:23,264 OUTCOMES. 3650 02:19:23,264 --> 02:19:28,603 TISHA, GOOD AFTERNOON. 3651 02:19:28,603 --> 02:19:33,975 >> SO THANK YOU FOR THE 3652 02:19:33,975 --> 02:19:36,244 OPPORTUNITY TO PRESENT -- SORRY. 3653 02:19:36,244 --> 02:19:37,979 IT WASN'T ON. 3654 02:19:37,979 --> 02:19:40,915 SO EARLIER TODAY NORA MENTIONED 3655 02:19:40,915 --> 02:19:42,617 HOW DEVASTATING THE OVERDOSE 3656 02:19:42,617 --> 02:19:44,252 CRISIS IS AND THE CRISIS THAT'S 3657 02:19:44,252 --> 02:19:47,689 MOST DEVASTATING FOR PEOPLE WHO 3658 02:19:47,689 --> 02:19:50,925 ARE LOVED ONES OF PEOPLE WHO 3659 02:19:50,925 --> 02:19:52,393 HAVE THE DISORDERS, THEY ALSO 3660 02:19:52,393 --> 02:19:53,495 FORM THE NETWORK THAT IS THE 3661 02:19:53,495 --> 02:19:56,564 FOUNDATION FOR PEOPLE'S RECOVERY 3662 02:19:56,564 --> 02:19:58,133 SUPPORT, RECOVERY CAPITAL AND 3663 02:19:58,133 --> 02:19:59,200 THEIR RECOVERY PATHWAYS. 3664 02:19:59,200 --> 02:20:01,970 SO THE GOAL OF THIS CONCEPT IS 3665 02:20:01,970 --> 02:20:03,171 TO ADDRESS SIGNIFICANT RESEARCH 3666 02:20:03,171 --> 02:20:05,006 GAPS AROUND OUR UNDERSTANDING OF 3667 02:20:05,006 --> 02:20:06,975 HOW TO BEST ENGAGE LOVED ONES IN 3668 02:20:06,975 --> 02:20:08,843 THE TREATMENT ENGAGEMENT AND 3669 02:20:08,843 --> 02:20:09,744 RECOVERY PATHWAYS. 3670 02:20:09,744 --> 02:20:12,247 IT WILL FOCUS ON SUPPORTING 3671 02:20:12,247 --> 02:20:13,648 PRAGMATIC TRIALS THAT CAN 3672 02:20:13,648 --> 02:20:15,583 SUPPORT SCALABLE SUSTAINABLE 3673 02:20:15,583 --> 02:20:17,886 SOLUTIONS TO EXISTING EVPs AND 3674 02:20:17,886 --> 02:20:20,355 SERVICE DELIVERY FRAMEWORKS THAT 3675 02:20:20,355 --> 02:20:21,789 EMPHASIZE THE ENGAGEMENT OF 3676 02:20:21,789 --> 02:20:23,691 LOVED ONES, SPECIFIC AREAS OF 3677 02:20:23,691 --> 02:20:25,093 INTEREST FOR THIS INCLUDE BUT 3678 02:20:25,093 --> 02:20:26,194 ARE NOT LIMITED TO STRATEGIES 3679 02:20:26,194 --> 02:20:29,063 THAT FOCUS ON REDUCING STIGMA 3680 02:20:29,063 --> 02:20:33,168 TOWARD ADDICTION AND MOUD AMONG 3681 02:20:33,168 --> 02:20:34,802 PERSONS, AND TO PROVIDE 3682 02:20:34,802 --> 02:20:36,437 ASSISTANCE TO SUPPORT PERSONS 3683 02:20:36,437 --> 02:20:37,805 AND NAVIGATING CARE FOR OPTIONS 3684 02:20:37,805 --> 02:20:40,074 FOR THEIR LOVED ONES, FIRMLY 3685 02:20:40,074 --> 02:20:41,809 ENGAGING PERSONS IN SERVICES, 3686 02:20:41,809 --> 02:20:44,612 AND LEVERAGING THE SUPPORT 3687 02:20:44,612 --> 02:20:47,882 PERSONS AS LATE INTERVENTIONIST 3688 02:20:47,882 --> 02:20:51,319 TO DELIVER INTERVENTION AND 3689 02:20:51,319 --> 02:20:56,291 ENHANCING COPING SKILLS. 3690 02:20:56,291 --> 02:20:59,327 THAT'S THE FOCUS OF THIS EFFORT. 3691 02:20:59,327 --> 02:21:00,161 TAKE QUESTIONS? 3692 02:21:00,161 --> 02:21:01,262 ANY QUESTIONS? 3693 02:21:01,262 --> 02:21:02,664 >> ANYONE ON THE SCREEN? 3694 02:21:02,664 --> 02:21:13,208 I CANNOT SEE THE SCREEN AS WELL. 3695 02:21:16,511 --> 02:21:18,179 I'M FASCINATED BY THIS TOPIC, 3696 02:21:18,179 --> 02:21:19,547 WONDER HOW YOU OPERATIONALIZE 3697 02:21:19,547 --> 02:21:22,884 AND TRACK RECOVERY CAPITAL. 3698 02:21:22,884 --> 02:21:24,919 >> I THINK WE WILL ENCOURAGE 3699 02:21:24,919 --> 02:21:27,889 PEOPLE TO LOOK AT THE VARIOUS -- 3700 02:21:27,889 --> 02:21:29,891 THERE'S MANY RECOVERY CAPITAL 3701 02:21:29,891 --> 02:21:31,292 FRAMEWORKS WAYS OF MEASURING IT, 3702 02:21:31,292 --> 02:21:33,695 WHAT I WOULD EXPECT IS WE WOULD 3703 02:21:33,695 --> 02:21:35,163 COURAGE PEOPLE TO CHOOSE A 3704 02:21:35,163 --> 02:21:37,999 RECOVERY CAPITAL FRAMEWORK AND 3705 02:21:37,999 --> 02:21:39,334 OPERATIONALIZE IT THROUGH THIS 3706 02:21:39,334 --> 02:21:41,869 EFFORT AND HOPEFULLY PERHAPS 3707 02:21:41,869 --> 02:21:44,205 EVEN ADVANCE OUR UNDERSTANDING 3708 02:21:44,205 --> 02:21:48,376 OF THE RECOVERY CAPITAL THROUGH 3709 02:21:48,376 --> 02:21:52,046 A DIFFERENT LENS. 3710 02:21:52,046 --> 02:21:53,114 ANY OTHER QUESTIONS? 3711 02:21:53,114 --> 02:21:58,620 IF NOT, TISHA, THANKS VERY MUCH. 3712 02:21:58,620 --> 02:22:00,855 >> NEXT PRESENTATION FROM THE 3713 02:22:00,855 --> 02:22:04,826 OFFICE OF TRANSLATIONAL 3714 02:22:04,826 --> 02:22:05,526 INITIATIVES. 3715 02:22:05,526 --> 02:22:06,227 WELCOME. 3716 02:22:06,227 --> 02:22:09,197 >> THANK YOU AND GOOD 3717 02:22:09,197 --> 02:22:09,464 AFTERNOON. 3718 02:22:09,464 --> 02:22:11,933 SO OUR FIRST CONCEPT IS 3719 02:22:11,933 --> 02:22:13,935 FOSTERING LAY COMMUNITY AND 3720 02:22:13,935 --> 02:22:16,271 COMMUNITY WITH LIVED EXPERIENCE 3721 02:22:16,271 --> 02:22:18,473 AWARENESS ON BIOMEDICAL PRODUCT 3722 02:22:18,473 --> 02:22:20,308 DEVELOPMENT FOR SUBSTANCE USE 3723 02:22:20,308 --> 02:22:26,047 DISORDER PROPOSED BY DR. JESS 3724 02:22:26,047 --> 02:22:26,314 LIEUUP. 3725 02:22:26,314 --> 02:22:28,683 IT'S COSTLY AND A LONG PROCESS, 3726 02:22:28,683 --> 02:22:30,585 THE PUBLIC FINDS MYSTERIOUS AND 3727 02:22:30,585 --> 02:22:31,786 DIFFICULT TO COMPREHEND. 3728 02:22:31,786 --> 02:22:34,122 THIS IS ESPECIALLY PROMINENT IN 3729 02:22:34,122 --> 02:22:35,223 SUBSTANCE USE DISORDERS LEADING 3730 02:22:35,223 --> 02:22:38,559 TO DISENFRANCHISEMENT OF THE 3731 02:22:38,559 --> 02:22:38,960 POPULATIONS. 3732 02:22:38,960 --> 02:22:40,061 THEREFORE, IT'S CRITICAL TO 3733 02:22:40,061 --> 02:22:43,765 ADDRESS THE GAP IN KNOWLEDGE AND 3734 02:22:43,765 --> 02:22:44,332 ENGAGEMENT. 3735 02:22:44,332 --> 02:22:46,668 RAISING SOCIETAL AWARENESS IN 3736 02:22:46,668 --> 02:22:47,902 THE PRODUCT DEVELOPMENT AREA 3737 02:22:47,902 --> 02:22:51,039 WOULD SIGNIFICANTLY FACILITATE 3738 02:22:51,039 --> 02:22:54,842 THAT OF INT VENTIVE 3739 02:22:54,842 --> 02:22:56,577 INTERVENTIONS INTO THE CARE. 3740 02:22:56,577 --> 02:22:57,812 THIS OFFERS A UNIQUE OPPORTUNITY 3741 02:22:57,812 --> 02:22:59,614 TO BRING TOGETHER THE EXPERTS 3742 02:22:59,614 --> 02:23:00,615 FROM THE PHARMACEUTICAL 3743 02:23:00,615 --> 02:23:03,751 INDUSTRY, ACADEMIA, PATIENT 3744 02:23:03,751 --> 02:23:04,852 ORGANIZATION, HEALTH 3745 02:23:04,852 --> 02:23:07,655 PROFESSIONALS, ETHICAL BODIES, 3746 02:23:07,655 --> 02:23:08,489 REGULATORY AUTHORITIES AND MEDIA 3747 02:23:08,489 --> 02:23:11,025 TO JOINTLY WORK IN AN OPEN AND 3748 02:23:11,025 --> 02:23:14,562 TRANSPARENT WAY TO IMPROVE THE 3749 02:23:14,562 --> 02:23:18,366 UNDERSTANDING OF THE BIOMEDICAL 3750 02:23:18,366 --> 02:23:19,300 RESEARCH AND DEVELOPMENT ALONG 3751 02:23:19,300 --> 02:23:22,437 THE PATIENTS, CAREGIVERS AND 3752 02:23:22,437 --> 02:23:26,007 INTERESTED LAY PEOPLE. 3753 02:23:26,007 --> 02:23:28,109 THE SECOND CONCEPT IS PROMOTING 3754 02:23:28,109 --> 02:23:29,010 DEVICE DEVELOPMENT FOR THE YOUTH 3755 02:23:29,010 --> 02:23:32,980 AFFECTED BY THE DRUG ADDICTION 3756 02:23:32,980 --> 02:23:36,184 AND SUBSTANCE MISUSE AND IT'S 3757 02:23:36,184 --> 02:23:44,859 PROPOSED BY DR. ANGELIONI. 3758 02:23:44,859 --> 02:23:47,261 MEDICAL THERAPEUTIC AND 3759 02:23:47,261 --> 02:23:48,896 DIAGNOSTIC DEVICES OFFERS 3760 02:23:48,896 --> 02:23:53,034 PROMISING MEANS TO MONITOR, 3761 02:23:53,034 --> 02:23:55,570 DIAGNOSE, TREAT YOUTH FROM 3762 02:23:55,570 --> 02:23:58,406 SUBSTANCE USE DISORDERS. 3763 02:23:58,406 --> 02:24:01,142 IN PARTICULAR DIGITAL HEALTH 3764 02:24:01,142 --> 02:24:01,809 TECHNOLOGIES, THE OPPORTUNITIES 3765 02:24:01,809 --> 02:24:04,846 FOR PEOPLE WHO ARE AVID USERS OF 3766 02:24:04,846 --> 02:24:06,581 SUCH TECHNOLOGY. 3767 02:24:06,581 --> 02:24:08,649 HOWEVER, UNDER THE CURRENT 3768 02:24:08,649 --> 02:24:10,585 PARADIGM, DEVICES ARE OFTEN 3769 02:24:10,585 --> 02:24:11,986 DESIGNED FOR ADULTS LIMITING THE 3770 02:24:11,986 --> 02:24:15,423 POTENTIAL FOR USABILITY AND 3771 02:24:15,423 --> 02:24:17,225 ACCEPTABILITY BY THE ADOLESCENT 3772 02:24:17,225 --> 02:24:18,259 POPULATION. 3773 02:24:18,259 --> 02:24:19,927 SIMILARLY, THE EXISTING A LEVELS 3774 02:24:19,927 --> 02:24:21,462 SUPPORTING THE MEDICAL DEVICES 3775 02:24:21,462 --> 02:24:23,731 ARE OFTEN BASED ON AN ADULT DATA 3776 02:24:23,731 --> 02:24:26,401 AND IT'S NOT OPTIMIZED FOR 3777 02:24:26,401 --> 02:24:26,868 ADOLESCENTS. 3778 02:24:26,868 --> 02:24:29,337 SO THE PROPOSED CONCEPT INVITES 3779 02:24:29,337 --> 02:24:31,773 RESEARCH AND DEVELOPMENT OF 3780 02:24:31,773 --> 02:24:33,741 NOVEL MEDICAL THERAPEUTIC AND 3781 02:24:33,741 --> 02:24:35,676 DIAGNOSTIC DEVICES, INCLUDING 3782 02:24:35,676 --> 02:24:38,713 SOFTWARE AS A MEDICAL DEVICE 3783 02:24:38,713 --> 02:24:40,181 SPECIFICALLY DESIGNED AND 3784 02:24:40,181 --> 02:24:43,284 DEVELOPED FOR YOUTH AND 3785 02:24:43,284 --> 02:24:44,619 ADOLESCENT POPULATION. 3786 02:24:44,619 --> 02:24:48,289 THE THIRD CONCEPT IS RAPID DRUG 3787 02:24:48,289 --> 02:24:52,427 AND AGNOSTIC IDENTIFICATION OF 3788 02:24:52,427 --> 02:24:54,162 EMERGING THREATS AND IT'S 3789 02:24:54,162 --> 02:24:56,330 PROPOSED BY DR. DAN COSTA. 3790 02:24:56,330 --> 02:24:58,266 NEW DRUGS ARE ENTERING THE DRUG 3791 02:24:58,266 --> 02:24:59,600 SUPPLY CONSTANTLY. 3792 02:24:59,600 --> 02:25:04,639 FIRST IT WAS FENTANYL, THEN 3793 02:25:04,639 --> 02:25:07,008 SILIN BECAME UBIQUITOUS. 3794 02:25:07,008 --> 02:25:08,576 FUTURE TECHNOLOGIES CAN DETECT 3795 02:25:08,576 --> 02:25:09,944 EMERGING THREATS IN REAL TIME 3796 02:25:09,944 --> 02:25:11,612 WITHOUT THE BURDEN OF LONG 3797 02:25:11,612 --> 02:25:13,247 DEVELOPMENT CYCLES SO THE 3798 02:25:13,247 --> 02:25:15,650 CONCEPT SOLICITS THE DEVELOPMENT 3799 02:25:15,650 --> 02:25:17,685 OF TECHNOLOGIES, SIMILAR IN 3800 02:25:17,685 --> 02:25:20,688 ANALYTICAL CAPABILITIES TO THIS 3801 02:25:20,688 --> 02:25:22,924 COMBINATION OF LIQUID 3802 02:25:22,924 --> 02:25:28,162 COMETOGRAPHY AND MASS 3803 02:25:28,162 --> 02:25:29,130 SPECTOGRAPHY, AND IT SHOULD BE 3804 02:25:29,130 --> 02:25:30,565 COST PER TEST. 3805 02:25:30,565 --> 02:25:34,268 SO HAVE A VERY SMALL FORM FACTOR 3806 02:25:34,268 --> 02:25:36,871 AND ALSO BE MORE AGILE, 3807 02:25:36,871 --> 02:25:39,173 POTENTIALLY AALLOWING THE RAPID 3808 02:25:39,173 --> 02:25:41,275 DETECTION OF THE IMAGING DRUGS 3809 02:25:41,275 --> 02:25:42,343 AT THE POINT OF MEET. 3810 02:25:42,343 --> 02:25:43,911 AND OUR FINAL CONCEPT IS 3811 02:25:43,911 --> 02:25:44,712 BUILDING AN INNOVATION PLATFORM 3812 02:25:44,712 --> 02:25:49,016 FOR THE REPURPOSING OF MEDICINAL 3813 02:25:49,016 --> 02:25:49,884 PRODUCTS FOR SUBSTANCE USE 3814 02:25:49,884 --> 02:25:51,185 DISORDERS AND IT'S PROPOSED BY 3815 02:25:51,185 --> 02:25:52,220 MYSELF. 3816 02:25:52,220 --> 02:25:56,757 SO DRUG PROPOSING FOR NEW 3817 02:25:56,757 --> 02:25:57,492 INVESTIGATIONAL DRUGS. 3818 02:25:57,492 --> 02:25:58,726 ALTHOUGH THE BASIC DRUG 3819 02:25:58,726 --> 02:26:01,295 ADDICTION RESEARCH IS HIGHLY 3820 02:26:01,295 --> 02:26:03,898 ACTIVE, THE TRANSITION TO THE 3821 02:26:03,898 --> 02:26:06,901 CLINIC IS SERIOUSLY LIMITED. 3822 02:26:06,901 --> 02:26:11,539 THE DRUG REPURPOSES HAS BARRIERS 3823 02:26:11,539 --> 02:26:18,679 CHALLENGES, INTEGRATING THE 3824 02:26:18,679 --> 02:26:20,248 EXTENSION OF DRUGS. 3825 02:26:20,248 --> 02:26:21,883 SO THIS CONCEPT WILL SUPPORT THE 3826 02:26:21,883 --> 02:26:27,255 DEVELOPMENT OF FIRST IN CLASS 3827 02:26:27,255 --> 02:26:29,690 COHORT AND THE EFFICIENT DRUG 3828 02:26:29,690 --> 02:26:31,559 REPURPOSING FOR SUBSTANCE USE 3829 02:26:31,559 --> 02:26:32,727 DISORDER ENSURING THE GLOBAL 3830 02:26:32,727 --> 02:26:33,661 MEDICAL IMPACT. 3831 02:26:33,661 --> 02:26:35,663 THIS PLATFORM WILL OPERATE AS A 3832 02:26:35,663 --> 02:26:38,099 HUB FOR KEY INFORMATION TRAINING 3833 02:26:38,099 --> 02:26:39,467 RESOURCES AND COOPERATION IN 3834 02:26:39,467 --> 02:26:42,103 DRUG REPURPOSING, PROVIDING 3835 02:26:42,103 --> 02:26:43,004 EXTENSIVE EXPERTISE THROUGHOUT 3836 02:26:43,004 --> 02:26:45,740 THE WHOLE VALUE CHAIN OF DRUG 3837 02:26:45,740 --> 02:26:48,042 REPURPOSING, AND IT CAN 3838 02:26:48,042 --> 02:26:49,911 ACCELERATE THE DRUG DISCOVERY 3839 02:26:49,911 --> 02:26:51,279 AND DEVELOPMENT FOR SUBSTANCE 3840 02:26:51,279 --> 02:26:51,746 USE DISORDER. 3841 02:26:51,746 --> 02:26:52,513 THANK YOU. 3842 02:26:52,513 --> 02:26:56,317 HAPPY TO TAKE ANY QUESTIONS. 3843 02:26:56,317 --> 02:26:59,120 >> ANY QUESTIONS? 3844 02:26:59,120 --> 02:27:01,289 >> I WANTED TO COMMENT THAT 3845 02:27:01,289 --> 02:27:02,590 BASICALLY DO SPEAK UP WHEN YOU 3846 02:27:02,590 --> 02:27:03,724 SEE THESE CONCEPTS BECAUSE IT 3847 02:27:03,724 --> 02:27:06,093 WAS ONLY A COUPLE OF YEARS AGO 3848 02:27:06,093 --> 02:27:08,362 WHERE THE POSSIBILITY OF 3849 02:27:08,362 --> 02:27:09,297 FENTANYL STRIPS WAS RAISED AND 3850 02:27:09,297 --> 02:27:12,500 THE NEED FOR IT WAS RAISED. 3851 02:27:12,500 --> 02:27:14,001 ATEPI ROSE TO THE CHALLENGE AND 3852 02:27:14,001 --> 02:27:16,637 ELAINE AND OUR TEAM AND COSTA. 3853 02:27:16,637 --> 02:27:18,506 HERE WE ARE YOU SAW THE EARLY 3854 02:27:18,506 --> 02:27:19,473 RESULTS TODAY. 3855 02:27:19,473 --> 02:27:20,841 I'M EXCITED ABOUT THE DRUG 3856 02:27:20,841 --> 02:27:22,376 IDENTIFICATION EMERGING THREATS 3857 02:27:22,376 --> 02:27:25,913 AND INNOVATIVE PLATFORM, THE 3858 02:27:25,913 --> 02:27:26,280 REPURPOSING. 3859 02:27:26,280 --> 02:27:27,181 THESE THINGS CAN BE MORE THAN A 3860 02:27:27,181 --> 02:27:28,182 GLEAM IN YOUR EYE. 3861 02:27:28,182 --> 02:27:30,184 THEY CAN ACTUALLY TURN OUT TO BE 3862 02:27:30,184 --> 02:27:31,719 SOMETHING PRETTY COOL AND VERY 3863 02:27:31,719 --> 02:27:31,953 HELPFUL. 3864 02:27:31,953 --> 02:27:36,657 SO JUST A COMMENT. 3865 02:27:36,657 --> 02:27:36,958 >> THANKS. 3866 02:27:36,958 --> 02:27:41,729 THANKS VERY MUCH. 3867 02:27:41,729 --> 02:27:44,498 >> THE NEXT PRESENTATION IS 3868 02:27:44,498 --> 02:27:47,768 GOING TO BE GIVEN BY DR. MONTOYA 3869 02:27:47,768 --> 02:27:48,302 MEDICAL CONSEQUENCES. 3870 02:27:48,302 --> 02:27:51,872 IVAN. 3871 02:27:51,872 --> 02:27:53,941 >> THANK YOU, NORA. 3872 02:27:53,941 --> 02:27:55,142 WE HAVE FOUR CONCEPTS TO 3873 02:27:55,142 --> 02:27:55,776 PRESENT. 3874 02:27:55,776 --> 02:28:01,082 THE FIRST ONE IS BY RAUL MANDLER 3875 02:28:01,082 --> 02:28:02,984 IN COMBINATION WITH THE HIV 3876 02:28:02,984 --> 02:28:04,919 RESEARCH PROGRAM AND WITH 3877 02:28:04,919 --> 02:28:06,787 MADONNA CHANDLER IS THE DIRECTOR 3878 02:28:06,787 --> 02:28:09,957 OF THE PROGRAM, AND THE TITLE IS 3879 02:28:09,957 --> 02:28:11,626 CLINICAL RESEARCH ON HIV 3880 02:28:11,626 --> 02:28:14,128 ASSOCIATED PAIN IN THE CONTEXT 3881 02:28:14,128 --> 02:28:15,363 OF SUBSTANCE USE DISORDERS. 3882 02:28:15,363 --> 02:28:17,465 YOU KNOW CHRONIC PAIN IS A 3883 02:28:17,465 --> 02:28:19,100 SIGNIFICANT BURDEN FOR PEOPLE 3884 02:28:19,100 --> 02:28:21,268 WHO LIVE WITH HIV, ESPECIALLY 3885 02:28:21,268 --> 02:28:24,005 THOSE WHO USE DRUGS, AND IT'S 3886 02:28:24,005 --> 02:28:25,439 FREQUENTLY ASSOCIATED WITH 3887 02:28:25,439 --> 02:28:28,109 DECREASED QUALITY OF LIFE, HIGH 3888 02:28:28,109 --> 02:28:29,644 DISABILITY AND, OF COURSE, DRUG 3889 02:28:29,644 --> 02:28:30,978 USE RELAPSE. 3890 02:28:30,978 --> 02:28:32,346 UNFORTUNATELY, LITTLE IS KNOWN 3891 02:28:32,346 --> 02:28:35,249 ABOUT THE MECHANISMS AND FACTS 3892 02:28:35,249 --> 02:28:36,984 ASSOCIATED WITH PAIN AND PEOPLE 3893 02:28:36,984 --> 02:28:40,354 WHO LIVE WITH HIV AND SUBSTANCE 3894 02:28:40,354 --> 02:28:40,554 ABUSE. 3895 02:28:40,554 --> 02:28:41,489 THERE'S LITTLE INFORMATION ABOUT 3896 02:28:41,489 --> 02:28:43,124 SAFE AND EFFECTIVE TREATMENT FOR 3897 02:28:43,124 --> 02:28:43,991 THIS POPULATION. 3898 02:28:43,991 --> 02:28:46,927 SO THE GOAL OF THIS CONCEPT IS 3899 02:28:46,927 --> 02:28:49,997 TO SUPPORT THE FUNDING 3900 02:28:49,997 --> 02:28:52,633 OPPORTUNITY TO PORT THE RESEARCH 3901 02:28:52,633 --> 02:28:55,302 TO HELP ELUCIDATE THE MECHANISMS 3902 02:28:55,302 --> 02:28:57,672 AND PATHWAYS OF PAIN IN PEOPLE 3903 02:28:57,672 --> 02:29:01,342 WHO LIVE WITH HIV AND SUBSTANCE 3904 02:29:01,342 --> 02:29:03,110 ABUSE AND THE DEVELOPMENT OF 3905 02:29:03,110 --> 02:29:04,378 SAFE AND EFFECTIVE TREATMENT 3906 02:29:04,378 --> 02:29:07,148 INCLUDING PHARMACOLOGICAL 3907 02:29:07,148 --> 02:29:08,783 DEVICES AND/OR KINDS OF 3908 02:29:08,783 --> 02:29:13,421 TREATMENTS FOR THIS COMORBIDITY. 3909 02:29:13,421 --> 02:29:15,956 THE SECOND CONCEPT IS BY DREW 3910 02:29:15,956 --> 02:29:17,358 THOMPSON TO DEVELOP MEDICATIONS 3911 02:29:17,358 --> 02:29:20,061 AND DEVICES FOR COMORBID 3912 02:29:20,061 --> 02:29:21,762 SUBSTANCE USE DISORDER. 3913 02:29:21,762 --> 02:29:26,500 SO WE HAVE A THEME HERE OF 3914 02:29:26,500 --> 02:29:26,867 COMPARABLILITY. 3915 02:29:26,867 --> 02:29:29,103 WE HEARD THIS MORNING FROM NORA 3916 02:29:29,103 --> 02:29:30,037 INVOLVING THOSE WITH MULTIPLE 3917 02:29:30,037 --> 02:29:31,372 DRUGS THOSE ARE VERY FREQUENT 3918 02:29:31,372 --> 02:29:34,442 AND THE MAJORITY OF OVERDOSE IN 3919 02:29:34,442 --> 02:29:36,544 THE UNITED STATES ARE WITH 3920 02:29:36,544 --> 02:29:39,547 MULTIPLE DRUGS. 3921 02:29:39,547 --> 02:29:43,584 POLYSUBSTANCE USE IS ASSOCIATED 3922 02:29:43,584 --> 02:29:45,986 WITH WORSE TREATMENT AND WORSE 3923 02:29:45,986 --> 02:29:46,253 OUTCOMES. 3924 02:29:46,253 --> 02:29:48,155 AND THIS IS TO SUPPORT RESEARCH 3925 02:29:48,155 --> 02:29:51,058 TO IDENTIFY NEW TARGETS AND 3926 02:29:51,058 --> 02:29:52,727 DEVELOP THERAPEUTIC APPROACHES 3927 02:29:52,727 --> 02:29:56,564 WHERE COMORBID USE DISORDERS AND 3928 02:29:56,564 --> 02:29:58,666 POLYSUBSTANCE OVERDOSE. 3929 02:29:58,666 --> 02:30:02,870 THE THERAPEUTIC COULD BE ALONE 3930 02:30:02,870 --> 02:30:03,771 OR IN COMBINATION. 3931 02:30:03,771 --> 02:30:06,640 THE ULTIMATE GOAL IS TO ADVANCE 3932 02:30:06,640 --> 02:30:11,345 DEVELOPMENT OF SAFE AND 3933 02:30:11,345 --> 02:30:14,582 EFFECTIVE FOR POLYSUBSTANCE USE 3934 02:30:14,582 --> 02:30:15,683 DISORDERS. 3935 02:30:15,683 --> 02:30:20,755 THE THIRD CONCEPT IS BY JAYBI 3936 02:30:20,755 --> 02:30:22,790 WONG THE DISCOVERY OF NATURAL 3937 02:30:22,790 --> 02:30:25,526 PRODUCTS TO TREAT SUBSTANCE USE 3938 02:30:25,526 --> 02:30:26,093 DISORDERS. 3939 02:30:26,093 --> 02:30:27,962 NATURAL PRODUCTS IN NATURAL 3940 02:30:27,962 --> 02:30:29,263 PRODUCT LIKE COMPOUNDS REPRESENT 3941 02:30:29,263 --> 02:30:32,566 THE HIGHLY DIVERSE AND PROMISING 3942 02:30:32,566 --> 02:30:34,435 CHEMICAL SPACE FOR DISCOVERY AND 3943 02:30:34,435 --> 02:30:37,071 DEVELOPING MEDICATIONS TO TREAT 3944 02:30:37,071 --> 02:30:40,241 DISEASES, INCLUDING CNS 3945 02:30:40,241 --> 02:30:40,541 DISEASES. 3946 02:30:40,541 --> 02:30:42,409 SO RECENT TECHNOLOGICAL ADVANCES 3947 02:30:42,409 --> 02:30:44,311 HAVE FACILITATED THE PROCESS OF 3948 02:30:44,311 --> 02:30:48,015 DISCOVERY OF NOVEL BIOACTIVE AND 3949 02:30:48,015 --> 02:30:53,788 NATURAL PRODUCTS, INCLUDING 3950 02:30:53,788 --> 02:30:55,055 PREFRACTIONISTATION, AND NATURAL 3951 02:30:55,055 --> 02:30:57,424 PROTEIN INSPIRED LIBRARY 3952 02:30:57,424 --> 02:31:00,628 GENERATION, CELL-FREE AND 3953 02:31:00,628 --> 02:31:03,330 CELL-BASED CLEANING AND TOOLS 3954 02:31:03,330 --> 02:31:06,801 FOR RAPID COMPOUND DEAL 3955 02:31:06,801 --> 02:31:09,370 REPLICATION FROM NATURAL 3956 02:31:09,370 --> 02:31:09,637 PRODUCTS. 3957 02:31:09,637 --> 02:31:10,671 AND ALSO ARTIFICIAL INTELLIGENCE 3958 02:31:10,671 --> 02:31:14,108 IN MATCHING ALGORITHMS ARE BEING 3959 02:31:14,108 --> 02:31:16,343 USED NATURAL PRODUCT DRUG 3960 02:31:16,343 --> 02:31:17,378 DISCOVERY TO INCREASE THE 3961 02:31:17,378 --> 02:31:18,712 PIPELINE OF THESE PRODUCTS. 3962 02:31:18,712 --> 02:31:22,049 SO THE GOAL OF THIS CONCEPT IS 3963 02:31:22,049 --> 02:31:23,184 TO LEVERAGE THE RECENT 3964 02:31:23,184 --> 02:31:25,386 TECHNOLOGY DEVELOPMENTS IN 3965 02:31:25,386 --> 02:31:28,022 PARTNERSHIP WITH THE NATIONAL 3966 02:31:28,022 --> 02:31:30,524 CANCER INSTITUTE, THE NATIONAL 3967 02:31:30,524 --> 02:31:31,559 CENTER FOR COMPLEMENTARY 3968 02:31:31,559 --> 02:31:32,626 INTEGRATIVE HEALTH AND NATIONAL 3969 02:31:32,626 --> 02:31:35,663 CENTER FOR ADVANCING 3970 02:31:35,663 --> 02:31:36,864 TRANSLATIONAL SCIENCE TO 3971 02:31:36,864 --> 02:31:40,000 ENCOURAGE AND SUPPORT THE 3972 02:31:40,000 --> 02:31:41,902 FUNDING OPPORTUNITY TO ADVANCE 3973 02:31:41,902 --> 02:31:45,139 RESEARCH OF NATURAL PRODUCT 3974 02:31:45,139 --> 02:31:45,973 FOCUSED RESEARCH INVOLVING FROM 3975 02:31:45,973 --> 02:31:48,809 LEAD DISCOVERY ALL THE WAY TO 3976 02:31:48,809 --> 02:31:51,078 DRUG DEVELOPMENT TO ADDRESS THE 3977 02:31:51,078 --> 02:31:52,279 CHALLENGE OF TREATMENT OF 3978 02:31:52,279 --> 02:31:54,181 SUBSTANCE USE DISORDERS. 3979 02:31:54,181 --> 02:31:57,985 AND THE LAST CONCEPT I AM THE 3980 02:31:57,985 --> 02:32:00,588 AUTHOR AND IT'S KIND OF A 3981 02:32:00,588 --> 02:32:01,422 DIFFERENT CONCEPT. 3982 02:32:01,422 --> 02:32:02,756 THE OTHERS ARE MORE LIKE 3983 02:32:02,756 --> 02:32:06,961 RESEARCH FOCUSED, AND THIS 3984 02:32:06,961 --> 02:32:11,565 CONCEPT IS TO REQUEST TO PUBLISH 3985 02:32:11,565 --> 02:32:16,437 A FUNDING OPPORTUNITY TO REQUEST 3986 02:32:16,437 --> 02:32:18,038 APPLICATIONS, LOOKING AT ANNUAL 3987 02:32:18,038 --> 02:32:19,840 CONFERENCE IN THERAPEUTICS 3988 02:32:19,840 --> 02:32:21,575 DEVELOPMENT FOR SUBSTANCE USE 3989 02:32:21,575 --> 02:32:21,842 DISORDERS. 3990 02:32:21,842 --> 02:32:24,111 SO THIS IS THE IDEA OF THIS 3991 02:32:24,111 --> 02:32:25,412 CONCEPT IS TO -- WE KNOW THAT 3992 02:32:25,412 --> 02:32:29,049 THE BODY OF RESEARCH OF NEW 3993 02:32:29,049 --> 02:32:32,052 THERAPEUTICS FOR SUBSTANCE USE 3994 02:32:32,052 --> 02:32:34,288 DISORDERS HAS BEEN INCREASING 3995 02:32:34,288 --> 02:32:35,756 ESPECIALLY AS A RESULT OF 3996 02:32:35,756 --> 02:32:36,123 HEALED. 3997 02:32:36,123 --> 02:32:36,991 AND MULTIPLE RESEARCH QUESTIONS 3998 02:32:36,991 --> 02:32:38,492 AND CHALLENGES HAVE EMERGED 3999 02:32:38,492 --> 02:32:40,327 DURING THIS TIME AND NEW TOOLS 4000 02:32:40,327 --> 02:32:43,397 TO IDENTIFY COMPOUNDS VALIDATE 4001 02:32:43,397 --> 02:32:45,532 AND LOOK AT THE PREDICTABILITY 4002 02:32:45,532 --> 02:32:48,502 OF PRECLINICAL MODELS, CLINICAL 4003 02:32:48,502 --> 02:32:52,172 TRIALS DESIGN, OUTCOME MEASURES, 4004 02:32:52,172 --> 02:32:53,440 REGULATORY REQUIREMENTS, ET 4005 02:32:53,440 --> 02:32:55,075 CETERA. 4006 02:32:55,075 --> 02:32:58,479 WE KNOW THAT MOST OF THE 4007 02:32:58,479 --> 02:33:00,781 PSYCHIATRIC CONFERENCE ARE NOT 4008 02:33:00,781 --> 02:33:02,683 FOCUSED ON SUBSTANCE ABUSE, AND 4009 02:33:02,683 --> 02:33:03,884 WE KNOW THE SUBSTANCE ABUSE 4010 02:33:03,884 --> 02:33:07,121 CONFERENCES ARE MORE FOCUSED ON 4011 02:33:07,121 --> 02:33:12,593 EITHER PRECLINICAL OR CLINICAL 4012 02:33:12,593 --> 02:33:13,127 RESEARCH. 4013 02:33:13,127 --> 02:33:14,762 THERE'S NO SINGLE CONFERENCE 4014 02:33:14,762 --> 02:33:16,697 WHERE PEOPLE WHO ARE DEVELOPING 4015 02:33:16,697 --> 02:33:18,032 TREATMENT OR SUBSTANCE USE 4016 02:33:18,032 --> 02:33:19,233 DISORDERS CAN GET TOGETHER AND 4017 02:33:19,233 --> 02:33:21,769 DISCUSS AND HAVE ALL THOSE 4018 02:33:21,769 --> 02:33:22,136 CHALLENGES. 4019 02:33:22,136 --> 02:33:24,872 AND TRY TO SOLVE THE CHALLENGES 4020 02:33:24,872 --> 02:33:26,140 ASSOCIATED WITH THE DEVELOPMENT 4021 02:33:26,140 --> 02:33:27,942 OF NEW THERAPEUTICS. 4022 02:33:27,942 --> 02:33:31,345 SO THE GOAL OF THIS CONCEPT IS 4023 02:33:31,345 --> 02:33:35,015 TO SUPPORT A FUNDING OPPORTUNITY 4024 02:33:35,015 --> 02:33:37,451 TO SUPPORT A CONFERENCE TO 4025 02:33:37,451 --> 02:33:39,586 DEVELOP AND IMPLEMENT AN ANNUAL 4026 02:33:39,586 --> 02:33:41,021 SCIENTIFIC MEETING THAT INVOLVES 4027 02:33:41,021 --> 02:33:44,491 PARTICIPANTS FROM ACADEMIA, 4028 02:33:44,491 --> 02:33:46,160 INDUSTRY AND, OF COURSE, NIDA TO 4029 02:33:46,160 --> 02:33:48,629 ADVANCE THE DEVELOPMENT OF 4030 02:33:48,629 --> 02:33:49,530 THERAPEUTICS AND SUBSTANCE USE 4031 02:33:49,530 --> 02:33:49,797 DISORDERS. 4032 02:33:49,797 --> 02:33:54,468 SO THE GOAL IS THIS FACILITATE 4033 02:33:54,468 --> 02:33:55,836 KNOWLEDGE SHARING, ENCOURAGING 4034 02:33:55,836 --> 02:33:58,005 INFORMATION BY IDENTIFYING AND 4035 02:33:58,005 --> 02:33:58,872 ADDRESSING COMMON CHALLENGES 4036 02:33:58,872 --> 02:34:01,108 FACED BY ALL SECTORS. 4037 02:34:01,108 --> 02:34:03,477 AS I SAID INCLUDING INDUSTRY, 4038 02:34:03,477 --> 02:34:05,479 FOSTER COLLABORATION, FACILITATE 4039 02:34:05,479 --> 02:34:07,147 TRANSACTIONS AND VERY IMPORTANT 4040 02:34:07,147 --> 02:34:10,551 IS TO INVOLVE THE FDA SO WE CAN 4041 02:34:10,551 --> 02:34:13,587 HAVE A VERY PRODUCTIVE 4042 02:34:13,587 --> 02:34:15,055 COMMUNICATION WITH THE FDA TO 4043 02:34:15,055 --> 02:34:17,624 ADVANCE THE DEVELOPMENT OF 4044 02:34:17,624 --> 02:34:18,692 PRODUCTS TOWARDS FDA APPROVAL. 4045 02:34:18,692 --> 02:34:20,694 THOSE ARE THE FOUR CONCEPTS THAT 4046 02:34:20,694 --> 02:34:24,164 WE HAVE FROM THE TMC. 4047 02:34:24,164 --> 02:34:27,634 YOU HAVE ANY QUESTIONS. 4048 02:34:27,634 --> 02:34:28,202 YES, PLEASE. 4049 02:34:28,202 --> 02:34:29,670 >> QUESTION ON THE LAST ONE, 4050 02:34:29,670 --> 02:34:31,438 SOUNDS LIKE A GREAT IDEA. 4051 02:34:31,438 --> 02:34:32,773 WONDERING IF THERE'S ANY THOUGHT 4052 02:34:32,773 --> 02:34:33,941 GIVEN TO HOW TO ENGAGE PEOPLE 4053 02:34:33,941 --> 02:34:35,743 WITH LIVED EXPERIENCE OR IF THAT 4054 02:34:35,743 --> 02:34:36,910 WOULD BE SOMETHING THAT YOU 4055 02:34:36,910 --> 02:34:39,480 WOULD EMPHASIZE? 4056 02:34:39,480 --> 02:34:48,956 >> ABSOLUTELY, YES. 4057 02:34:48,956 --> 02:34:50,224 THAT WILL BE PEOPLE WHO DEVELOP 4058 02:34:50,224 --> 02:34:51,125 COMMUNICATIONS AND PEOPLE WHO 4059 02:34:51,125 --> 02:34:54,294 HAVE HISTORY AND CAN PROVIDE 4060 02:34:54,294 --> 02:34:55,696 FEEDBACK ABOUT LIKE, FOR 4061 02:34:55,696 --> 02:34:57,931 EXAMPLE, OUTCOMES OR WAYS TO 4062 02:34:57,931 --> 02:34:59,133 TREAT DIFFERENT INNOVATIVE 4063 02:34:59,133 --> 02:34:59,767 APPROACHES. 4064 02:34:59,767 --> 02:35:02,369 SO IT WILL BE OPEN TO BASICALLY 4065 02:35:02,369 --> 02:35:03,937 ANYONE INTERESTED IN THE 4066 02:35:03,937 --> 02:35:14,415 TREATMENT OF SUBSTANCE USE 4067 02:35:19,420 --> 02:35:21,889 DISORDERS. 4068 02:35:21,889 --> 02:35:23,924 >> I THINK THAT'S WHAT HE'S 4069 02:35:23,924 --> 02:35:25,592 SUGGESTING THAT THEY SHOULD BE 4070 02:35:25,592 --> 02:35:26,927 AN INTEGRAL PART OF THE 4071 02:35:26,927 --> 02:35:28,996 OPERATIONS BECAUSE OTHERWISE 4072 02:35:28,996 --> 02:35:31,065 THEY ARE NOT NECESSARILY 4073 02:35:31,065 --> 02:35:31,331 INCLUDED. 4074 02:35:31,331 --> 02:35:34,701 NOT JUST WAITING FOR THEM TO 4075 02:35:34,701 --> 02:35:44,178 COME IN. 4076 02:35:44,178 --> 02:35:53,253 >> ABSOLUTELY. 4077 02:35:53,253 --> 02:36:03,730 OKAY. AND NEUROSCIENCE AND 4078 02:36:10,804 --> 02:36:11,038 BEHAVIOR. 4079 02:36:11,038 --> 02:36:12,072 >> GOOD AFTERNOON, EVERYBODY. 4080 02:36:12,072 --> 02:36:14,208 SO THE FIRST CONCEPT THAT I'LL 4081 02:36:14,208 --> 02:36:18,412 BE PRESENTING I'M A SIGNATURE 4082 02:36:18,412 --> 02:36:20,047 AND COLLABORATION AMONGST MYSELF 4083 02:36:20,047 --> 02:36:29,756 AND DOCTORS KATHLEEN BORGMAN 4084 02:36:29,756 --> 02:36:30,290 OTHERS. 4085 02:36:30,290 --> 02:36:32,126 ASSOCIATED WITH HIV PAIN IN THE 4086 02:36:32,126 --> 02:36:33,427 CONCEPT OF SUBSTANCE USE 4087 02:36:33,427 --> 02:36:34,228 DISORDERS. 4088 02:36:34,228 --> 02:36:43,837 PAIN IS MORE THAN JUST 4089 02:36:43,837 --> 02:36:45,139 NOCICEPTION IT'S COMPLEX AND 4090 02:36:45,139 --> 02:36:46,607 CHALLENGING TO BOTH STUDY AND 4091 02:36:46,607 --> 02:36:46,907 TREAT. 4092 02:36:46,907 --> 02:36:49,243 FOR HIV WITH COMORBID SUBSTANCE 4093 02:36:49,243 --> 02:36:50,477 USE DISORDER MYRIAD CONTRIBUTING 4094 02:36:50,477 --> 02:36:53,347 FACTORS ARE EMERGING IN BOTH THE 4095 02:36:53,347 --> 02:36:54,381 MOLECULAR AND BEHAVIORAL LEVELS 4096 02:36:54,381 --> 02:36:56,049 THAT SHOULD BE ADDRESSED WITH 4097 02:36:56,049 --> 02:36:58,385 TARGETED RESEARCH INTO CORE 4098 02:36:58,385 --> 02:36:59,686 MECHANISMS OF HOW AND WHY PAIN 4099 02:36:59,686 --> 02:37:01,355 IS EXPERIENCED BY PEOPLE LIVING 4100 02:37:01,355 --> 02:37:06,260 WITH HIV AND COMPLICATED BY SUV. 4101 02:37:06,260 --> 02:37:08,795 IT WILL PROBING AND MEDICATIONS 4102 02:37:08,795 --> 02:37:10,898 AND PAIN THE PAIN IN CONTEXT OF 4103 02:37:10,898 --> 02:37:13,867 HIV INFECTION WITH SPECIAL 4104 02:37:13,867 --> 02:37:15,002 ASPECTS OF GUIDING INTERVENTION 4105 02:37:15,002 --> 02:37:22,075 AND REDUCE THE RISK OF ANALGESIC 4106 02:37:22,075 --> 02:37:23,443 MEDICATION OVER LONG-TERM USE. 4107 02:37:23,443 --> 02:37:25,012 THE SECOND TOPIC THAT I'LL 4108 02:37:25,012 --> 02:37:27,781 PRESENT IS ALSO COLLABORATIVE 4109 02:37:27,781 --> 02:37:29,316 EFFORT WITH MYSELF AND DR 4110 02:37:29,316 --> 02:37:32,352 DR. PAWLICK. 4111 02:37:32,352 --> 02:37:35,289 THIS IS THE DISCOVERY OF CIRCUIT 4112 02:37:35,289 --> 02:37:36,890 MECHANISMS REWARD PROCESSING IN 4113 02:37:36,890 --> 02:37:38,425 THE BRAIN IS OBVIOUSLY A CORE 4114 02:37:38,425 --> 02:37:40,093 COMPONENT OF THE NEUROBIOLOGY OF 4115 02:37:40,093 --> 02:37:40,627 ADDICTION. 4116 02:37:40,627 --> 02:37:42,896 HOWEVER, THE REWARDING ACUTELY 4117 02:37:42,896 --> 02:37:43,997 REWARDING PROPERTIES OF A DRUG 4118 02:37:43,997 --> 02:37:45,499 DO NOT ALWAYS PREDICT THE RISK 4119 02:37:45,499 --> 02:37:48,368 OF ADDICTION FOR THAT DRUG, 4120 02:37:48,368 --> 02:37:49,736 PARTICULARLY THE INDIVIDUAL 4121 02:37:49,736 --> 02:37:49,937 LEVEL. 4122 02:37:49,937 --> 02:37:50,537 RATHER, THERE ARE INTRICATE 4123 02:37:50,537 --> 02:37:53,707 CIRCUITS OF OPPOSING SIGNALS AND 4124 02:37:53,707 --> 02:37:54,875 CONTEXTUAL MODIFIERS OF THE 4125 02:37:54,875 --> 02:37:56,076 DRUG'S PERCEIVED EFFECTS THAT 4126 02:37:56,076 --> 02:37:58,345 MUST ALSO BE CONSIDERED IN THE 4127 02:37:58,345 --> 02:38:00,013 MECHANISMS AND TRAJECTORIES OF 4128 02:38:00,013 --> 02:38:00,747 ADDICTION. 4129 02:38:00,747 --> 02:38:01,882 THIS CONCEPT WILL ADDRESS 4130 02:38:01,882 --> 02:38:04,017 CIRCUITS AND THE SIGNALLING 4131 02:38:04,017 --> 02:38:05,118 MECHANISMS ASSOCIATED WITH THOSE 4132 02:38:05,118 --> 02:38:07,321 CIRCUITS THAT ACT TO OPPOSE OR 4133 02:38:07,321 --> 02:38:09,423 OTHERWISE MODULATE THE ADDICTIVE 4134 02:38:09,423 --> 02:38:10,891 PROPERTIES OF DRUGS. 4135 02:38:10,891 --> 02:38:12,993 THIS WILL BE USED FOR POTENTIAL 4136 02:38:12,993 --> 02:38:13,827 TARGETS FOR FUTURE THERAPEUTICS 4137 02:38:13,827 --> 02:38:15,529 AND ALSO TO ADVANCE OUR 4138 02:38:15,529 --> 02:38:17,698 UNDERSTANDING OF HOW THE BRAIN 4139 02:38:17,698 --> 02:38:18,799 PROCESSES DRUG ASSOCIATED 4140 02:38:18,799 --> 02:38:21,835 STIMULI AND HOW THE BALANCE 4141 02:38:21,835 --> 02:38:23,971 BETWEEN ACTIVE AND COUNTER 4142 02:38:23,971 --> 02:38:26,540 ADDICTIVE ANALYSIS CONTRIBUTE TO 4143 02:38:26,540 --> 02:38:27,941 THE SPECTRUM OF SUBSTANCE ABUSE 4144 02:38:27,941 --> 02:38:31,545 DISORDER PATHOLOGY THAT WE 4145 02:38:31,545 --> 02:38:33,513 OBSERVE. 4146 02:38:33,513 --> 02:38:35,916 THE THIRD CONCEPT IS 4147 02:38:35,916 --> 02:38:36,583 NEUROMODULATION CONTROLLERS IN 4148 02:38:36,583 --> 02:38:38,185 SUBSTANCE USE DISORDER. 4149 02:38:38,185 --> 02:38:42,422 NEUROMODULATION IS ADVANCING IN 4150 02:38:42,422 --> 02:38:46,760 ITS DEVELOPMENT OF TARGETS TO 4151 02:38:46,760 --> 02:38:48,795 INTERVENE NEUROPSYCH CONDITIONS 4152 02:38:48,795 --> 02:38:53,200 AND NEUROSUBSTANCE DISORDERS AND 4153 02:38:53,200 --> 02:38:56,737 NEUROMODULATION IS AN INTENSIVE 4154 02:38:56,737 --> 02:38:58,739 ITERATIVE PROCESS WITH TRIAL AND 4155 02:38:58,739 --> 02:39:00,741 ERROR STIMULATION MODALITIES, 4156 02:39:00,741 --> 02:39:02,676 PARAMETERS AND ANATOMICAL 4157 02:39:02,676 --> 02:39:03,710 TARGETS BEFORE SIGNIFICANT 4158 02:39:03,710 --> 02:39:05,679 THERAPEUTIC IMPROVEMENTS ARE 4159 02:39:05,679 --> 02:39:06,380 ACHIEVED IF AT ALL. 4160 02:39:06,380 --> 02:39:08,715 HOWEVER ONE OF THE MOST 4161 02:39:08,715 --> 02:39:10,284 ATTRACTIVE ASPECTS OF THIS 4162 02:39:10,284 --> 02:39:13,587 THERAPY IS ITS ADAPTABILITY 4163 02:39:13,587 --> 02:39:14,888 POTENTIAL FOR INDIVIDUALIZATION 4164 02:39:14,888 --> 02:39:17,057 BUT TO ENSURE THE MOST ROBUST 4165 02:39:17,057 --> 02:39:18,592 AND WIDESPREAD APPLICATION AND 4166 02:39:18,592 --> 02:39:20,327 ADOPTION OF THESE APPROACHES THE 4167 02:39:20,327 --> 02:39:22,162 PROCESS NEEDS TO BE STREAMLINED. 4168 02:39:22,162 --> 02:39:25,232 THIS CONCEPT WILL MOTIVATE THE 4169 02:39:25,232 --> 02:39:28,468 DESIGN BUILD TEST CYCLE FOR 4170 02:39:28,468 --> 02:39:31,571 SYSTEM CONTROL THEORY PHASED 4171 02:39:31,571 --> 02:39:34,141 LOOP EVALUATION OF 4172 02:39:34,141 --> 02:39:34,841 NEUROMODULATION THERAPIES AND 4173 02:39:34,841 --> 02:39:35,676 SUBSTANCE USE DISORDER. 4174 02:39:35,676 --> 02:39:38,178 IT WILL CHALLENGE THE FIELD TO 4175 02:39:38,178 --> 02:39:40,280 PRESENT RATIONALE FOR KEY 4176 02:39:40,280 --> 02:39:41,081 MARKERS OF TARGETED ENGAGEMENT 4177 02:39:41,081 --> 02:39:43,050 RESPONSE TO MODULATION AND THE 4178 02:39:43,050 --> 02:39:44,551 OPTIMIZATION PROCESS RELATIVE TO 4179 02:39:44,551 --> 02:39:48,288 CURRENT METHODS. 4180 02:39:48,288 --> 02:39:51,992 THE NEXT CONCEPT IS 4181 02:39:51,992 --> 02:39:56,630 MULTI-SENSORY INTEGRATION 4182 02:39:56,630 --> 02:39:57,631 INTRACEPTION, DISORDER. 4183 02:39:57,631 --> 02:39:58,965 THE PSYCHO ACTIVE DRUGS 4184 02:39:58,965 --> 02:40:00,467 INCLUDING ADDICTIVE ONES IS KEY 4185 02:40:00,467 --> 02:40:02,936 TO THE IMPACT THE EXPERIENCE 4186 02:40:02,936 --> 02:40:03,870 WILL HAVE ON SUBSEQUENT 4187 02:40:03,870 --> 02:40:05,205 BEHAVIOR, SUCH AS THE DESIRE TO 4188 02:40:05,205 --> 02:40:06,773 HAVE THE EXPERIENCE AGAIN OR 4189 02:40:06,773 --> 02:40:07,441 NOT. 4190 02:40:07,441 --> 02:40:09,609 ADDICTIVE DRUGS IS PART OF THEIR 4191 02:40:09,609 --> 02:40:11,178 CONSTELLATION OF EFFECTS WITHIN 4192 02:40:11,178 --> 02:40:14,748 THE BRAIN MAY ALSO ACT WITH 4193 02:40:14,748 --> 02:40:16,383 SECONDARY REINFORCING PROPERTIES 4194 02:40:16,383 --> 02:40:18,885 THAT AUGMENT THE INTENSITY OF 4195 02:40:18,885 --> 02:40:20,921 STIMULI LIKE SENSORY 4196 02:40:20,921 --> 02:40:22,489 INFORMATION. 4197 02:40:22,489 --> 02:40:23,990 INTRIGUELY, NOVEL STIMULI IS 4198 02:40:23,990 --> 02:40:25,792 BEING EXPLORED FOR POTENTIAL 4199 02:40:25,792 --> 02:40:27,361 VALUE AS THERAPEUTICS AND 4200 02:40:27,361 --> 02:40:28,795 THERAPEUTIC ADJUVANTS BUT LITTLE 4201 02:40:28,795 --> 02:40:31,832 IS KNOWN ABOUT THE COMPLEX 4202 02:40:31,832 --> 02:40:34,201 INTERPLAY BETWEEN DRUG EFFECTS 4203 02:40:34,201 --> 02:40:36,370 AND CONTEXTUAL PROCESSING AND 4204 02:40:36,370 --> 02:40:37,838 WHETHER IT MAY BE LEVERAGED AS A 4205 02:40:37,838 --> 02:40:39,106 MEAN TO INTERVENE IN THE CYCLE 4206 02:40:39,106 --> 02:40:40,574 OF ADDICTION. 4207 02:40:40,574 --> 02:40:42,342 THIS CONCEPT WILL MOTIVATE 4208 02:40:42,342 --> 02:40:43,710 RESEARCH INTO NEUROCIRCUITS THAT 4209 02:40:43,710 --> 02:40:45,479 ARE RESPONSIBLE FOR INTEGRATING 4210 02:40:45,479 --> 02:40:47,214 COMPLEX MULTI-SENSORY INPUTS HOW 4211 02:40:47,214 --> 02:40:49,850 DRUGS ACT ON THESE CIRCUITS TO 4212 02:40:49,850 --> 02:40:51,718 MODIFY SUBJECTIVE EXPERIENCES 4213 02:40:51,718 --> 02:40:55,288 AND HOW FORMS OF LASTISTY MAY BE 4214 02:40:55,288 --> 02:40:56,690 USED AS THERAPEUTICS IN 4215 02:40:56,690 --> 02:40:58,225 SUBSTANCE USE DISORDER. 4216 02:40:58,225 --> 02:41:01,428 AND LASTLY, AT LEAST FOR THIS 4217 02:41:01,428 --> 02:41:03,430 SLIDE, WE HAVE THE MATERNAL 4218 02:41:03,430 --> 02:41:06,533 MORTALITY FROM DRUG OVERDOSE. 4219 02:41:06,533 --> 02:41:12,706 THIS IS PRESENTED BY NARE. 4220 02:41:12,706 --> 02:41:16,276 WHILE NIDA RESEARCH FOCUSES ON 4221 02:41:16,276 --> 02:41:19,045 THIS BUT NONE ON THE OVERDOSE. 4222 02:41:19,045 --> 02:41:22,416 THE BIOLOGICAL MECHANISMS 4223 02:41:22,416 --> 02:41:24,418 INCREASING TO MORTALITY AND 4224 02:41:24,418 --> 02:41:26,620 MIGHT ENHANCE TREATMENT QUALITY 4225 02:41:26,620 --> 02:41:28,288 DURING PREGNANCY IN THE 4226 02:41:28,288 --> 02:41:29,189 POSTPARTUM PERIOD. 4227 02:41:29,189 --> 02:41:32,025 THE GOAL OF THIS CONCEPT IS TO 4228 02:41:32,025 --> 02:41:35,162 ESTABLISH RESEARCH THAT CAUSES 4229 02:41:35,162 --> 02:41:38,265 THE UNDERSTANDING BY OVERDOSE 4230 02:41:38,265 --> 02:41:40,867 AND THE EPIDEMIOLOGY AND 4231 02:41:40,867 --> 02:41:42,202 TREATMENT STRATEGIES IN THIS 4232 02:41:42,202 --> 02:41:43,003 HIGH RISK POPULATION. 4233 02:41:43,003 --> 02:41:44,771 NOW I'LL BE HAPPY TO TAKE ANY 4234 02:41:44,771 --> 02:41:46,573 QUESTIONS. 4235 02:41:46,573 --> 02:41:47,741 >> YES, SHELLY. 4236 02:41:47,741 --> 02:41:48,909 >> THANKS SO MUCH FOR THAT. 4237 02:41:48,909 --> 02:41:50,477 I JUST WANTED TO COMMENT AND ASK 4238 02:41:50,477 --> 02:41:52,379 YOU A QUESTION ABOUT THE LAST 4239 02:41:52,379 --> 02:41:53,747 CONCEPT THAT YOU JUST PRESENTED 4240 02:41:53,747 --> 02:41:57,150 ON MATERNAL MORTALITY. 4241 02:41:57,150 --> 02:42:00,420 JUST BECAUSE COUPLE THINGS THAT 4242 02:42:00,420 --> 02:42:02,289 HAVE OUTLINED AROUND THE 4243 02:42:02,289 --> 02:42:04,090 IDENTIFICATION OF SPECIFIC 4244 02:42:04,090 --> 02:42:04,758 WINDOWS OF VULNERABILITY DURING 4245 02:42:04,758 --> 02:42:07,994 GESTATION AND POSTPARTUM 4246 02:42:07,994 --> 02:42:08,395 PERIODS. 4247 02:42:08,395 --> 02:42:10,864 HOW YOU IDENTIFY THE POSTPARTUM 4248 02:42:10,864 --> 02:42:13,800 PERIOD WILL BE CRITICAL TO YOUR 4249 02:42:13,800 --> 02:42:14,568 CONCEPT BECAUSE POSTPARTUM IS 4250 02:42:14,568 --> 02:42:18,505 JUST DEFINED AS PERRY PARTUM 4251 02:42:18,505 --> 02:42:20,807 LEVEL, EIGHT WEEKS, FOUR WEEKS, 4252 02:42:20,807 --> 02:42:23,076 IT'S ACTUALLY 12 TO 24 MONTHS IS 4253 02:42:23,076 --> 02:42:26,947 THE POSTPARTUM PERIOD. 4254 02:42:26,947 --> 02:42:28,415 MASSACHUSETTS ONE OF THE HIGHEST 4255 02:42:28,415 --> 02:42:29,950 PERIODS OF OVERDOSE FROM OPIOIDS 4256 02:42:29,950 --> 02:42:32,285 MAYBE YOU KNOW THIS WAS IN THE 4257 02:42:32,285 --> 02:42:34,488 FINAL PART OF THE FIRST YEAR 4258 02:42:34,488 --> 02:42:35,956 FOLLOWING BIRTH. 4259 02:42:35,956 --> 02:42:37,824 AND SO IN FACT I THINK HOW 4260 02:42:37,824 --> 02:42:40,227 YOU'RE GOING TO DEFINE THAT IS 4261 02:42:40,227 --> 02:42:43,697 CRITICAL TO THE WAY IN WHICH YOU 4262 02:42:43,697 --> 02:42:46,032 WILL RECEIVE APPLICATIONS AS 4263 02:42:46,032 --> 02:42:49,069 LIKE ONE CRITICAL THING. 4264 02:42:49,069 --> 02:42:50,904 NOW, THE SECOND THING IS HOW YOU 4265 02:42:50,904 --> 02:42:53,607 MIGHT DEFINE THE DIAD, WHEN 4266 02:42:53,607 --> 02:42:55,242 YOU'RE TALKING ABOUT THE 4267 02:42:55,242 --> 02:42:56,376 POSTPARTUM PERIOD YOU NEED TO 4268 02:42:56,376 --> 02:42:59,079 DISCUSS THE INFANT THAT'S ALSO 4269 02:42:59,079 --> 02:43:00,714 THE -- IT'S NOT LIKE A LOT OF 4270 02:43:00,714 --> 02:43:03,650 WHAT WE DO IS WE LOOK AT THE 4271 02:43:03,650 --> 02:43:05,552 INFANT OR WE LOOK AT THE MOTHER 4272 02:43:05,552 --> 02:43:10,957 BUT WE DON'T LOOK AT THE DIAD, 4273 02:43:10,957 --> 02:43:13,693 VERY IMPORTANT AS KNOWN FOR 100 4274 02:43:13,693 --> 02:43:14,494 PLUS YEARS. 4275 02:43:14,494 --> 02:43:17,364 AND THE THIRD THING WOULD BE 4276 02:43:17,364 --> 02:43:18,231 WHEN YOU'RE LOOKING AT THE WHOLE 4277 02:43:18,231 --> 02:43:19,799 BUNCH OF FACTORS THAT GO INTO 4278 02:43:19,799 --> 02:43:20,000 THIS. 4279 02:43:20,000 --> 02:43:23,069 I KNOW YOU WANT THEM AS A COAL 4280 02:43:23,069 --> 02:43:26,039 SOCIO CULTURAL AND ENVIRONMENTAL 4281 02:43:26,039 --> 02:43:28,174 AREA, I THINK WE REALLY DO NEED 4282 02:43:28,174 --> 02:43:29,342 PERTINENT TO THESE CONVERSATIONS 4283 02:43:29,342 --> 02:43:32,546 WE HAD WE DO NEED TO LOOK AT THE 4284 02:43:32,546 --> 02:43:36,483 LACK OF SUPPORT FOR MATERNAL 4285 02:43:36,483 --> 02:43:39,286 HEALTH, WHICH FOLLOWS ON IN THE 4286 02:43:39,286 --> 02:43:42,088 POSTPARTUM PERIOD AND CAN 4287 02:43:42,088 --> 02:43:44,658 INCLUDE EVERYTHING FROM TRYING 4288 02:43:44,658 --> 02:43:47,627 TO FOOD SECURITY, HEALTH 4289 02:43:47,627 --> 02:43:49,329 INSECURITY, IT'S SLEEP RELATED 4290 02:43:49,329 --> 02:43:50,430 ISSUES, PAIN RELATED ISSUES IT'S 4291 02:43:50,430 --> 02:43:51,298 ALL THOSE ISSUES. 4292 02:43:51,298 --> 02:43:54,868 I KNOW YOU CAPTURED ONE GREAT 4293 02:43:54,868 --> 02:43:58,138 THING HERE WHICH IS THE 4294 02:43:58,138 --> 02:43:59,005 MORBIDITIES, POSTPARTUM AND 4295 02:43:59,005 --> 02:44:00,373 MENTAL HEALTH CONDITIONS, I 4296 02:44:00,373 --> 02:44:02,676 THINK ALL THOSE THINGS 4297 02:44:02,676 --> 02:44:04,244 EXPLICITLY WITH THE SOCIO 4298 02:44:04,244 --> 02:44:05,412 ENVIRONMENTAL FACTORS ARE GOING 4299 02:44:05,412 --> 02:44:06,479 TO BE REALLY CRITICAL. 4300 02:44:06,479 --> 02:44:09,349 I WOULD JUST SAY POSTPARTUM, 12 4301 02:44:09,349 --> 02:44:12,752 TO 24 MONTHS, AND THE DAD. 4302 02:44:12,752 --> 02:44:14,154 THOSE TWO THINGS ARE REALLY 4303 02:44:14,154 --> 02:44:15,288 CRITICAL TO THIS. 4304 02:44:15,288 --> 02:44:16,423 IT'S A GREAT CONCEPT. 4305 02:44:16,423 --> 02:44:16,856 >> ABSOLUTELY. 4306 02:44:16,856 --> 02:44:19,392 THIS IS SANILA. 4307 02:44:19,392 --> 02:44:20,994 THANK YOU VERY MUCH FOR THOSE 4308 02:44:20,994 --> 02:44:21,294 COMMENTS. 4309 02:44:21,294 --> 02:44:24,097 I JUST WANTED TO -- SO ONE OF 4310 02:44:24,097 --> 02:44:26,399 THE GOALS IS DEFINITELY IF YOU 4311 02:44:26,399 --> 02:44:27,867 LOOK AT THE POSTPARTUM PERIOD 4312 02:44:27,867 --> 02:44:30,103 WITH GREATER GRANULARITY. 4313 02:44:30,103 --> 02:44:31,237 IN FACT, THERE WAS A STUDY WHICH 4314 02:44:31,237 --> 02:44:35,275 SHOWS THAT THERE'S AN INCREASE 4315 02:44:35,275 --> 02:44:35,675 IN VULNERABILITY. 4316 02:44:35,675 --> 02:44:39,913 THE POSTPARTUM PERIOD AND NOT IN 4317 02:44:39,913 --> 02:44:41,982 THE POSTPARTUM PERIOD, IT'S 4318 02:44:41,982 --> 02:44:44,117 CRITICAL TO LOOK AT THE 4319 02:44:44,117 --> 02:44:45,251 POSTPARTUM PERIOD WITH THE 4320 02:44:45,251 --> 02:44:47,787 REALLY FINE LENS TO FIGURE OUT 4321 02:44:47,787 --> 02:44:50,190 PERIODS OF VULNERABILITY AND 4322 02:44:50,190 --> 02:44:59,065 THEN TO UNDERSTAND MECHANIC SCLI 4323 02:44:59,065 --> 02:45:00,166 WHAT'S GOING ON THERE. 4324 02:45:00,166 --> 02:45:01,935 >> THESE ARE GREAT CONCEPTS. 4325 02:45:01,935 --> 02:45:05,071 I WANTED TO ESPECIALLY FOR THE 4326 02:45:05,071 --> 02:45:08,074 ANTI-ADDICTIVE CIRCUITS AND 4327 02:45:08,074 --> 02:45:11,277 MULTI-SENSORY AND MODULATION, I 4328 02:45:11,277 --> 02:45:14,681 THINK YOU WOULD -- WITH THE 4329 02:45:14,681 --> 02:45:17,584 NOTICES BEING BOTH HUMAN AND 4330 02:45:17,584 --> 02:45:18,518 BASIC STUDIES? 4331 02:45:18,518 --> 02:45:19,619 >> OKAY. 4332 02:45:19,619 --> 02:45:19,919 GREAT. 4333 02:45:19,919 --> 02:45:25,959 >> I WOULD ENCOURAGE THAT. 4334 02:45:25,959 --> 02:45:29,229 ANY OTHER QUESTIONS? 4335 02:45:29,229 --> 02:45:32,932 IF NOT, WE THANK YOU VERY MUCH 4336 02:45:32,932 --> 02:45:37,137 AND NOW WE MOVE TO DR. JONATHAN 4337 02:45:37,137 --> 02:45:42,542 PAWLICK. 4338 02:45:42,542 --> 02:45:43,910 >> GOOD AFTERNOON. 4339 02:45:43,910 --> 02:45:46,179 SO WE HAVE FIVE OTHER CONCEPTS 4340 02:45:46,179 --> 02:45:46,780 TO PRESENT. 4341 02:45:46,780 --> 02:45:48,982 THE FIRST ONE IS THE EFFECTS OF 4342 02:45:48,982 --> 02:45:51,885 HIV ON DRUG SEEKING AND 4343 02:45:51,885 --> 02:45:52,919 IMPULSIVE BEHAVIOR. 4344 02:45:52,919 --> 02:45:59,793 WHICH IS A CONCEPT I DEVELOPED. 4345 02:45:59,793 --> 02:46:02,195 WHILE SUBSTANCE USE AND HIV ARE 4346 02:46:02,195 --> 02:46:06,599 HIGHLY COMORBID DISORDERS AND 4347 02:46:06,599 --> 02:46:10,904 SUBSTANCE ABUSE EXACERBATES IT, 4348 02:46:10,904 --> 02:46:14,374 EMERGING EVIDENCE SHOW VIRAL 4349 02:46:14,374 --> 02:46:15,775 PROTEINS MIGHT HAVE EFFECTS FOR 4350 02:46:15,775 --> 02:46:18,178 SOME ADDICTIVE SUBSTANCES THE 4351 02:46:18,178 --> 02:46:19,813 KEY QUESTION IS WHETHER HIV 4352 02:46:19,813 --> 02:46:20,947 INCREASES THE SEVERITY OF THE 4353 02:46:20,947 --> 02:46:22,882 DRUG USE AND ADDICTION AND 4354 02:46:22,882 --> 02:46:24,684 UNDERSTANDING WHETHER HIV 4355 02:46:24,684 --> 02:46:26,753 INFECTION ALTERS DRUG SEEKING 4356 02:46:26,753 --> 02:46:28,488 BEHAVIOR AND IMPULSIVITY IS 4357 02:46:28,488 --> 02:46:30,123 IMPORTANT FOR BETTER MANAGING 4358 02:46:30,123 --> 02:46:33,860 THE TREATMENT OF SUD AND HIV 4359 02:46:33,860 --> 02:46:34,260 INFECTION. 4360 02:46:34,260 --> 02:46:35,762 MUCH OF OUR RESEARCH HAS BEEN 4361 02:46:35,762 --> 02:46:38,064 FOCUSED ON LOOKING WHETHER THE 4362 02:46:38,064 --> 02:46:41,334 DRUG ACTUALLY EXACERBATES HIV. 4363 02:46:41,334 --> 02:46:44,404 THIS IS SORT OF THE INVERSE OF 4364 02:46:44,404 --> 02:46:45,839 IT. 4365 02:46:45,839 --> 02:46:49,309 THE SECOND CONCEPT BY WOO IN MY 4366 02:46:49,309 --> 02:46:52,579 BRANCH IS IN VIVO RESEARCH ON 4367 02:46:52,579 --> 02:47:00,587 THE EFFECTS OF HIV EXPRESSION 4368 02:47:00,587 --> 02:47:01,287 PERSIST 4369 02:47:01,287 --> 02:47:02,655 PERSISTENCE, IT FOCUSES ON THE 4370 02:47:02,655 --> 02:47:04,357 COMPLEX INTERACTION BETWEEN 4371 02:47:04,357 --> 02:47:05,759 METHAMPHETAMINE USE AND HIV 4372 02:47:05,759 --> 02:47:08,595 DISEASE BIOLOGY IN VIVO, BECAUSE 4373 02:47:08,595 --> 02:47:11,064 MOST OF THE RESEARCH THAT WE 4374 02:47:11,064 --> 02:47:14,901 HAVE DONE IS IN IN VITRO. 4375 02:47:14,901 --> 02:47:16,970 SO IT REALLY SUPPORTS 4376 02:47:16,970 --> 02:47:19,606 MECHANISTIC STUDIES AND RESEARCH 4377 02:47:19,606 --> 02:47:21,241 CONNECTING RESEARCH OUTCOMES 4378 02:47:21,241 --> 02:47:23,243 WITH THE IN VIVO MODELS OF HIV 4379 02:47:23,243 --> 02:47:26,246 AND CLINICAL STUDIES IN PEOPLE 4380 02:47:26,246 --> 02:47:32,418 WHO HAVE HIV ACROSS THE HUMAN 4381 02:47:32,418 --> 02:47:32,685 LIFESPAN. 4382 02:47:32,685 --> 02:47:34,621 NEXT ONE IS ANOTHER CONCEPT BY 4383 02:47:34,621 --> 02:47:36,656 WOO IN MY BRANCH. 4384 02:47:36,656 --> 02:47:42,595 IT IS EXPLORING THE ROLES OF 4385 02:47:42,595 --> 02:47:44,998 ENDOCABINOIDS AND ENDOGENOUS ON 4386 02:47:44,998 --> 02:47:45,732 BRAIN DEVELOPMENT. 4387 02:47:45,732 --> 02:47:48,434 WE'RE SEEING INCREASING, WOMEN 4388 02:47:48,434 --> 02:47:52,372 ARE INCREASINGLY USING CABINOIDS 4389 02:47:52,372 --> 02:47:53,439 AND CANNABIS DURING DEVELOPMENT. 4390 02:47:53,439 --> 02:47:55,074 SO THIS INITIATIVE SEEKS TO 4391 02:47:55,074 --> 02:47:57,844 FOSTER STUDIES ON THE ROLE OF 4392 02:47:57,844 --> 02:48:00,914 THE ENDOCABINOIDS AND THE IMPACT 4393 02:48:00,914 --> 02:48:03,583 THAT AN EXOGENOUS EXPOSURE 4394 02:48:03,583 --> 02:48:05,418 DURING BRAIN DEVELOPMENT. 4395 02:48:05,418 --> 02:48:06,786 SPECIFIC PROGRAM INTERESTS 4396 02:48:06,786 --> 02:48:08,788 INCLUDE ARE THE ROLE OF THE 4397 02:48:08,788 --> 02:48:11,891 ENDOCABINOIDS AND THE GENETIC 4398 02:48:11,891 --> 02:48:14,727 EPIGENETIC REGULATION OF 4399 02:48:14,727 --> 02:48:16,429 DEVELOPMENT, THE NEURAL AND 4400 02:48:16,429 --> 02:48:22,335 GLIAL PROGRESSION AND 4401 02:48:22,335 --> 02:48:24,304 NEUROCIRCUIT AND SYNAPTIC 4402 02:48:24,304 --> 02:48:25,805 PLASTICITY AND THE EXPOSURE ON 4403 02:48:25,805 --> 02:48:27,941 THE DEVELOPING BRAIN. 4404 02:48:27,941 --> 02:48:33,146 THE NEXT CONCEPT IS BY JOHN 4405 02:48:33,146 --> 02:48:34,581 SATTERLY, LOOKING AT SUSTAINED 4406 02:48:34,581 --> 02:48:36,416 ADDICTION RECOVERY MECHANISMS, 4407 02:48:36,416 --> 02:48:38,518 ATTRIBUTES, PROCESSES AND 4408 02:48:38,518 --> 02:48:39,819 PERSISTENCE CALLED STARMAP. 4409 02:48:39,819 --> 02:48:41,120 AND THIS SEEKS TO SUPPORT 4410 02:48:41,120 --> 02:48:43,389 RESEARCH ON MECHANISMS ON 4411 02:48:43,389 --> 02:48:43,957 SUSTAINED RECOVERY. 4412 02:48:43,957 --> 02:48:47,293 AND THE LAST CONCEPT BY SUSAN 4413 02:48:47,293 --> 02:48:50,563 WRIGHT IS ON DATA INTEGRATION TO 4414 02:48:50,563 --> 02:48:54,300 REVEAL BY LOCAL PATHWAYS 4415 02:48:54,300 --> 02:48:56,469 UNDERLYING SUBSTANCE USE 4416 02:48:56,469 --> 02:48:59,038 DISORDER IT TRIES ATTEMPTS TO 4417 02:48:59,038 --> 02:49:00,640 INTEGRATE IMAGING ACROSS 4418 02:49:00,640 --> 02:49:05,278 MODALITIES DTI RESTING STATE OF, 4419 02:49:05,278 --> 02:49:07,247 MFRI AND IMAGING WITH GENETIC 4420 02:49:07,247 --> 02:49:08,414 SURVEY DATA. 4421 02:49:08,414 --> 02:49:08,681 THANK YOU. 4422 02:49:08,681 --> 02:49:17,390 QUESTIONS. 4423 02:49:17,390 --> 02:49:18,524 >> COMMENT I THINK IT'S A 4424 02:49:18,524 --> 02:49:19,692 USEFUL FIELD TO LOOK AT SOME OF 4425 02:49:19,692 --> 02:49:20,960 THE THINGS THAT ARE GOING ON 4426 02:49:20,960 --> 02:49:22,095 WITH LONG-TERM RECOVERY. 4427 02:49:22,095 --> 02:49:24,130 IT'S VERY TOUGH IN HUMAN 4428 02:49:24,130 --> 02:49:26,366 POPULATIONS TO GET LARGE 4429 02:49:26,366 --> 02:49:28,201 POPULATIONS OF PEOPLE, TO GET 4430 02:49:28,201 --> 02:49:30,570 THEM TO CHARACTERIZE THEM. 4431 02:49:30,570 --> 02:49:31,604 SO GOOD CONCEPT. 4432 02:49:31,604 --> 02:49:35,174 BY ALL MEANS. 4433 02:49:35,174 --> 02:49:35,975 >> THANKS. 4434 02:49:35,975 --> 02:49:39,479 I HAD A QUESTION ABOUT THE FIRST 4435 02:49:39,479 --> 02:49:43,149 ONE, DRUG SEEKING IS USUALLY 4436 02:49:43,149 --> 02:49:46,686 TYPICALLY IN MY WORLD ANYWAY 4437 02:49:46,686 --> 02:49:48,221 IT'S A CRIMINAL JUSTICE TERM. 4438 02:49:48,221 --> 02:49:50,356 I WAS CURIOUS ABOUT -- 4439 02:49:50,356 --> 02:49:51,925 >> THE TERMINOLOGY IS MOSTLY 4440 02:49:51,925 --> 02:49:54,494 BEING APPLIED TO ANIMAL STUDIES. 4441 02:49:54,494 --> 02:49:55,228 >> I'M SORRY. 4442 02:49:55,228 --> 02:49:59,299 >> IT'S BEING APPLIED HERE 4443 02:49:59,299 --> 02:50:01,434 ANIMAL STUDIES IN TERMS OF 4444 02:50:01,434 --> 02:50:03,069 RELAPSE, FOLLOWING EXTENSION OR 4445 02:50:03,069 --> 02:50:11,611 DRUG INDUCED RELAPSE. 4446 02:50:11,611 --> 02:50:13,112 >> DO YOU HAVE A CONCERN? 4447 02:50:13,112 --> 02:50:16,049 >> IT SEEMS AS A SOMEWHAT 4448 02:50:16,049 --> 02:50:16,983 STIGMATIZING TERM. 4449 02:50:16,983 --> 02:50:18,518 >> YOU SUGGEST THE -- 4450 02:50:18,518 --> 02:50:20,753 >> BASICALLY. 4451 02:50:20,753 --> 02:50:23,957 >> REINSTATEMENT OR -- 4452 02:50:23,957 --> 02:50:27,226 >> IF YOU HAVE ANOTHER TERM FOR 4453 02:50:27,226 --> 02:50:29,629 IT, WE'RE HAPPY TO CHANGE THE 4454 02:50:29,629 --> 02:50:30,229 TERM. 4455 02:50:30,229 --> 02:50:32,198 >> IT'S BASICALLY THE 4456 02:50:32,198 --> 02:50:32,732 INTERPLAY. 4457 02:50:32,732 --> 02:50:34,033 YOU'RE LOOKING AT THE CHRONIC 4458 02:50:34,033 --> 02:50:36,569 CONDITION AND WHETHER OR NOT THE 4459 02:50:36,569 --> 02:50:39,672 PERSON IS USING MORE SUBSTANCES 4460 02:50:39,672 --> 02:50:40,974 THAT'S THE INTERPLAY BETWEEN HIV 4461 02:50:40,974 --> 02:50:41,441 AND -- 4462 02:50:41,441 --> 02:50:44,344 >> SO THE QUESTION IS IN TERMS 4463 02:50:44,344 --> 02:50:46,379 OF THE BASIC SCIENCE MECHANISM 4464 02:50:46,379 --> 02:50:47,981 OF WHETHER THE ACTUAL PROTEINS 4465 02:50:47,981 --> 02:50:50,450 OR THE INFECTION ALTERS THE 4466 02:50:50,450 --> 02:50:56,189 REWARD PATHWAYS TO ENHANCE 4467 02:50:56,189 --> 02:51:01,027 ADDICTION OR THE COMPULSIVITY OF 4468 02:51:01,027 --> 02:51:02,762 DRUG USE. 4469 02:51:02,762 --> 02:51:04,430 I'M ASKING YOU IF YOU HAVE A 4470 02:51:04,430 --> 02:51:05,098 BETTER TITLE. 4471 02:51:05,098 --> 02:51:11,137 >> WELL WHAT YOU JUST SAID. 4472 02:51:11,137 --> 02:51:13,906 ON COMPULSIVE DRUG USE AND 4473 02:51:13,906 --> 02:51:21,414 IMPULSIVE BEHAVIOR, NOTED. 4474 02:51:21,414 --> 02:51:23,216 >> IF IT'S INDIVIDUAL ANIMAL 4475 02:51:23,216 --> 02:51:26,285 MODELS I DON'T KNOW IF YOU HAVE 4476 02:51:26,285 --> 02:51:28,488 TO LEVERAGE DRUG SEEKING. 4477 02:51:28,488 --> 02:51:31,758 THE SIGNALS, THE CUES. 4478 02:51:31,758 --> 02:51:33,760 >> THIS IS AGAIN WHERE THE 4479 02:51:33,760 --> 02:51:36,229 PRECLINICAL WORLD AND THE 4480 02:51:36,229 --> 02:51:39,665 CLINICAL WORLD RELIES BECAUSE 4481 02:51:39,665 --> 02:51:40,633 THIS IS THE TERMINOLOGY THAT'S 4482 02:51:40,633 --> 02:51:43,136 USED EVERYWHERE AND I HAD 4483 02:51:43,136 --> 02:51:47,073 ANNETTE WAS CONSIDERED 4484 02:51:47,073 --> 02:51:48,041 STIGMATIZING. 4485 02:51:48,041 --> 02:51:50,376 IS IT NOT JUST PER SE COMPULSIVE 4486 02:51:50,376 --> 02:51:52,245 BECAUSE THE COMPULSIVE YOU'RE 4487 02:51:52,245 --> 02:51:53,679 ACTUALLY TAKING THIS AND YOU 4488 02:51:53,679 --> 02:51:55,581 JUST TAKE IT COMPULSIVELY DRUG 4489 02:51:55,581 --> 02:51:57,650 SEEKING IS GETTING TO THE STAGE 4490 02:51:57,650 --> 02:52:00,019 WHERE YOU'RE GOING TO BE 4491 02:52:00,019 --> 02:52:00,353 ADMINISTERING. 4492 02:52:00,353 --> 02:52:02,321 SO IT ENTAILS OTHER COMPONENTS. 4493 02:52:02,321 --> 02:52:04,991 LET'S THINK IF THERE'S ANOTHER 4494 02:52:04,991 --> 02:52:05,391 WORD. 4495 02:52:05,391 --> 02:52:08,594 IT'S NOT JUST COMPULSIVE THAT 4496 02:52:08,594 --> 02:52:12,031 COULD BE USEFUL. 4497 02:52:12,031 --> 02:52:14,200 >> IT'S REINSTATEMENT OF DRUG 4498 02:52:14,200 --> 02:52:14,500 USE. 4499 02:52:14,500 --> 02:52:18,304 IT'S THE ACQUISITION OF DRUG USE 4500 02:52:18,304 --> 02:52:21,774 SO DRUG SEEKING TO ME NEVER -- I 4501 02:52:21,774 --> 02:52:23,810 NEVER THINK OF IT AS 4502 02:52:23,810 --> 02:52:24,143 STIGMATIZING. 4503 02:52:24,143 --> 02:52:28,414 RATHER I THINK OF THE ACTIONS, 4504 02:52:28,414 --> 02:52:33,519 BEHAVIOR OF OUR -- IF IT'S 4505 02:52:33,519 --> 02:52:35,154 STIGMATIZING IN TERMS OF THE 4506 02:52:35,154 --> 02:52:36,022 CLINICAL TIME -- 4507 02:52:36,022 --> 02:52:38,224 >> I BET I KNOW SORT OF HOW 4508 02:52:38,224 --> 02:52:39,892 YOU'RE THINKING ABOUT IT, 4509 02:52:39,892 --> 02:52:42,061 THOUGH, BECAUSE IF PATIENTS ARE 4510 02:52:42,061 --> 02:52:43,796 PEOPLE STRUGGLING WITH ADDICTION 4511 02:52:43,796 --> 02:52:45,398 ARE SEEKING A PRESCRIPTION, 4512 02:52:45,398 --> 02:52:48,034 SOMEWHERE, AND SAID, OH, THESE 4513 02:52:48,034 --> 02:52:51,237 DRUGS, SHE'S DRUG SEEKING, THAT 4514 02:52:51,237 --> 02:52:54,340 OF COURSE IS DIFFERENT THAN 4515 02:52:54,340 --> 02:52:54,674 THESE MODELS. 4516 02:52:54,674 --> 02:52:55,808 >> ARE THESE ACTUAL STUDIES? 4517 02:52:55,808 --> 02:52:56,876 >> THIS IS GOING TO BE AN 4518 02:52:56,876 --> 02:53:00,646 ANIMAL STUDY. 4519 02:53:00,646 --> 02:53:07,753 >> CALL IT BOARD -- 4520 02:53:07,753 --> 02:53:12,825 >> ON MOTIVATED DRUG. 4521 02:53:12,825 --> 02:53:15,528 >> IT DOESN'T TYPICALLY 4522 02:53:15,528 --> 02:53:15,795 CAPTURE. 4523 02:53:15,795 --> 02:53:16,696 >> CAPTURE IT. 4524 02:53:16,696 --> 02:53:18,331 >> ACTUALLY -- 4525 02:53:18,331 --> 02:53:23,736 >> NO, IT'S NOT OLD. 4526 02:53:23,736 --> 02:53:25,204 >> THEY'RE SEEKING IT -- 4527 02:53:25,204 --> 02:53:26,739 >> LET'S THINK ABOUT IT. 4528 02:53:26,739 --> 02:53:29,942 I DON'T THINK IT'S A SIMPLE ONE. 4529 02:53:29,942 --> 02:53:32,011 I THINK IT WILL BE GOOD TO ASK 4530 02:53:32,011 --> 02:53:35,414 QUESTIONS ANIMAL MODELS LIKE 4531 02:53:35,414 --> 02:53:37,316 GEORGE, WHAT OTHER WORDS COULD 4532 02:53:37,316 --> 02:53:38,284 CAPTURE IT. 4533 02:53:38,284 --> 02:53:39,819 PEOPLE WITH THESE LIVES THE 4534 02:53:39,819 --> 02:53:40,219 ANIMAL MODEL. 4535 02:53:40,219 --> 02:53:42,321 >> CAN I JUST MAKE ONE QUICK 4536 02:53:42,321 --> 02:53:42,588 COMMENT? 4537 02:53:42,588 --> 02:53:43,656 I THINK IT'S A REALLY 4538 02:53:43,656 --> 02:53:45,691 INTERESTING -- I THINK IT'S A 4539 02:53:45,691 --> 02:53:48,161 REALLY INTERESTING CONVERSATION, 4540 02:53:48,161 --> 02:53:52,465 AND BECAUSE TRYING TO FIGURE OUT 4541 02:53:52,465 --> 02:53:55,801 THE TERMINOLOGY THAT ACCURATELY 4542 02:53:55,801 --> 02:53:59,272 WILL REFLECT THE PRECLINICAL 4543 02:53:59,272 --> 02:54:01,174 ANIMAL MODELS IS REALLY 4544 02:54:01,174 --> 02:54:06,245 IMPORTANT AND ALSO I THINK WE 4545 02:54:06,245 --> 02:54:07,680 THINK ABOUT ADDICTION, SOME OF 4546 02:54:07,680 --> 02:54:10,850 THOSE TERMS THEN MAKE A LEAP 4547 02:54:10,850 --> 02:54:11,817 ACROSS INTO THE CLINICAL 4548 02:54:11,817 --> 02:54:14,287 POPULATIONS WHERE THEY TAKE ON A 4549 02:54:14,287 --> 02:54:15,922 MEANING THAT IS INCREDIBLY 4550 02:54:15,922 --> 02:54:19,158 HIGHLY STIGMATIZED, LIKE DRUG 4551 02:54:19,158 --> 02:54:20,660 SEEKING IS WITHIN CLINICAL 4552 02:54:20,660 --> 02:54:22,528 POPULATIONS VERY STIGMATIZED. 4553 02:54:22,528 --> 02:54:24,297 SO IT'S JUST -- WE'RE NOT GOING 4554 02:54:24,297 --> 02:54:25,998 TO SOLVE THIS HERE, BUT IT IS 4555 02:54:25,998 --> 02:54:28,467 ONE OF THESE REALLY INTERESTING 4556 02:54:28,467 --> 02:54:29,769 CONVERSATIONS BECAUSE WE ALL 4557 02:54:29,769 --> 02:54:33,372 KNOW THE LANGUAGE IS REALLY 4558 02:54:33,372 --> 02:54:33,639 IMPORTANT. 4559 02:54:33,639 --> 02:54:36,175 AND SO I'M TRYING TO FIGURE OUT 4560 02:54:36,175 --> 02:54:38,177 WHAT'S GOING TO BE ACCURATE WHEN 4561 02:54:38,177 --> 02:54:42,114 YOU'RE STUDYING ANIMAL MODELS, 4562 02:54:42,114 --> 02:54:43,216 BUT RECOGNIZING IN FACT -- I 4563 02:54:43,216 --> 02:54:44,584 DON'T KNOW HOW TO SOLVE THAT 4564 02:54:44,584 --> 02:54:46,886 PROBLEM, RECOGNIZING IN FACT THE 4565 02:54:46,886 --> 02:54:48,788 TERMINOLOGY TAKES A LEAP OVER 4566 02:54:48,788 --> 02:54:51,591 INTO CLINICAL SCIENCE AND THEN A 4567 02:54:51,591 --> 02:54:53,526 LEAP INTO POLICY AND 4568 02:54:53,526 --> 02:54:54,527 STIGMATIZING POPULATIONS. 4569 02:54:54,527 --> 02:54:57,230 SO WE'RE NOT SOLVING IT TODAY, 4570 02:54:57,230 --> 02:54:59,165 BUT I THINK THE CONVERSATION'S 4571 02:54:59,165 --> 02:54:59,999 INCREDIBLY IMPORTANT JUST IN 4572 02:54:59,999 --> 02:55:01,267 TERMS OF HOW WE THINK OF THE 4573 02:55:01,267 --> 02:55:04,337 SCIENCE OF ADDICTION, YOU KNOW? 4574 02:55:04,337 --> 02:55:06,038 >> YOU HAVE SOME MORE THOUGHTS. 4575 02:55:06,038 --> 02:55:09,475 PLEASE CONTACT ME OR NORA AND -- 4576 02:55:09,475 --> 02:55:11,544 >> ABSOLUTELY, WE'LL WORK ON 4577 02:55:11,544 --> 02:55:11,711 IT. 4578 02:55:11,711 --> 02:55:13,579 ACTUALLY THE CONCEPT YOU HAVE 4579 02:55:13,579 --> 02:55:15,147 TERMS THAT ARE BASICALLY VERY 4580 02:55:15,147 --> 02:55:16,716 NEUTRAL THEN THEY GET INTO A 4581 02:55:16,716 --> 02:55:17,917 CONTEXT AND IF SOMETHING 4582 02:55:17,917 --> 02:55:20,186 HAPPENS, THEN THEY BECOME 4583 02:55:20,186 --> 02:55:20,519 STIGMATIZING. 4584 02:55:20,519 --> 02:55:21,287 THE LANGUAGE IS SOMETHING THAT 4585 02:55:21,287 --> 02:55:25,224 IS CHANGING AND IS VERY MUCH 4586 02:55:25,224 --> 02:55:28,261 DEPENDENT ON CIRCUMSTANCES AND 4587 02:55:28,261 --> 02:55:28,494 CULTURE. 4588 02:55:28,494 --> 02:55:31,297 SO I ACTUALLY WOULD AGAIN 4589 02:55:31,297 --> 02:55:32,932 SEEK -- THE FIRST TIME, JUST 4590 02:55:32,932 --> 02:55:35,801 LIKE SEEKING. 4591 02:55:35,801 --> 02:55:39,639 I'M GOING TO BE SEEKING ADVICE 4592 02:55:39,639 --> 02:55:40,740 FOR GETTING ALTERNATIVE 4593 02:55:40,740 --> 02:55:43,876 TERMINOLOGIES THAT WILL REFLECT 4594 02:55:43,876 --> 02:55:45,544 WHAT WE WANT TO DO, BECAUSE 4595 02:55:45,544 --> 02:55:46,812 CREATING THAT ENHANCED 4596 02:55:46,812 --> 02:55:50,049 MOTIVATION FOR THE DRUG WHICH 4597 02:55:50,049 --> 02:55:52,551 WILL LEAD WHAT THESE MODELS ARE 4598 02:55:52,551 --> 02:55:53,819 TO DO TO SEEK TO CHANGE 4599 02:55:53,819 --> 02:55:55,154 BEHAVIORS TO ENRICH IT. 4600 02:55:55,154 --> 02:55:56,322 I GUESS SOMEONE WHO IS GOING 4601 02:55:56,322 --> 02:55:57,590 INTO THE PHARMACIES TO GET THEIR 4602 02:55:57,590 --> 02:55:59,125 MEDICATION IS DOING BECAUSE THEY 4603 02:55:59,125 --> 02:56:00,593 ARE SEEKING IT. 4604 02:56:00,593 --> 02:56:01,827 IT STARTS TO GET ALCOHOL. 4605 02:56:01,827 --> 02:56:03,462 THEY'RE SEEKING THE DRUG. 4606 02:56:03,462 --> 02:56:05,898 >> THERE COULD BE ENHANCED DRUG 4607 02:56:05,898 --> 02:56:11,103 MOTIVATION, ENHANCED DRUG USE. 4608 02:56:11,103 --> 02:56:11,937 >> IT'S MOTIVATION. 4609 02:56:11,937 --> 02:56:15,374 >> NO, WE'RE NOT GOING TO SOLVE 4610 02:56:15,374 --> 02:56:15,541 IT. 4611 02:56:15,541 --> 02:56:17,109 >> WE'RE NOT GOING TO TRY TO 4612 02:56:17,109 --> 02:56:18,611 SOLVE IT HERE. 4613 02:56:18,611 --> 02:56:21,147 SO I THINK THE WAY THAT SHELLY 4614 02:56:21,147 --> 02:56:24,283 BROUGHT IT UP IS VERY GOOD. 4615 02:56:24,283 --> 02:56:27,186 IN TERMS OF WHAT WE'RE USING IN 4616 02:56:27,186 --> 02:56:30,589 THE CLINICAL WORLD WE NEED TO BE 4617 02:56:30,589 --> 02:56:32,258 MINDFUL THEY CAN HAVE 4618 02:56:32,258 --> 02:56:32,958 STIGMATIZED PERSPECTIVES IN THE 4619 02:56:32,958 --> 02:56:34,527 CLINICAL WORLD AND UNDERSTANDING 4620 02:56:34,527 --> 02:56:37,029 HOW TO USE THEM PROPERLY. 4621 02:56:37,029 --> 02:56:38,831 WE ALSO UNDERSTAND THAT LANGUAGE 4622 02:56:38,831 --> 02:56:39,098 CHANGES. 4623 02:56:39,098 --> 02:56:41,067 >> COULD I MAKE A COMMENT? 4624 02:56:41,067 --> 02:56:43,069 >> ABSOLUTELY, YES. 4625 02:56:43,069 --> 02:56:45,004 >> ACKNOWLEDGING THAT WE'RE NOT 4626 02:56:45,004 --> 02:56:47,340 GOING TO SOLVE IT. 4627 02:56:47,340 --> 02:56:50,476 WOULD IT BE POSSIBILITY TO 4628 02:56:50,476 --> 02:57:00,186 INCLUDE IN THE ACKNOWLEDGMENT OF 4629 02:57:00,186 --> 02:57:01,554 STIGMATIZATION, IF WE DON'T DO 4630 02:57:01,554 --> 02:57:03,656 THAT IS FOR THIS AND OTHER 4631 02:57:03,656 --> 02:57:03,889 WORDS. 4632 02:57:03,889 --> 02:57:04,657 >> WE CAN. 4633 02:57:04,657 --> 02:57:06,692 IF YOU FEEL THERE'S CERTAIN 4634 02:57:06,692 --> 02:57:07,827 TERMS WE HAVE THAT COULD BE THE 4635 02:57:07,827 --> 02:57:10,229 POTENTIAL FOR STIGMATIZING, 4636 02:57:10,229 --> 02:57:11,731 ABSOLUTELY, WE'RE REQUESTING 4637 02:57:11,731 --> 02:57:13,099 PROPOSAL THAT'S NOT WORTH HUMAN 4638 02:57:13,099 --> 02:57:16,736 STUDIES BUT THAT COULD BE A 4639 02:57:16,736 --> 02:57:17,837 MISUSE. 4640 02:57:17,837 --> 02:57:19,505 WE CAN DEFINITELY LOOK A 4641 02:57:19,505 --> 02:57:21,941 CLARIFYING STATEMENT NOT JUST 4642 02:57:21,941 --> 02:57:24,744 FOR THIS ONE, BUT FOR OTHERS 4643 02:57:24,744 --> 02:57:27,980 EMERGING IN THE FUTURE. 4644 02:57:27,980 --> 02:57:31,117 JUST A SUGGESTION. 4645 02:57:31,117 --> 02:57:32,151 >> THANKS VERY MUCH. 4646 02:57:32,151 --> 02:57:36,255 I DIDN'T SEE ANY HANDS ON OUR 4647 02:57:36,255 --> 02:57:40,526 CLOUD PARTICIPANTS. 4648 02:57:40,526 --> 02:57:41,794 NOW IT IS 4:15. 4649 02:57:41,794 --> 02:57:43,362 WE'RE GOING TO GO TO THE NEXT 4650 02:57:43,362 --> 02:57:43,662 STAGE. 4651 02:57:43,662 --> 02:57:45,231 WE CAN JUMP INTO PUBLIC COMMENTS 4652 02:57:45,231 --> 02:57:45,731 AT THIS POINT. 4653 02:57:45,731 --> 02:57:46,999 SO AT THIS POINT I'M GOING TO 4654 02:57:46,999 --> 02:57:48,734 ASK IF THERE ARE ANY MEMBERS OF 4655 02:57:48,734 --> 02:57:50,536 THE PUBLIC THAT WISH TO COMMENT. 4656 02:57:50,536 --> 02:57:52,671 IF THAT IS THE CASE, PLEASE 4657 02:57:52,671 --> 02:57:54,540 INTRODUCE YOURSELF AND KEEP YOUR 4658 02:57:54,540 --> 02:57:56,342 COMMENTS TO UNDER THREE MINUTES. 4659 02:57:56,342 --> 02:57:59,445 MEMBERS OF THE PUBLIC NOT IN THE 4660 02:57:59,445 --> 02:58:02,581 ROOM WHO WISH TO EXPRESS ON ANY 4661 02:58:02,581 --> 02:58:05,885 ITEMS DURING THIS MEETING MAY DO 4662 02:58:05,885 --> 02:58:07,386 SO WRITING TO DR. SUSAN WHITE 4663 02:58:07,386 --> 02:58:08,621 THE EXECUTIVE SECRETARY WITHIN 4664 02:58:08,621 --> 02:58:09,822 TEN DAYS OF THE MEETING. 4665 02:58:09,822 --> 02:58:11,624 SO IF THERE'S ANY MEMBER OF THE 4666 02:58:11,624 --> 02:58:14,693 PUBLIC THAT WANTS TO SPEAK NOW, 4667 02:58:14,693 --> 02:58:18,164 PLEASE COME TO THE MICROPHONE, 4668 02:58:18,164 --> 02:58:19,231 INTRODUCE YOURSELVES AND POSE 4669 02:58:19,231 --> 02:58:20,433 YOUR QUESTION. 4670 02:58:20,433 --> 02:58:30,643 OR COMMENT. 4671 02:58:34,447 --> 02:58:35,448 I DON'T THINK WE HAVE ANY 4672 02:58:35,448 --> 02:58:36,615 COMMENTS. 4673 02:58:36,615 --> 02:58:38,250 I DIDN'T GET ANY WRITTEN 4674 02:58:38,250 --> 02:58:38,751 BEFOREHAND. 4675 02:58:38,751 --> 02:58:43,823 THAT MEANS THAT WE CAN ADJOURN. 4676 02:58:43,823 --> 02:58:45,090 YES, WE HAVE TIME TOMORROW. 4677 02:58:45,090 --> 02:58:47,159 YOU WANT TO GUIDE US, WE START 4678 02:58:47,159 --> 02:58:47,526 AT 10:00 A.M. 4679 02:58:47,526 --> 02:58:49,028 >> WE START AT 10:00 A.M. AND 4680 02:58:49,028 --> 02:58:50,396 IT'S IN A DIFFERENT -- WE START 4681 02:58:50,396 --> 02:58:52,431 AT 10:00 A.M. AND IT'S IN A 4682 02:58:52,431 --> 02:58:53,833 DIFFERENT PLACE. 4683 02:58:53,833 --> 02:58:56,902 THE ADDRESS IS 5700 ROCKLESS 4684 02:58:56,902 --> 02:58:59,171 DRIVE YOU SHOULD HAVE THAT 4685 02:58:59,171 --> 02:59:01,040 INFORMATION ON THE AGENDA. 4686 02:59:01,040 --> 02:59:04,176 AND WE MAY NEED TO TAKE -- IT'S 4687 02:59:04,176 --> 02:59:06,946 SEVERAL MILES FROM THE HOTEL BUT 4688 02:59:06,946 --> 02:59:11,150 YOU MAY NEED TO TAKE -- 4689 02:59:11,150 --> 02:59:14,453 >> BY THE WAY, IT'S REALLY NICE 4690 02:59:14,453 --> 02:59:16,989 THAT THE MARRIOTT THEY HAVE 4691 02:59:16,989 --> 02:59:19,124 SUPERS IN THE CIRCLE. 4692 02:59:19,124 --> 02:59:19,325 UBERS. 4693 02:59:19,325 --> 02:59:21,227 ONE MINUTE. 4694 02:59:21,227 --> 02:59:22,661 >> ONE MINUTE. 4695 02:59:22,661 --> 02:59:26,432 SOMEONE'S READING MY MIND. 4696 02:59:26,432 --> 02:59:27,833 >> I THINK IT'S NICE OUT. 4697 02:59:27,833 --> 02:59:30,269 MAY BE GOOD TO TAKE A WALK. 4698 02:59:30,269 --> 02:59:32,438 ANYWAY, I LOOK FORWARD TO SEEING 4699 02:59:32,438 --> 02:59:33,105 YOU TOMORROW. 4700 02:59:33,105 --> 02:59:34,874 YOU'LL ALSO HEAR THE UPDATES ON 4701 02:59:34,874 --> 02:59:38,210 THE ABCD STUDY AND A LITTLE BIT 4702 02:59:38,210 --> 02:59:41,714 ON THE HBD STUDY AS WELL AND 4703 02:59:41,714 --> 02:59:43,849 DATA ON SOME OF OUR AGENCY AND 4704 02:59:43,849 --> 02:59:45,317 THE INVESTIGATORS THAT WE'VE 4705 02:59:45,317 --> 02:59:48,287 BEEN TALKING ABOUT HOW THEY USED 4706 02:59:48,287 --> 02:59:48,787 ABC BEFORE. 4707 02:59:48,787 --> 02:59:49,722 >> THANKS VERY MUCH. 4708 02:59:49,722 --> 02:59:52,324 AND HAVE A NICE EVENING AND LOOK 4709 02:59:52,324 --> 02:59:53,893 FORWARD TO SEEING YOU TOMORROW. 4710 02:59:53,893 --> 02:59:54,360 >> THANK YOU. 4711 02:59:54,360 --> 02:59:54,727 >> THANKS. 4712 02:59:58,898 --> 03:00:08,941 4:16.