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Archive for May 2015

Science Policy Around the Web – May 29, 2015

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By: Julia Shaw, Ph.D.

Pills prepared for H.I.V. patients in Thailand. Credit: Taylor Weidman/Getty Images

Global Health – Treatment for HIV

H.I.V. Treatment Should Start at Diagnosis, U.S. Health Officials Say

The Strategic Timing of Antiretroviral Treatment (Start) trial, the largest clinical trial evaluating the benefits of early antiretroviral treatment for HIV, was ended prematurely after interim analyses revealed a 53% reduction in AIDS-related death or illness in subjects who began taking antiretroviral drugs at diagnosis compared to those who started only after their CD4 T cell counts in blood dropped below 350 cells/ml or after succumbing to an AIDS-related event like infection with an opportunistic pathogen. Although the news is not a surprise to those working in the HIV field, according to the director of the National Institute for Allergy and Infectious Disease, Dr. Anthony Fauci, for those who may have been exposed to the virus it is “another incentive to seek out testing and start therapy early, because you will benefit.” Additionally, those on a consistent regimen of anti-HIV drugs are over 90% less likely to infect others.

As of 2014, only 13 million out of an estimated 35 million infected with HIV were on antiretroviral treatment. Experts estimate identifying and treating all HIV positive individuals would cost at least three-times the amount currently donated through organizations like The Global Fund to Fight AIDS, Tuberculosis and Malaria and the President’s Emergency Plan for AIDS Relief. Aside from the cost of drugs, in the United States — where only 30% of those infected take antiviral drugs consistently — many still fear drug side-effects yet most modern formulations do not have the harsh side-effects of the earlier generation of drugs. When the study began in 2009, guidelines set forth by the Centers for Disease Control and Prevention recommended starting therapy when a patient’s CD4 count fell below 500. The World Health Organization suggested waiting until the count fell below 350. This study provides strong evidence that in terms of lives saved, earlier treatment is clearly effective. (Donald G. McNeil Jr., The New York Times)

The Environment – Clean Water

President Obama asserts power over small waterways

The Environmental Protection Agency (EPA) and Army Corps of Engineers have finalized their proposal for the controversial “waters of the United States rule”, a rule designed to clarify which waterways are protected by the Clean Water Act. Past Supreme Court decisions have questioned whether small tributaries, streams, and wetlands were subject to the regulations of the Clean Water Act, prompting the construction of this new rule. Republicans and like-minded businesses fear excessive federal involvement and regulation of minor waterways, ditches and puddles. However Gina McCarthy, head of the EPA, maintains the rule will “protect the streams and wetlands that one in three Americans rely on for drinking water . . . This rule will make it easier to identify protected waters and will make those protections consistent with the law as well as the latest peer-reviewed science.” McCarthy further contends the federal government’s jurisdiction would increase less than 3% and that the rule does not hamper agriculture or remove existing exemptions for farmers, ranchers, or foresters, frequently the most vocal opponents to the rule. Despite efforts in both the House and Senate to overturn the rule, President Obama stands firmly in support of the new regulations stating, “Too many of our waters have been left vulnerable to pollution.” (Timothy Cama, The Hill)

International Funding for the Sciences

Russian foundation tarred with ‘foreign’ label

Russia’s foreign agent law was enacted in 2012, targeting nongovernmental organizations concerned with human rights and free elections. The law forces burdensome reporting requirements and necessitates that any materials produced by the organization indicate that a foreign agent produced them. On Monday, the Russian government identified the Dynasty Foundation, a nonprofit based in Moscow and one of the country’s leading science foundations supporting science education and early-career scientists, as a “foreign agent.” The ruling was made despite a petition organized by 28 members of the Russian Academy of Sciences (RAS) arguing that the foundation’s work is fully transparent and “has nothing to do with advocacy of foreign states’ interests.” Funding for the foundation is heavily dependent on its founder, Dmitry Zimin, a Russian telecom tycoon who regularly transfers funds, some $10 million per year since its inception in 2002, from his offshore accounts to the foundation. President Putin’s spokesperson, Dmitry Peskov, stated that if Dynasty “gets money from abroad, then it is a foreign agent” which is subject to the foreign agent law. In response, Zimin has threatened to stop funding the institution. A meeting of Dynasty officials set for June 8th will decide the foundation’s future. (Vladmir Pokrovsky, Science Insider)

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May 29, 2015 at 9:00 am

To bee or not to bee: Protecting pollinators through national action

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By: Lynn Mirigian, PhD

One in every three bites of food we take can be attributed to the work of a honeybee, or less often, to another pollinator. Apples, almonds, avocados, and strawberries are just a few crops that require pollinators, but pollinator populations are seriously declining. The 70 billion dollar global (USA-15 billion) crop industry that is fueled by pollinators is being threatened by dwindling pollinator populations.1, 2 In addition, loss of pollinators may pose public health risks. In developing nations, for example, it is hypothesized that a decrease in pollinators could lead to an increase in Vitamin A deficiency which could double the risk of mortality from malaria, measles, and diarrhea.3 Because of the serious economic and public health consequences of pollinator population collapse, an inter-agency task force directed by President Obama has announced the National Strategy to Promote the Health of Honey Bees and Other Pollinators.

Honey bee colonies were first introduced to the US in the early 1600’s and are now commercialized. There are between 2,000-3,000 professional US beekeepers employed for both pollination services and to support honey production.1 In addition to honey bees, 4,000 wild bee species, as well as butterflies, bats, birds, and other animals function as pollinators in the US.4 Numerous species of bees live alone in isolation, but many key pollinators exist as a superorganism in a colony. The colony is supported by a queen, who mates with ~20 reproductive drones early in life to provide a lifetime supply of sperm, and the queen lays all of the eggs the colony needs for up to 4 years. The vast majority of bees produced in the colony are worker bees, following a career trajectory of hive and brood maintenance then foraging duties. Foraging bees collect pollen and nectar as a protein and carbohydrate source, respectively. Attracted to brightly colored flowers, bees travel from flower to flower, collecting food but also transferring pollen to facilitate plant reproduction (i.e. fruit formation). Colony success and survival is predicated on all members collectively working together. Over the past 3 decades, honey bee populations have dwindled for reasons only partially understood.

One challenge to healthy bee populations is habitat loss and reduced availability of diverse foraging and nesting resources. These problems likely arise from increased pesticide usage. Insecticides and herbicides are commonly used in commercial agriculture and are highly toxic to pollinators, such as honey bees. Herbicides can be harmful for bees’ survival, by killing valuable “weeds” that are both potential nesting sites and valuable food sources that improve pollen diversity necessary for bee health and proper nutrition. Besides herbicide usage, habitat transformation can also cause malnutrition, which affects gene expression in worker bees,5 and increases lethality to pesticides.6 Since specifics behind the ideal honey bee habitat and nutrition remain unknown, implementing large scale changes and policy is not yet realistic. Experiments are ongoing to determine whether buffer zones between commercial agriculture fields and bee colonies or planting tailored seed mixes to improve habitat will positively affect bee colony success.

Most relevant to honey bees, neonicotinoids are a class of insecticides used on rapeseed, which is used to make canola oil. Although neonicotinoids are coated onto seeds in an attempt to eliminate direct contact with pollinators, they can still affect bees in two ways. The insecticide dust created during planting kills the bee immediately upon exposure, and small amounts of the toxin remain in the nectar and pollen of the mature rapeseed plant. The toxicity of these trace amounts of neonicotinoids on bees has been hotly contested, demonstrating the need for further research. Research suggests that even small amounts of neonicotinoids can impact a bee’s brain function and prevent them from foraging well or being able to return home,7 however scientists still do not understand how much insecticide bees actually ingest and how often they are exposed to these chemicals in their native environments. In the absence of a more complete picture of bees’ experiences in their natural habitats, it is difficult to propose bee-safe farming insecticide practices.

Besides pesticide use and habitat transformation, arthropod pests, pathogens, and colony collapse disorder (CCD) represent additional factors underlie recent reductions in bee numbers. The Varroa destructor mite feeds on honeybee blood (hemolymph), grows its young on developing bees, and can increase bees’ susceptibility to viruses. As a potential protective mechanism, some bees possess a behavioral trait (varroa sensitive hygiene) that drives them search out and cannibalize developing bees that have been infected with the young mites. Breeding for this trait is an avenue of research currently being pursued. A large problem in preventing the spread of pests and pathogens is that most bee colonies travel throughout different parts of the US. For example, 60-70% of all commercial bee colonies are relocated to almond orchards every spring, a large majority of which are in California.8 So many bee colonies in one place can lead to disease spread, compounded by the fact that wild bees can also become infected.9 Finally, CCD, a syndrome in which there is a rapid loss of adult worker bees not attributed to parasite or disease, has claimed numerous bee colonies in the past few years. While CCD is still not well understood, the proportion of losses due to the disorder has been reducing each year.

The multiple causes of honey bee decline are addressed in the National Strategy to Promote the Health of Honey Bees and Other Pollinators. This strategy recommends a 34 million dollar budget increase in 2016 from 2015. Pertaining to the honey bee, the plan’s goals are to “Reduce honey bee colony losses during winter to no more than 15% within 10 years” and “Restore or enhance 7 million acres of land for pollinators over the next 5 years through Federal actions and public-private partnerships.” To achieve those goals the task force proposes the following:

  • The Pollinator Research Action Plan
  • The Pollinator Best Practice Management Guidelines for Federal Building and Designed and Natural Landscapes
  • The National Seed Strategy for Rehabilitation and Restoration
  • A public outreach and education strategy

Previous strategies to address honeybee decline have been ongoing since 2007 and have seen little success, as made evident by the continued decline of the honeybee population. This National Strategy hopes to achieve what other programs have failed to do by expanding past plans, collaborating between multiple federal agencies and the private sector, and by supporting numerous research initiatives to determine the precise reasons for declining bee numbers by making evidence-based recommendations for how to restore pollinator populations.

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May 27, 2015 at 9:12 am

Science Policy Around the Web – May 26, 2015

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By: Sara Cassidy M.S., Ph.D

photo credit: Matti Mattila via photopin cc

Biomedical Research Funding

21st century cures chugs along

A $13 billion package (HR 6) to spur new medical cures sailed through the House Energy and Commerce Committee Thursday (5/21). The non-partisan so-called 21st Century Cures bill, authored by Fred Upton (R-MI), Frank Pallone (D-NJ), Joe Pitts (R-PA), Gene Green (D-TX) and Diana DeGette (D-CO), aims to modernize and personalize health care, encourage greater innovation, support research, and streamline the system to deliver better faster cures to more patients. The unanimous 51-0 vote sets up floor consideration for the legislation, which would overhaul how the Food and Drug Administration (FDA) evaluates new medical products and provide $10 billion in mandatory funding for the National Institutes of Health (NIH). Rep. Pitts remarked, “Today’s vote is an important next step for this committee as we work to get 21st Century Cures enacted into the law by the end of the year. I want to thank my colleagues on both sides of the aisle for their hard work to modernize our discovery, development and delivery system, which will give hope to millions of Americans for an accelerated path to cures.” Additional markups to the applauded legislation include, $550 million in mandatory funding to the FDA over five years, a mandate to the National Institute on Minority Health and Health Disparities to increase the representation of underrepresented minorities in clinical trials, and specific language on research surrounding Lyme and other tick-borne diseases. Parallel efforts in the Senate, led by the Health, Education, Labor and Pensions Chairman Lamar Alexander (R-TN) are on a much slower timeline, but Rep. Upton had said he thinks the bill could land on the president’s desk before the end of the year. (Melanie Zanona, CQ Roll Call)

Policy Development

OSTP seeks experts to weigh in on microbiome research

The Office of Science and Technology Policy (OSTP) released a Request For Information (RFI) on Wednesday (5/20) seeking advice from industry, academia, research laboratories, and other stakeholder groups involved in microbiome research. The goal of the RFI is to identify the unifying questions in microbiome research, as well as the tools, technologies, and training needed to answer these questions. OSTP is specifically looking for information matching the mission statements of multiple Federal agencies, private sector interests, and current White House Policy Initiatives. Due in large part to improved sequencing technologies over the past 10 years, human microbiome studies have exploded onto the research scene, with potential implications in human health in diverse settings such as obesity and cancer. There is currently one FDA approved microbiome based treatment, fecal microbial transplant, for the treatment of relapsing Clostridium difficile infections. However, most of the field is currently stalled in correlative associations with disease and would like to progress to causative or predictive of disease. The OSTP hopes the RFI will result in a focusing of the microbiome research field, potentially harnessing its therapeutic capacity. Responses will be accepted until 6/15/15. (American Society for Microbiology, Public Affairs Office)

Legislative policy

Senators create a new caucus specifically for the NIH

Sens. Linsdey Graham (R-SC) and Dick Durbin (D-IL) will co-chair a nascent caucus aimed at boasting funds for the National Institutes of Health (NIH). The NIH has lost 25% of its purchasing power since 2003, which the senators attribute to sequestration and flat budgets. The senators believe inadequate funding has stalled the ability of the agency to find cures for some the countries most devastating diseases, like heart disease, Alzheimer’s, and cancer. Despite the fact that many Congress members have recently publicly voiced their support for increasing the NIH budget (including Newt Gingrich and Eric Cantor), paying for it will continue to be an enormous challenge in a political climate where budget cuts and sequestration are de rigeur. And although many are in favor, none have yet proposed a way to pay for it. The other members of the caucus include Sens. Tammy Baldwin (D-WI), Richard Blumenthal (D-CN), Ben Cardin (D-MD), Robert Casey (D-PA), Joe Donnelly (D-ID), Al Franken (D-MN), Angus King (I-ME), Amy Klobuchar (D-MN), Edward Markey (D-MA), Claire McCaskill (D-MO), Jim Moran (R-KS), Gary Peters (D-MI), Brian Schatz (D-HI), and Roger Wicker (R-MS). (Sarah Ferris, The Hill)

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May 26, 2015 at 9:00 am

Science Policy Around the Web – May 22, 2015

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By: Agila Somasundaram, Ph.D.

“Ball-and-stick model of the morphine molecule, C17H19NO3.” by Ben Mills. – Own work. source

Drug Policy and Biotechnology

A Way to Brew Morphine Raises Concerns Over Regulation

Traditionally, heroin has been made from poppy – the opium from poppy seeds yields morphine, which can then be refined to heroin. However, it might soon be possible to convert sugar to morphine using genetically modified yeast. There are several steps in this conversion, and a recent study by scientists from the University of California, Berkeley, and Canada’s Concordia University, published in the journal Nature Chemical Biology, has provided the final missing one. This has triggered a debate on whether synthesis of morphine should be regulated, and if yes, how? Dr. Kenneth A. Oye, a professor of engineering and political science at M.I.T., and other experts argue that this technology could benefit the heroin trade more than the prescription painkiller industry, because drug sellers currently rely on smuggling raw materials from countries like Afghanistan and Laos, and brewing close to home would save them costs. The pharmaceutical industry, on the other hand, has a steady supply of cheap opium from countries like India and Australia, or can synthesize opiates in their own labs. Dr. Oye and others suggest that steps should be taken to prevent abuse of the synthetic approach, including restricting access to the bio-engineered yeast strains and the DNA. Biotech experts who counter these suggestions say that Dr. Oye’s precautions might be overkill, because producing morphine by fermentation using engineered yeasts is a delicate process that may not yet be ready for producing heroin in large quantities. They argue that restricting access to DNA stifles research and may not necessarily succeed in preventing a heroin synthesis epidemic. Robert H. Carlson, the author of “Biology Is Technology,” says, “DNA synthesis is already a democratic, low-cost technology. If you restrict access, you create a black market.” Because the genetically modified yeast strain is not commonly available yet, the Drug Enforcement Administration (DEA) is not too concerned about an imminent threat. But FBI Supervisory Special Agent Edward You is glad that the debate on regulating access has begun before the synthetic technology is ready. He says, “We want the people in the field to be the sentinels, to recognize when someone is trying to abuse or exploit their work and call the FBI.” (Donald G. McNeil Jr., The New York Times)

GMOs

In unusual move, German scientists lobby for GM labeling

Whether or not to label genetically modified (GM) food is a topic of huge debate, and generally, people who oppose GM food want the food labeled. In a surprising move, German scientists and other supporters of GM crops are lobbying for labeling GM crops because they want the public to know that there is nothing to be afraid of, hoping that this would make it easier for GM products to reach the consumer. This petition requests the German government to draft a law that would require labeling of all products that contain or have been produced using GM organisms. The petition was drafted by Horst Rehberger, leader of the group Forum Grüne Vernunft (Forum Green Reason), and has the support of several prominent scientists and politicians. It requires 50,000 signatures in 4 weeks to be considered by the German parliament. Though GM crops and food derived directly from them are already labeled in Germany, certain products in which genetic engineering plays an indirect role are not required to be labeled. This petition seeks to address the deficiencies in the current system. But environmental organizations like the Greenpeace are concerned that labeling all GM products, irrespective of how much genetic engineering actually went into their making, would negate the differences and could distract the public from the real issue, and make it harder for consumers to make choices. Proponents of the GM labeling say that the labels should be graded differentially, for instance, between products that contain GM organisms versus products that were processed by GM organisms. “I think we just need to be honest and transparent to consumers,” says Wilfried Schwab, a professor of biotechnology of natural products at Technische Universität München. The proposal is a chance to change the conversation about GM organisms, says geneticist Hans-Jörg Jacobsen. Modeling studies have suggested that if GM food was sold at a 15 % discount, and organic food at a 15 % premium, consumers are more likely to choose GM products. With time, a GM label could even become a positive sign, Jacobsen says. (Kai Kupferschmidt, Science Insider)

Privacy and Genomic Data

Microbiomes raise privacy concerns

The human body harbors many types of bacteria, collectively called the microbiome. The microbiome’s influence on our health has become an important topic of research. A recent study published in the Proceedings of the National Academy of Sciences suggests that it would be possible to uniquely identify an individual based on information contained in their microbiome DNA. This information could also reveal details about their health, diet or ethnicity, raising privacy concerns. Curtis Huttenhower, a computational biologist at the Harvard T. H. Chan School of Public Health in Boston, Massachusetts, and lead author of the study, says, “As the field develops, we need to make sure there’s a realization that our microbiomes are highly unique.” Huttenhower’s team investigated if microbiomes lasted long enough in humans to help identify individuals over time. They used the microbiome data publicly available through the National Institutes of Health (NIH) Microbiome Project (HMP). Though the HMP does not identify individuals by name, a participant’s first sample could be compared with a second one donated much later. The researchers found that the microbiome in a person’s stool sample offered the best signature – a person’s first sample could be linked to their second sample using microbial DNA 86% of the time, whereas skin samples could be match only about 25% of the time. But Huttenhower concludes that it would be “exceptionally challenging to do anything with the microbiome data in a single study,” and that privacy risks would come when a person participated in two different microbiome studies that each contained different pieces of identifiable information. Publicly available microbiome data poses privacy risks also because of the presence of potentially identifiable human DNA, suggests another study published recently in the journal Genome Research. A team lead by computational biologist Jonathan Allen of Lawrence Livermore National Laboratory in California has found that the HMP database has stretches of human DNA called short tandem repeats that are used in forensics to distinguish between individuals (even though NIH took measures to eliminate human DNA from the HMP as much as possible). Even if this information per se does not help form a precise DNA signature of an individual, the increase in publicly available DNA databases increases the risk. Amy McGuire, a bioethicist at Baylor College of Medicine in Houston, Texas, says that those who participated in the HMP study were advised of the risk, and that there should not be premature panic over this. Laura Rodriguez, director of policy at the NIH’s National Human Genome Research Institute, says that an overreaction could slow understanding of the microbiome, and that as long as precautions are taken to eliminate privacy concerns (such as removing human DNA from the HMP) “we would want to keep it in open access because of the value it adds to science.” (Ellen Callaway, Nature)

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May 22, 2015 at 11:00 am

Evidence-Based Treatments for Alcohol Use Disorder

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By: Sylvina Raver, Ph.D.

Alcohol use disorder, or AUD, is a medical diagnosis given to people who seriously struggle to control their drinking. Approximately 7.2% of American adults suffer from AUD, the consequences of which are hard to overstate. The Centers for Disease Control and Prevention (CDC) estimate that excessive alcohol use contributes to approximately 88,000 deaths per year, and costs the US economy billions of dollars annually in health care costs, criminal justice, automobile accidents, and lost workplace productivity. For those who seek treatment for excessive drinking – either voluntarily or through court-mandated recovery programs – the traditional treatment method has been a faith-based 12-step program, such as Alcoholics Anonymous (AA). For many people, AA is a life-saving experience. But for many others, AUD persists despite determinedly “working the 12 steps” of the program.

A recent article published by The Atlantic calls into question Americans’ reliance on 12-step programs as the primary method to treat AUD. The article’s author claims that compelling data in support of AA’s efficacy are seriously lacking, and that accumulating scientific evidence argues against many tenants of the program. In contrast to AA, which is notoriously difficult to study, many other treatments have been rigorously tested, and now have large bodies of research that support their efficacy. Since its passage in 2010, the Affordable Care Act (ACA) has mandated that health insurance plans and state-run Medicaid programs must cover substance abuse services, which include treatments for AUD, as an “essential health benefit.” However, the law does not specify which treatment programs are the most effective and thus should be covered. As private insurers and government health care programs expand coverage for AUD treatments under the ACA, it’s crucial to consider those methods that have sound experimental support and that are in accordance with what modern neuroscience tells us about disorders of alcohol use and abuse.

The precise mechanisms that underlie AUD, as well as the genetic underpinnings responsible for people’s differential susceptibility to the disease, are the focus of ongoing research, and accumulating evidence indicates an intersection between the brain’s arousal, reward, and stress systems. Early use of alcohol is pleasurable and positively reinforcing, but the drug can take on negative reinforcing qualities during the transition to dependence, as users drink to prevent negative consequences, including withdrawal symptoms. Chronic alcohol abuse leads to adaptations in brain networks and neurotransmitters that control motivation, reward, stress, and arousal. If AUD’s progression is not halted through interventions and appropriate treatments, these alcohol-induced neuroadaptations can worsen over time and contribute to the deadly nature of severe AUD.

Fortunately, treatments for AUD can be extremely effective, although many of them are not well known outside of the medical and addiction communities. The 12 steps outlined by Alcoholics Anonymous have become synonymous with treatment for alcohol abuse in the US, and are deeply entrenched in rehabilitation culture. When it was introduced in the 1930’s, AA was modern in treating alcoholism as a disease, rather than simply as a failure of moral character. However, some of its central tenants are now at odds with our current knowledge of AUD. For example, AA members are instructed to admit that they are “powerless” over alcohol and to completely abstain from drinking. While this approach may be necessary for some individuals, total alcohol abstinence can actually be detrimental to many patients’ recovery process. Basic and clinical neuroscience research has shown that complete abstinence from alcohol can actually increase one’s urge to drink, leading animals and humans to binge once they have access to alcohol again. Furthermore, the type of black-or-white dichotomy inherent to AA – either completely abstinent or not, alcoholic or not – does a disservice to the vast majority of those with AUD who land along a spectrum of problematic alcohol use. The newest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) combines two previously distinct disorders, alcohol abuse and alcohol dependence, into the single, overarching Alcohol Use Disorder (AUD). AUD is further classified as mild, moderate or severe, depending on the number of criteria that a person meets, and treatment programs must be individually adopted for the severity of one’s disorder. Approximately 15% of adults with AUD fall on the severe end of the spectrum and require intensive treatment for their disease. However, the remaining 85% fall in to the mild or moderate categories, and seem to benefit most from brief interventions by medical professionals that help them change unhealthy drinking habits.

Twelve-step programs, such as AA, are not the only options available for AUD treatment, and many approaches are supported by decades of solid research. These treatment practices are collectively called “evidence-based treatments” and can be broadly classified as pharmacotherapies and behavioral therapies. Many experts in addiction medicine believe that pharmacotherapy, or medication-assisted treatment, represents a powerful yet underutilized tool to address moderate and severe AUD. A recent panel convened by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and the Substance Abuse and Mental Health Services Administration (SAMHSA) issued a report that describes the use of FDA-approved medications in clinical practice for the treatment of AUD. These include:

  • Naltrexone (in both oral and extended-release injectable forms), which blocks opioid receptors in the brain to interfere with the rewarding effects of drinking and reduces cravings for alcohol,
  • Disulfiram, which interferes with alcohol degradation to produce an unpleasant reaction if a person drinks alcohol,
  • Acamprosate, which acts on the GABA and glutamate neurotransmitter systems to help reduce the effects of alcohol withdrawal, including anxiety, insomnia, restlessness, and dysphoria.

The NIAAA/SAMHSA panel concludes, “Medication-assisted treatment shows a lot of promise in reducing alcohol use and promoting abstinence in patients diagnosed with alcohol use disorder.”

            Behavioral therapies are also highly effective for addressing AUD, and can be combined with pharmacotherapies or pursued on their own. These approaches help people to modify their attitudes and behaviors about alcohol, become engaged in their treatment, and increase their arsenal of coping skills to better handle stressors and environmental cues that may trigger problem drinking. Evidence-based behavioral therapies for AUD include:

  • Cognitive Behavioral Therapy, which recognizes that learning processes play a central role in alcohol addiction and helps patients to enhance their self-control through developing effective coping strategies,
  • Contingency Management Interventions/Motivational Incentives, which involve giving patients tangible rewards (often financial) to reinforce positive behaviors, such as reducing their alcohol use, attending counseling sessions, and completing goal-related activities,
  • Motivational Enhancement Therapy, which helps patients resolve any ambivalence about engaging in AUD treatment to stop or reduce their alcohol use, and aims to evoke rapid and internally motivated changes, rather than guide the individual stepwise through the recovery process,
  • Community Reinforcement Approach Plus Vouchers, a 24-week outpatient therapy that uses a range of recreational, familial, social, and vocational reinforcers, combined with material incentives, to make a non-alcohol or responsible-alcohol-using lifestyle more rewarding than the alternative,
  • 12-Step Facilitation Therapy (such as Alcoholics Anonymous), which is an active engagement strategy to promote abstinence with the support of 12-step self-help groups and adherence to the principals of: 1) acceptance of the chronic, progressive nature of the disease; 2) surrender to a higher power/fellowship of the support structure; and 3) active involvement in 12-step meetings and related activities.

Of the estimated 17 million Americans who suffer from AUD, only about 13% receive any type of treatment. The ACA may have the power to drastically improve this situation with its emphasis on primary prevention, so that patients struggling with mild symptoms of AUD can be more easily identified before the disorder progresses. Addiction experts and other health care providers have identified the crucial roles that general and mental healthcare settings – including primary, urgent, and emergency care – can play in early identification of problematic alcohol use, and in providing initial brief interventions for patients. These types of early screening and intervention efforts, combined with evidence-based treatments, can provide hope to the tens of millions of Americans struggling with AUD.

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May 20, 2015 at 9:00 am

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Science Policy Around the Web – May 19, 2015

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By: Courtney Pinard, Ph.D.

Gender Bias in Science Funding

Pentagon Request for Information About Gender Bias in Grant Funding

Last year, members of the U.S. House of Representatives asked a congressional watchdog agency to analyze the issue of gender discrimination in the grantsmaking process. Six agencies were asked to report information about their applicants including the National Institutes of Health (NIH), the National Science Foundation (NSF), the National Aeronautics and Space Administration (NASA), the Department of Defense (DOD), and the Department of Energy (DOE). While the Government Accountability Office (GAO) found that both the NIH and NSF routinely report information on gender and minority status on their applicants, they found that NASA, DOD, and DOE do not report demographic information. The three agencies previously claimed that they had “no use for this information” and that their “computer systems lacked the capacity” to collect additional data on applicants. In response, the White House budget office has provided agencies with templates for the collection of demographic information to be completed by the time the final GAO report is due this fall. Today, the DOD announced that it would start collecting information on gender. Lawmakers hope to explore whether success rates at federal research agencies differ by gender. (Jeffrey Mervis, Science Insider)

Public Health

Federal Government Invests to End the Rape Kit Backlog

Every two minutes someone is sexually assaulted in the United States. With the crime of sexual assault, the victim’s body is part of the crime scene. Immediately following the assault, many victims endure an arduous process in emergency rooms and health clinics with hopes that the police will use the collected biological material as scientific evidence to accurately and quickly identify and prosecute the perpetrator. Mainly, the police use the FBI’s Combined DNA Index System (CODIS) of known offender’s DNA records to find suspects. According to a recent report, 100,000 to 400,000 untested kits remain untested nationwide. In Memphis, Tennessee alone, for example, there are 12,374 untested rape kits. The reason for this backlog is, in part, due to the cost of the tests; it costs $1,000 to $1,500 to process one rape kit. In response to lobbying efforts by advocacy groups, such as the Natasha Justice Project and the Joyful Heart Foundation, the federal government has invested $41 million to support law enforcement agencies testing backlogged rape kits. This investment will hopefully lead to the prosecution of those sexual assault perpetrators still at large. New York City has taken the lead and cleared their backlog of 17,000 rape kits, resulting in 200 prosecutions throughout the city. Now, more than 20 states have passed legislation holding jurisdictions accountable for their rape kit backlogs. (Abigail Tracy, Scientific American; Vocativ)

Climate Change

Scientists Find That Global Warming is Causing Stronger Hurricanes

Hurricane Sandy costs the U.S. over $60 billion in damages and was rated as the second costliest storm behind Hurricane Katrina. Although Sandy was rated a category 1 storm when it hit the Northeastern U.S., the size of the post-tropical cyclone created a surge typical of a much larger storm. According to a study published this week in Nature Climate Change and led by researchers at Florida State University, stronger hurricanes, like Sandy, are becoming more common with increases in ocean temperature. The study examined how both frequency and intensity of tropical cyclones vary with ocean warmth. (Angela Fritz, Washington Post; Nature)

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May 19, 2015 at 9:00 am

Science Policy Around the Web – May 18, 2015

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By: Amanda Whiting, Ph.D.

Agriculture and Food Policy

Food industry braces for Obama trans fat ban

The Food and Drug Administration (FDA) is expected to announce its final determination on the use of partially hydrogenated oils (or trans fats) in food products as early as next week. The announcement is expected to ban the use of trans fats. This potentially marks a final step in removing artificial trans fats from the American diet, a move that began in 2013 when the Obama administration issued a tentative determination stating that partially hydrogenated oils are not generally regarded as safe (GRAS). Partially hydrogenated oils are created when unsaturated liquid oils are exposed to hydrogen, which reduces their unsaturation and creates solid fats that improve food product texture and shelf life. Consumption of trans fats have been linked to cardiovascular disease and their removal could “prevent 20,000 heart attacks and some 7,000 deaths” according to FDA estimates, said Sam Kass, the former senior adviser for nutrition at the White House and executive director of Let’s Move!, to Politico. While the potential health benefits of such a policy are easily apparent, there are other repercussions to consider with a policy change such as this. Trans fats have been used in a myriad of smaller applications, such as in the sprinkles on cupcakes to prevent color leaching, to prevent baked goods from sticking to equipment, and to stabilize flavors in food products, that may not have been well considered by the FDA. Food manufacturers will need tweak their recipes and/or find alternative substances to fill the void left by a trans fat ban. In the past, they have turned to palm oil, though there are environmental concerns over rainforest deforestation to harvest the palm oil. Getting rid of trans fats is not a bad idea in terms of public health – let’s hope that its alternative does not end up having an unintended detrimental effect elsewhere. (Helena Bottemiller Evich, Politico)

Antibiotic resistance

Guarantee drug companies a profit to develop new antibiotics, U.K. report says

With the increasing, widespread and global appearance of antibiotic resistant infections, the need to develop new potent antibiotics to tackle these threats is quite clear. Once developed however, in order to prevent resistance from developing to the new drugs, their use – and in our current economic model, their sales – must be restricted and limited. This presents drug companies with a problem, since the high cost of drug research and development is often driven and funded with an eye on the potential future sales of a drug. This makes it highly economically undesirable for a drug company to spend resources to develop a drug that must then be restricted, despite the very great worldwide need for such drugs. A report commissioned by the government of the United Kingdom, seeks to fix this problem. In the report, it is suggested that global governments “unite to offer multibillion-dollar incentives for drug developers, and pharmaceutical companies should pool their billions in support of early-stage research.” Most interestingly, the report suggests a way to incentivize drug development without encouraging overuse by “de-linking” a drug company’s profits from the drug’s sales. Specific examples of how this could be accomplished include having a “designated global body” buy the rights to a new pharmaceutical (at $2-3 billion per antibiotic) and then carefully manage the worldwide supply, or having a company retain the rights to the drug but receive a “bonus” for developing and introducing it to market, while being patient with overall (rather than initial blockbuster) sales. While this would take worldwide cooperation, aligning financial incentives for drug companies with the needs public health via a unifying policy could help kick-start drug development where we need it most. (Kelly Servick, ScienceInsider)

Federal Funding

Key House Republican says 70% of NSF’s research dollars should go to “core” science—not geo or social research

Two out of the six research directorates at the National Science Foundation (NSF) have been targeted to not receive any additional funds in the 2016 federal spending bill. The current spending bill allots an additional $50 million to the overall NSF budget, much smaller than the total $379 million (or 4.3% increase) requested. The markup of the House spending bill from the Commerce, Justice, and Science (CJS) subcommittee would allow the NSF to spread the additional $50 million in funds only in areas that have been deemed “pure sciences” – namely, biology, computing, engineering, and math and physical sciences. The bill prevents NSF from funding research in geoscience and the social and behavioral sciences. Both Representative John Culberson (R–TX), chair of the CJS subcommittee, and Representative Lamar Smith (R–TX), chair of the science committee who introduced the America COMPETES Act to set NSF policies, say they support the NSF and simply want to make sure what it funds is in the “national interest.” That is all well and good, but what is in the “national interest” today may not be where the groundbreaking research of tomorrow is born. Scientific research is increasingly breaking out of such siloed classifications and into multidisciplinary fields and collaborative discovery that require inputs from all areas. While Rep. Culberson may favor funding only the “hard sciences,” understanding our own home planet and our human-to-human interactions are also areas worthy of study and research. (Jeffrey Mervis, ScienceInsider)

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Written by sciencepolicyforall

May 18, 2015 at 9:00 am