By Dennis Miller, BHC Senior Writer

In an effort to address the growing problem of substance abuse and related problems among military personnel, two major federal agencies have joined forces to launch a major research initiative. The National Institute on Drug Abuse (NIDA), part of the National Institutes of Health, in partnership with two other NIH Institutes ― the National Institute on Alcohol Abuse and Alcoholism (NIAAA), and the National Cancer Institute (NCI) ― is collaborating with the Department of Veterans Affairs (VA) to launch a first-of-its-kind joint funding project to support research on substance abuse and its associated problems among U.S. military personnel, veterans and their families.

The inter-agency initiative will make available a $7 million pool to fund research into the unique needs of military personnel returning from the wars in Iraq and Afghanistan. The idea of a cross-agency collaboration was first suggested at a meeting held in January about the complex interplay of problems faced by military personnel and their families, which include traumatic brain injury, post traumatic stress disorder, depression, anxiety, sleep disturbances, and substance abuse of tobacco, alcohol and other drugs. The combination of these problems ― any one of which individually would pose a serious challenge to most people ― have been particularly devastating to military personnel and their families. Yet little research has been done on the cascade of problems this combination of wartime-related issues is causing servicemembers and their families.

Organizers hope the collaboration will allow each agency to bring its strengths and expertise to bear on these issues and fund research to foster a broader understanding of the interplay of all of these forces on military personnel and develop better coordinated prevention and treatment strategies. Grant applications will be reviewed by an NIH review panel, with each agencies funding grants in line with its respective mission. NIDA will fund $2 million; NIAAA $2 million, NCI $1 million and the VA $2 million. The deadline for grant applications is December 22, 2009.

Behavioral Health Central recently spoke about this unique collaboration with Eve Reider, Ph.D., Acting Branch Chief of the Preventive Research Branch in the Division of Epidemiology Services and Prevention Research at the National Institute on Drug Abuse. Dr. Reider has been closely involved with the initiative since it was first proposed in January and was instrumental in making it a reality.

To listen to the interview, click the audio icon above. The following is a written transcript:

BHC: This is Dennis Miller of Behavioral Health Central. I'm speaking with Dr. Eve Reider, Acting Branch Chief of the Preventive Research Branch in the Division of Epidemiology Services and Prevention Research at the National Institute on Drug Abuse, about a unique new $7-million partnership between various institutes of the National Institutes of Health (NIH) and the Veterans Administration (VA), to conduct research on substance abuse and associated problems among military personnel, veterans and their families.

Dr. Reider thank you for joining us today.

Eve Reider: Thank you. This is great.

BHC: Tell us about this new inter-agency project ― what it is, how it came about and what its goals are.

ER: It's called the Request for Applications, and it's focused on the military veterans and their families. And the focus is substance use and abuse and associated problems. And we're very excited. This represents the second step in an initiative that we have been doing with the military and veterans for the past year. We had a meeting in January, a multi-agency meeting that included the DOD, which is the Department of Defense, the Veterans Administration, and other NIH agencies, and it focused on epidemiology, prevention and treatment of substance abuse and comorbidities.

It was a very exciting meeting. Basically, the idea of it was to bring these agencies together in terms of scientific expertise and knowledge so that we can best help our troops, the returning veterans and their families. And so, from that meeting, we now have this RFA (Request for Applications). It's $7 million, and it involves the Veterans Administration, the National Institute on Drug Abuse, National Institute on Alcoholism and Alcohol Abuse, and the National Cancer Institute. And we would like people to submit applications on epidemiology, etiology, prevention, and treatment of substance abuse in U.S. military personnel, veterans and their families. We're very excited about it.

BHC: Is it relatively common for different NIH institutes to collaborate between themselves and with other federal agencies such as you're describing here?

ER: Well, certainly, collaborations go on all the time. This is unique in terms of it being focused on substance abuse and associated problems and involving the Department of Defense, Veteran's Affairs and various NIH institutes. And it's been a great collaboration from the beginning.

We're just very happy that it's happening, because clearly the DOD and the VA are the experts on the military and the veterans, and we bring expertise in terms of substance abuse, and other agencies bring their areas of expertise, So, by bringing us all together to work on these things, there's coordination of efforts as well as pooling of resources and money to move things forward for these populations.

BHC: What type of research do you envision being funded under this initiative?

ER: It's all researcher-initiated, so it's whoever wants to submit something, and then it would be reviewed by scientific panels, and then they'd decide the best areas which should be funded. But the types of things could be a broad array of things. It could be research on families looking at the impact of deployment on families and the best ways to help prevent problems including substance abuse and associated mental health problems in families; it could be prevention of substance abuse problems in military across the deployment cycle; it could be drug abuse treatment for either military personnel or veterans.

BHC: Was this funding made available through some special action by Congress? Is it part of the Recovery Act? Or is this just using the agency's general funding to promote this kind of research?

ER: It's using the agency's general funding for the research. And basically, I would say, it comes out of the meeting that we had in terms of all of these agencies being involved and working together and deciding that it would be important for each of them to contribute.

BHC: What are some of the major issues that are being faced by returning war veterans and their families?

ER: Well there's a lot of complexities regarding substance use and abuse in the military cultures. So there's a zero tolerance regarding drug use, there's a stigma regarding getting drug abuse and mental health treatment, there's issues regarding the impact of obtaining treatment on one's career, one's military career like things like security clearance, and there's no confidentiality of medical records. So these are the complexities regarding just drug use and abuse.

And then, we've been learning some things as time has gone along. There's a great study that's going on called the Millennium Cohort Study. This is a 21-year epidemiological study that started in 2001. They've been following military people over time, and it's large numbers so they can really get a handle on some of the things that are going on since the start of the war efforts in Iraq and Afghanistan.

So some of it is that they're finding out there are problems with alcohol abuse ― particularly in the Reserve and the National Guard ― and that some of this is related to combat exposure. There are problems with post-traumatic stress disorder, and they're also finding that combat exposure is key to some of these mental health problems. And other difficulties include tobacco, particularly for those people who were using tobacco before, as well as some people starting. And an increase in relationship problems. The longer people are deployed, the more they're having problems in their relationships at home. And that's from a different study, that finding is, but there are a lot of concerns about how things are going at home.

BHC: Dr. Reider, was there a sense behind this initiative that efforts to address these problems separately within the various silos each NIH agency typically deal with were perhaps too fragmented, when a more holistic approach was what was needed?

ER: There are a lot of agencies and a lot of people involved, and it was just a sense that ― I think the biggest piece is that we do research and so we know a lot about substance abuse in terms of prevention and treatment from the research that we've been doing. And so we have information about that. And it's more about, we know about evidence-based prevention and treatment programs, and so can some of this knowledge that we've learned be utilized in these different settings?

I'm in the Prevention Research Branch and we know a lot about preventing drug use and abuse and use, and we know a lot about family programs, so our thinking is we have some programs that we know work, and could they be adapted to work with military families? So it's more like, can people use some of the expertise that we have and can it work in different settings?

BHC: How can researchers go about getting more information about applying for this funding and the process they need to follow?

ER: We have funding opportunity announcements in the NIH Guide. They certainly can call me and I can hear their ideas and set them up with the right people to talk to about applications. It's on the web ― there are people they can talk to. We're just very excited to get people's applications.

BHC: What do you hope to be the ultimate outcome of this initiative?

ER: That we fund some really great projects and that they're helpful to people. And that we can continue to be doing this, to be helpful to our troops, veterans and their families, so that they can do as well as possible across the deployment cycle.

BHC: Well, great. Anything we didn't touch on here that you feel like you'd like to mention in closing?

ER: No, we're just looking forward to people submitting. We're very excited about this initiative.

BHC: Well, Dr. Reider, I really want to thank you for talking to us today about this.

ER: Thank you.

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