a profound effect on the hormonal control of 

 water and mineral balance. The manner in 

 which alcohol may affect the production and 

 release of hormones is not well understood 

 and needs further explication. In view of the 

 great technical and scientific advances made 

 in endocrine research, it is expected that the 

 support base for endocrine-alcohol research 

 will increase. 

 These important areas of research are expected 

 to attract increasing attention in the coming years. 

 Of special interest will be the relationship be- 

 tween these biological factors and psychosocial 

 ones. 



NIDA 



The research programs of NIDA seek to extend 

 our knowledge of the pharmacology, biochemis- 

 try, and neurophysiology of abused drugs and the 

 mechanisms involved in drug tolerance, depend- 

 ence, and addiction. The research program in- 

 cludes social as well as biomedical factors. Re- 

 search areas of current and future interest in- 

 clude: 



• Endorphin research. The discovery of endog- 

 enous morphine-like substances (endorphins) 

 in the brain of man and other vertebrates is a 

 major milestone in the efforts to understand 

 the mechanisms of action of narcotic drugs. 

 Endorphins may be involved in the addictive 

 process itself, that is, in the development of 

 tolerance and dependence in opiate (heroin) 

 addicts. "Endorphine deficiency" might be 

 identified as a genetic or acquired trait that 

 predisposes some subjects to become victims 

 of opiate dependence. The clarification of 

 this notion by intensive research efforts 

 should be of significance in developing new 

 treatment modalities or in designing better 

 and more effective prevention strategies for 

 opiate addiction. 



• A less obvious but equally exciting possibili- 

 ty is that endorphins may somehow be in- 

 volved in more general processes that control 

 normal behavior and mental health. Two re- 

 cent reports demonstrated that endorphins 

 can produce a cataleptic state in animals 

 characterized by a failure to respond to envi- 

 ronmental stimuli in a normal, functional 

 manner. The possibility that this induced 

 behavior may be an acceptable model for 

 dysfunctional states (such as schizophrenia) 

 warrants further consideration. To examine 

 this possibility, a research effort by NIDA in 

 collaboration with NIMH and/or other insti- 

 tutes is being explored. The biochemical, 

 enzymatic, neurophysiological, neuropsy- 



92 HEALTH, EDUCATION AND WELFARE 



chological, and neuropharmacological ques- 

 tions raised by the existence of these sub- 

 stances will require continuing exploration. 



• Genetic and developmental studies. The ge- 

 netic, mutagenic, and reproductive effects 

 associated with the use of abused drugs 

 alone or in combination with other drugs and 

 environmental stimuli have been studied on a 

 limited basis. Although there are no unequi- 

 vocal findings that indicate a high risk of 

 genetic damage associated with abused drugs 

 or with drugs used in treatment, a continued 

 program of investigation is necessary in this 

 important area. There are some indications 

 that abused drugs may cause some problems. 

 Preclinical studies are now underway to clari- 

 fy previous contradictory results concerning 

 the reproductive effects of marihuana. Some 

 limited studies are being carried out with 

 opiates but it is important to conduct more 

 extensive studies to include other drugs. 



• Inhalant abuse. This area of drug use exem- 

 plifies the problems associated with drug in- 

 teractions. Not only are the substances used 

 composed of mixtures, but there are poten- 

 tial interactions with other agents and condi- 

 tions (e.g., barbiturates, malnutrition). The 

 potential problems in these areas have not 

 been sufficiently investigated and should be 

 given more attention in the future. 



• Health consequences of chronic marihuana 

 use. Additional research on the effects of 

 chronic marihuana use will be necessary in 

 light of the fact that 36 million Americans 

 have tried the drug and nearly 15 million use 

 it more or less regularly. While the picture 

 regarding marihuana use is far from com- 

 plete, it should be emphasized that there is 

 good evidence that its use is by no means 

 harmless. Indeed, there is evidence that 

 many years of use by substantial numbers is 

 required for the full implications of wide- 

 spread drug use to surface. Furthermore, 

 marihuana is most widely used by adoles- 

 cents and young adults during critical stages 

 in their personality development and while 

 they are developing intellectual and psycho- 

 social skills. To what extent, if any, chronic 

 intoxication affects development is still un- 

 known. 



In light of the above, it seems imperative to 

 carry out large longitudinal epidemiological- 

 biomedical studies on the long-term health conse- 

 quences of regular marihuana use. Such studies 

 should resolve a number of questions regarding 

 the hormonal, developmental, immunological, car- 

 diovascular-pulmonary, and psychomotor conse- 

 quences of chronic use of marihuana. 



