Research and Projects

 

 

The faculty members have carried out several research projects funded by national and internationally recognized agencies like Indian Council of Medical Research (ICMR), Ministry of Health and Family Welfare, Ministry of Social Justice and Empowerment, Ministry of Finance, Council of Scientific and Industrial Research (CSIR), Department of Science and Technology (DST), WHO (India), WHO (Geneva), and United Nations Office of Drugs and Crime (UNODC). The centre has several sophisticated equipments to carry out tests on health damage and detection of drugs of abuse in body fluids, pre clinical laboratory experiments and behavioural pharmacology on drugs of abuse among animals. Some of the research projects have resulted in publications by the centre.

 Some of the important research projects are listed below.

Some Ongoing Projects

  • Nodal Regional Technical Training Centre (Nodal RTTC): Training of doctors and nurses working with IDU – Targeted Interventions (TIs) in North India, in collaboration with National AIDS Control Organisation (NACO) and the Project Management Unit (PMU) of Emmanuel Hospital Association (EHA). A part of the Global Fund for AIDS TB and Malaria (GFATM), Round 9 HIV-IDU grant “Hifazat” (Atul Ambekar, Ravindra Rao)  (2012- Ongoing). As part of the above mentioned project, NDDTC has been designated to function as the Nodal RTTC. Various activities under the project include:

-    Coordination and hand-holding of other RTTCs (KEM Hospital, Mumbai, Central      Institute of Psychiatry (CIP), Ranchi, Regional Institute of Medical Sciences (RIMS),    Imphal, NEIGRIMS, Shillong) 

-    Training of doctors and nurses working with IDU – TIs functioning under NACO in North Indian states

-    Developing and finalizing the course / curriculum for the training

-    Conducting Operations Research on IDU issues

  • Study to explore transition to injecting drug use by opioid users in North India, (Atul Ambekar, Anita Chopra, Hem Sethi), Project supported by SPYM, Regional Resource and Training Centre, North, MSJE, Govt of India (2012 – ongoing).

·       Feasibility of transporting urine samples of drug users on filter paper for screening drugs of abuse: A pilot exploratory study, (Raka Jain.,  Atul  Ambekar,  Rizwana  Quraishi),  Project funded by Indian Council of Medical Research funded ( 2012-Ongoing).

  • Effect of nalbuphine on opiate withdrawal in rats: Behavioural, Biochemical and Molecular study, (Raka Jain,  T.S. Roy, Anju Dhawan), Project funded  by Indian Council of Medical Research funded, (2012-Ongoing).

 

  •  Methadone Maintenance Treatment in India: A multi-site feasibility and effectiveness study. In collaboration with UNODC ROSA, (Anju Dhawan, Rajat Ray, Atul Ambekar, Raka Jain, Deepak Yadav, Anita Chopra) (2012- Ongoing).

     With support from UNODC ROSA, and overall coordination of NDDTC AIIMS a multisite project on exploring feasibility and effectiveness of Methadone Maintenance       Treatment (MMT) is underway. Other institutes collaborating in this study are:

- KEM Hospital, Mumbai

- Regional Institute of Medical Sciences (RIMS), Imphal, Manipur 

- Civil Hospital, Kapurthala, Punjab

- Civil Hospital, Bathinda, Punjab

  • National capacity building of medical professionals on treatment of substance use disorders. (Rajat Ray, Anju Dawn).  Funded by NFDAC, Ministry of Finance, Government of India. (2011 - Ongoing).

The project involves Training of Doctors in more than 500 district hospitals of the country. Other institutes collaborating with NDDTC, AIIMS in this venture are:

·        Central Institute of Psychiatry (CIP), Ranchi

·        Government Medical College (GMC), Chandigarh

·        KEM Hospital, Mumbai

·        National Institute of Mental Health and Neurosciences (NIMHANS), Bangaluru

·        Regional Institute of Medical Sciences (RIMS), Imphal 

  • Developing a network of De-addiction services from the government, NGO and private sector and project. (Rajat Ray, Anju Dhawan). Funded by WHO (2011 - Ongoing).

·        Efficacy of varenicline for smokeless tobacco use.  (Raka Jain,  Sonali Jhanjee, Veena Jain, R Schnoll) Funded by National Institute on Drug Abuse (NIDA), NIH, US Govt. in collaboration with AIIMS and UPENN (University of Pennsylvania) (2011- Ongoing).

  • National Drug Use Survey, Maldives, (Idaho Fahumy, Yaseer Wasim, Atul Ambekar, R. M. Pandey), Project of UNODC ROSA (2011-Ongoing).

 

  • A pilot study of feasibility and efficacy of Brief intervention compared with Simple Advice when linked to the Brief ASSIST for Substance Use Disorders in Primary Health Care and Community Setting, ( Atul Ambekar, Deepak Yadav), Project of University of Adelaide, WHO Collaborating Centre (2011 – Ongoing).

 

 

  • Co-ordination and convergence of Delhi District health services programmes and drug use intervention for the out of school child. (Rajat Ray, Anju Dhawan). Funded by WHO India (2010 - Ongoing).

·        Development of a web-Portal on problem alcohol use in India. (Rajat Ray,  Atul Ambekar,  Sanjay Gupta), Funded by World Health Organisation (Geneva)  (2010 – Ongoing).

 

·        Addressing Alcohol Use at Diverse Workplace settings.  (Rajat Ray, Atul Ambekar, Rakesh Lal, Deepak Yadav), Funded by World Health Organisation (India), ( 2010 – Ongoing).

 

·        Rapid Situation Assessment of Drug and Alcohol Use at Digboi, Assam,  (Rajat Ray,  Atul Ambekar, Dr. Rakesh Lal, Deepak Yadav), Funded by India Oil Corporation Ltd, AOD, Digboi (2010- Ongoing).

 

  • A workplace intervention to address Alcohol and Drug use at India Oil Corporation Ltd, AOD, Digboi, Assam (Rakesh Lal, Atul Ambekar) (2010- Ongoing).

The refinery of Indian Oil Corporation Ltd (IOCL), Assam Oil Division (AOD) at Digboi, Assam is among the world’s oldest functional refineries. The township of Digboi has been facing problems related to Alcohol use. As a response to a request from the management of Oil Refinery, a project has been initiated at the refinery which involves collaboration between three organisations:

1.    Indian Oil Corporation Ltd, Assam Oil Division, Digboi, Assam

2.    Department of Psychiatry, Assam Medical College, Dibrugarh, Assam

3.    NDDTC, AIIMS, New Delhi

While the expenditure and infrastructure for various project activities is being contributed by the IOCL, AOD, Digboi the two academic medical institutions are contributing through providing their professional expertise. Various activities being / have been conducted are:

·        A Rapid Situation Assessment of Drug and Alcohol Use at Digboi

·        Training of Doctors and paramedical staff at AOD hospital, Digboi

·        Orientation and sensitisation of various stakeholders (NGOs, Staff unions etc.)

·        Awareness generation in the community

·        Establishment of a Substance Use Treatment Unit at AOD hospital, Digboi

·        Establishing a referral / consultation system for graded level of care at Digboi

 

Departmental Research (Ongoing)

·        Effect of Nitric Oxide Synthase Inhibitor L-NNA on Sensitization to the  Operant Decrement Produced by Naloxone in Morphine Treated Rats. (Raka Jain) (2009- Ongoing).

  • Association of ANKK I polymorphism and Nicotine Dependence (ND): A Pilot Study. (R, Quraishi , Raka Jain), (2010 -Ongoing).
  • Naltrexone estimation from plasma samples of detoxified subjects. (R, Quraishi , Raka Jain), (2010 -Ongoing).

 

 Completed (Funded)

·        Oral Substitution Treatment in Tihar Prisons. Sonali Jhanjee, Raka Jain,  Hem Sethi.  Funded by UNODC-ROSA, (October. 2008-2012).

 

  • Effectiveness of Yoga in patients of Opiate Dependence. Anju Dhawan, Raka Jain, Deepak Yadav.  Funded by  AYUSH, MOH & FW. (2008-2011)
  • Molecular Genetics of Alcohol Dependence: Contribution Of Polymorphisms in Dopaminergic and Serotonergic Pathway Genes. Meera Vaswani, Atul Ambekar, Funded by ICMR(2008-2010).
  • Molecular Genetics of Alcohol Dependence: Contribution of Polymorphisms in Dopaminergic and Serotonergic Pathway Genes. (Meera Vaswani, Atul Ambekar), Funded by ICMR (2008-2010).

·        Oral Substitution Treatment with Buprenorphine. Anju Dhawan, Raka Jain,  Anita Chopra & Sonali Jhanjee.  Funded by United Nations Office on Drugs and Crime, Regional Office for South Asia, New Delhi (2005-2010).

 

·        Post Marketing Surveillance of Addnok-N (combination of Buprenorphine and Naloxone). Rajat Ray,  Meera Vaswani.  (2007 –2010).

 

  • Oral Substitution treatment

Oral Substitution Treatment with Buprenorphine funded by United Nations Office on Drugs and Crime, Regional Office for South Asia, New Delhi.  Project was initiated in 2006. 

A multi site  pilot intervention study of opiate dependent users was carried out to test the effectiveness of buprenorphine as a medication for long term treatment of opioid dependence in India. It also aimed to establish guidelines for practice of oral substitution with buprenorphine.

 The study used a ‘pre-post design’ with assessments at baseline, 3 months, 6 months and 9 months. A total of 231 opioid dependent patients from five sites across the country were identified and recruited. 

 

Highlights of the findings:

 

·            In the total sample, the retention rate was 79% at 3 months, 70% at 6 month and 64% at 9 month follow up with a compliance rate of more than 80 percent among those retained in treatment.

·            A significant reduction in drug use was found, as the mean number of days heroin being used was 24.9 ± 10.1 days at baseline which reduced to less than two   days at 9 month follow up assessment.

·            There was a significant reduction (p<.001) in injection use, which declined from 52% at baseline to 13% at 9 month follow up assessment.

·            There was a concurrent decrease in sexual risk behaviour with increased condom use.

·            The drug, legal, family-relationships and psychological domain scores of the ‘Addiction severity index (ASI)’ declined substantially at 3 months indicating an improvement.

·            The scores in all the four domains (physical, psychological, social relationship and environment) of ‘WHO Quality of Life’ at 9 month follow up showed an increase, thus indicating an improvement in the quality of life as experienced by the patients.

·           The process indicators in terms of implementation of oral substitution were also documented using qualitative techniques.  Most patients and family members across all centers expressed satisfaction with treatment and with the improvement the patients were experiencing.

 

The results of this study were in keeping with the excellent results shown in controlled trials with sublingual buprenorphine maintenance. This treatment is increasingly being regarded as the mainstream treatment for opioid dependence.

 National and Regional Database on Drug abuse & HIV/AIDS

There   are many publications on Drug abuse & HIV/AIDS that are not   readily accessible or available to the policy makers and researchers to plan prevention and controlling measures. Many studies conducted on these issues   have not been published or not reported in the format which may be easily understood. The collection and collation of such information can bridge the gap and Policy makers & planners and Administrators and Researchers, whether Government or Non-Government, would   have authentic, reliable and adequate data on these issues before undertaking any programme or formulating any policy. In this regard, AIIMS, with funding support from UNODC ROSA   has been implementing a  Project “Setting up of National and Regional   Database on Drug abuse & HIV/AIDS” in South Asia using secondary data.  AIIMS is the central repository and participating centers are located in Bangladesh, Maldives, Nepal, Pakistan and Sri Lanka.  It was envisaged that such an exercise would also promote regional sharing of information and resources for a concerted and convergent responses to Drug and HIV issues through National and Regional database.

 AIIMS was given the responsibility of  the development of an appropriate and  user-friendly computer software  and a  manual for creating the database on Drug abuse and HIV/AIDS for entering the collected data into the software. This Database Software on Drug abuse and HIV/AIDS was then installed in all participating centers.  In all participating countries a training workshop was held for the data entry personnel in getting familiar with the database Software in locating the data sources and in data entry in the Software as per the format.   Each country was   then requested to send the filled in Software with the articles.  

 Necessary guidelines for locating the articles, data entry  and other relevant aspects were sent to all the countries.  Based on inclusion criteria for Data (documents/studies)  all  documents on HIV/AIDS/high risk behaviors and drug or alcohol use/abuse/dependence were collected.

 Assessment of and intervention for Inhalant Use among out of school Adolescents (Street children)

Funded by WHO (India) as a biennium activity.

This   activity was aimed at assessing the pattern of substance use among out of school adolescents (street children) in two metro cities (Delhi and Banglaore).  Many NGOs working with children who are living on the streets are the project partners. Information has   been collected from out of school children/adolescents and from service providers working with out of school children/adolescents using various data collection technique.  This data has been used to develop an intervention package, which is being implemented simultaneously in Delhi and Bangalore.

 A district based model for provision of care

Funded by Ministry of Health and Family Welfare, Government of India

NDDTC, in collaboration with the state and district level governments is implementing a project, “district based model for provision of care to substance users.” It involves strengthening the involvement of existing district level health infrastructure in detection, management and delivery of care for alcohol and other drug abuse/dependent individuals. It is currently being implemented in four states in one district each viz Mandsaur (MP); Morigaon (Assam); and Meerut (UP). Under this project, it is proposed to train health staff and start points of treatment at District hospital / civil hospital, CHC’s and PHC’s in each district. 

 

Project sponsored by United Nations Office of Drugs and Crime, Regional Office for South Asia ((UNODC, ROSA) and United Nations Inter regional Crime and Justice Research Institute (UNICRI)

·         Global study on Illegal Drug Markets-A Multi-centred Project

Project sponsored by UNODC and Ministry of Social Justice and Empowerment, Government of India

·         National Survey on Extent, Pattern and Trends of Drug abuse in India

 Projects sponsored by UNODC ROSA

·         Oral Substitution Treatment with buprenorphine.

·         Collaborative study of creation of a database on drug abuse and HIV/AIDS


Projects sponsored by WHO (Geneva):

 1. Alcohol policy in developing countries

2. Development and validation of ASSIST

3. Development of methodology to study determinants of sexual behaviour among alcohol users in diverse cultural settings

4. Alcohol and Sexual behaviors across cultures: A Literature review from 7 countries

5. Identification and Management of Substance Use disorders in Primary Care Settings using ASSISTT

6.International Randomized Controlled Trial of Brief Intervention in Substance Use Disorders

 7. Developing a web portal and online assessment and intervention module for problem alcohol users (a multi-country, WHO headquarter project, ongoing))

Projects sponsored by WHO (India) and Ministry of Health and Family Welfare, Government of India:
 

·    A survey of prevalence of drug dependence and co-morbidity in the general population of Thrissur

·    Evaluation of government de-addiction centres in the country

·   Advanced Statistical Analysis of National Survey data and AIIMS Survey data on drug abuse using new methodologies without the addition of new data

·   Tobacco as a gateway drug and the prevalence of substance use behavioural disorders including tobacco in Metropolis Delhi

·    Rapid Assessment Survey Project on Alcohol, Tobacco and other substances in the Districts of Darjeeling, Kohima, Aizwal

·   Rapid Assessment Survey Project on Alcohol, Tobacco and other substances in the districts of North Goa, Jodhpur, Madras

·    Buprenorphine maintenance programme in Kohima district

·  Identification and Management of Alcohol Use Related Disorders in two Districts Hospital in Goa

·    Workshop on strengthening of De-addiction centerss

·    Workshop on streamlining of Opium registry in India

·    Workshop on managing alcohol use in primary care settings in India

Project sponsored by Ministry of Health & Family Welfare, Government of India

·  Community based pilot project: Multi-centred Project at Mandsaur (MP), Barabanki (UP) and Imphal (Manipur)

Project sponsored by the Ministry of Finance, Government of India

·  Health Status of Workers at Government Opium and Alkaloid Factory, Ghazipur, U.P.

Project sponsored by Department of Science and Technology (DST), Government of India::

·         Opioids in autonomic control: Effect of physical training.

Projects sponsored by Centre for Scientific and Industrial Research (CSIR), Government of India:

·    Role of dopamine in experimentally induced nicotine tolerant rate

·   Role of Nitric Oxide Synthase Inhibitors in Modifying Nicotine Withdrawals in Rats

Project sponsored by other agencies:

·    Post-marketing Surveillance of Higher Strength (0.4 & 2.0mg) Buprenorphine

·    Post Marketing Surveillance of Addnok-N (combination of Buprenorphine and Naloxone), sponsored by Rusan Pharma, June 2006

·   Genetic basis of Alcohol Induced Pancreatic Disorders. with Dept of Gastroentrology, AIIMS, funded by ICMR

·   Phase – 2 clinical study to evaluate the safety and efficacy of ESD-27 in patients of chronic primary insomnia.  Interdepartmental project with Dept. of Neurology (Neurophysiology Section)   Funded by Himalaya Drug Company.

·    Distribution of alleles at the human ALDH2 and ADH2 Loci in North Indian subjects Size estimation of IDU at 300 sites in India, in collaboration with SPYM, New Delhi, funded by DFID (UK)

·    Size estimation of IDU at Punjab and Haryana, in collaboration with SPYM, New Delhi, funded by UNAIDS

 

Project sponsored by AIIMS:
 
·   Concurrent and discriminant validity of Alcohol Use Disorders Identification Test (AUDIT) in Urban Community and De-addiction centre Sample.

·   Blocking of Enhanced Sensitivity to Behavioural Effects of naloxone Induced by Narcotic Agonists in Rats

·  Effects of the NMDA Receptor Antagonist (Ketamine) to the Operant Decrement produced by naloxone in Morphine-treated Rats

·    Brief Intervention in Alcohol Use: A community based comparative study

Others:

Most of the activities of the centre have been published as Books and monographs and research reports. In last four years, the faculty has produced about 40 publications in scientific journals and made various presentations at scientific conferences in the country as well as all over the world.