Will NIDA follow NIAAA in using reduced use as an endpoint?

A decade ago, when the National Institute on Alcohol Abuse and Alcoholism (NIAAA) declared that a reduction in drinking, and not a cessation of use, was a possible “endpoint,” or outcome, in clinical trials for treatment for alcohol use disorder (see https://onlinelibrary.wiley.com/doi/10.1002/adaw.30085 ), this was an important breakthrough. Will the Food and Drug Administration (FDA) now allow the same criterion to be used for clinical trials to treat substance use disorder (SUD). National Institute on Drug Abuse director Nora Volkow, M.D. hopes so. In a blog published last week, she wrote: “For many people trying to recover from a substance use disorder, perhaps for the majority, abstinence may be the most appropriate treatment objective. But complete abstinence is sometimes not achievable, even in the long‐term, and there is a need for new treatment approaches that recognize the clinical value of reduced use.”