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Stumbling Toward the Future with NIDA

Merging two huge federal drug and alcohol agencies? No problem.

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Not on my turf.
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By Dirk Hanson

06/20/11

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We remember a time when you had your alcohol researchers sitting in this corner, and your illegal drug researchers sitting in the opposite corner, and only very rarely did the twain meet. In matters pertaining to alcohol, meet the National Institute on Alcohol Abuse and Alcoholism (NIAAA), whose mission sometimes seemed as ill defined as its name. And in all matters pertaining to “drugs of abuse,” which basically means any illegal drug, plus tobacco, welcome to the National Institute on Drug Abuse (NIDA). But isn’t alcohol a drug of abuse? A fair question, and in fact there were always so many questions about the division that the National Institutes of Health (NIH), the umbrella organization under which the Institutes operate, finally decided it made sense, and some might even say money, to merge them.  After a series of deferrals, deadlines, committee reports, careful political positioning and endless internal debate, NIH announced that the merger would take place… in October of 2013. We could hear the huge sigh of relief blowing through the NIAAA from all the way over here. As the little brother in the enterprise, NIAAA will essentially be swallowed by the new institute, which is provisionally named the National Institute of Substance Use and Addiction Disorders. Or will be, if it ever emerges from the NIH cloud.
 
"People are awaiting the plan with bated breath and with some anxiety about how this will play out," one researcher said, according to a Los Angeles Times report by Shari Roan.  "There are strong arguments for keeping it separate and strong arguments for merging it."

In earlier discussions, acting NIAAA director Dr. Kenneth Warren offered up what has come to be seen as the basic counter-argument: “The best way forward is a structure that increases collaboration all across NIH… nothing is gained by structural merger.” Warren said he favored “a separate, but equal” pair of agencies. “Alcoholism is a much broader issue than simply addiction.”

The assertion that alcoholism is not simply an addiction distills the disagreement down to its essence, which can be found not so much within the arena of science as within the arenas of morality, ethics, and the law. NIH Director Francis Collins told Science: “Alcohol is after all a legal substance and 90% of us at some point in our lives are comfortable with taking it in while the drug abuse institute is largely focused on drugs that are not legal.” To the alcohol people, that distinction is important. It appears that one of the goals is to keep themselves at a distance from research on illegal drugs. Whether that proves to be a research goal that still makes sense is another matter entirely.

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