NIH Director Supports Dissolution of NIDA, NIAAA and Creation of Single Addiction Institute

by U.S. Medicine

January 22, 2011

BETHESDA, MD—NIH is examining the possibility of creating a single institute for substance use, abuse, and addiction research. The new institute would combine the relevant research portfolios dealing with those issues currently under the purview of NIDA, NIAAA, and other institutes.

Over the last decade, as research into substance abuse has grown, a number of advocacy groups have questioned the current organization of that research at NIH. In 2003, a National Academies panel recommended a study to evaluate a merger of NIAAA and NIDA. During the inaugural meeting of NIH’s Scientific Management Review Board (SMRB)—a group established by the NIH Reform Act of 2006 to advise NIH and HHS officials on the organization of scientific efforts—board members unanimously agreed to examine a possible merger.

The SMRB recently recommended the dissolution of NIDA and NIAAA, and the creation of a new institute—a recommendation that NIH Director Francis Collins, MD, PhD, supports.

“The formation of a single, new institute devoted to such research makes scientific sense and would enhance NIH’s efforts to address the substance abuse and addiction problems that take such a terrible toll on our society,” Collins said. He then tasked NIH Principal Deputy Director Lawrence Tabak, DDS, PhD, and NIAMS Director Stephen Katz, MD, PhD, to put together a task force of experts across all NIH institutes to examine the current research portfolio. The task force will determine where substance use, abuse, and addiction research programs currently exist and make recommendations about what programs should be moved to the proposed new institute.

The task force is also charged with identifying NIDA and NIAAA research that would not fit in the proposed institute and recommending where such research should be moved.

Such a merger is by no means universally supported. In February, the NIAAA Advisory Council passed a resolution strongly advising NIH against a reorganization that eliminates NIAAA as an independent institute. The resolution encouraged “increased collaboration across NIH institutes and centers” as a way to strengthen research.

However, the NIDA Advisory Council unanimously passed a resolution supporting the creation of a single entity for all drug use and addiction research. According to the SMRB report, these resolutions reflect the views of respective NIAAA and NIDA staff, grantees, and constituency groups. Both the alcohol and drug research communities largely favor increased collaboration between the two institutes. However, the drug research community believes that increased collaboration would be achieved best through a structural merger of the two institutes, while the alcohol research community believes these objectives could be achieved without a merger.

NIAAA supporters also cautioned that this type of reorganization might jeopardize advances in alcohol research. This is partly due to the size difference between the two research budgets. In fiscal year 2009, the NIAAA budget was $450,095,000, and the NIDA budget was $1,032,457,000. Subsequently in FY 2009, NIDA received 1,871 applications and funded 403, while NIAAA received 811 applications and funded 191. According to the SMRB report, this discrepancy in budget and portfolio size perpetuates the fear of some that the larger institute will consume NIAAA
in a structural merger of the two institutes.

Some stakeholders were also concerned that such a merger could eradicate the portions of each portfolio not focused on addiction. For example, NIAAA funds research on the end-organ effects of alcohol, particularly the liver. Stakeholders underscored the potential loss that this research might sustain through a merger and argued that this issue should be a critical factor in the ultimate decision.

Whatever course NIH follows will take considerable time and planning. Collins expects the task force to produce a reorganization plan for consideration sometime in the summer of 2011. In the meantime, all existing research programs will continue as before.

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