The “merger” of the National Institute on Drug Abuse (NIDA) and the National Institute on Alcohol Abuse and Alcoholism (NIAAA) is moving ahead slowly, secretly, but—in the views of most—inexorably to a conclusion, which will emerge as a draft after the election in November and in final proposed form in the president’s budget for fiscal year 2014 next February. One thing is clear, however: “Merger” is a misnomer.
The two institutes will not be merged into the sum of both current parts. Most of the institutes’ current research portfolios—but not all, and in fact quite possibly not the biggest—will be incorporated into the new institute. Portfolios from other National Institutes of Health (NIH) institutes outside NIDA and NIAAA might go to the new institute as well.
The most important question, involving which portfolios will go where, still hasn’t been answered. The current portfolios for AIDS, fetal alcohol syndrome (FAS), liver disease and smoking—where the most money is at the two institutes—may or may not stay within the new institute. Also unknown to many is whether the new institute will cover all addictions (including those such as food and gambling) or will be devoted to the health effects of alcohol and drugs only. The interviews conducted for this article leave the impression that the new institute will be about all addictions, not just drugs and alcohol.
But the alcoholism research field, which believes it would lose out under such a definition, is still fighting the reorganization. And some openly question whether the “merger” ever will come to pass at all.
A done deal?
Barbara McCrady, PhD, president of the Research Society on Alcoholism (RSA), says she doesn’t necessarily think the reorganization is going to happen. “Many alcohol researchers, including myself and including RSA, have not given up expressing our concerns and opinions about this,” she says. “I don’t think it’s a done deal yet.”
McCrady, professor of psychology at the University of New Mexico Center on Alcoholism, Substance Abuse, and Addictions, says taking FAS out of alcoholism research and putting it into child health and development would make no sense. “How do you separate them, and how do you prevent FAS if you separate them?” she says.
Noting that NIDA’s budget already is more than twice the size of NIAAA’s, despite the fact that alcohol causes a much heavier public health burden than drugs, McCrady says that if this continues under a new institute, alcohol would be “completely overshadowed.” But, she adds, there is now “serious consideration about whether this new institute makes sense in our economic climate.”
Not everyone within NIAAA is so sanguine about the possibility of a change in direction, however. High-level people are leaving the institute this year, and more plan to leave after the reorganization takes place. NIAAA currently is led by an acting director (Kenneth R. Warren, PhD), while NIDA has longtime director Nora Volkow, MD. The Lancet reported last year that Volkow thinks there should be one institute for drugs and alcohol and that she would like to be its director (http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)61236-1/fulltext).A further ironic twist is that Volkow’s lab at Brookhaven is funded by NIAAA; technically, she is an NIAAA intramural scientist, which preserves an arm’s-length distance between NIDA and her lab, which focuses on drug abuse and brain scans.