Common Sense v. Politics: Should Federal Addiction and Alcohol Agencies Be Merged?

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It seems like a no-brainer. The National Institutes of Health (NIH) currently has two bodies devoted to studying problems of addiction: the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and the National Institute on Drug Abuse (NIDA). Why not combine them into one agency, as a recent policy review by an NIH working group suggested?

The idea makes sense on the surface, but common sense may be no match for politics. The alcohol industry has long opposed any measure that includes alcohol in the “war on drugs” or that emphasizes its addictive nature, which merging NIAAA and NIDA into a new “National Institute on Addictions” would do. (More on Addiction Files: Recovering From Drug Addiction, Without Abstinence)

Support for the status quo also comes from those on the drug-research side who believe that all illegal drugs should remain that way. Lumping together research on alcohol and research on illicit drugs may confuse the matter, they suggest:  it certainly would draw attention to the fact that American drug laws have a historical and cultural basis, rather than one related to the amount of harm caused by particular substances. (Currently, however, both NIAAA and NIDA do research on nicotine.)

There’s another, somewhat moralistic argument for keeping the institutes separate. As Dr. Deborah Hasin, argued at a February national advisory meeting on the question, “[There is] a need for a public health message more nuanced for alcohol than for drugs, including nicotine. In contrast with drugs, light drinking is not ‘bad.'” It was a curious statement from a scientist who is supposedly charged with studying the effects of psychoactive substances objectively. Further, her comment wasn’t quite accurate, considering that the research on health effects of light use of marijuana does not find significant dangers, aside from those like arrest and impurities that result from its illegal status. (More on Will the Government’s Drug ‘Take-Back’ Do Anything to Reduce Misuse?)

A second researcher at the meeting made a case opposing the merger from a very different perspective. He claimed that the problem with NIDA is that it is forbidden to look for positive effects of illegal drugs.  NIAAA, however, can study the health benefits of alcohol

From the meeting minutes:

Dr. Howard Moss called attention to the political relationships surrounding the potential for a merger, noting that NIDA is under regulatory control of the Office of National Drug Control Policy, while NIAAA is not. NIDA is unable to fund research that demonstrates the benefits of illicit drugs, while NIAAA can talk about potential benefits of moderate alcohol use. He noted that a merger might place constraints on future research; 17 states have medical marijuana laws on the books or under discussion, though NIH has funded no research on its benefits.

It will be interesting to see how the NIH bureaucracy, Congress and lobbyists respond to the report. Many addiction and alcoholism researchers also oppose the merger on general principle, knowing that it will result in budget cuts that will make getting research funding more competitive. But if these two agencies on addiction cannot be merged, I wouldn’t hold my breath for any real cost-cutting or redundancy-reduction efforts to be made anywhere in the strapped federal budget.

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