NIH Director Favors Merging Addiction Institutes

The National Institutes of Health (NIH) will likely merge its two institutes that study addiction. In a statement today, NIH Director Francis Collins said he had received a formal recommendation from an NIH advisory board to create a single institute to study substance use, abuse, and addiction.

The proposal "makes scientific sense," Collins said. He plans to form a task force to figure out by next summer what programs will be folded into the "proposed new institute," which will effectively merge the National Institute on Drug Abuse (NIDA) and the National Institute on Alcohol Abuse and Alcoholism (NIAAA).

Collins's decision is controversial. NIAAA's $462 million budget is less than half that of the $1.06 billion drug abuse institute, yet it funds a slightly higher proportion of submitted grants. Alcoholism researchers and patient advocates worried that their smaller institute would be swallowed up and that certain studies, such as research on alcoholism-related liver disease, would be cut short. Opponents also argued that combining addiction studies would give the legal consumption of alcohol a negative stigma. The NIAAA council voted earlier this year against a merger; NIDA's council voted in favor.

According to the advisory panel’s report, the new institute would also house the National Cancer Institute's (NCI's) tobacco addiction programs. And nonaddiction research would go elsewhere—for example, NIAAA's research on fetal alcohol syndrome would likely be transferred to the National Institute of Child Health and Development.

The notion of combining the two institutes was suggested by a National Academies panel in 2003 amid concerns voiced by former NIH Director Harold Varmus (now NCI director) that NIH's sprawling 27 institutes and centers are too difficult to manage. But it was not until Congress created a Scientific Management Review Board (SMRB) in 2006, aimed at examining NIH's structure, that things began to happen. In September, an SMRB working group recommended either combining NIDA and NIAAA or better coordinating addiction research across NIH. The full board—which included Varmus—voted 12 to 3 in favor of the merger.

It's not a done deal, however. Collins's boss, Health and Human Services Secretary Kathleen Sebelius, has to approve the merger plan and then notify Congress. Lawmakers will have 180 days to intervene before Collins can proceed with the reorganization.