NIH Backs Off Plan to Merge Addiction Institutes

In a surprising move, the National Institutes of Health (NIH) has backed off of a controversial plan to merge its two institutes that study drug abuse and alcohol addiction. NIH Director Francis Collins said today that the agency will instead work on coordinating addiction research across the agency.

Collins announced 2 years ago that NIH planned to follow an advisory board's recommendation to combine the National Institute on Drug Abuse (NIDA) and the National Institute on Alcohol Abuse and Alcoholism (NIAAA). His decision divided the research community. NIDA grantees liked the idea, believing that it made sense scientifically. But alcoholism researchers fiercely opposed it. They worried that their ideas would get short shrift and have a harder time winning funding as part of the twice-as-large NIDA, which had lower grant success rates that NIAAA. Along with the beverage industry, some researchers warned that combining drug abuse and alcoholism research would stigmatize the legal consumption of alcohol.

Despite expressing his preference, Collins gave each side time to marshal its arguments. The leisurely decision-making stood in contrast to Collins' quick implementation last year of another controversial reorganization, this one abolishing an NIH center that funded research resources.

NIDA and NIAAA were once part of a single unit within NIH's parent agency that also included mental health. But in 1992, drug abuse and alcoholism research were moved to NIH and made separate entities. In 2003, a report by the Institute of Medicine of the U.S. National Academies pointed to the merits of a merger between NIAAA and NIDA.

In a statement today, Collins said that after review and consultation with stakeholders, NIH has opted instead for "functional integration." The phrase signifies an attempt to improve the coordination of its substance use, abuse, and addiction-related research without merging the two institutes. NIH has already been working on coordination and these efforts have "bolstered my confidence" that structural change isn't needed, Collins wrote. "Moreover, given budget uncertainties, …[t]he time, energy, and resources required for a major structural reorganization are not warranted, especially given that functional integration promises to achieve equivalent scientific and public health objectives," he wrote.

As NIH deputy director Lawrence Tabak explains it, "The last 2 years have been one of intensive analyses of the [addiction] portfolio. As the folks working on these analyses got to know each other better, it became a natural progression towards better interaction." For example, the intramural programs of NIAAA and NIDA are already sharing a clinical director, he notes. And "functional integration" also means that a "subset" of crosscutting research will be reviewed jointly by the councils of NIDA, NIAAA, and the National Cancer Institute, which funds research on tobacco addiction, he says. (Read more details on how this will work.)

The Distilled Spirits Council was quick to praise the decision: "We commend NIH Director Dr. Francis Collins for considering all viewpoints and making an evidence-based decision," it said in a statement. Several months ago, Collins had told an outside advisory group that the beverage industry was not happy about the merger. But Tabak said that although "many groups weighed in" both for and against the merger, today's decision "was driven by scientific opportunity."

Alan Kraut, executive director of the Association for Psychological Science, expressed disappointment that the merger has been called off. But he applauds NIH's plan to forge closer ties between the two institutes. "I hope moving ahead 'functionally' will preserve some of the best of what was proposed—that there is so much overlap in the basic questions of brain and behavior involved in both alcohol and substance abuse," he says.

The decision is also a blow to NIH watchers who think the agency would function more efficiently if some of its 27 centers and institutes were consolidated. The blogger DrugMonkey commented today, ""[I]f you can't merge these two ICs [NIDA and NIAAA] then there is no point in any talk about merging any existing" institutes and centers.