NIH abandons plan to replace NIDA and NIAAA with new institute

NIH Director Francis Collins announced in mid-November that NIH would pursue only a functional rather than a structural integration of substance use, abuse and addiction research

A plan to replace the National Institute on Drug Abuse (NIDA) and the National Institute of Alcohol Abuse and Alcoholism (NIAAA) with the National Institute on Substance Use and Addictive Disorders (NISUAD) at the National Institutes of Health (NIH) fell apart unexpectedly in mid-November. The news came in the form of a press release from NIH Director Francis Collins which stated in part:

“After rigorous review and extensive consultation with stakeholders, I have concluded that it is more appropriate for NIH to pursue functional integration, rather than major structural reorganization, to advance substance use, abuse, and addiction-related research. To that end, the National Institute on Drug Abuse (NIDA) and the National Institute on Alcohol Abuse and Alcoholism (NIAAA) will retain their institutional identities, while strengthening their ongoing efforts to work more closely with each other and with related research programs at other institutes and centers.”

The news caught the scientific community by surprise as it had been led to believe that NIH would soon be releasing a draft strategic plan for the new institute as well as a much-anticipated portfolio analysis indicating which areas of the current NIH substance use research portfolio would be included in the new institute. The reorganization had been controversial from the start and while APA never took a position on whether or not NIH should pursue a structural reorganization, we took early and frequent opportunities to question the process. In an oral statement (PDF, 172KB) delivered at the inaugural meeting of the NIH Scientific Management Review Board (the group tasked with evaluating the proposal), Steve Breckler, APA's executive director for science, stated:

“Unless the scientific benefits to a merger are real and measurable, they may not justify the risks to the budget and support we know exists now. So the question we’d ask the Board is, do they really have enough information to invest their valuable time and resources into the consideration of a selective merger of any two institutes to the exclusion of others or other potential organizational constructs that should be the Board’s primary focus?” 

In the end, it appears that Director Collins may have arrived at similar conclusions, favoring instead a functional integration of the portfolios under consideration:

“NIH has made significant progress in the last two years, coordinating research on substance use, abuse, and, addiction across its various institutes and centers. This progress has bolstered my confidence that NIH can achieve the SMRB recommendations without structural reorganization. Moreover, given budget uncertainties, NIH must focus on advancing the entire biomedical research enterprise. The 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.”

A brief description of the new Trans-NIH Substance Use, Abuse, and Addiction Functional Integration (PDF, 72KB) is available on the NIH Feedback website. In addition, a scientific strategic plan, which emerged from stakeholder input in response to a Request for Information, will be used as a starting point to move integration efforts forward in several areas cited as new opportunities (PDF, 131KB) for the basic, prevention and treatment sciences as well as the medical consequences of substance use, abuse and addiction. Importantly, the description of the integration calls for developing evaluation plans for all integrative initiatives, thereby addressing another concern expressed by APA (PDF, 278KB) as discussions for the new institute were evolving.

APA has consistently advocated for the NIH substance use, abuse and addiction portfolio to incorporate the full range of existing NIDA and NIAAA research and to fully integrate research on tobacco use, comorbid mental health disorders and other compulsive behaviors. Additional information about how the integration will proceed is expected to be the focus of a joint meeting of the NIDA and NIAAA Advisory Committees and the National Cancer Advisory Board (NCAB) slated for Dec. 13.