Editor’s Note: Ready or not – and like it or not! — the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and the National Institute on Drug Abuse (NIDA) are scheduled for merger in less than 18 months. Points contributing editor Ron Roizen offers a two-part post on the history of the two institutes, the recent push toward merger, and the merger’s possible effects. This signal change in the organization of federally funded alcohol and drug research in the U.S. compels the attention of readers from across Points’ spectrum of history, policy, and advocacy. In addition to welcoming comments, we invite research and policy professionals with an interest in post-length comments on the merger– or on Roizen’s take on the merger– to contact Managing Editor Trysh Travis (email@example.com) to discuss future stints as guest bloggers.
The planned decommissioning of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and the National Institute on Drug Abuse (NIDA) and the creation of a new National Institutes of Health (NIH) institute to take their places, now scheduled for launch in October, 2013 (FY2014), are notable developments in the history of the federal role in the application of science to alcohol- and drug-related public problems in the U.S. The push for merger of these two formerly separate public problem domains is by no means new. Sociologist David J. Pittman published an article titled, “The Rush To Combine: Sociological Dissimilarities of Alcoholism and Drug Abuse,” nearly a half-century ago, criticizing what he regarded as the contemporary trend toward conflation.(1) Pittman’s 1967 article appeared of course before either NIAAA, created in 1970, or NIDA, created in 1973, had arrived on the scene.
Despite their surface similarities, the two institutes grew out of quite different cultural and political circumstances. NIAAA’s creation was the product of a constituency-driven movement to modernize American attitudes toward alcoholism and, beyond that, to enhance the nation’s awareness of and substantially enlarge its response capacity with respect to a massive putative “hidden alcoholism” problem lurking unrecognized in our population.(2) The testimonies of Alcoholics Anonymous’s (AA) William Griffith Wilson,(3) National Council on Alcoholism’s (NCA) Mrs. Marty Mann, and actress Mercedes McCambridge highlighted the 1969 hearings of the Senate Special Subcommittee on Alcoholism and Narcotics, chaired by Senator Harold Hughes, which in turn lead to NIAAA’s creation.(4)
According to Nancy Olson’s account, R. Brinkley Smithers and Thomas P. Pike – the latter, an early member of AA, vice chair of the board of the Fluor Corporation, and an influential Republican who also offered testimony at the Hughes hearings – played key roles in convincing President Richard M. Nixon to sign the “Hughes Act” creating NIAAA, despite veto recommendations from some influential members of Nixon’s administration.(5) NIDA’s creation, in 1973, on the other hand, grew out of palpable public anxiety regarding the diffusion of illicit drug use in the 1960s, worry about the potential consequences of continuing heroin use by military personnel returning from wartime Vietnam, and disenchantment with the nation’s predominantly criminal justice response to drug problems to date.(6) Reform-minded members of the medical and legal professions also played key roles in the creation of the alcohol and drug institutes. Both institutes banked on the promise of modern science to improve knowledge and strengthen social responses to their respective problem domains. But the meaning and relevance of science’s authority and prospects differed for each. On the alcohol side, NIAAA’s creation represented a crowning achievement for the modern alcoholism movement, now lending the prestige and resources of a freestanding federal agency to alcoholism’s disease status and its importance as a public health problem. On the drug side, NIDA’s creation was intended to buttress mainstream society’s claims regarding the evils of illicit drugs, affirm the importance of maintaining an official tabu on drug use, and, at the same time, advance the prospects for effective treatment for drug use victims. The passage of time showed that neither NIAAA nor NIDA stuck entirely faithfully to the scripts suggested by these founding intentions, although neither institute may be said to have abandoned these scripts either.