title: Should the reorganization of addiction-related research across all the National Institutes of Health be structural?--The devil is truly in the details.
abstract: The recent proposal to dissolve the National Institute on Alcohol Abuse and Alcoholism and National Institute on Drug Abuse and create a new institute for substance use, abuse, and addiction will require significant effort by the staff of both institutes, the Advisory Councils, and outside experts to overcome complex challenges that could threaten its success. Although integration of the grants portfolios can be achieved, harmonization of goals and policies related to legal use of alcohol versus illegal consumption of drugs will present serious challenges. Consolidating the infrastructure of the 2 existing institutes would entail avoiding encroachment on grant funding. A new institute for substance use, abuse, and addiction would require an enormous amount of cooperation from other institutes as the portfolios of research on alcohol, tobacco, and other drug abuse should logically be transferred to the new institute. In the near term, a structural reorganization would be less efficient and more costly than the individual institutes are currently. Increasing efficiency and reducing costs over time will necessitate careful strategic planning. Success in this difficult task would be made easier and less costly by first implementing carefully placed building blocks of increasing functional reorganization. The newly created institute should increase opportunities for specialization within disorders of addiction, attract new leadership, and build a novel strategic plan that will energize scientists and staff and incorporate ideas of stakeholders to advance the public good in preventing and treating alcohol, tobacco, and all addictions. Attention must be paid to the devil in the details.
authors: Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, PO Box 800623, Charlottesville, VA 22908-0623, USA. bankolejohnson@virginia.edu
authors: Bankole A
authors: BA
authors: Johnson
authors: Robert O
authors: RO
authors: Messing
authors: Michael E
authors: ME
authors: Charness
authors: John C
authors: JC
authors: Crabbe
authors: Mark S
authors: MS
authors: Goldman
authors: R Adron
authors: RA
authors: Harris
authors: Henry R
authors: HR
authors: Kranzler
authors: Mack C
authors: MC
authors: Mitchell
authors: Sara Jo
authors: SJ
authors: Nixon
authors: Edward P
authors: EP
authors: Riley
authors: Marc A
authors: MA
authors: Schuckit
authors: Kenneth J
authors: KJ
authors: Sher
authors: Jennifer D
authors: JD
authors: Thomas
mesh_terms: D000437:Alcoholism / Q000453:epidemiology; D016739:Behavior, Addictive; D035843:Biomedical Research / Q000191:economics / Q000458:organization & administration*; D015897:Comorbidity; D004500:Education, Graduate; D017598:Efficiency, Organizational; D006801:Humans; D007857:Leadership; D054563:National Institute on Alcohol Abuse and Alcoholism (U.S.) / Q000191:economics / Q000458:organization & administration*; D054577:National Institute on Drug Abuse (U.S.) / Q000458:organization & administration*; D009316:National Institutes of Health (U.S.) / Q000191:economics / Q000458:organization & administration*; D009488:Neurosciences; D057766:Policy; D019966:Substance-Related Disorders / Q000453:epidemiology; D014481:United States / Q000453:epidemiology