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Should the Reorganization of Addiction-Related Research Across All the National Institutes of Health Be Structural?—The Devil Is Truly in the Details

Authors

  • Bankole A. Johnson,

    1. From the Department of Psychiatry and Neurobehavioral Sciences (BAJ), University of Virginia, Charlottesville, Virginia; Ernest Gallo Clinic and Research Center, Department of Neurology (ROM), University of California San Francisco, San Francisco, California; VA Boston Healthcare System, Department of Neurology (MEC), Harvard Medical School, Boston University School of Medicine, Boston, Massachusetts; Portland Alcohol Research Center, Department of Behavioral Neuroscience (JCC), Oregon Health & Science University and VA Medical Center, Portland, Oregon; Alcohol and Substance Use Research Institute, Department of Psychology (MSG), University of South Florida, Tampa, Florida; Section of Neurobiology (RAH), School of Biological Sciences, Waggoner Center for Alcohol and Addiction Research, University of Texas at Austin, Austin, Texas; Department of Psychiatry (HRK), Treatment Research Center, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Internal Medicine (MCM), Johns Hopkins University School of Medicine, Johns Hopkins Bayview Medical Center, Baltimore, Maryland; Division of Addiction Research, Department of Psychiatry (SJN), University of Florida, Gainesville, Florida; Department of Psychology (EPR, JDT), Center for Behavioral Teratology, San Diego State University, San Diego, California; Department of Psychiatry (MAS), University of California, San Diego, La Jolla, California; Department of Psychological Sciences (KJS), University of Missouri-Columbia, and Midwest Alcoholism Research Center, Columbia, Missouri.
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  • Robert O. Messing,

    1. From the Department of Psychiatry and Neurobehavioral Sciences (BAJ), University of Virginia, Charlottesville, Virginia; Ernest Gallo Clinic and Research Center, Department of Neurology (ROM), University of California San Francisco, San Francisco, California; VA Boston Healthcare System, Department of Neurology (MEC), Harvard Medical School, Boston University School of Medicine, Boston, Massachusetts; Portland Alcohol Research Center, Department of Behavioral Neuroscience (JCC), Oregon Health & Science University and VA Medical Center, Portland, Oregon; Alcohol and Substance Use Research Institute, Department of Psychology (MSG), University of South Florida, Tampa, Florida; Section of Neurobiology (RAH), School of Biological Sciences, Waggoner Center for Alcohol and Addiction Research, University of Texas at Austin, Austin, Texas; Department of Psychiatry (HRK), Treatment Research Center, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Internal Medicine (MCM), Johns Hopkins University School of Medicine, Johns Hopkins Bayview Medical Center, Baltimore, Maryland; Division of Addiction Research, Department of Psychiatry (SJN), University of Florida, Gainesville, Florida; Department of Psychology (EPR, JDT), Center for Behavioral Teratology, San Diego State University, San Diego, California; Department of Psychiatry (MAS), University of California, San Diego, La Jolla, California; Department of Psychological Sciences (KJS), University of Missouri-Columbia, and Midwest Alcoholism Research Center, Columbia, Missouri.
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  • Michael E. Charness,

    1. From the Department of Psychiatry and Neurobehavioral Sciences (BAJ), University of Virginia, Charlottesville, Virginia; Ernest Gallo Clinic and Research Center, Department of Neurology (ROM), University of California San Francisco, San Francisco, California; VA Boston Healthcare System, Department of Neurology (MEC), Harvard Medical School, Boston University School of Medicine, Boston, Massachusetts; Portland Alcohol Research Center, Department of Behavioral Neuroscience (JCC), Oregon Health & Science University and VA Medical Center, Portland, Oregon; Alcohol and Substance Use Research Institute, Department of Psychology (MSG), University of South Florida, Tampa, Florida; Section of Neurobiology (RAH), School of Biological Sciences, Waggoner Center for Alcohol and Addiction Research, University of Texas at Austin, Austin, Texas; Department of Psychiatry (HRK), Treatment Research Center, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Internal Medicine (MCM), Johns Hopkins University School of Medicine, Johns Hopkins Bayview Medical Center, Baltimore, Maryland; Division of Addiction Research, Department of Psychiatry (SJN), University of Florida, Gainesville, Florida; Department of Psychology (EPR, JDT), Center for Behavioral Teratology, San Diego State University, San Diego, California; Department of Psychiatry (MAS), University of California, San Diego, La Jolla, California; Department of Psychological Sciences (KJS), University of Missouri-Columbia, and Midwest Alcoholism Research Center, Columbia, Missouri.
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  • John C. Crabbe,

    1. From the Department of Psychiatry and Neurobehavioral Sciences (BAJ), University of Virginia, Charlottesville, Virginia; Ernest Gallo Clinic and Research Center, Department of Neurology (ROM), University of California San Francisco, San Francisco, California; VA Boston Healthcare System, Department of Neurology (MEC), Harvard Medical School, Boston University School of Medicine, Boston, Massachusetts; Portland Alcohol Research Center, Department of Behavioral Neuroscience (JCC), Oregon Health & Science University and VA Medical Center, Portland, Oregon; Alcohol and Substance Use Research Institute, Department of Psychology (MSG), University of South Florida, Tampa, Florida; Section of Neurobiology (RAH), School of Biological Sciences, Waggoner Center for Alcohol and Addiction Research, University of Texas at Austin, Austin, Texas; Department of Psychiatry (HRK), Treatment Research Center, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Internal Medicine (MCM), Johns Hopkins University School of Medicine, Johns Hopkins Bayview Medical Center, Baltimore, Maryland; Division of Addiction Research, Department of Psychiatry (SJN), University of Florida, Gainesville, Florida; Department of Psychology (EPR, JDT), Center for Behavioral Teratology, San Diego State University, San Diego, California; Department of Psychiatry (MAS), University of California, San Diego, La Jolla, California; Department of Psychological Sciences (KJS), University of Missouri-Columbia, and Midwest Alcoholism Research Center, Columbia, Missouri.
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  • Mark S. Goldman,

    1. From the Department of Psychiatry and Neurobehavioral Sciences (BAJ), University of Virginia, Charlottesville, Virginia; Ernest Gallo Clinic and Research Center, Department of Neurology (ROM), University of California San Francisco, San Francisco, California; VA Boston Healthcare System, Department of Neurology (MEC), Harvard Medical School, Boston University School of Medicine, Boston, Massachusetts; Portland Alcohol Research Center, Department of Behavioral Neuroscience (JCC), Oregon Health & Science University and VA Medical Center, Portland, Oregon; Alcohol and Substance Use Research Institute, Department of Psychology (MSG), University of South Florida, Tampa, Florida; Section of Neurobiology (RAH), School of Biological Sciences, Waggoner Center for Alcohol and Addiction Research, University of Texas at Austin, Austin, Texas; Department of Psychiatry (HRK), Treatment Research Center, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Internal Medicine (MCM), Johns Hopkins University School of Medicine, Johns Hopkins Bayview Medical Center, Baltimore, Maryland; Division of Addiction Research, Department of Psychiatry (SJN), University of Florida, Gainesville, Florida; Department of Psychology (EPR, JDT), Center for Behavioral Teratology, San Diego State University, San Diego, California; Department of Psychiatry (MAS), University of California, San Diego, La Jolla, California; Department of Psychological Sciences (KJS), University of Missouri-Columbia, and Midwest Alcoholism Research Center, Columbia, Missouri.
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  • R. Adron Harris,

    1. From the Department of Psychiatry and Neurobehavioral Sciences (BAJ), University of Virginia, Charlottesville, Virginia; Ernest Gallo Clinic and Research Center, Department of Neurology (ROM), University of California San Francisco, San Francisco, California; VA Boston Healthcare System, Department of Neurology (MEC), Harvard Medical School, Boston University School of Medicine, Boston, Massachusetts; Portland Alcohol Research Center, Department of Behavioral Neuroscience (JCC), Oregon Health & Science University and VA Medical Center, Portland, Oregon; Alcohol and Substance Use Research Institute, Department of Psychology (MSG), University of South Florida, Tampa, Florida; Section of Neurobiology (RAH), School of Biological Sciences, Waggoner Center for Alcohol and Addiction Research, University of Texas at Austin, Austin, Texas; Department of Psychiatry (HRK), Treatment Research Center, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Internal Medicine (MCM), Johns Hopkins University School of Medicine, Johns Hopkins Bayview Medical Center, Baltimore, Maryland; Division of Addiction Research, Department of Psychiatry (SJN), University of Florida, Gainesville, Florida; Department of Psychology (EPR, JDT), Center for Behavioral Teratology, San Diego State University, San Diego, California; Department of Psychiatry (MAS), University of California, San Diego, La Jolla, California; Department of Psychological Sciences (KJS), University of Missouri-Columbia, and Midwest Alcoholism Research Center, Columbia, Missouri.
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  • Henry R. Kranzler,

    1. From the Department of Psychiatry and Neurobehavioral Sciences (BAJ), University of Virginia, Charlottesville, Virginia; Ernest Gallo Clinic and Research Center, Department of Neurology (ROM), University of California San Francisco, San Francisco, California; VA Boston Healthcare System, Department of Neurology (MEC), Harvard Medical School, Boston University School of Medicine, Boston, Massachusetts; Portland Alcohol Research Center, Department of Behavioral Neuroscience (JCC), Oregon Health & Science University and VA Medical Center, Portland, Oregon; Alcohol and Substance Use Research Institute, Department of Psychology (MSG), University of South Florida, Tampa, Florida; Section of Neurobiology (RAH), School of Biological Sciences, Waggoner Center for Alcohol and Addiction Research, University of Texas at Austin, Austin, Texas; Department of Psychiatry (HRK), Treatment Research Center, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Internal Medicine (MCM), Johns Hopkins University School of Medicine, Johns Hopkins Bayview Medical Center, Baltimore, Maryland; Division of Addiction Research, Department of Psychiatry (SJN), University of Florida, Gainesville, Florida; Department of Psychology (EPR, JDT), Center for Behavioral Teratology, San Diego State University, San Diego, California; Department of Psychiatry (MAS), University of California, San Diego, La Jolla, California; Department of Psychological Sciences (KJS), University of Missouri-Columbia, and Midwest Alcoholism Research Center, Columbia, Missouri.
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  • Mack C. Mitchell Jr,

    1. From the Department of Psychiatry and Neurobehavioral Sciences (BAJ), University of Virginia, Charlottesville, Virginia; Ernest Gallo Clinic and Research Center, Department of Neurology (ROM), University of California San Francisco, San Francisco, California; VA Boston Healthcare System, Department of Neurology (MEC), Harvard Medical School, Boston University School of Medicine, Boston, Massachusetts; Portland Alcohol Research Center, Department of Behavioral Neuroscience (JCC), Oregon Health & Science University and VA Medical Center, Portland, Oregon; Alcohol and Substance Use Research Institute, Department of Psychology (MSG), University of South Florida, Tampa, Florida; Section of Neurobiology (RAH), School of Biological Sciences, Waggoner Center for Alcohol and Addiction Research, University of Texas at Austin, Austin, Texas; Department of Psychiatry (HRK), Treatment Research Center, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Internal Medicine (MCM), Johns Hopkins University School of Medicine, Johns Hopkins Bayview Medical Center, Baltimore, Maryland; Division of Addiction Research, Department of Psychiatry (SJN), University of Florida, Gainesville, Florida; Department of Psychology (EPR, JDT), Center for Behavioral Teratology, San Diego State University, San Diego, California; Department of Psychiatry (MAS), University of California, San Diego, La Jolla, California; Department of Psychological Sciences (KJS), University of Missouri-Columbia, and Midwest Alcoholism Research Center, Columbia, Missouri.
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  • Sara Jo Nixon,

    1. From the Department of Psychiatry and Neurobehavioral Sciences (BAJ), University of Virginia, Charlottesville, Virginia; Ernest Gallo Clinic and Research Center, Department of Neurology (ROM), University of California San Francisco, San Francisco, California; VA Boston Healthcare System, Department of Neurology (MEC), Harvard Medical School, Boston University School of Medicine, Boston, Massachusetts; Portland Alcohol Research Center, Department of Behavioral Neuroscience (JCC), Oregon Health & Science University and VA Medical Center, Portland, Oregon; Alcohol and Substance Use Research Institute, Department of Psychology (MSG), University of South Florida, Tampa, Florida; Section of Neurobiology (RAH), School of Biological Sciences, Waggoner Center for Alcohol and Addiction Research, University of Texas at Austin, Austin, Texas; Department of Psychiatry (HRK), Treatment Research Center, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Internal Medicine (MCM), Johns Hopkins University School of Medicine, Johns Hopkins Bayview Medical Center, Baltimore, Maryland; Division of Addiction Research, Department of Psychiatry (SJN), University of Florida, Gainesville, Florida; Department of Psychology (EPR, JDT), Center for Behavioral Teratology, San Diego State University, San Diego, California; Department of Psychiatry (MAS), University of California, San Diego, La Jolla, California; Department of Psychological Sciences (KJS), University of Missouri-Columbia, and Midwest Alcoholism Research Center, Columbia, Missouri.
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  • Edward P. Riley,

    1. From the Department of Psychiatry and Neurobehavioral Sciences (BAJ), University of Virginia, Charlottesville, Virginia; Ernest Gallo Clinic and Research Center, Department of Neurology (ROM), University of California San Francisco, San Francisco, California; VA Boston Healthcare System, Department of Neurology (MEC), Harvard Medical School, Boston University School of Medicine, Boston, Massachusetts; Portland Alcohol Research Center, Department of Behavioral Neuroscience (JCC), Oregon Health & Science University and VA Medical Center, Portland, Oregon; Alcohol and Substance Use Research Institute, Department of Psychology (MSG), University of South Florida, Tampa, Florida; Section of Neurobiology (RAH), School of Biological Sciences, Waggoner Center for Alcohol and Addiction Research, University of Texas at Austin, Austin, Texas; Department of Psychiatry (HRK), Treatment Research Center, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Internal Medicine (MCM), Johns Hopkins University School of Medicine, Johns Hopkins Bayview Medical Center, Baltimore, Maryland; Division of Addiction Research, Department of Psychiatry (SJN), University of Florida, Gainesville, Florida; Department of Psychology (EPR, JDT), Center for Behavioral Teratology, San Diego State University, San Diego, California; Department of Psychiatry (MAS), University of California, San Diego, La Jolla, California; Department of Psychological Sciences (KJS), University of Missouri-Columbia, and Midwest Alcoholism Research Center, Columbia, Missouri.
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  • Marc A. Schuckit,

    1. From the Department of Psychiatry and Neurobehavioral Sciences (BAJ), University of Virginia, Charlottesville, Virginia; Ernest Gallo Clinic and Research Center, Department of Neurology (ROM), University of California San Francisco, San Francisco, California; VA Boston Healthcare System, Department of Neurology (MEC), Harvard Medical School, Boston University School of Medicine, Boston, Massachusetts; Portland Alcohol Research Center, Department of Behavioral Neuroscience (JCC), Oregon Health & Science University and VA Medical Center, Portland, Oregon; Alcohol and Substance Use Research Institute, Department of Psychology (MSG), University of South Florida, Tampa, Florida; Section of Neurobiology (RAH), School of Biological Sciences, Waggoner Center for Alcohol and Addiction Research, University of Texas at Austin, Austin, Texas; Department of Psychiatry (HRK), Treatment Research Center, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Internal Medicine (MCM), Johns Hopkins University School of Medicine, Johns Hopkins Bayview Medical Center, Baltimore, Maryland; Division of Addiction Research, Department of Psychiatry (SJN), University of Florida, Gainesville, Florida; Department of Psychology (EPR, JDT), Center for Behavioral Teratology, San Diego State University, San Diego, California; Department of Psychiatry (MAS), University of California, San Diego, La Jolla, California; Department of Psychological Sciences (KJS), University of Missouri-Columbia, and Midwest Alcoholism Research Center, Columbia, Missouri.
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  • Kenneth J. Sher,

    1. From the Department of Psychiatry and Neurobehavioral Sciences (BAJ), University of Virginia, Charlottesville, Virginia; Ernest Gallo Clinic and Research Center, Department of Neurology (ROM), University of California San Francisco, San Francisco, California; VA Boston Healthcare System, Department of Neurology (MEC), Harvard Medical School, Boston University School of Medicine, Boston, Massachusetts; Portland Alcohol Research Center, Department of Behavioral Neuroscience (JCC), Oregon Health & Science University and VA Medical Center, Portland, Oregon; Alcohol and Substance Use Research Institute, Department of Psychology (MSG), University of South Florida, Tampa, Florida; Section of Neurobiology (RAH), School of Biological Sciences, Waggoner Center for Alcohol and Addiction Research, University of Texas at Austin, Austin, Texas; Department of Psychiatry (HRK), Treatment Research Center, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Internal Medicine (MCM), Johns Hopkins University School of Medicine, Johns Hopkins Bayview Medical Center, Baltimore, Maryland; Division of Addiction Research, Department of Psychiatry (SJN), University of Florida, Gainesville, Florida; Department of Psychology (EPR, JDT), Center for Behavioral Teratology, San Diego State University, San Diego, California; Department of Psychiatry (MAS), University of California, San Diego, La Jolla, California; Department of Psychological Sciences (KJS), University of Missouri-Columbia, and Midwest Alcoholism Research Center, Columbia, Missouri.
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  • Jennifer D. Thomas

    1. From the Department of Psychiatry and Neurobehavioral Sciences (BAJ), University of Virginia, Charlottesville, Virginia; Ernest Gallo Clinic and Research Center, Department of Neurology (ROM), University of California San Francisco, San Francisco, California; VA Boston Healthcare System, Department of Neurology (MEC), Harvard Medical School, Boston University School of Medicine, Boston, Massachusetts; Portland Alcohol Research Center, Department of Behavioral Neuroscience (JCC), Oregon Health & Science University and VA Medical Center, Portland, Oregon; Alcohol and Substance Use Research Institute, Department of Psychology (MSG), University of South Florida, Tampa, Florida; Section of Neurobiology (RAH), School of Biological Sciences, Waggoner Center for Alcohol and Addiction Research, University of Texas at Austin, Austin, Texas; Department of Psychiatry (HRK), Treatment Research Center, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Internal Medicine (MCM), Johns Hopkins University School of Medicine, Johns Hopkins Bayview Medical Center, Baltimore, Maryland; Division of Addiction Research, Department of Psychiatry (SJN), University of Florida, Gainesville, Florida; Department of Psychology (EPR, JDT), Center for Behavioral Teratology, San Diego State University, San Diego, California; Department of Psychiatry (MAS), University of California, San Diego, La Jolla, California; Department of Psychological Sciences (KJS), University of Missouri-Columbia, and Midwest Alcoholism Research Center, Columbia, Missouri.
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Reprint requests: Bankole A. Johnson, DSc, MD, Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, PO Box 800623, Charlottesville, VA 22908-0623. Tel.: 434-924-5457; Fax: 434-244-7565; E-mail: bankolejohnson@virginia.edu

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.

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