National Institutes of Health Scientific Management Review Board members voted 12 to 3 in September in favor of dissolving both the National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism in order to form a new institute devoted to addiction research. Structural reorganization was one of two options the review board's Substance Use, Abuse, and Addiction Working Group proposed in a report, which has since been revised to include the meeting proceedings. It is now in the hands of NIH Director Francis Collins, who must decide whether or not to accept SMRB's recommendation to merge the institutes.
Under the second option proposed by the working group, NIAAA would remain separate, and a trans-NIH initiative would be formed to accommodate the agency's entire portfolio of addiction research — including, for example, tobacco addiction-related research currently funded by the National Cancer Institute. Whether Collins ultimately supports either option, members of the SUAA Working Group "strongly agree that some form of reorganization is required in order to effectively capitalize upon existing and potential synergies, address scientific opportunities, meet public health needs, and train the next generation of investigators," according to their report.
Those in favor of a structural reorganization suggest that "the existence of separate institutes for alcohol and drugs perpetuates the misconception … that alcohol is not, in fact, a drug." Conversely, those opposed to a merger say that separate institutes are necessary to maintain a consistent public health image; combining research on licit and illicit substances, they fear, could assign an unnecessary stigma to alcohol.
If a new institute is indeed established, it would absorb all addiction research portfolios at NIH. Research not related to addiction would be transferred to other institutes "as deemed appropriate," according to SUAA.
Under the NIH Reform Act of 2006, should Collins accept the SMRB's recommendation, he must submit a proposal for the termination of NIDA and NIAAA and the creation of a new institute to the Department of Health and Human Services Secretary Kathleen -Sebelius. If she were to approve such a proposal, Sebelius would -present the matter to the US Congress.