Extramural Research at the National Institute on Drug Abuse: Funding, Interests, and Public Policy

Article excerpt

Increased attention to drug abuse in the late 1980s led to large increases in funding for research at the National Institute on Drug Abuse. There was some expectation that new knowledge and improved technology would help shift the drug control focus away from law enforcement and toward treatment and prevention. The Institute and her primary research constituency of medical schools and universities responded with an important new emphasis on applied research focused on pressing social and medical problems. However, when public attention to drug abuse decreased in the mid 1990s, research sponsorship and activity reverted somewhat to its traditional concern with several areas of basic medical research relevant to but somewhat removed from the immediate needs of treatment and prevention programs. Advocates of demand side alternatives are left to wait for a medical breakthrough amidst a modest but steady stream of incremental research contributions to practice.

For several decades drug abuse control policy has been stalled in the U.S. at the crossroads of law enforcement and treatment/prevention. Law enforcement continues to dominate the policy mix despite widespread doubts about its overall efficacy and critics' claims of important social costs. Treatment and prevention programs have been expanded, but they still flounder on perceptions of a very limited technology and disappointing results. When the drug abuse issue burst onto the policy agenda in the late 1980s, there seemed to be little choice but to spend additional money on the standard policy areas of law enforcement, treatment, and prevention. Large budget increases were also devoted to drug abuse research, however, in the hope of improving existing services and developing new policy alternatives. With policy otherwise stuck, perhaps expanded research will lead to new knowledge and methods, better treatment and prevention programs, and thus a more effective mix of drug control policies.

Feverish concern over drugs in the late 1980s brought large increases in funding for drug control (see Figure 1 ). Total federal spending on domestic law enforcement, treatment, and prevention increased 491 % from 1986 to 1995 or from $1.9 billion to $11.2 billion; It now stands at $14.1 billion (1999). Across 1986 to 1995 domestic law enforcement funding increased 523% from $1.1 billion to $7 billion, while treatment and prevention went up 445% from $780 million to $4.3 billion. The law enforcement share of this domestic pie went from 51% to 62%, while treatment and prevention went from 49% to 38%. Increases were particularly large in 1987, 1989, and 1990 at 62%, 39%, and 53% (U.S. Office of Management and Budget, 1971-1999).

Increased expenditures for research on drug abuse treatment and prevention across the national government roughly parallel those for services across the boom years (see Figure 2). Federal spending for treatment and prevention research increased 425% from 1986 to 1995 or from $83.9 million to $440.8 million and now stands at $653 million ( 1999). Particularly large budget increases for treatment and prevention research also came in 1987 (69%, to $142 million), 1989 (37%, to $205.9 million), and 1990 (40%, to $287.9 million). Since then they have risen steadily to $655 million per year in 1999 (U.S. White House, 1999). Treatment and prevention research is thus a major investment and an important strategy in the latest push to relieve the nation of its drug abuse problem.

The lead federal research agency, the National Institute on Drug Abuse (NIDA), was established in 1972 as a key part of President Nixon's "war on drugs." Its mandate was to support and conduct research, provide technical assistance, and supervise treatment grants to states and localities. With the shift to block grant funding of local treatment programs in 1982, NIDA lost its supervisory role and became mostly a research actor.

The purposes of this paper are to describe and assess NIDA's research program across its 20-year history with an emphasis on the recent expansion. …