On December 31, 1970, Congress passed the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment, and Rehabilitation Act, the legislation that created the National Institute on Alcohol Abuse and Alcoholism (NIAAA). The new Institute’s mandate was to “develop and conduct comprehensive health, education, training, research, and planning programs for the prevention and treatment of alcohol abuse and alcoholism.” Five decades later, NIAAA is the world’s largest funder of alcohol research—supporting comprehensive, multidisciplinary studies to pursue the mission of advancing and disseminating evidence-based knowledge to improve the diagnosis, prevention, and treatment of alcohol use disorder (AUD) and alcohol-related problems across the lifespan.
NIAAA is now celebrating its 50th anniversary, a milestone that has prompted NIAAA leadership to reflect on these five decades of progress.
NIAAA Director George F. Koob, Ph.D., comments, “While we have much more work to do, today we know more about how alcohol affects the brain and body than ever before, and we have better interventions to prevent and treat alcohol misuse, thanks largely to the determined and uncompromising efforts of the talented researchers supported by NIAAA. These efforts have provided the foundation for the recognition of AUD as a medical disorder ranging from mild to severe, rather than a moral failing.” Patricia A. Powell, Ph.D., Deputy Director of NIAAA, adds, “We’ve worked hard to share this information with health professionals and the public, and I think more recently we’re beginning to see a nationwide shift in attitudes about alcohol-related issues.”
Antonio B. Noronha, Ph.D., Director of NIAAA’s Division of Neuroscience and Behavior, says, “One cannot overstate the importance of NIAAA support for shaping our current understanding of the neurological underpinnings related to AUD. From early independent studies that discovered unique brain wave patterns and neuroimaging patterns found in people with a history of AUD, to today’s large-scale multi-disciplinary research networks such as the Integrative Neuroscience Initiative on Alcoholism [INIA], NIAAA has been the engine driving new discoveries about alcohol’s impact on the brain across the lifespan. Researchers continue to push the boundaries of alcohol regarding tolerance, pain modulation, sleep-related problems, and many other fields of neuroscience exploration.”
George Kunos, M.D., Ph.D., Director of NIAAA’s Division of Intramural Clinical and Biological Research (DICBR), states, “At the time that NIAAA was established, little was known about how alcohol alters brain function. With NIAAA support, researchers have discovered how specific neuronal proteins are altered by acute and chronic alcohol exposure, and how these effects influence brain function and behavior.” DICBR’s Deputy Director, David Lovinger, Ph.D., notes, “Since NIAAA’s establishment, a variety of preclinical and clinical methods for measuring alcohol consumption and assessing intoxication, tolerance, dependence, and withdrawal have been developed.” Indeed, the work of NIAAA-supported intramural and extramural researchers has shed light on the cellular and molecular mechanisms that underlie the effects of alcohol on the brain and liver, paving the way for the development of novel pharmacotherapies for the treatment of AUD and alcohol-associated liver disease (ALD).
Kathy Jung, Ph.D., Director of NIAAA’s Division of Metabolism and Health Effects, comments: “From its earliest years, NIAAA has championed pivotal studies on fetal alcohol spectrum disorders [FASD]. This includes ground-breaking research focused on alcohol as a teratogen, and innovative neuroimaging and neurobehavioral research in humans revealing that brain regions involved in learning, memory, attention, decision-making, emotional control, and motor skills appear to be most sensitive to prenatal alcohol exposure. Furthermore, NIAAA-supported research has advanced our understanding of FASD prevalence and the development of effective learning and behavioral interventions to help people with FASD.
“In addition, over the past decades NIAAA-supported investigators have contributed significantly to an enhanced understanding of how alcohol contributes to tissue injury throughout the body as well as co-occurring health conditions such as HIV infection.
“More recently, NIAAA broke new ground in the area of alcohol biosensors through the Wearable Alcohol Biosensor Challenge, raising renewed interest and new possibilities based on modern technologies.”
Ralph Hingson, Sc.D., Director of the Division of Epidemiology and Prevention Research, reflects, “Since the founding of NIAAA, several areas of alcohol prevention have shown substantial progress. This includes NIAAA-supported research demonstrating the effectiveness of the minimum legal drinking age of 21, a key public health strategy.
“Historically, NIAAA has paid special attention to preventing and reducing underage drinking and alcohol misuse among college students, contributing to a steady decline in underage drinking over the past two decades. Also, NIAAA-funded investigators demonstrated that the younger the age that people begin to drink, the greater the likelihood they will develop AUD. NIAAA also convened a task force of college presidents and researchers in the late 1990s, culminating in a landmark report on the magnitude of college drinking problems and evidence-based interventions to prevent them. The report gave national visibility to the need to reduce binge drinking and alcohol-related consequences among college students. NIAAA has invested similarly in disseminating research findings about effective college alcohol interventions. A prime example is CollegeAIM—the College Alcohol Intervention Matrix, a resource to help college and university officials identify interventions to reduce student drinking and related problems.”
Raye Z. Litten, Ph.D., Acting Director of NIAAA’s Division of Medications Development and Division of Treatment and Recovery Research, reflects: “When NIAAA was founded, only one compound—disulfiram—was available to treat AUD, and health professionals were just beginning to make inroads in behavioral therapies. Today, thanks in large part to NIAAA’s investment in treatment research, patients with AUD have access to two additional medications approved by the Food and Drug Administration [FDA]—acamprosate and oral and long-term injectable naltrexone—and many other promising compounds are under investigation. In addition, a menu of behavioral therapies, such as cognitive behavioral therapy, motivational enhancement therapy, 12-step facilitation therapy, brief intervention, and couples therapy, have demonstrated efficacy in clinical studies.
“NIAAA also has demonstrated a longstanding commitment to disseminating science-based research information, tools, and resources for clinicians, patients, and families, including web-based tools such as the NIAAA Alcohol Treatment Navigator. These and other programs are milestones of NIAAA’s distinguished record of pursuing strategies to make evidence-based behavioral therapies and medications more accessible by integrating them into mainstream medicine.”
As NIAAA reflects on 50 successful years of alcohol research, the Institute is poised to build on the progress that has been made to gain greater insights for the future. In the coming year, visit the NIAAA website and follow NIAAA on Twitter and Instagram for more updates about NIAAA's milestones and the continued commitment to advance the field of alcohol research. For our resources mentioned in this article and more, visit the NIAAA Alcohol Treatment Navigator, CollegeAIM, and Rethinking Drinking.
This feature originally appeared in the NIAAA Spectrum. Volume 12, Issue 1. Winter 2020.