This report was edited and produced by EEI under the able direction of Claire Kincaid and June Morse. INTRODUCTION S ince 1971, the Special Reports to Congress on Alcohol and Health have documented many significant milestones in alcohol research. From summaries of broad areas of research such as genetics, neurosciences, alcohol-related medical and social problems, epidemiology, prevention, and treatment to specific research milestones such as the finding that there is a genetic component to alcoholism, the identification of the fetal alcohol syndrome, the development of viable animal models, and the determination of a relationship between lowered minimum drinking ages and increased alcohol-related automobile accidents and fatalities, the Special Reports have served as a marker by which we know where we have been, where we are now, and where we must look in the future. Like its predecessors, the Eighth Special Report to the U.S. Congress on Alcohol and Health describes important alcohol research milestones. It also documents a major milestone for the alcohol field: It is the first Special Report to be issued after the transfer of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and its responsibilities for the Nation's alcohol research portfolio to the National Institutes of Health (NIH). The alcohol field will gain from this move in several ways. By standing in the company of other medical research Institutes, the quality and accomplishments of alcohol research will be better recognized. Further, the inclusion of alcohol research findings in NIH's extensive research dissemination activities will permit more people to have access to these findings. Increased recognition for alcohol research and the opportunity to reach a wider audience will help further reduce the stigma associated with alcoholism and focus attention on alcohol-related problems by scientists, physicians and other health care professionals, educational institutions, and the general public. They will also help alcohol scientists to be more competitive in obtaining their fair share of curriculum time, space, and support from university and other institutional officials. Most important, alcohol abusers and alcoholics will gain the benefits that will accrue from research stimulated and nurtured within the NIH community. The NIH community will also benefit. As can be seen from the wealth of information in the Eighth Special Report, we bring with us a quality research program that is rich in diversity and that can be the basis of increased collaborative activities with our NIH colleagues. We also bring a well-developed understanding of the connections between basic biological and behavioral research, particularly important in light of the increasing awareness by the medical community and the American public of the link between behavior and illness. While the move to NIH represents a new opportunity for increased visibility, respect, and collaboration within the medical research community, it also represents a challenge to both alcohol research and to the alcohol field. For alcohol research, the challenge will be to see ourselves as a part of rather than apart from the medical research community. From the Institute's earliest beginnings, alcohol researchers have had to fight against stigma and stereotypes to conduct the type of high-quality research necessary to understand the complexities of alcohol abuse and alcoholism. Our location away from the main body of biomedical research helped nurture both alcohol research and researchers but also gave the impression that alcohol abuse and alcoholism were not legitimate illnesses. The move to NIH will confirm in the public's mind what we have known all along that alcohol abuse and alcoholism are major health problems deserving the same type of attention as other health concerns. It was important to be apart to nurture our field; it is now important to be a part of the larger effort to help improve health outcomes for our Nation's citizens. It is clear from the outstanding progress made thus far in understanding the biological, behavioral, social, and economic causes and consequences of alcohol abuse and alcoholism documented by the Eighth Special Report that we are ready for the challenge. For the alcohol field, the challenge will be to not lose sight of the fact that each of us-researcher, clinician, policymaker alike-share the same basic goals: to reduce the incidence and prevalence of alcohol abuse and alcoholism, and to reduce the morbidity and mortality associated with the use of alcohol. Like alcohol research, alcoholism prevention and treatment also developed and matured apart from medicine. It is an active field that demands attention to alcohol-related policies and programs and participates in shaping our country's response to alcohol-related problems. The field is also becoming increasingly sophisticated in its understanding of and desire for prevention and treatment measures that have undergone the careful scrutiny we commonly expect for other illnesses. The move of alcohol research to NIH, away for the first time from our colleagues in alcoholism prevention and treatment, means that we must redouble our efforts to maintain lines of communication and collaboration within the field. Like siblings discovering that they can chart their own course away from the family without severing the bonds that hold the family together, we must understand that collaboration is not just desirable but absolutely necessary if patients with alcoholism are to be as well served as patients with other diseases. The bottom line is that we all want the same thing. The challenge will be to understand that we must do it together to achieve success. I am proud of the accomplishments of alcohol research as documented in the Eighth Special Report to the U.S. Congress on Alcohol and Health. I wish to acknowledge and thank the scientists who helped us share the results of alcohol research with our colleagues in medicine and in the alcohol field and with our constituents in the general public. I also wish to express my appreciation to the NIAAA staff who have once again shown extraordinary competence in pulling together a document of this magnitude. My special thanks to Dr. Kenneth Warren, Director of NIAAA's Office of Scientific Affairs, for his overall direction of the preparation of this report and to Ms. Jane Lockmuller, Scientific Communications Branch, NIAAA, for her outstanding management, writing, and editing expertise that made this document possible. Enoch Gordis, M.D. Director National Institute on Alcohol Abuse and Alcoholism |