Your News Feature “A hard habit to break” (Nature 430, 394–395; 2004) reports on the commitment of Nora Volkow, the director of the National Institute on Drug Abuse (NIDA), to pursue science despite pressures to follow politically motivated agendas.
However, the article less fully describes the mission, goals or scientific achievements of NIDA over the past 30 years. NIDA's previous director, Alan Leshner, should be credited for conveying a clear science-based message that drug addiction is a brain disease, deserving the same research and medical-insurance support as other diseases targeted by the National Institutes of Health (NIH).
Contrary to the assertion that NIDA shuns research into ‘harm reduction’ strategies, NIDA studies have examined the impacts of needle-exchange programmes and the effectiveness of office-based methadone maintenance — with documented success. NIDA has also funded extensive research on methadone to understand exactly what features of methadone maintenance make it an effective treatment for opiate addiction.
NIDA has supported basic and applied clinical research on the molecular, neurobiological and behavioural basis of drug abuse and addiction. It has also supported neurochemical, pharmacological and behavioural research for development of long-term treatments for each of the specific addictions. NIDA has funded research on the treatment, epidemiology and prevention of drug abuse, in accord with its NIH research mandate.
Like other NIH institutes, NIDA does not set policy. Rather, it supports the best science, providing information, which, if appropriately used, can inform the development of enlightened policies. NIDA supports research that documents the most effective approaches for treatment of a disease. Unlike the diseases and diverse disorders that are the domain of other NIH institutes, drug abuse and drug addiction have only recently been accepted as diseases of the brain with molecular genetic, environmental and drug-induced bases. As such, these diseases, like all others, require appropriate intervention and chronic treatment for some, and prevention for others.
Mary Jeanne Kreek The Rockefeller University, 1230 York Avenue, New York, New York 10021, USA
Other signatories to this letter:
Reese Jones University of California, San Francisco, USA
Herbert D. Kleber Columbia University, USA
Thomas Kosten Yale University, USA
Charles O'Brien University of Pennsylvania, USA