Leveraging Collaboration to Address Alcohol Problems
Alcohol consumption affects virtually every tissue and organ in the body and is associated with more than 200 diseases and injury-related conditions. For this reason, collaborative efforts across the National Institutes of Health (NIH) are critical. Research collaborations allow scientists from diverse fields of study to work together in new ways and to apply their unique strengths and resources toward a common problem.
“We’ve long recognized the cross-disciplinary nature of alcohol problems,” said National Institute on Alcohol Abuse and Alcoholism (NIAAA) Director George F. Koob, Ph.D. “While collaboration has always been an essential component of the research enterprise, this approach is particularly crucial to improving the prevention, diagnosis, and treatment of alcohol-related problems. Alcohol is relevant to many diseases and conditions, and building strategic relationships with our fellow NIH Institutes, Centers, and Offices [ICOs] is pivotal to advancing cross-cutting mission-related research areas and maximizing research resources.”
NIH-wide collaborations leverage the vast scientific resources and expertise across ICOs, enabling coordinated responses to complex problems that benefit from interdisciplinary or multidisciplinary approaches. Key areas of collaboration include:
Neuroscience research has broad applications for the study of neurological and psychiatric disorders, including alcohol and other substance use disorders.
NIAAA is one of 14 NIH ICOs that work together with the NIH Office of the Director on the NIH Blueprint for Neuroscience Research, a collaborative framework that supports research on the nervous system. By pooling resources and expertise, the “Blueprint” identifies cross-cutting areas of research and confronts challenges too large for any single NIH component. Several areas of collaboration include drug discovery and development for central nervous system (CNS) disorders, neuroscience training, and research on neuroimmune interactions involved in the transition from healthy brain function to the onset and progression of CNS disorders.
As part of the Brain Research through Advancing Innovative Neurotechnologies® (BRAIN) Initiative, NIAAA works with nine other NIH Institutes and Centers on a large-scale effort to accelerate neuroscience research by developing novel tools for studying the brain. Technological advances resulting from this initiative will facilitate innovative research that can enhance our understanding of a wide variety of brain disorders.
Within NIH’s Intramural Research Program, scientists at NIAAA lead a collaboration of basic and clinical researchers who compose the NIH Center on Compulsive Behaviors (CCB), which include addiction, tics, and binge eating, are driven by shared neurocircuitry. Accordingly, the mission of the CCB is to understand the neurobiology of complex behaviors that result in compulsive and repetitive actions, and to develop and test new therapeutics aimed at alleviating or reversing them.
The relationship between alcohol and pain is complex. At high doses, alcohol dulls pain; however, long-term excessive drinking makes physical pain worse.
Understanding the relationship between alcohol and pain is an important area of research that may have implications for the opioid epidemic. NIAAA participates in the Helping to End Addiction Long-term (HEAL) InitiativeSM, one avenue for supporting research in this area. The HEAL Initiative is an aggressive, NIH-wide effort to speed scientific solutions for both addiction and pain management to stem the national opioid public health crisis.
NIAAA also participates in the NIH-Department of Defense-Veterans Affairs (NIH-DoD-VA) Pain Management Collaboratory, led by the National Center for Complementary and Integrative Health, to build cost-effective large-scale clinical research capacity in military and veterans healthcare delivery organizations that focus on non-pharmacological approaches to pain management and other comorbid conditions, such as alcohol misuse.
Prevention and Treatment of Substance Misuse and Co-occurring Disorders
Alcohol misuse commonly co-occurs with other substance use and mental health disorders and plays a prominent role in suicides and in opioid and other drug overdoses. To support improvements in the prevention and treatment of substance misuse, NIAAA partners with the National Institute on Drug Abuse (NIDA) and the National Cancer Institute (NCI) through the Collaborative Research on Addiction at NIH (CRAN) to integrate resources and expertise to advance research on substance use, substance misuse, and addiction, as well as public health outcomes. A major initiative led by CRAN is the Adolescent Brain Cognitive DevelopmentSM Study (ABCD Study®) study, the largest long-term study of brain development and child health in the United States. NIAAA also collaborates with NIDA and the National Institute of Mental Health (NIMH) in exploring research strategies for addressing deaths due to substance misuse and suicide.
Effects of Alcohol on Health
Alcohol misuse contributes to nearly half of all liver disease deaths in the United States, and alcohol-associated liver disease (ALD) is now the leading cause of liver transplantation due to chronic liver disease. In addition to supporting basic, translational, and clinical research on potential ALD treatments, NIAAA is collaborating with the National Institute of Diabetes and Digestive and Kidney Diseases to enhance research on the shared mechanisms between alcohol-associated and non-alcohol-associated fatty liver disease and how one condition may exacerbate the other.
In the area of cancer research, NIAAA and NCI have partnered to stimulate research on the relationships between alcohol consumption and cancer risk and outcomes, including studies on the biological and behavioral mechanisms through which alcohol influences cancer risk. A better understanding of these relationships could lead to improved therapeutic approaches and preventive strategies.
Fetal alcohol spectrum disorders research represents another key area of collaboration. A sponsor and chair of the Interagency Coordinating Committee on Fetal Alcohol Spectrum Disorders (ICCFASD), NIAAA works with the Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIMH, and other federal partners to coordinate communication and collaboration across disciplines and federal agencies that address issues related to prenatal alcohol exposure.
One in ten adults ages 65 and older engage in binge drinking, and most older adults take a medication that could result in a harmful interaction with alcohol. NIAAA encourages research to increase the understanding of the effects of alcohol use on the brain and body of older adults, such as the link between advanced age and the risk for alcohol-induced brain damage and cognitive decline. Recently, NIAAA has partnered with the National Institute on Aging to expand research on the neurobiological mechanisms that underlie the influence of alcohol on the onset and progression of Alzheimer’s disease and related dementias.
Overall, the adverse effects of alcohol misuse manifest throughout the body and across all segments of society. By collaborating with other NIH Institutes or federal agencies, NIAAA researchers bring diverse scientific knowledge and expertise to bear on these public health problems of mutual interest and concern, and thus multiply the value of crucial research resources. Through strategic relationships with NIH ICOs and other federal partners, NIAAA will continue to advance its mission to generate and disseminate fundamental knowledge about the effects of alcohol on health and well-being, and apply that knowledge to improve the diagnosis, prevention, and treatment of alcohol-related problems across the lifespan.