• Conducts and supports basic and biobe-havioral research aimed at determining the causes of alcoholism, discovering how alcohol damages the organs of the body, and developing prevention and treatment strategies for application in the Nation's health care system;

• Serves as a national resource for the collection, analysis, and dissemination of scientific findings;

• Supports training and development of scientists for participation in alcohol research programs and activities;

• Conducts policy studies that have broad implications for alcohol problem prevention, treatment, and rehabilitation activities; and

• Conducts epidemiological studies as well as national and community surveys to assess the risks for and magnitude of alcohol-related problems among various population groups.

May 14, 1974--Passage of P.L. 93-282, which established NIAAA, NIMH, and NIDA as coequal institutes within the Alcohol, Drug Abuse and Mental Health Administration.

July 26, 1976--Expansion of NIAAA's research authority to include behavioral and biomedical etiology of the social and economic consequences of alcohol abuse and alcoholism under authority of the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act amendments of 1976 (P.L. 94-371).

August 1981--Passage of the Omnibus Budget Reconciliation Act of 1981 (P.L. 97-35) transferred responsibility and funding for alcoholism treatment services to the states through the creation of an Alcohol, Drug Abuse, and Mental Health Services block grant administered by ADAMHA and strengthened NIAAA's research mission.

October 27, 1986--Creation of a new Office for Substance Abuse Prevention in ADAMHA by the Anti-Drug Abuse Act of 1986 (P.L. 99-570) consolidated the remainder of NIAAA's nonresearch prevention activities with those of NIDA and permitted NIAAA's total commitment to provide national stewardship to alcohol research.

July 10, 1992--NIAAA became a new NIH research institute under authority of ADAMHA Reorganization Act (P.L. 102-321).

Born on February 21, 1931, in New York, N.Y., Dr. Gordis received his B.A. degree from Columbia University in 1950 and his M.D. degree from the Columbia College of Physicians and Surgeons in 1954. He trained in internal medicine at the Mt. Sinai Hospital in New York. Following his residency, he spent 10 years at New York City's Rockefeller University conducting research in the areas of lipid metabolism, toxicology of carbon tetrachloride, analytical biochemistry of drug stereoisomers, the metabolism of alcohol, and alcohol withdrawal.

Subsequently he founded the alcohol treatment program at the city hospital center at Elmhurst, N.Y., and was professor of clinical medicine at Mt. Sinai School of Medicine. He directed Elmhurst's alcoholism program from 1971 until his appointment as NIAAA director in November 1986.

Dr. Gordis is a member of numerous organizations including the Institute of Medicine of NAS, the American Physiological Society, the American Federation for Clinical Research, Sigma Xi, the American Gastroenterological Association, fellow of the American College of Physicians, and the Research Society on Alcoholism.

Genetics

The legacy of alcoholism in families has prompted researchers to explore the genetic and environmental factors that contribute to heightened vulnerability to alcoholism and the genetic factors that appear to protect certain individuals from developing the disease. Among it research activities in genetics, NIAAA has a cooperative agreement for a multidisciplinary, collaborative study involving seven research institutions across the U.S. to determine how vulnerability to alcoholism is transmitted through families. This study, initiated in the fall of 1989, involves the detailed diagnostic evaluation and genetic typing of 2,400 individuals comprising several hundred families in which alcoholism may be inherited. The long-term objective of this research is to pinpoint genes that influence the susceptibility to alcoholism.

Alcohol and Pregnancy

NIAAA supports many laboratory studies of alcohol's effects on prenatal and postnatal development. In recent years studies to determine why and how alcohol adversely affects the developing fetus have uncovered a number of mechanisms that likely contribute in differing degrees to fetal alcohol syndrome. Alcohol may inhibit cell growth, migration, and differentiation by interfering with the signaling molecules that control these steps in development. Last year, NIAAA funded a new study of relationships between alcohol consumption levels and the prevalence of alcohol-related birth defects among several Native American communities at relatively high-risk of fetal alcohol syndrome.

The effects of low-level or moderate drinking on prenatal development are of considerable concern because this pattern of drinking is so prevalent. Because alcohol's effects on development lie on a dose-dependent continuum, it is important to assess developmental patterns in children in relation to a wide range of prenatal exposure levels. NIAAA supports longitudinal studies of the relationship between maternal alcohol consumption during pregnancy and developmental outcomes in offspring. Neuro-behavioral deficits are expressed in different forms according to age, and difficulties with social and academic functioning appear to be lifelong.

Medications Development

NIAAA is strongly committed to the development of pharmacological interventions to diminish the craving for alcohol, reduce risk of relapse, and safely detoxify dependent individuals undergoing treatment. Pharmacologic agents are at various stages of development ranging from preclinical research to clinical application for the treatment of alcoholism.

Naltrexone, an opioid antagonist, has recently been approved by FDA as a safe and effective adjunct to psychosocial treatment for alcoholism.

Since alcohol-seeking behavior is complex and involves several neurotransmitter systems and neurohormones, NIAAA is exploring a range of additional medications to modify drinking behavior. Serotonin uptake inhibitors have shown considerable promise in animal models and may assist alcoholics with collateral depression. Related topics of interest are medication compliance, differential effect of pharmacotherapies on subtypes of alcoholics, and effects of medications when combined with psychosocial interventions.

Neurosciences

NIAAA-funded research is exploring the numerous targets in the brain on which alcohol acts. New methodologies are now becoming available to measure how alcohol acts on neural circuits in the brain to alter behavior. Noninvasive, functional imaging technologies are being used in animal and human studies to identify the neural circuits involved int the reinforcing properties of alcohol leading to and maintaining addictive alcohol-seeking behaviors. In addition, important new assessments are being made of alcohol-linked behaviors in freely behaving animals performing behavioral tasks combined simultaneously with changes in neurotrasmitters and neuro-modulators in specific brain circuits using in vivo techniques such as microdialysis, voltammetry, or electrophysiological recordings in multiple areas of the brain. Such studies will lead to the development of therapeutic agents to treat alcohol abuse and alcoholism.

Studies on the effects of ethanol on cell membrane receptors, ion channels, and expression of genes coding for these important proteins are yielding intriguing insights into basic mechanisms of ethanol's action. Combined with studies on region specific effects of ethanol on the release of neurotransmitters, these investigations will elucidate how ethanol produces reward, dependence, tolerance, and brain damage. Behavioral studies on animals, using mainly mice and monkeys, combined with molecular genetics and behavioral manipulations during development, examine important protective and causal factors for alcohol abuse and dependence.

NIAAA utilizes a combination of clinical and basic research facilities which enables a coordinated interaction between basic research findings and clinical applications in pursuit of these goals. An inpatient ward and a large outpatient program are located in the NIH Clinical Center.

Genetics of Alcoholism

This research focuses on investigating the genetic determinants of the risk for alcoholism. Studies on impulsive and violent alcoholics show that there is a clinical subgroup of alcoholics with polydrug abuse and antisocial personality features who also display deficits in serotonin function. The goal of this research is to understand how natural variants of genes involved in serotonergic neurotransmission affect human behavior. Two approaches are used: molecular cloning and expression studies of genes involved in serotonin function, and intensive behavioral and neuropsychological studies of human families and animal strains with natural variants of serotonin genes.

In conducting this research NIAAA scientists examine a variety of populations to determine how genetics and environment interact in the development of alcoholism and concomitant psychopathologies including drug abuse, antisocial personality, anxiety, and mood disorders. Techniques include family transmission studies and genetic linkage analyses using selected candidate genes and a large number of polymorphic markers.

To identify genes for complex, heterogeneous psychiatric diseases, it is helpful to define genetic characteristics which could correlate more precisely with genotypes. Neurophysiologic differences in alcoholism may serve this purpose these differences include a diminished amplitude of a specific electrophysiological trait--called the P300 evoked potential--and the low voltage alpha component of the electroencephalogram. Approaches include family transmission studies and a genetic linkage study to map the genes determining the variants. Psychiatric interviews are conducted to correlate neurophysiological phenotype with clinical phenotype and behavior.

Alcohol and Essential Fatty Acids.

NIAAA researchers are investigating the biological functions of essential fatty acids and the adverse effects of alcohol on these functions. A clinical study of alcoholics has indicated that there is a loss of essential polyunsaturated fatty acids in the tissues and blood cells of these patients. Such losses are believed to be related to the tissue damage that occurs in almost every organ system in alcoholics but particularly in the liver and brain. Alcohol is perhaps the only dietary constituent that is capable of depleting the omega-3 fatty acids from the brain, and this may lead to the degeneration of neural cells and a loss in brain and visual function. An interdisciplinary approach is taken in these studies.

Losses of organ polyunsaturated fats as a consequence of chronic alcohol abuse, the underlying metabolic mechanisms and modulating nutritional factors, and the consequences for membrane function as assessed by biochemical and biophysical means are an integral part of this work. Fluorescence spectroscopy and magnetic resonance imaging are the principal tools used to study the functions of polyunsaturated phospholipids in membranes. Mass spectrometry is used for sensitive analysis of fatty acid metabolites in humans. Studies are also being conducted on the lipid requirements of the nervous system during early development, and the full range of experimental and clinical approaches available in the laboratory are employed in this effort.

Molecular Mechanisms of Alcohol Action in the Brain.

Recent NIAAA research studies have demonstrated that alcohol affects signal transduction systems involved in the regulation of nerve cell excitability and the transmission of information at synapses. Using newly developed physiological and molecular biological techniques, institute scientists are working toward determining the molecular mechanisms of alcohol's interaction with these signal transduction systems. Scientists also will investigate the molecular alterations of neural function associated with alcohol tolerance, dependence, and withdrawal. This information will significantly lead to our understanding of the molecular basis of alcohol dependence and to development of new treatments and prevention strategies.

Mutually beneficial collaborative research efforts have been developed with other countries and international organizations. Research information is exchanged on a regular basis with over 30 countries. This office also coordinates the institute's science education initiative. Special projects in collaboration with educators of K-12 students are in progress.

Among its many recent collaborative national and international activities, NIAAA has cosponsored projects with other institutes and organizations studying birth defects, liver disease, AIDS, women's health, minority health, aging, and health services research. NIAAA has supported sicentific eschanges to increase the research capability of scientists in several foreign countries or to support collaborative research with grantees. The institute has responded to requests for joint research efforts, developed productive cooperative projects, or supported grantees to work with scientists in Finland, Poland, Mexico, Russia, the Czech Republic, Canada, Spain, and many other countries.