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March 2013 (Volume 91)
Quarterly Article
Grischa Metlay
December 2024
Dec 19, 2024
Back to The Milbank Quarterly
Context: The formation of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and the Special Action Office for Drug Abuse Prevention (SAODAP) in the early 1970s dramatically expanded scientific and medical efforts to control alcoholism and drug abuse in the United States.
Methods: Drawing on a variety of primary, secondary, and archival sources, this article describes the creation and early years of these agencies.
Findings: I show that while the agencies appeared at roughly the same time, their creation involved separate sets of issues and actors. In addition, I show that SAODAP received more money and resources, even though advocates for alcoholics mobilized a stronger lobbying campaign.
Conclusions: Two factors explain this discrepancy in money and resources: (1) alcoholism was framed as a public health problem, whereas drug abuse was drawn into broader debates about crime and social decline; and (2) alcohol programs relied on congressional support, whereas drug programs found champions at high levels of the Nixon administration. These political and cultural factors help explain why current programs for illegal drugs receive more federal support, despite alcohol’s greater public health burden.
Author(s): Grischa Metlay
Keywords: alcoholism, drug abuse, substance abuse, National Institute on Alcohol Abuse and Alcoholism, National Institute on Drug Abuse, Special Action Office for Drug Abuse Prevention, policy history
Read on Wiley Online Library
Volume 91, Issue 1 (pages 123–162) DOI: 10.1111/milq.12004 Published in 2013