The creation of a new Institute of Addictions was recently recommended by an expert working group of the National Institute of Health. It recommended replacing the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and the National Institute on Drug Abuse (NIDA.) The two groups completely disagree — it is rare for an issue like this to cause such division within the NIH. Earlier this year, advisers to NIAAA voted unanimously against the plan, whereas advisers to NIDA voted unanimously for it. Dr Inaba shares his thoughts.