A Plan to Address Racism in Addiction Science

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Racism is rampant in the US with effects that are pervasive and wide-ranging, including in the areas of science and health. In 2020, in response to events like the murder of George Floyd that highlighted once again how far our society is from real racial equity, leaders from across the country stepped forward to provide their commitments to making a difference, NIH leadership included. Francis Collins and Larry Tabak announced the NIH-wide UNITE Initiative to end structural racism in biomedical sciences, and in parallel NIDA established the Racial Equity Initiative (REI) to work toward eliminating racism and racial bias from (1) the NIDA workplace, (2) the larger workforce of scientists and staff supported by our Institute, and (3) the portfolio of addiction-related research NIDA funds.

Since establishing the REI, workgroups composed of NIDA staff volunteers have held numerous listening sessions to solicit input from our staff on the three goals of the initiative, and we held a scientific meeting in February 2021 on enhancing research in health disparities associated with substance use and addiction. The meeting was open to the public and featured leaders in the addiction research community with expertise in social determinants of health. The result of these and other activities is a draft Racial Equity Initiative Action Plan to focus our efforts in eliminating racism and racial bias over the coming years.

The draft Action Plan consists of Goals and Objectives designed to further the missions of the three workgroups: Workplace, Workforce, and Research Gaps and Opportunities. Before finalizing and implementing the Action Plan, we are now seeking input from the public in all three areas, including input from the scientific community, healthcare professionals, and people who use drugs or have addiction, and their families.

The aim of the NIDA REI Workplace Workgroup is to create opportunities for safe and regular communication among staff and between staff and management about concerns related to racial bias and harassment and take measures to promote racial equity, inclusion, and diversity—both in NIDA’s headquarters in Bethesda, Md., and at its Intramural Research Program in Baltimore. Special focus will be given to providing ongoing opportunities for sharing and obtaining feedback from NIDA staff about the workplace climate and implementing measures to keep that climate free from harassment and discrimination.

The NIDA REI Scientific Workforce Diversity Workgroup aims to increase racial and ethnic diversity, equity, and inclusivity in the wider community of addiction researchers. It requires identifying disparities and systemic barriers to workforce diversity, increasing engagement among students and those scientists, and taking measures to ensure that groups historically underrepresented in addiction science are fostered throughout their education, incentivized to pursue an addiction science career, and retained in that career path. The latter goal may entail continuing to implement policy changes in grantmaking with the goal of recruiting and retaining a more diverse community of scientists studying addiction. Objectives include addressing factors such as racial imbalance on review committees that perpetuate the bias in favor of white grant applicants and holding principal investigators and their institutions accountable for diversity and inclusivity. 

Inevitably, lack of diversity and imbalances in the research community are self-perpetuating, contributing to blind spots in the kinds of topics that receive the most attention. The aim of the NIDA REI Research Gaps and Opportunities Workgroup is to increase support for research on social determinants of drug use, addiction, and related conditions and the ways these contribute to racial health disparities in our society. Although social determinants are already a research priority for NIDA, a key focus of this Initiative will be to identify topics (such as stigma) that have not been given adequate priority in the past and to test and implement sustainable remediation strategies to address them. Developing tools to measure social determinants and ensuring the inclusion of underrepresented minorities in clinical trials are among the many objectives of this part of the Action Plan.

By sharing this draft plan with the research community, stakeholders, and others, we ask for input and perspectives that can inform our work. We are listening, and we are particularly interested in listening to those who have been directly or indirectly impacted by structural racism or racial bias in NIDA practices or research. Sharing your thoughts and views will help ensure that the plan is comprehensive, realistic, and meets the needs of those most affected by racial discrimination and unconscious bias.

The draft Action Plan can be read here and instructions on how to submit feedback by May 31st can be found in the Request for Information (RFI) (NOT-DA-22-052). Your input will make our field more diverse and improve the important science that we do.