Concepts of Addictive Substances and Behaviours across Time and Place; new book published from ALICE RAP European initiative on addiction and lifestyle
Matilda Hellman, Virginia Berridge, Karen Duke, and Alex Mold (eds) Concepts of Addictive Substances and Behaviours Across Time and Place, Oxford University Press, Oxford, 2016.
It drew on work generated as part of Area 1 of the large scale European research project, funded by the Social Sciences and Humanities Division of the seventh framework programme (FP7).
The area was termed ‘ownership of addiction’ and comprised 3 ‘workpackages’ or groups of researchers dealing with different themes and topics.
Workpackage one studied concepts of addiction over time and in different countries. This workpackage was mentioned in Alex Mold’s recent blog about the Barcelona conference which brought some of the key overall findings of ALICE RAP together. It dealt with addiction over time, taking an historical approach and did this through looking at different countries at different times; at the regional level and the role of European agencies; and at the role of WHO at the international level.
Workpackage 2 dealt with the governance of addiction, specifically focussing on the role and influence of different stakeholders in the development of policy and practice. The research explored a diverse range of topics- opioid substitution treatment; the role of the Alcohol Health Alliance health pressure group in the UK; drug consumption rooms in Denmark; alcohol policies in diverse European countries and the role of heroin assisted treatment across Europe.
The third and final workpackage focussed on perceptions of addiction in different European countries- through the study of portrayal in the mass media; through professional understandings and general population responses.
All three areas contributed chapters to this book.
Virginia Berridge led workpackage one and the initial three chapters in this book showcase some of the work from that group, together with the research of an allied Scandinavian group whose work complemented some of the main historically focussed research. The chapter on concepts of addiction in the 1970s and 1980s led by Alex Mold with the workpackage partners as co authors, identified three key periods when concepts changed: the 1860s to the 1920s and 1930s when ideas about disease and addiction were developing in North America and Europe; the 1950s and 60s, the post World War 2 years, when distinct national differences were still identifiable; and the 1970s and 1980s, when greater uniformity and the influence of an international set of definitions, was more visible, and when tobacco started to come onto the agenda. The chapter showed that the standard Anglo-American ‘history of addiction’ as a concept failed to take on board the diversity and range of concepts in European countries.
A chapter led by Bagga Bjerge, from the Centre for Alcohol and Drug Research at Aarhus University in Denmark, looked at a regional bloc, the Nordic countries of Denmark, Sweden and Finland.These countries are often identified as a regional entity but analysing the history of policies and concepts for drugs, shows divergences over time, but also a trend towards policy convergence more recently.
The final historical chapter, led by Suzanne Taylor from the LSHTM Centre, examined the role of WHO and its expert committees in the post World War Two period and the part these have played in establishing a more commonly accepted international set of definitions. Concepts of ‘addiction’ and of ‘habit’ gave way in the 1970s to the concept of ‘dependence’ as part of attempts to establish a ‘combined approach’ for drugs and for alcohol. There were moves to apply this concept to tobacco too – thus bringing all three sets of substances – drugs, alcohol and tobacco – together. But tobacco operated within a different framework – that of public health. The policy framework was different and the role of professionals also differed across the substances – pharmacologists and psychiatrists for the drug and alcohol committees and public health personnel for tobacco.
The historical chapters showed that complexity and different national and international influences have been a central part of understanding addiction. Time and place are crucial components of any understanding of addiction: we should approach current moves to change and modify governing concepts with those historical insights to the fore.