Closing remarks: Addiction societies as valuable assets

Authors


Between 2001 and 2007, Addiction published a series of 13 specially commissioned statements describing the life and times of a range of societies which deal with alcohol and drugs [1–13]. The international coverage of this series was wide, and we have here reports from North America, South America, Europe, Asia and Australasia. Table 1 lists these societies, and gives their dates of foundation and key features. Twelve of these organizations are identifiable as national societies, with the 13th (the Kettil Bruun Society) international in its membership and purpose. With this series now wound down, it is time both for a vote of thanks to all those who contributed generously and thoughtfully, and for an overall appraisal of what these contributions in sum can tell.

Table 1.  Addiction societies contributing to the recent published series: key features
Title of organizationYear of foundationMembershipSociety journal(s)Annual society awardYear of publication addiction in series
1. SOCIDROGALCOHOL: the Spanish Society for the Study of Alcohol, Alcoholism and other Drug Dependencies1969816AdiccionesYes2001
2. ABEAD, The Brazilian Association for the Study of Alcohol and Other Drugs1978840Society Bulletin and the Brazilian Journal on Chemical Dependence (Jornal Brazileiro de Dependências Químicas)2002
3. The Research Society on Alcoholism (USA)19771500Alcoholism: Clinical and Experimental ResearchYes2002
4. ERIT-Italia, the Italian Federation for Professionals Working in the Field of Drug Abuse1993203Personalità/Dipendenze2002
5. Israeli Society for the Prevention of Alcoholism1976100Alcohol in Israel—interdisciplinary scientific journal2002
6. The Italian Association on Addiction Psychiatry (SIPDip)19895722003
7. Kettil Bruun Society for Social and Epidemiological Research on Alcohol19871972004
8. The Japanese Society of Alcohol-Related Problems1979543Journal of the JapaneseSociety of Alcohol-Related Problems2004
9. The Society for the Study of Addiction (UK)1884478Addiction and Addiction Biology2004
10. Association for Medical Education and Research in Substance Misuse (US)1976300Substance AbuseYes2006
11. The Australian Professional Society on Alcohol and Other Drugs1981382Drug and Alcohol ReviewYes2006
12. The Finnish Alcohol and Drug Research Society1960400A yearbook2007
13. The German Society for Addiction Research and Addiction Treatment1978400SUCHT2007

To put this exercise into context, consider the following. A recent internet search of addiction organizations identified 38 societies whose mission statements suggested primary involvement in issues related to the misuse of alcohol, drugs, tobacco and other psychoactive substances. The organizations could be classified into three broad categories: multi-disciplinary societies, professional specialty societies and research societies. These societies have been established at both the national and international levels.

Multi-disciplinary societies (n = 12) are open to professionals of all disciplines who work in the addiction area, including treatment, prevention, research, policy and education. The Brazilian Association for the Study of Alcohol and Other Drugs (ABEAD) is a good example of a multi-disciplinary national society, as is the British Society for the Study of Addiction. The International Council on Alcohol and Addictions, one of the oldest international organizations, is open to professionals from all disciplines related to addiction. Professional specialty societies (n = 14) are typically special interest groups organized within larger disciplinary societies, such as the Alcohol, Tobacco and Other Drugs section of the American Public Health Organization. Several of these specialty societies are international in scope, such as the International Society of Addiction Journal Editors (ISAJE). The main purpose of research societies (n = 12) is to provide a forum for new scientific developments, usually within the context of an annual meeting. The Research Society on Alcoholism (RSA) and the International Society for Biomedical Research on Alcoholism are examples of this type of organization. Among the national-level societies, 20 countries were represented, with the greatest number coming from the United States. Only a few societies were located in developing countries.

Focusing on reports from a sample of 13 societies the present paper represents, of course, a far from complete coverage of all such entities world-wide: what we have achieved is a convenience sample drawn from a much larger universe; but there is such a harvest of ideas and experiences to be found across these reports as to make the attempt to hear what is being told undoubtedly a rewarding endeavour. As far as we are aware, questions around what addiction societies are, what they do, the ‘itness’ of them, have seldom or never been asked previously.

VAST DIVERSITY OF ACTIVITY BUT A FUNDAMENTAL COMMONALITY OF PURPOSE

Let us try first to summarize the activities in which these organizations are reported to be engaged. First and foremost, they run meetings: these come in all shapes and sizes, ranging from gigantic annual events of the Big Top variety to small topic-based workshops which might be compared to a modest kind of tented bivouac. Some of these organizations influence national policy; ABEAD [2] exemplifies that kind of ambition and is close to government, while others stay clear of that type of involvement and are focused more on science as science; the German Society [13] has assissted the renaissance of the national addiction base. Publications are another main function in terms of journals, yearbooks, bulletins, guidelines and educational materials. Centres may engage in prevention activities directed at the public, and the Israeli Society [5] conducts 1000 school-based workshops each year. There is a networking element in most of their activities, and they seek to collaborate with other national or international organizations.

Diversity is the order of the day, and no two of these societies run identical programmes—the content of their work more exemplifies pick and mix. However, it seems likely that behind the varied and varying day-to-day activities lie certain shared intentions. These societies are committed to the strengthening of a sense of community—a building of shared understanding across the broad multi-disciplinary and multi-professional arena of addiction specialists. Encouraging addiction professionals to talk to each other, to know each other, to bond, is a strong covert intention whatever the overt intentions, the country or the language spoken. There is also a common concern for enhancing the status of addictions as an important field of endeavour, with the overcoming of stigma and government neglect.

EXPERIMENTS OF NATURE

Part of the fascination in reading these 13 statements end-to-end is the way in which, time and again, they describe an organization which seems to have come into being more or less spontaneously—these are truly experiments of nature and all the better for it, rather than their being the products of government intention. Their births, however, have context—for the British Society for the Study of Addiction (SSA) in 1884 [9] the context was the ambition of doctors to mobilize parliamentary support for the compulsory treatment of ‘inebriates’, whereas for the Italian Association on Addiction Psychiatry (SIPDip) [4] the context was the attempt to claw back a role for psychiatry in the face of political chaos; the spur to the RSA's foundation was the expansion in research funding which came with the initiation of the National Institute on Alcohol Abuse and Addiction (NIAAA) [3]. Each society is shaped by national assumptions as to the proper role of voluntary action, the habits of the nation bureaucracies and the fluctuating national political scene. A model apt for one country could be alien in many another—one cannot hope to understand societies without understanding society.

Some countries have just one major body dealing with alcohol and other drugs, while others may have a plethora. This kind of diversity is illustrated by our having published two different reports from Italy [4,6]. A more radical example of multiplicity is to be found in the report from Japan [8], which mentions that besides the Japanese Society of Alcohol Related Problems, there also exists the Japanese Medical Society on Alcohol and Drug Studies, a National Society of Biomedical Research on Alcohol, a Society of Psychiatric Research on Alcohol and one focused on Addiction Behaviour. The Germans describe a recent initiative which will establish a shared annual meeting between different societies [13].

ASSETS, BUT WHAT ARE THEIR FUTURE?

Scrutiny of these reports, in terms of a reading between the lines as well as of the lines themselves, suggests that if we are to build on their achievements the following three questions may perhaps be addressed usefully.

  • 1The need to share further experiences and generate mutual support—are these societies sharing their experiences adequately between each other? That is a question with echoes for anyone who, over the last 10 years, has watched the evolution of the ISAJE [14]. That initiative succeeded because it met needs. There may now be a place for a parallel initiative to help to bring together these addiction societies in collegiate fellowship, rather than only the addiction journals. The aim should be to provide a forum where there can be shared consideration of such issues as definition of purpose; governance and good organizational management; shared consideration of methods relating to the broad content of society activities and the enhancement of related skills; competence in lobbying and relationships with governments; and the ethical dimensions. What should be resisted is the cry sometimes heard for even bigger conferences or congresses, and grand imperial ambitions. The need, if it exists, is for a small, friendly and lively informal setting where people who have responsibilities and interests in common can, mutually, meet, talk and learn.
  • 2The need to support addiction societies in the developing world—how can established groups aid the development of such societies in large parts of the world which do not at present have this kind of resource? Any such initiatives would need to be culturally sensitive—the respect for context—but the fact is that when setting up this recent journal series Addiction, despite its best efforts, could not locate societies devoted to the addictions that operated in the developing world. Even where resources might not easily allow development of specialist treatment services, specialist research centres or the publication of national journals, voluntary action catalysed by local associations may constitute entirely feasible kinds of initiatives capable of considerable impact.
  • 3The need for some self-reflection—it is remarkable for an interdisciplinary field of academicians, clinical researchers, basic scientists and practitioners to be so unreflective about the way they manage their professional lives at an organizational level. Few authors have attempted to even map the infrastructure of addiction science, much less explain its raison d'être from the perspectives of the sociology of science. What purpose is served by the continuous schedule of professional meetings? Are specialty addiction journals better organs of communication than disciplinary journals? What influence do our societies have on alcohol policy, professional ethics, career development and the translation of research into practice? These are perhaps questions for a more mature field of knowledge than addiction studies, but they are worth asking nevertheless.

So much for a brief and inevitably tentative attempt to distil what can be learnt from these remarkable experiments of nature—spread across the world's map, even if somewhat unequally. We have here an immensely valuable stock of assets deserving of nurturing and further development.