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ABSTRACT Background In 1804 Thomas Trotter, a recently retired Physician to the Fleet, published his 'Essay on Drunkenness'. This was the first ever book-length consideration of the phenomenon of alcohol dependence and its treatment. Aims The aim of this paper is to explore the impact of that treatise on the evolution of relevant ideas over the years that have followed. Methods A factual analysis of the content of the Essay is the starting-point, followed by an examination of sequential published appraisals on the significance, or lack of significance, of this work. Findings and Conclusions To the modern reader, Trotter is likely to be seen as prescient, with his assertion that 'the habit of drunkenness is a disease of the mind', setting the scene for two centuries of debate. The literature, however, seems to suggest that Trotter did not, in fact, achieve much impact either on professional opinion or on the emergent temperance movement. It was Benjamin Rush's 1785 pamphlet on 'Ardent Spirits' which achieved iconic status. Rush and Trotter, although in some ways overlapping in their ideas, differed in other respects. [ABSTRACT FROM AUTHOR]

The article offers world new briefs. Yuri V. Fedotov, currently the Russia's Ambassador to Great Britain, will replaced Antonio Maria Costa in leading the United Nations Office on Drugs and Crime (UNODC) starting the end of July 2010. City authorities in Moscow banned the selling of vodka from 10 p.m. to 10 a.m., part of a series of effort to cut the country's drinking habit. A coroner in Great Britain confirmed the first person in Northern Ireland who died after taking in the drug mephedrone.

The authors reflect on drug trafficking and abolishing of death penalty. They say that the execution of convicted people with violation of drug-related offenses should be abolished because it violates the policy measure and human rights. According to Amnesty International, a total of 135 nations have already abolished death penalty and 63 nations still remain as retentionists. Futhermore, the authors mention that as young as 13 years old in some countries, children may be judicially killed.

In 1965 the British government was forced to admit that the country had an escalating heroin problem, with the supply coming mainly from prescribing by private practitioners. Within the official responses to what was seen at that time as a very worrying public health situation was the decision to fund the setting-up of the Addiction Research Unit (ARU) at the Institute of Psychiatry, London. The US National Institute of Mental Health (NIMH) generously sponsored a study tour for the nominated director of the ARU shortly before the opening of the British research centre. Extensive contemporaneous diary notes of a visit included contact with administrators, researchers, clinicians, parish priests, narcotic agents and addicts themselves. From a mass of often conflicting advice, some insights could be derived. In particular, these included the need for an awareness of any country's way of dealing with drug problems as a dynamic, multi-factorial total system—a holistic ‘national response’. A further conclusion was to see policy itself as a complex subject for analysis: drug policy should be as much an issue for research as drug taking. Besides these broad conclusions, the experience provided many specific leads to development of a British addiction research programme, and fostered professional friendships of immeasurable worth. [ABSTRACT FROM AUTHOR]

This paper builds upon the work of previous authors who have explored the evolution of ideas in the alcohol arena. With revisions in the relevant sections of ICD and DSM forthcoming, such matters are of considerable contemporary importance. The focus here will be upon the history of the last 200 years. The main themes to be explored include the flux of ideas on what, over time, has counted as the trouble with drink, ideas on the cause of the problem and the impact of this thinking on public action. Medical authorities of the late Enlightenment period made the revolutionary suggestion that habitual drunkenness constituted a disease, rather than a vice. The thread of that idea can be traced to the present day, but with an alternative perception of drink itself or alcohol-related problems generally, as cause for concern, also having a lineage. There are several inferences to be drawn from this history: the need for vigilance lest disease formulations become stalking-horses for moralism and social control, the need to integrate awareness of alcohol dependence as a dimensional individual-level problem, with a public health understanding of the vastly amorphous and at least equally important universe of alcohol-related problems; the dangers lurking in scientific reductionism when the problems at issue truly require a multi-disciplinary analysis; and the need for global consensus rather than cultural imposition of ideas on what counts as the problem with drink. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented on death penalty for drug trafficking.

Aims This paper has as its focus a study tour made by the author in 1961. Diary notes are used to capture a historical moment in the evolution of alcohol studies. The paper will argue for the continuing value today of such experiences in support of career development and the building of ‘the field’. Data sources Diary notes and personal recollection. Findings The United States was at the time more active than the United Kingdom in its response to alcohol problems. There was, however, a disjunction between the elite American research world and the world of action, which was not informed greatly by research. For the most part, treatment services and prevention strategies seemed driven by opinion rather than by evidence. But at the level of serious scientific endeavour there was opportunity to meet influential figures including Seldon Bacon, Morris Chafetz, Milton Gross, Ebbe Curtis Hoff, Harris Isbell, E. M. Jellinek, Mark Keller, Benjamin Kissen, Robert Strauss, Wolf Schmidt and Abraham Wikler, who generously made their time available. Conclusions These diary notes provide a snapshot of a field of endeavour at a critical stage of transition from uninformed assumptions towards establishment of a research base which can inform public action. The visit was of tangible value to the visitor in several different identified ways. Such an experience is inevitably time-bound and personal, but there are general conclusions to be drawn as to the benefits which will be derived from early travel opportunities in a field such as alcohol studies, which is all too easily culture-bound in its horizons and assumptions. Alcohol science needs to be more reflective on its history and the mechanisms that help to make it happen. [ABSTRACT FROM AUTHOR]

The article discusses the series of 13 commissioned statements published by "Addiction" depicting the life and times of a range of societies dealing with alcohol and drugs. The international coverage of the series includes reports from North and South America, Europe, Asia, and Australasia. Lists of societies and dates of foundation and key features are also presented in the article. Twelve of the organizations are identifiable as national societies with the 13th international in its membership and intention.

Background In 1977 the World Health Organization (WHO) published a report entitled ‘Alcohol-Related Disabilities’. The crucial contribution of this report was to differentiate between alcohol dependence, on one hand, and alcohol-related disabilities (or problems) on the other hand. Essentially, it offered a bi-axial mapping of the field of concern. Aims This paper seeks to identify the multiple influences which shaped the evolution of this report. Methods Use is made of unpublished archival material and recall of personal involvement, together with relevant published material. Results Three major influences made it possible to move beyond the confines of previous WHO thinking on alcohol: the multi-disciplinary nature of the input; the internationality of the enterprise; and the expectations set that the concepts developed should speak to the practical world. Conclusions The arena of drug and alcohol policy has, for more than a century, been rich in its reports. This case study, although limited in its immediate content, points to the need for further analysis of the history of such reports. [ABSTRACT FROM AUTHOR]

Provenance This paper derives from a lecture given before the Society for the Study of Addiction in November 2004, on the author's retirement from the position of Editor-in-Chief of Addiction, one of the Society's journals. Aim To identify the live processes which have influenced the journal's evolution since its foundation in 1884. Conclusions Over the 120-year period a strong, continuing historical thread has been the fluctuating success of the journal's engagement with its ‘Invisible College’, the community which it seeks to serve. It is argued that the journal's future success will depend on its capacity to explore and nurture further this two-way relationship. Addiction is a journal with an active and clearly articulated, multiple vision of it purpose, and this vision is outlined. It dares to try to influence its future with the authority so to do rooted in its ability to reflect the aspirations and concerns of its readers. It is ‘a journal of the second kind’. [ABSTRACT FROM AUTHOR]

In October 2004 the "Addiction" periodical published an editorial criticizing the decision of the British Secretary of State for Culture, Media and Sport to appoint the Chief Executive of the Portman Group, a drinks industry lobby, to the Board of the Alcohol and Education Research Council. We argued that this appointment was contrary to the public interest and should be reversed. We took our stand from the proposition that protecting ‘the integrity of the science base from distortion by industry lobbyists is our concern and duty whatever the country, whatever the research or training body, and across the whole spectrum of vested interests’.

Editorial. Details the Addictions Horizons exercise organized by the journal 'Addiction' aimed at increasing involvement of the scientific constituency in the making of editorial choices. Intentions; Methods; Outcome.

Editorial. Comments on the conflict of interest in the International Life Sciences Institute (ILSI) publication. Publication of the book 'Health Issues Related to Alcohol Consumption, 2nd Edition'; Financial funding from the drinks industry; Information about ILSI.

This paper seeks to identify the main questions which have emerged from the preceding papers concerning the supply side of alcohol. On any rational analysis these issues are of thoroughly legitimate concern to public health researchers. We list them under seven headings: (1) what drives the alcohol supply side? (2) What is the impact of alcohol supply on demand? (3) What are the benefits and risks to health and safety stemming from deregulation and what are the possibilities to avoid negative effects? (4) What is the size and significance of the alcohol supply which may derive from other than the officially approved channels? (5) Who are the important actors in the alcohol supply system? (6) What are local influences on alcohol supply and its distribution throughout communities? (7) What is to be learned from tobacco and other risky commodities about the importance of supply? Finally, we outline a series of possible next steps for a supply side initiative. [ABSTRACT FROM AUTHOR]

Editorial. Evaluates the mission of the periodical `Addiction.' Definition of the mission of `Addiction'; Examination of the intentions of several types of the features that constitute the journal's regular output; Contribution of the features to the fulfillment of the periodical's central purpose; Emphasis on the commitment of the periodical to a partnership with its constituency.

Editorial. Describes the `Addiction' convention, which was a two-day meeting of editors of peer-reviewed journals within its specialized field, held in July 1997. Identification of peer-reviewed journals publishing in the specialist field of substance use and related problems; Purpose of the endeavor; Description of the Farmington Consensus.

Suggests that the target for public policy is the prevention of population-wide alcohol-related problems, with problems broadly defined. Alcohol and public policy project; Alcohol problems perspective; Alcohol policies in the problems perspective; Rationality as basis for a European way in responding to alcohol problems.

Editorial. Discusses the editorial review process in the periodical `Addiction.' Submission by a New York University professor of a jargon-laden parody to a scholarly journal to see whether meaningless nonsense would pass editorial review; History of the periodical; Bases for the acceptance or rejection of articles.

Presents a reply to commentaries on the topic `Alcohol Policy and the Public Good,' which was published in the February and November issues of `Addiction.' Interaction between alcohol policies and national diversities; Aims and means of harm reduction; Bias as an issue.

Editorial. Comments that scientists are becoming more involved in the field of alcohol research. Offer of the Portman Group for British scientists; Support of a research center from a major wine producer in California to study alcohol genetics.

Editorial. Presents a comparative study of biomedical ethics and its role in biomedical journal publishing. Ethical problems; Failure at self-regulation; Ethical standards and safeguards made to strengthen scientific publishing; Prevention of the publication of fraudulent reports.

Focuses on exploration of the possible interaction between treatment intensity, patient characteristics with particular reference to degree of dependence on alcohol and 12-month treatment outcome. Empirical evidences of the study; How the study was done; Results of the study.

Attempts to delineate the meaning of a concept of addiction and reductionism in the analysis of ideas. The respectable meaning of reductionism; Good and bad of reductionism; Reductionism and the world of addiction; The challenge to addiction studies.

The casenotes of 144 doctors who had received treatment for substance misuse were analysed. There were no differences between general practitioners (n = 61) and hospital doctors (n = 58) in terms of their substance misuse histories or the problems they incurred. Differences emerged between the consultant (n = 24) and the non-consultant (n = 34) grades of hospital doctor. The consultants were older at onset of problematic use (42.6 ± 8. 6 vs. 29. 9 ± 9. 8 years); they suffered fewer career problems and misused fewer substances. The most frequent pathways into substance use were personality difficulties (76 subjects, 52.8%) and anxiety or depression (46 subjects, 31.9%). A history of depression (n = 36) was associated with perceived stress at work (p = 0.014), and at home (p = 0.06). Past neurotic disturbances (n = 20) were associated with personality difficulties (p = 0. 035), anxiety or depression (p = 0.004), and with an earlier onset of problematic substance use (30.2 ± 8.3 vs. 36.5 ± 9.8 years, p = 0.014). Principal components of possible antecedents yielded one major component on which all elements loaded; this was labelled the 'disturbance score'. This score showed a reduction with increasing age of onset of problematic substance use. [ABSTRACT FROM AUTHOR]

Focuses on the treatment of alcohol dependence syndrome (ADS) in the United States. Characterization of ADS; Difficulty of associating clinical syndrome with psychological basis of dependence; Elements of the syndrome.

This paper explores how treatment research is to catch within its design those many unplanned influences which lie outside therapeutic control, but which may influence processes of change. These factors are excluded from the conventional controlled trial. The background literature is briefly reviewed. A study is then described which employed a computer assisted method of textual analysis and an entirely open-ended coding system. The material which was analysed derived from interviews with 49 subjects whose accounts were tape recorded 10 years after treatment contact. Episodes of successful or unsuccessful 'change attempt' (CA) were identified. The two types of CA were compared in relation to coded issues pertaining to the periods before, during and after the episode. A number of significant findings are reported. In the pre-attempt phase 'Success' CAs were significantly associated with traumatic events in the person's life, and with a variety of positive and negative events. During the 'attempt' phase, 'Success' was associated with choice of an abstinence goal. For 'post-attempt', 'Success' was associated with 'Substitution; 'Altruism' 'Fulfilment', and finding the process 'Difficult' The very preliminary nature of these findings is stressed and the need for further rigorous methodological development. [ABSTRACT FROM AUTHOR]

Information was abstracted from the hospital notes of 144 doctors who had received treatment for drug and alcohol dependency. These problems affect those in every speciality, and at all degrees of seniority. Over half came into treatment following medical referral. Social morbidity was an important contributory reason for seeking help. The mean age at presentation was 43.1 years; the mean duration of problematic use prior to this was 6.4 years for drug misusers and 6.7 years for alcohol misusers. Alcohol was the current problem for 41.6% and drug misuse for 26.4%; 31.3% were misusing both alcohol and drugs at presentation. Of the 83 subjects who were misusing drugs, only four had ever used blackmarket supplies. Psychotropic agents are readily available to doctors, but the consequences of this are not addressed. Those who develop dependency suffer a delay of years before reaching help. [ABSTRACT FROM AUTHOR]

This article describes the linked clinical, research and teaching functions of the Maudsley's Alcoholism Treatment service. Emphasis is placed on the heterogeneity of the patients who are seen. Therapy must therefore always be patient-specific and the Procrustean insistence that patients should fit the programme rather than the programme fit the patients should be resisted. Within the diversity of approaches which are employed some important common elements can though be identified: detailed case assessment as the necessary basis for everything else, goal setting, a flexible intensity of response, networking with other treatment resources, and attention to methods of patient recruitment. The relationship between outpatient and inpatient services is discussed: about 80% of all new referrals are treated entirely on an outpatient basis. The clinical setting provides a teaching base for the Diploma in Addiction Z. There is a close link between this clinical service and the Addiction Research Unit; issues of clinical and research collaboration and the interpretation and clinical application of research findings are considered. Whatever the theories in which a team believes or the techniques which it practices, the nurturing of hope is the vital essence of the practical business of treatment. [ABSTRACT FROM AUTHOR]

Five types of question are posed around withdrawal symptoms. (1) The reasons for the fluctuations over time in medical awareness of alcohol's capability to produce withdrawal symptoms. (2) What type of drinking schedules instigate withdrawal experience? (3) Do withdrawal phenomena get worse over time? (4) The 'addiction memory' question; and lastly (5) Is withdrawal a reinforcer for drinking behaviour? These issues point to a need for a renascence in the kind of research which is based on clinical observation and on listening to what patients have to tell, with such lines of work brought into much closer contact than before with corresponding laboratory investigation. [ABSTRACT FROM AUTHOR]

Provides information on the Addiction Research Unit (ARU) of the Institute of Psychiatry, University of London in London, England. Organization and setting within which ARU operates; Tasks and responsibilities of the unit's alcohol and drug section; Plans and research challenges of ARU.

This paper identifies four broad types of influence which have contributed to the dynamics of British drug policy development over many decades: international influences, varieties of fear, professional entrepreneurship, and the perceived tension between treatment and control A follow-through of these same themes to current policy concerns is traced. The need w develop a comparative and international framework for policy analysis is stressed. Policy research, it is argued, deserves to be given greater attention as the necessary means toward a more informed sense of feasibilities and policy options. [ABSTRACT FROM AUTHOR]

Previous work on prediction of outcome among patients with drinking problems is briefly reviewed. The literature suggests that few predictors of consistent strength have been identified. Two reasons frequently put forward for conducting such investigations are the belief that findings may be useful to clinical policies either by indicating which patients should be excluded from treatment or by assisting in matching. At present such amibitions seem premature. The separation between theory-rich research on community samples and often very barely descriptive studies on clinical populations should be overcome. With the issues raised by this review taken as the background, results are then presented on a 10-year follow-up of a group of 99 married male alcoholics seen at the Maudsley Hospital. The usual predictive approach of running individual Intake variables against a range of Outcome variables reveals little of significance and actual drinking behaviour cannot be predicted at all. When, however, outcome is measured in terms of dimensions deriving from a principal components analysis, a number of very significant predictors are found which bear differentially on the two components. Prediction research may provide a test-bed for theory but advances will depend on the development of ideas on the nature of outcome processes. [ABSTRACT FROM AUTHOR]

Various strands of the research literature which have bearing on the concept of attribution for change in drinking behaviour are reviewed. The reasons which subjects give for amelioration in their drinking are likely to reflect a mixture of the way in which change is being subjectively construed together with report on the influences and processes which may objectively contribute to change. We present data on such attributions as given by 66 alcoholics on whom we have detailed 10-year information on multiple aspects of outcome and who also completed a 70-item Attributions Inventory. A factor analysis of the Attributions data reveals two factors which have been labelled respectively 'Active' and 'Responsive', and it is suggested that this may be a more appropriate analytical framework than the single dimension of Internal/External locus of control. The relationship between Attribution factors on the one hand and Outcome components and clusters on the other, is explored. 'Active' Attribution is significantly and positively related to better 'High Dependence' Outcome, whereas 'Responsive' Attribution relates significantly and positively to better 'Low Dependence' outcome. Potential theoretical and clinical implications are discussed. [ABSTRACT FROM AUTHOR]

The application of a dimensional concept of dependence which has received much attention over recent years in relation to alcohol, is explored here in relation to opiate dependence. A Severity of Opiate Dependence Questionnaire (SODQ) was completed by 98 subjects attending a New York drug treatment clinic. The factor structure of this questionnaire was explored and a strong first factor (39% of variance) identified which loaded on items conceptually related to a dimensional opiate dependence syndrome. Some preliminary investigation was made of issues relating to validity: SODQ correlated significantly with 'number of fixes a day' and with a subjective measure of dependence (OSDQ), but not with quantity of heroin used or milestones in drug career. Research leads are discussed. [ABSTRACT FROM AUTHOR]

A 'provisional description' of the alcohol dependence syndrome was first given in 1976. An outline is provided of the historical background to the syndrome formulation. Ideas emanating from the Maudsley campus were important but so was the international input from a WHO Scientific Group. Since its original delineation the syndrome idea has attracted discussion and has become a focus for research. Studies which bear on the measurement and validity of the syndrome concept are summarized and criteria for the establishment of validity discussed. Understanding of the nature of this condition is still incomplete but research has now reached a stage where it is legitimate to go beyond the question as to whether a dimensional syndrome exists, to an exploration of theoretical questions relating to its scientific basis. Further elucidation will require contributions from many different disciplines. The syndrome can offer part of the explanation of why some people continue to drink too much in the face of negative consequences but measurement and conceptualization of this one dimension should help toward the design of more powerful, multidimensional and interactive models. A plea is made for a spirit of openness and interdisciplinary enquiry rather than perseveration with the unproductive rhetoric of the 'disease' debate. [ABSTRACT FROM AUTHOR]

Longitudinal studies of drinking are now of great importance. Two concepts need to be distinguished. Career is the evolution of the individual's role, while Natural History pertains to the sequential development in tissue or body-system reactivity to alcohol. The richness of ideas and research opportunities relating separately to each of these dimensions is discussed, and also the need for synthesis. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented about drinking problems and the Fifth Edition of "Diagnostic and Statistical Manual of Mental Disorders."

The authors reflect on the need for the abolishment of the death penalty for people convicted of drug trafficking and other drug-associated offences. They mention the responsibility of the international addictions science community to back the abolitionist cause. They present both sides of the argument by citing several cases that have the same impact as drug trafficking.

Presents an obituary for president of the organization Society for the Study of Addiction Robert Kendell who died in November 2002.

Presents an obituary for Max Glatt, researcher and editor of the 'British Journal of Addiction.' Personal background; Academic background; Awards and achievements; Contributions to the Society for the Study of Addiction.

Editorial. Comments on the failure of the journal 'Addiction' to promote addiction treatment. Presentation of several treatments published in the journal; Claims for the efficacy and safety of any treatment for substance abuse; Responsibility of addiction treatment specialists to protect patients.

Editorial. Comments on a meeting regarding alcoholism and other addiction. Identification of some dangers related to addiction; Benefits clinicians gain from patients; Rewards of a bridge to understanding addiction.

States the findings in the previous study regarding the differential characteristics of patients with drinking problems who at two-year follow-up were abstinent or drinking in a controlled fashion. Implications of the analysis indicating absence of matching effects over the initial 12-month follow-up; Conclusions.

Comments on a study which examined the nature of inebriety. Information on Thomas Trotter's description of drunkenness as a disease; Discussion of the argument made by ALL Davies about alcoholism.

Profiles the late British psychiatrist Doctor D.L. Davies. Career history; Contributions to study of alcoholism; Educational background; Professional affiliations.

The author presents an excerpt from the book "The Duxhurst industrial farm colony for female inebriates," by L.H. Somerset. In the book, Somerset, shared her experiences of helping inebriate women through "Our Farm Home," the first institution employing women in outdoor work of farm and gardens. The author comments that the book is a foundation of the belief that inebriate women could be relieved by removal from 'intoxicated' environment.

Excerpts from "Preparations: new and old," which is a listing of recently published memoranda, and an extensive section of book reviews in the January 1912 issue of British Journal of Inebriety, is presented.

The article focuses on a report regarding pulque-drinking in Mexico by English surgeon John Bland-Sutton which was published in "The British Journal of Inebriety" in 1912. According to the report, pulque was produced by fermentation of the sap of the maquey (Agave Mexicana) in England, London. It describes the aguamiel from the plant as sweet, pale yellow fluid with good taste and very attractive to insects. Moreover , the process of fermentation was more than 24 hours.