The Addiction Lives series offers personal anecdotes, career highs and lows, and histories of substance use policy, through in-depth interviews with people who have made an impact on the field of addiction. Addiction journal and the Society for the Study of Addiction have jointly published 13 interviews to date, the most recent of which were with Sir Ian Gilmore, Viv Evans, and Robin Davidson. Natalie Davies shares some of the highlights.
The Addiction Lives series has been running since 2017 under the editorship of Professor Virginia Berridge. It is a joint print/web collaboration between Addiction journal and the Society for the Study of Addiction, and was inspired by Addiction Interviews, which ran for 36 years and featured conversations with over 100 people – in particular, scientists and those who had developed links with policy. The latest interviews in the Addiction Lives series were with Sir Ian Gilmore, Viv Evans, and Robin Davidson.
Sir Ian Gilmore has held many distinguished positions, including Professor of Medicine, President of the Royal College of Physicians of London, President of the British Society of Gastroenterology, Founder and Chair of the Alcohol Health Alliance, and adviser to the government on alcohol policy.
Kieran Moriarty interviewed Sir Ian in January 2023 about his work with successive governments on health policy, the impact of COVID-19 on alcohol-related harm, and the need to train liver specialists in addiction.
Sir Ian’s introduction to alcohol-related harm was through working as a doctor specialising in liver disease. He discovered that many of his patients had developed liver disease as a result of heavy drinking. “To use the old public health analogy, I spent years pulling drowning people out of the water, without thinking of walking upstream to see why they were falling in, in the first place. So, alcohol harm was really a major part of my work.”
He describes three main groups of patients cared for by fellow hepatologists (doctors who treat diseases of the liver, gallbladder, biliary tree, and pancreas): one is people with alcohol-related disease, one is people experiencing the consequences of obesity, and the other is people experiencing the consequences of viral hepatitis. And, he describes how the overlaps between liver disease and addiction are so self-evident that it makes sense to improve addiction knowledge and practice among liver specialists.
When it’s three in the morning and you’re under stress, remember what a privilege it is for patients to trust you and pour out their most heartfelt problems to you.
The interview also includes a brief discussion of why Sir Ian resigned ‘rather publicly’ as co-chair of a Public Health England (PHE) committee. “I did that as a last resort as PHE were going ahead with an education project jointly with the largely alcohol industry-funded Drinkaware. We were late to hear about it, but I am pleased to say that as a result PHE developed guidelines about who they would work with in future and this excluded commercial partners with a potential conflict.” The alcohol industry also comes up in a few other places in the context of government policy. Sir Ian shares that he was “getting used to political influence, as it were, getting in the way of evidence-based policy”.
Viv Evans is Chief Executive of Afdam, the national charity that supports and works with children, friends, and families affected by somebody else’s substance use. She has expertise in health education and promotion, which was forged through early roles including working for the NHS as a Health Education Officer. This involved going into schools and youth clubs to talk about sex education and drug education.
Virginia Berridge interviewed Viv in January 2023 about family drug and alcohol courts, workforce development via the Skills Consortium, and how Viv helped bring awareness to the hidden harm of substance use to children.
The term ‘hidden harm’ comes up frequently throughout the interview – both as a reference to the landmark report she worked on, and as a phrase that has become ‘part of the vocabulary’ in the substance use field thanks to this very report.
I still get a huge amount of satisfaction from my job, a huge amount, despite the difficulties, despite the challenges.
Hidden Harm was published in 2003 and focused on the impact of illicit drug use on children – what their lives were like, how many children were affected, and what was being done to support them. Viv says that, although the report is now 20 years old, its findings and recommendations continue to be instructive. “It was certainly the first piece of major research that had been done. I remember becoming interested in it, and becoming aware of it when I was doing some workshop for teachers and they were mentioning that sometimes there were children left in the playground at the end of the school day because their parents hadn’t picked them up, because their parents weren’t in a condition to do so.”
Robin Davidson is a Consultant Clinical Psychologist who worked for Leeds Addiction Unit. Duncan Raistrick talked to him in November 2022 about evidence-based mutual aid, the medical model of addiction, and Leeds United.
Robin says that his interest in addiction stemmed from his father. “He was an evangelist in a Dockside City Mission in Belfast and that’s where essentially I spent my childhood and early teens. As a child I would see these men come into his Mission, who were basically serious drinkers and usually serious gamblers and they would become, in the local vernacular, ‘saved.’” Yet, despite being amazed by the “sudden transformative change in these dockside men from working class Belfast”, Robin admitted he was somewhat suspicious in his early career of the spiritually-grounded fellowship Alcoholics Anonymous (AA) “because it didn’t meet my criteria as an empiricist and as a scientific psychologist”.
If I was living life over again, I wouldn’t change it one bit. I think that our speciality has so much to offer in terms of behavioural change, in terms of this motivation, commitment and all of these sorts of things, that it’s a joy as a clinical psychologist to work in addictions.
Robin later became Chair of SMART Recovery, which like AA is a mutual-aid-based organisation, but unlike AA seeks to use therapeutic interventions such as motivational interviewing and cognitive-behavioural therapy. Robin contemplates the differences between people who choose SMART Recovery and those who choose fellowships such as AA. However, he ultimately acknowledges the value of both. “We enjoyed the idea of people dipping into both, backwards and forwards as necessity called, or their individual needs, called.”
Browse the entire collection of interviews here. And, if you have any suggestions for people who could be featured in Addiction Lives in the future, please email Jean from Addiction journal.
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