Professor of Addiction Psychiatry, Head of the Alcohol Research Group, and Consultant Psychiatrist at the National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London and South London and Maudsley NHS Foundation Trust. Trained in medicine in Glasgow and completed psychiatry training at the Maudsley Hospital in London. Principal investigator on several research grants from the Department of Health, National Institute for Health Research, the Medical Research Council and the European Commission, including the DH funded national alcohol needs assessment project and a national research programme on alcohol screening and brief intervention (SIPS). Provided advice to governments on alcohol and drug misuse strategy. Member of the WHO Expert Committee on Drug Dependence and Alcohol Problems, and Chair of the NICE guideline development group on management of harmful drinking and alcohol dependence. Past Chair of the Addictions Faculty at the Royal College of Psychiatrists, and Chair of the Medical Council on Alcohol. Member of the Public Health England Alcohol Leadership Board and Chair of the Public Health England Alcohol Treatment Expert Group. National Professional Adviser in Substance Misuse, Care Quality Commission. Leads alcohol research within the South London NIHR CLAHRC. NIHR senior investigator award 2017.
In 1997 I was invited by Griffith Edwards to write an article for Addiction in the “What I would most like to know” series. The published article was entitled: “Alcohol Interventions: do the best things come in small packages?” The context was the growth in research evidence on alcohol screening brief intervention accompanied by declining interest in specialist treatment interventions. An influential review, funded by the Department of Health in 1993, concluded that “Brief interventions are as effective as more expensive specialist treatments,” prompting a further shift in the direction of brief interventions. In my Addiction article I urged caution in over-interpreting the evidence available at the time and pointed to key unanswered research questions. Now, just over 20 years on, we know much more about the effectiveness and cost effectiveness of alcohol interventions. The main observation is that the decline in specialist alcohol treatment has continued, whilst brief interventions have not fully lived up to their early promise. However, re-examining the evidence on alcohol interventions within a Value Based Healthcare paradigm presents a rather different picture of the relative merits of brief and more intensive interventions, particularly when applied to populations of considerably different morbidity and cost. At its inception, the Society for the Study of Addiction was a strong advocate for better specialist treatment for people affected by alcohol. Today, the evidence suggests that we should be more confident in our advocacy for specialist treatment, as part of the range of public health measures to reduce alcohol-related harm.