Professor James Griffith Edwards
3 October 1928 - 13 September 2012

Professor Griffith Edwards, one of the leading alcohol researchers of the last half century and an inspiration to many, has died in London after a short illness.

Professor Eilish Gilvarry, President Society for the Study of Addiction, issued a statement on behalf of the Society:

It is with great regret that I must report the death of Professor Griffith Edwards, CBE. Emeritus Professor of Addiction Behaviour at the Institute of Psychiatry; in 1967 founder and Director of the Addiction Research Unit at the Institute of Psychiatry, later to become the National Addiction Centre; author, contributor to and editor of numerous books including ‘Alcohol Policy and the Public Good’; ‘Alcohol, the world’s favourite drug’; ‘Matters of substance: Drugs – and why everyone’s a user’; ‘Alcohol: the ambiguous molecule’ and ‘Drug policy and the public good’; adviser to governments of the UK and the USA, and the WHO; and editor, commissioning editor and editorial adviser of the Society’s journal, Addiction from 1978 until his death, he was one of the most significant figures in addiction research of the last half-century.

Throughout his career his approach combined the clinical and basic sciences of addiction with the more applied and social sciences, and he sought to promote a scientifically informed, evidence-based approach to addiction policy. He was also an extraordinary intuitive clinician and an inspirational teacher and mentor, as evidenced by the many whose lives and careers he touched.

As a tribute to Professor Edwards, we are re-printing the text of an interview carried out for the magazine of the Institute of Alcohol Studies, UK Alcohol Alert, in the winter of 2000.

Griffith Edwards is a world expert in alcohol and drug addiction. The founder of the National Addiction Centre, and adviser to governments throughout the world, from Bolivia to Russia by way of the White House, he is a medical scientist who has studied the problem for forty years. To mark the publication of his major new book, Alcohol: the ambiguous molecule, he is interviewed for Alert by the Institute of Alcohol Studies’s Andrew McNeill.

AM: May I ask you about the primary purpose of your new book? Who did you have in mind when you were writing it? GE: I won’t say that it is for “the educated layman” because that is such a patronising phrase. I dislike segregating people into the intelligent elite and the rest. I suppose I wanted to see people on trains reading the book. But I have no ideas of revolutionising the world - an easy madness when you write a book. I wanted it to contribute to public debate and to encourage people to think about alcohol, not just about addiction. So it was a book to address and engage the public. AM: At the end of the book you describe two possible futures for this country: the first is a ‘let it rip’, twenty-four hour a day drinking binge in which we all drink ourselves to death; the second is alcohol going somewhat out of fashion. You seem to think the second is more likely. Why?

GE: I think you need to look at historical processes and the ways in which certain reactions occur. There have been times, such as the present, when society’s use of alcohol has become damaging. For example, I tried to do some calculations on what it would have been like at the beginning of the 19th century at the time of the birth of the Temperance Movement and I am not surprised the Movement came into being. It is quite clear that in the 1700s and 1800’s the scenes of public drunkenness on the streets of this country were unimaginable. It was the appalling upswing in cancer deaths, sudden and tragic, which brought about the change in attitude towards tobacco. It took a long time for the reaction against tobacco, but it came. Today you can find mothers rising against heroin abuse on their council estates. Eventually the people may say enough. Of course, one can see that in certain Latin countries like France, drinking has declined. It is no longer cool to drink a lot of wine at lunchtime if you are a young French person. You will find that nowadays many French professional families have wine no more than once or twice a week.

We swim in the sea of public attitudes and I think that people have become more conscious of health. With that in mind, it is possible that our drinking behaviour will move towards a different pattern from the one we have seen in post war years. In some ways, these were years with a ‘let it rip’ attitude, although we never got back to the Georgian dining table where a gentleman slipped under the table towards the end of the evening. That sort of behaviour would not do one’s professional reputation any good today but it once was alright. Once it was perfectly acceptable for a judge or a doctor pass out drunk. So there are profound changes in fashion and I believe that fashions are to some extent affected by the slow infiltration of science. My book might make a microscopic contribution to that process. But changes in attitude must be supported by wise legislation. Legislation is educative. From the research angle, I think having 24 hour drinking is an interesting experiment. But, of course, it is also a very negative message educationally.

AM: Do you feel that there is a difficulty in getting the alcohol message across to the public in a positive rather than a negative way?

GE: Yes. It is easy to be accused of being a health fascist. I expect to take such statements with good will and a little laughter. I think I am trying to provide scientific information rather than reacting emotionally. But, of course, I am not merely a calculating machine. I have my own ethical values and I rejoice in our society, in its culture, and its civilisation. To me health is something to do with the health of all the people. I am not a doctor treating individuals only. Compassion for individuals is very important but not enough. You cannot individualise the whole thing. You can’t deal with smoking just by helping the next person in an anti-smoking clinic. You have got to be concerned with the entirety and that is as real to me as the health of the individual.

AM: We are at the moment awaiting the national Alcohol Strategy. There may be a call for more research. Can I put the point to you that we actually know enough already in order to put into place a strategy for reducing alcohol-related harm? Do you agree with that?

GE: Yes, I think I do. We have very good science in this arena and it has been revolutionised over the last thirty years. On the other hand, consider what happened with tobacco. Sir Richard Doll showed us the connection between cigarette smoking and cancer in the early 50’s. Some people said that it was unnecessary to do any further research: that the answer was simply to stop people smoking by raising the tax. But during the last fifty years there have been huge research advances in cigarette issues and I think it’s a good thing we didn’t shut down our research base when Sir Richard published his work. In our own field, we have enough research to get an Alcohol Strategy underway but I think there is far more needed to make it as effective and strong as possible.

AM: In relation to that, do you believe that there is a satisfactory mechanism in existence for feeding the findings of scientific research into the alcohol policy making process?

GE: In relation to alcohol, having looked at the situation in other countries, I think it is difficult to make a relationship between science and policy and scientists ought to be modest in their claims: politicians, after all, are there on the vote of the people. Alcohol policy has to be formed against a background of many political decisions and multiple considerations - including, of course, getting re-elected. I have never expected to do more than inform the government of my concerns. I won’t get angry if they don’t take my advice but I will come back to them and inform them, inform them and inform them again. At present I don’t think that there is a good mechanism for the voice of those working with alcohol issues to reach government. There is such a mechanism in relation to drugs. The Advisory Council on the Misuse of Drugs (ACMD) has extraordinarily independent responsibility. It isn’t a poodle of the government and it can set up working groups which examine all the evidence, prepare a scientifically thought out case, and report to ministers. What is more, there is a statutory responsibility of ministers to respond point by point to that report. They don’t have to swallow it whole but they do have to come back and say whether they like it or don’t like it and what they are going then to do.

AM: Would you like to see the same arrangement for alcohol?

GE: The temptation is to say that we should have exactly the same set-up for alcohol. I think the ACMD is a good model but I am not sure that it should be imitated in every detail. The ACMD puts the viewpoints of experts and practitioners in the field together with those of different government departments: for instance, the Department of Trade and Industry, the Department for Education and Science, the Home Office; the Departments of Health and Social Security. There is no tension because we are all on one side serving our country as best we can. The difficulty on the alcohol front arises with the drinks industry. This is because a government with an Alcohol Policy may say that an important part of it must be considerations of profit or the protection of the Scotch whisky industry. They will say that there must be a balance between health issues and employment issues, or advertising revenue, or whatever. So the drinks industry has to be given a voice. I think that it would be difficult to get good policy advice in those circumstances. It would be better to say that alcohol policy advice was related to health and social welfare where I think that the drinks industry is not a legitimate actor. The industry has a legitimate role as a producer but I think that the issue becomes too broad if you put those interests in with the total package of policy concerns. I am not against the drinks industry but out of courtesy to them I would not want to put them into a forum where their presence is inappropriate.

AM: What sort of things would you like to be in a National Strategy? What do you think it should be aiming to do? Do you think it should be concentrating on controlling consumption or on changing the culture?

GE: Partly on dealing with individual problems as they come: the questions of public order, lager louts; the issue of drinking and the young; drunk driving. There is a very big issue of alcohol and crime. These need to be dealt with separately from the drinks industry which is necessarily compromised by a fundamental conflict of interests. The industry has produced a report saying that there is no relationship between drinking and crime. Of course, that is simply not true but commercial interests force them to say it. I would say to anyone advising the government that many individual issues need to be taken on the hoof. There is always then the question of putting individual issues within a larger frame so that you have a sense of background issues and foreground issues.

You ask whether one should control the drink supply and hope the rest will look after itself? Controlling the drink supply is important but there are plenty of other small things which are important too. I think it is easier to deal with problems which are of immediate social and political concern. When you get into very abstract debate you usually get lost and ministers don’t want to hear. I hope an alcohol policy forum will approach large and difficult questions such as the acceptable national level of drinking as well as the smaller ones but I think the important thing is to get it up and running and you make sure you have got around the table civil servants from every department. I think you then need some people who are front line actors such as probation officers, magistrates, and teachers. You don’t need it crowded with heavy scientists. You do need some people with academic research background. We need quick action. We would certainly need to tap expertise from other countries. I don’t believe that these issues can be dealt with by little England alone.

AM: In the last few years you have been very much involved in the relationships between science and policy making. Do you feel there is a tension between the role of scientist and the role of advocate? Or do you think the two things need each other?

GE: I don’t think there needs to be a strong line taken that scientists should keep clear of advocacy. Richard Doll never bothered about it but Charles Fletcher, another leading researcher, helped set up an activist organisation in ASH. I am willing to tell the truth as I see it but I am not willing to exaggerate or distort the truth, however good the cause. An honest activist doesn’t do that either but there are activist skills, which I don’t have. I want to keep my scientific credentials. On a good day I think I am a scientist, on another day I think I am a jobbing researcher. I don’t want to be swept into any sort of partisan position. I live in a world where other people are going out and doing things like defacing billboards. I would probably fall off the ladder. So I think that when advocacy uses science well and honestly you have very strong movements. For example, the relationship between health advocates and science is very strong in tobacco, it is quite strong in food. It is quite strong in poverty issues. Honesty in both scientists and advocates is vital. There is no need for trumpeting the latest exaggerated horror story or to claim to have all the answers when only one tenth of them are available. I want science to be used for the public good and I am happy sometimes to be a player in that endeavour provided that none of us accidentally compromises the integrity of science.