The foibles and ironies of alcohol science never cease to amaze me!

Robin Room¹ reported yesterday (8/25/97) in a post to the email discussion group, ADDICT-L, that the editors of addiction-related journals have just signed an agreement--called the "Farmington statement"--requiring authors of scientific papers henceforth to disclose their funding sources.

The compact's text, Room² added, will soon be published in Addiction and perhaps in other co-signatory journals as well.

There's nothing new of course about the scientific practice of citing and crediting one's funding source in scientific publications.

Indeed, scientists ordinarily want to acknowledge their funding-source institutions--to say thank you and to allow the funding-source institution to receive its proper share of credit for the publication.

But the agenda behind the Farmington statement is new and different--part of the would-be drying tendency in government- and foundation-funded alcohol science.

It is aimed at flushing-out industry-sponsored alcohol research--thus providing in effect a warning label for the unwary consumer of the alcohol science literature.

A good intro to the story of the new anxieties that fostered the Farmington statement is available in two issues of the prestigious British journal, Addiction--the first³ offers an editorial titled "Science and the drinks industry: cause for concern" authored by Thomas Babor, Griffith Edwards, and Tim Stockwell; the second⁴ offers several responses to the editorial and a reply by Babor et al.

For my money at least, the really extraordinary thing about this new disposition toward industry-sponsored research is that it stems from a crucial misreading of alcohol science's recent conceptual history.

The misread argument goes something like this:  

• The emergence of a disaggregationist,⁵ New Public Health Approach (NPHA) to alcohol-related problems re-directed scientific and policy attentions away from alcoholism and back toward alcohol, per se, as the key causal source of something called "alcohol-related problems."

• As alcohol's problem-occasioning potentials increasingly became the focus of new scientific attentions, the role and place of industry- sponsored research became increasingly marginalized.

• After all, if the new alcohol science planted blame squarely on the industry's product, then what could industry-sponsored research contribute to alcohol science other than disinformation and diversion?
  

"Liquorspeak," the authors of the Addiction editorial termed it.

Such is the deep structure of the new antipathy toward industry-sponsored alcohol science and the "problem" that the Farmington statement sought to address.

The key question is: How good is the conceptual lynchpin of this argument?

Which is to say: How solid is the contention that an iron weld joins  

I. a disaggregationist conceptual perspective toward alcohol-related problems and

II. the notion that alcohol, per se, is the paramount problem-occasioning vector in such problems?
 
Answer: In fact, the contention is not very good at all.

The disaggregationism-means-alcohol-is-at-fault contention is the logical equivalent of saying that because something is not a swantherefore it must be a duck.

Obviously, the set of all non-swans comprises considerably more than the set of all ducks!

Consider two clear counterexamples to the disaggregationism-means- alcohol-is-at-fault thesis:

The Harm Reduction Model


Counterexample:  As it happens, the New Public Health Approach (NPHA) model re alcohol and the Harm Reduction Model (HRM) re illicit drugsshare the disaggregationist viewpoint on the problems they seek to conceptualize.

Indeed, the NPHA alcohol paradigm and the HRM drug paradigm are arguably the same conceptual system fielded into the differing sociocultural circumstances of the alcohol and drugs problem arenas.

Both approaches are based on a disaggregationist theme; both invite a perspective that emphasizes the severality of alcohol- or drug-related problems; both, in fact, separate the phenomenon of consumption or use from the various and sundry phenomena called "problems."

The odd, intriguing, and important difference between the HRM and the NPHA idioms occurs in practice: namely, whereas the HRM approach de-emphasizes the role of the drug use in explaining drug-related harms, the NPHA re-emphasizes the role of alcohol use in explaining alcohol-related problems.

In other words, ostensibly the same disaggregationist orientation to drugs and to alcohol has opposing conceptual and policy implications regarding the centrality of the substance use, per se, with regard to science and policy.

It logically follows, of course, that the disaggregationist paradigm, per se, must harbor no necessary implication re the question of the centrality of substance use, per se--since the implications regarding use are opposite in this two realms. 


The "Early Alcohol-Problems Perspective" Counterexample:
 
The celebrated "alcoholism paradigm" was not, in fact, the first conceptual orientation embraced at Yale's Laboratory of Applied Physiology, the U.S.'s pioneering alcohol-science enterprise in the 1940s.⁶

As Mark Keller has pointed out, the early Yale group embraced an "alcohol-problems" perspective, which--like the NPHA today-- disaggregated alcohol problems into a complex array of elements.

That's why, incidentally, several of the original institutions of the new scientific approach to alcohol (e.g., the Quarterly Journal of Studies on Alcohol and the Yale Summer School of Alcohol Studies) used the word "alcohol," not the word "alcoholism," in their titles.

But the disaggregationist alcohol-problems perspective that the Yale group advanced emphasized the pluralism of alcohol problems in order to distinguish their focus and orientation form the temperance movement's singular preoccupation with something called "the alcohol problem."

In other words, the early-Yale formulation of a disaggregationist, alcohol-problems perspective was part of the group's effort to draw attention away from, not toward, alcohol, per se, as a problem- occasioning agent! The folk at Yale were very keen on distancing and distinguishing themselves from the unfashionable temperance sensibility and its singular focus on alcohol, per se, as the root of all alcohol problems.

Try telling them that an alcohol-problems perspective carries the inevitable corollary that alcohol science must concentrate conceptual and policy attentions on alcohol use, per se!

There is a delicious historical irony in all this.

If, as I've suggested, the Addiction editorial and the Farmington statement are in fact based on a crucial misreading of the disaggregationist model's conceptual and policy implications/imperatives, then the move led by Addiction's editors to marginalize industry-funded alcohol science may itself be regarded an expression of the cultural politics at work in shaping publicly-funded alcohol science!

The mind reels!

---

Footnotes:

¹ Robin Room, Subject: Re: Sources of funding--reply-Reply Date: Mon, 25 Aug 1997 11:35:35-0400 on the ADDICT-L listserve group, ADDICT-L@listserv.kent.edu.

² Robin Room, Subject: Re: Sources of funding--reply-Reply Date: Mon, 25 Aug 1997 11:36:18-0400 on the ADDICT-L listserve group, ADDICT-L@listserv.kent.edu.

³ See Addiction 91(1):5-9, 1996.

⁴ See Addiction 91(12):1869-1879, 1996.

⁵ In their clearest explication of the tie between the survey-based disaggregationist perspective and the new preoccupation with alcohol, per se, Babor et al., wrote in their reply to commentators (Addiction 91[12]:1877-1879, 1996):  

."...we refuse to retreat from our contention that the industry is wrong to assert that alcohol related problems are experienced by only a small percentage of the population. This is surely not just some socially constructed whim but the result of decades of epidemiological research relating to such issues as road safety and violence." (p. 1878)
 

⁶ For a fuller account of the scientific orientation of the Yale alcohol science group over its first five years of operation, see Ron Roizen, "Paradigm Sidetracked: Explaining Early Resistance to the Alcoholism Paradigm at Yale's Laboratory of Applied Physiology, 1940-1944," paper presented at the Alcohol & Temperance History Group's International Congress on the Social History of Alcohol, Huron College, London, Ontario, Canada, 13-15 May 1993.