“Addiction”, August 2004. Posted 10 Sept 04
Dear Colleagues,
I enjoy reading book reviews, partly because I rarely get around to reading the works themselves. Editor Griffith Edwards, author of numerous books himself, often undertakes such reviews in Addiction. He sometimes declares, but apparently does not act on his conflict of interest as an author of books on alcoholism, a field in which he is a peerless authority. In the reviews, he often reveals as much about himself as his subject. When authors’ views depart from his own, he often praises aspects of the work and then turns to indecorous and pointed criticism. For example, this month ina review of what promises to be a fascinating new book on drugs in China by some (we are told) eminently qualified authors (Dikotter, Laamann and Xun): “Unfortunately, at the same time it is a text marred by serious weaknesses.The intention is early declared of debunking ‘narcophobic discourse’ and that phrase is wearily repeated page after page. The authors go on to state that their aim ‘is to provide a critical analysis of narcophobic discourse and an in-depth examination of the social costs of government attempts to police the bloodstream of the nation’ - what is to be made of that strange image is unclear.” writes Edwards of this historical work. Then: “… it is evident that these writers have no intention of weighing the evidence dispassionately or seeing two sides of any question.”
What Edwards surprisingly omits from his review is that indeed 20th century China is probably one of the few shining examples of prohibition actually having the desired effect (law enforcement leading to near elimination drug use). But this was only achieved at the cost of civil liberties to an unprecedented degree in human history (and hence the belabouring of the ‘anti-narcotic’ sentiments by these authors, I imagine). Rather than discussing the merits of such rather major issues, or historical lessons for others, Edwards heaps scorn on these authors for what he perceives as theirpainting ‘opium as good’ and ‘narcophobia’ as bad (Edwards seems to espouse the exact opposite).
Opium, like most traditional drugs, can be both ‘good’ and ‘bad’ in different circumstances. Edwards knows that. Despite lacking a scientific basis, the blanket prohibition philosophy Edwards appears to support has proven to be counter-productive in most countries. Current prohibitions in our own society are associated with continued and often increasing and widespread availability of drugs to our citizens, most worrying, to the very young, poor and vulnerable. Edwards knows that. In addition, such policies deny medical uses of appropriate drugs in some instances (eg. cannabis,amphetamine, heroin). Edwards knows that. Yet he still sings the same old tune that appears to place confidence in the current prohibitions. The world is moving on, albeit slowly, and, while nobody I know has seriously suggested placing drugs on the supermarket shelves, there are better means to effective drug control than those existing in most countries currently.
According to London press reports, cannabis is now virtually decriminalised in the UK, an issue Edwards has yet to address to my knowledge. Portugal has apparently decriminalised all psychoactive drugs. The Dutch and Swiss now prescribe heroin to a small proportion of their addicts, as does the UK. Germany now has federal laws legalizing injecting rooms. South Australia decriminalized cannabis almost 30 years ago. Canberra, Darwin, Belgium, Holland … the list goes on. The lack of serious commentary in Addiction on these major issues does not reflect well on the journal’s management.
Edwards and co-authors have also written in reviews that the American prohibition period needs closer attention for its positive side, citing respected academic historian Ian Tyrrell. Can they be serious? Did the trains run on time? An underlying implication is that if we just tried a little harder that prohibition (of psychoactive drugs and/or alcohol) mightjust ‘work’. When I sent a mild letter pointing to these inconsistencies, Addiction used their “Iguana” chat column* to attempt to patronise and humiliate me, even suggesting that I take some tablets and lie down! Therewas no offer of genuine debate on the issues ‘between people of goodwill’ (to quote Edwards). Just a reminder that the editor’s decision is final. On another occasion: “I hope, however, you will think me in no waydiscourteous if I say that I do not see it as useful to re-open correspondence with you about …”. [Meaning, on this occasion, that a lead article ‘Additional methadone increases craving for heroin …’ remainsunchallenged despite the serious implications.]
In the review on drugs in China, as a further example which some may interpret as intolerance or a lack of equipoise, Edwards is extremely critical of some possible minor errors which would detract little from the authors’ overall message about drugs in China. Morphine is implied to be ‘semi-synthetic’; penicillin introduction in the 1940’s “took care of its [opium’s] medical uses”; tobacco is described as a stimulant. None of these seem like hanging offences to me and the meanings are reasonably clear, even if not all necessarily pin-point accurate from these non-medical authors.
In the July edition, Edwards also featured himself in one of a pair of book reviews on alcohol history in, respectively, Canada and the United States. Edwards spends over a third of his review commenting upon the appropriateness or otherwise of a media announcer deigning to write a historical work. He castigates the poor amateur on ‘getting caught up with the history of prohibition’ upon which Edwards then launches into his own opinions again: ‘Prohibition is an experience from which America has had difficulty moving on, but a book that reinforces such perseveration is not a recommended guide.’ After lambasting the authors over three more alleged errors, he goes out below the belt saying that ‘The validity of such claims should be checked out before being put into a newscast.’ This review is sadly unhelpful in informing us on the book’s general merits.
Robin Room is a frequent author in Addiction’s pages, whether reviews, research or commentary. He writes two alcohol book reviews, one being of a classic text (a suggestion I made to Griffith Edwards some years ago – with a submission on De Quincey’s confessions book* - a suggestion Addiction has finally chosen to act upon, albeit un-attributed). It is hard to write two lengthy reviews about alcohol policy without stating categorically the negative consequences of prohibition (which I was fascinated to learn was also tried, without lasting success, in some jurisdictions in Canada, Norway, Turkey, Soviet Russia and Finland up to 1930 - and also Box Hill insuburban Melbourne I understand). But Room manages to avoid writing about the unpleasantness of the prohibition period(s), despite the substantial loss of life, crime, corruption and under-age drinking attributed toenforced temperance policies. Intriguingly, these terms are not used, nor their consequences addressed. Room knows the best approaches to alcohol harms, including restricted hours of sales, age limits, responsible bartending, scaled taxation, honest labelling, limited advertising, driver breath testing and education, all within community expectations and tolerance. Yet for some reason, he stops short of being definitive on the inappropriateness of blanket prohibition of alcohol, leaving this perilous door yet wide open.
Life goes on. Our 100 year old flagship journal miraculously continues too, and will likely outlive Edwards, Room, Byrne and other current players. So will harm minimisation policies, variations upon which doctors have beenespousing since the time of Hippocrates.
comments by Andrew Byrne ..
*Copies available on request.
