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Kicking a long-term habit

March 17, 1995

Britain's first professor of addiction took up his post this month, in a move which he hopes will break down taboos over the role of addictions research in informing public policy.

John Strang is based at the National Addiction Centre at the Institute of Psychiatry in the University of London. His chair is funded by the charity Action on Addiction. He takes it up at a time when the United Kingdom's alcohol consumption is increasing, there are 30,000 deaths a year from alcohol abuse and 100,000 deaths a year from tobacco abuse - and, he says, the public feels increasingly despondent that anything can be done about drug dependency.

He said: "There is a lack of vision in the way we invest in our understanding of both addiction and its effects. It includes a confusion in people's minds about whether or not it is a legitimate aim for science."

But Professor Strang is excited about the future for addiction research, claiming that it has "arrived as a science".

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Large-scale studies are showing that addictions are more malleable than was previously thought. "People change," he says. "It's not true, for example, that the UK has a stable homeostasis. Within the UK we have had huge differences that indicate the malleability of behaviour. We have enormously encouraging decreases in cigarette smoking," he says. This is due to influences at macroscopic levels - price, availability and the acceptability of smoking as a behaviour.

"A lot of the general public think that demand is fixed," he said. "Individuals feel that way about families and colleagues."

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But the data show that for every 10 per cent increase in the price of alcohol or tobacco there is a permanent, 5 per cent decrease in consumption.

Professor Strang wants to see whether this effect can be extrapolated to other forms of drug abuse. "All the indications are that it's a fundamental role of economics of drug abuse in society."

If the economic lever holds, he says, then it could be used to manipulate the black market in drugs, for example by concentrating on seizing a particularly damaging form of a drug in order to force up prices. "We need to look at how we can influence the business of the black market," he says. "I would like to be able to tell you how the different markets had gone up and down over the years. I would then feel that I was serving the public debate. But I can't give you those data because of a lack of investment in the scientific infrastructure in addictions research."

Professor Strang hopes that his post will enable him to coordinate multi-disciplinary research at the macroscopic, the human and the genetic levels of addiction. A study of drug injecting in prisons and an anthropological study of parties where some people accept heroin and some do not can both feed into the assessment of what triggers people to start taking drugs or to move onto more dangerous forms. "These factors are of enormous significance," he says.

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Results indicate that it is a sudden disruption of drug supply that moves people onto a more dangerous form, for example from smoking heroin to injecting it - and one example of a sudden disruption is moving into prison.

There are also studies of a new withdrawal drug, lofexidine, for people coming off heroin. So far the signs are good that it is safe, effective and non-abusable. Meanwhile, genetic research is pointing to the theory that about a third of the variance in addiction is due to inheritance.

Whatever the research uncovers, the NAC has developed strong links with Government so that it can feed its analysis to influential ears: "It would be a waste of our resources if we were merely looking at treatment and prevention without passing it on," said Professor Strang.

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