Building the connections between science, practice and policy: Griffith Edwards and the UK National Addiction Centre

This Supplement presents a series of papers written by key players in the development of a multi-disciplinary research programme that established the Addiction Research Unit (ARU) as one of the modern world's premier academic centres for applied research on alcohol, tobacco and other drugs. The papers are developed from presentations made at a 1-day conference that took place on Thursday 24 January 2013. The conference was held at the Institute of Psychiatry, Kings College London, not far from the former pre-fabricated temporary premises in which the ARU was originally established (and where it remained for quarter of a century). It is also not far from the small office in the new Addiction Sciences building where Griffith Edwards spent the latter part of his career. The conference was organized not only to pay fitting tribute to the memory of Griffith Edwards. It was also an occasion for reflection about the issues he cared deeply about: addiction science, clinical practice and public policy; and without being on the agenda, the day's proceedings tell the story of how institutions mould their inhabitants, and how leaders shape and create institutions. The conference was supported by the Institute of Psychiatry, the Society for the Study of Addiction (SSA) and the international journal Addiction, three institutions that contributed enormously to the dramatic growth in the interdisciplinary field of addiction studies over the past 50 years. When he died in September 2012 at the age of 83, Griffith Edwards had been ‘retired’ for 18 years; but, of course, he did not stop working. His energy, creativity and productivity continued to grow right up to the end, when old age finally conquered his body, but not his spirit. If the child is father to the man, then Griffith was the child of the Institute of Psychiatry, where he developed and matured as an addiction psychiatrist. If he expanded his horizons much further than psychiatry—into epidemiology, history, biography, fiction, journal editing, mentoring, institution building and many more areas of endeavour—it is partly because his unique personality was moulded by the institution that nurtured him. More than anywhere else he might have gone after his medical studies, the Institute of Psychiatry was the right place for a young man on a mission. That mission matured over the course of his remarkable career, to the point where it included not only scientific breakthroughs and theoretical contributions but also institutions devoted to addiction science, such as the National Addiction Centre, and the scholarly journal, Addiction. ‘The Maudsley Hospital and the still quite new Institute of Psychiatry constituted a unique centre of research excellence. It had particular strength in those days in social psychiatry, embodied in some big figures who influenced Griffith's thinking… Add Griffith Edwards’ breadth of vision and iconoclasm and the scene was set for a bold research project which became a classic, the influence of which is felt to this day.’ Professor Jim Orford ‘During his long career Griffith Edwards performed multiple roles. His gift was to weave ideas taken from these various professional strands into a coherent tapestry of work that will outlive him… A clinician of great humanity, he was an astute observer of alcohol-dependent individuals and would listen carefully to their stories week after week at his ward round.’ Dr Jane Marshall ‘The concept of the alcohol dependence syndrome (ADS) is one of the most enduring and significant legacies from the late Griffith Edwards’ stellar career… During those 3 years I sat in on many ward rounds at the Alcoholism Treatment Unit of the Bethlem Royal Hospital where Griffith presided as the consultant in charge. He would hold forth on these occasions with extraordinary and often spellbinding eloquence on the plight of each patient brought up for discussion.’ Professor Tim Stockwell ‘The most important debate that has ever occurred in tobacco control is under way and it carries the signature of Griffith Edwards’ ARU.’ Professor Peter Hajek ‘He was an innovator and a leader before these were buzz-words. His curiosity never abated. He was inspirational… It was his humanity that was paramount and informed his eclectic professional and cultural pursuits.’ Professor Ilana Crome ‘Griffith Edwards made empirical contributions early in his career to the literature on Alcoholics Anonymous (AA), but the attitude he adopted towards AA and other peer-led mutual help initiatives constitutes an even more important legacy.’ Professor Keith Humphreys ‘We all shared the experience of entering what we thought was a new area for research, only to find that Griffith had somehow been there long before, being modest and downplaying his past contributions while encouraging others to do better. His interest in marginalized and forgotten people, his desire to improve approaches at every level, was exemplified in his early work on addictions and the criminal justice system… The tradition of broad-based research that responds to the policy imperatives of the day has continued within the National Addiction Centre.’ Professor Michael Farrell ‘My next encounter was in 1991 when I visited the National Addiction Centre as a new entrant to the addictions field. Griffith gave me a warm welcome, showed a keen interest in my as-yet largely unpublished work, and invited me to one of his and Sue's “suppers” at Crooms Hill. I got to know him better over later visits, and by the late 1990s a visit to London was incomplete unless it included an hour of stimulating conversation over lunch with Griffith.’ Professor Wayne Hall ‘In the later years of his life, Griffith himself provided the raw material for historical research, granting interviews to PhD students and lending swathes of archival material. Our user group study was enriched by the early papers of Phoenix House in Camberwell which he lent to us. The Addiction Research Unit itself is now a subject of emergent interest for historians, not least because of its early focus across the substances, drugs, alcohol and tobacco…’ Professor Virginia Berridge ‘I worked closely with Griffith, who was extraordinarily generous, supportive and challenging in equal parts…’ Professor John Strang ‘One thread that provides a clear link between the first and the last monographs, and between science and policy, is Griffith Edwards. He was clearly the dominant force behind each of these books, without ever being domineering. He had many skills but few personal agendas. He spoke and acted with the natural authority of a born leader. What counted most to him was the ability to share ideas, launch projects and move mountains, preferably by means of evidence-based policy. His home on Greenwich Park was often used as the base of operations for project meetings, with his Scottish terrier providing comic relief to the assembled academics as they were debating a point or formulating a conclusion. He understood that creativity and consensus among a team of rivals is often produced by the hospitality of a gentleman, and by the distraction of a little dog chasing balls in an English drawing room.’ Professor Thomas F. Babor What is extraordinary about these comments is what they say about the breadth of Griffith Edwards’ contributions to addiction science, and the people and the institutions he influenced personally and professionally. Each of the commentators is an expert in their own right, and each one benefited from their connections with Griffith Edwards and the ARU. The personal reflections collected in this Supplement tell about the role of the ARU and Griffith Edwards in the growth of addiction science. They are part of the living record of an interdisciplinary field devoted to the understanding of one of the most inscrutable afflictions of modern society. To those of us who had the pleasure of knowing him, of working within the institutions that he created, there can be no greater testimony to his accomplishments than to share the knowledge collected in this issue. The American philosopher Ralph Waldo Emerson once said that an institution is the lengthened shadow of one man. The journal Addiction and the Addiction Research Unit are institutions that stand today in the shadow of one man who, fortunately for us, created the kinds of hospitable environments that welcomed the world community of addiction scholars. With Griffith's shadow set firmly in the background, the people and institutions he influenced now face the challenge of continuing the work of addiction science. TFB has no conflicts of interest. JS has received research grant support and/or payment in the form of honoraria, consultancy payments and/or travelling and/or accommodation and/or conference expenses from pharmaceutical companies who produce, or have been considering producing, new medicines for use in the addiction treatment field, including (past 3 years) Viropharma, Martindale/Catalent, Reckitt-Benkiser, Schering-Plough, Lundbeck, UCB, MundiPharma, Alkermes, Teva and also discussions with Lightlake, Lanacher, Rusan/iGen and Indivior; this includes companies who are considering development of naloxone products, including at least one which has a patent registration which includes declaration of contribution from JS. JS's employer (King's College London) has also recently submitted a patent application for a medication formulation to address heroin overdose. RW has received travel funds and hospitality from, and undertaken research and consultancy for pharmaceutical companies that manufacture or research products aimed at helping smokers to stop. These products include nicotine replacement therapies and Zyban (bupropion). This has led to payments to him personally and to his institution. He undertakes lectures and training in smoking cessation methods which have led to payments to him personally and to his institution. He has received research grants from medical charities and government departments.

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