Addictive Behaviours in a changing world – the challenge for stakeholders.

ICAA has long aimed to provide a neutral forum in which responses to addictive behaviour can be explored in the interests of individuals, organisations, governments and the global community. In recent times economic and health crises have both exacerbated problems for existing addiction issues and highlighted the potential for new and changing patterns of addiction. In looking to the future ICAA will aim to address both ongoing issues with alcohol, gambling and narcotics, and new concerns around the impact of cannabis legalisation, IT dependence and tobacco substitutes.

In laying out our planned pathway, it is important to restate the nature of the addictions field, and some of the dynamic forces which underpin its current, conflicted state.

Addictive behaviour may be defined as the continuation/repetition of a gratifying behaviour or consumption despite strong negative consequences. However, since potentially addictive substances and activities only create problems for a minority of consumers, and assuming that freedom of choice should in large part, be of paramount importance, the challenge for all stakeholders is to identify and implement strategies by which harmful levels of consumption or activity can be reduced.

Historically, the response to addiction might best be described as broad-brush, less than clinically scientific and commonly partisan or political. The evidence for this is to be found in a strong tendency in the first place, to place the blame for addiction on the availability of the substance or behaviour "if it didn't exist, people couldn't use it". This abstentionist approach has traditionally underpinned a conceptualisation of issues based on good versus evil and continues to be promoted through organisations opposed to the availability of alcohol, drugs, gambling, nicotine, pornography, etc. This first approach brings with it the demonisation of organisations providing addictive substances and activities and creates dilemmas for Governments who profit considerably from the taxation of addictive behaviours, and for example, from state-run or state-endorsed lotteries.

A second broad approach to addiction is based on prevention or harm reduction. It assumes that cessation of use is automatically effective, however, if cessation is unattainable, then clarity is required over what is to be prevented, or what harms are to be reduced. This second approach has gained considerable traction since the 1970's. Over several decades it has led to initiatives ranging from industry-supported drink-driving campaigns to needle and syringe exchange schemes, and from reducing the availability of gambling machines through to the provision of alternative nicotine delivery systems. The importance of this second approach lies in the fact that it invites and legitimises greater involvement in addressing addiction-related harm from both governments and from the providers of addictive substances and behaviours.

It is ICAA's belief that progress towards reducing harms caused by addictive behaviours to individuals, families and the broader community, will be achieved by placing the individual at the centre of our concern. Refocussing on client issues and client pathways moves the focus away from polarised and politicised debate about who is responsible for a situation and encourages a more scientific and individualised understanding of the individual's journey into addiction. It allows for, even requires, that all those who have a scientifically valid contribution to make to our understanding of the nature of addiction and the complexity of the pathways into harm should have their views and their research heard and valued for the science behind what is said and done, not judged on the source of their funding.

In a series of newsletters and on-line workshops between now and the planned conference on Women in Addiction to take place in Canada in September 2022, ICAA will lay out the questions to be explored in dealing with Alcohol, Cannabis, Gambling and Technology dependence.

The areas to be explored will address:

• Recognising and understanding differential responses based on bio-genetic factors such as brain chemistry
• Recognising and increasing our understanding of the crucial role of social determinants in creating and maintaining patterns of addictive behaviour.
• Establishing a clear distinction between abstinence and harm reduction
• Focussing the discussion on the impact of use on the individual rather than on levels of use
• Demonstrating the ways in which there is a gradation of individual impact based on the above factors
• Suggesting ways in which policy formulation might or should take these factors into account

These are challenging times in which pandemics, economic upheaval and political uncertainty continue to dominate the news much of our thinking and to throw obstacles in the way of progressive work on addictive behaviours. However, for as long as addiction continues to undermine society ICAA will work to bring stakeholders together to explore scientifically backed, effective ways of reducing harm.

We anticipate 2022 with both concern and excitement but above all with the hope and expectation that you will want to share our vision and our determination to place the addicted individual at centre of reducing harm and changing lives.

Finally, may we take this opportunity of wishing you all the very best for the festive season and for the New Year.

Warm regards
ICAA