Policy makers need to embrace an inclusive, ’whole-of-society’ approach to tackle addiction

Photo courtesy of epSos.de
Photo courtesy of epSos.de

By Aidan Gilligan, Founder & CEO of SciCom

Aidan contributed this article as part of our call for blogposts on conference themes. Submit your blogpost: http://bit.ly/1yyo1P2

Having worked inside the EU’s scientific services for nearly ten years, it often amazed me how important legislation about the food we eat, the air we breathe or the transport we use is decided without the broader scientific inputs of those actually doing the science and ‘in the know’. The approach was too often: ‘Here is the policy we want. Find the science to support it.’

We have all heard about ‘bad science’ or ‘bad pharma’ but what is less spoken about is the impact of the ‘bad policy-maker’. Of course, science does not always have clear answers. And important factors beyond the reach of science are often involved: fear, hype, ignorance, resentment, or economic and political advantage. But the simple truth is that when it comes to substance addictions today, the lives of millions of people needlessly hang in the balance.

Now in its fourth year, SciCom – Making Sense of Science (www.sci-com.eu) is an advocate for science diplomacy. If diplomacy is the art of getting people to engage with each other when they otherwise might not want to, then science diplomacy is about encouraging stakeholders holding different opinions to meet, discuss and ideally agree some common ground. It is about establishing the most basic of starting-points, supported by compelling scientific evidence, enabling all stakeholders to progress and enact meaningful change.

In the developed world, our greatest causes of preventable death are substance addictions linked to life-style, namely tobacco, alcohol and drugs. This is a policy choice we choose to accept. In fact, we practically nurture it. It is our way of life. Our laws, attitudes and social structures underpin it. But that does not mean that science is turning a blind eye. On the contrary, the race for ground-breaking brain research is unlocking the very secrets of our personalities, causing a revolution in how we might address addiction and frame public policy.

In a perfect world we would use this new novel science to create better policies, positively impacting the lives of many. In the real world, unfortunately, civil servants and, indeed, scientists too often think that they are the policy-makers. At the same time, too many elected officials think that they are the scientists and know best.

What is certain is that both groups fall into the trap of thinking that constant negative messaging on the harm caused by lifestyle choices is readily understood or sinks in. Ten years after Europe’s first smoking ban in Ireland, for example, the Chief Medical Officer’s Report shows a 3-4% total Irish population smoking increase. Alcohol awareness campaigns face similar hurdles. Science and policymaking clearly need to work together better if we are to come up with truly effective solutions.

There are just some of the questions we tackled at the 2013 ‘Substance Addictions and their Brain Reward Systems’ High-Level Consultation Event in Brussels. We assembled a group of experts and individuals with pertinent experiences of real-life support to policy-making in the area of substance addictions – perhaps never before brought together in this format.

What is crucial is that this body of experts represented all stakeholder groups and stages of scientific interaction, from conception and development to implementation, monitoring and evaluation. Everybody’s science was welcome. In truth, delegates love being taken out of their usual institutionalised preserves and meeting the people they are not supposed be in the same room as, let alone converse with in public. Surely this should be the norm? Medical experts and researchers should be sharing platforms with the alcoholics and the drinks companies and the policy-makers. You can only get the full picture if everybody takes part.

Three small working groups were set-up to look at ‘global policy and research insights’ into drugs, alcohol and tobacco. Everything was done deliberately to avoid a top-down approach and pre-judging the outcomes. The common thread was identifying best practices and pitfalls based on real-life experiences. You can read the full summary report here.

This larger 2013 event reinforced our 2012 finding that scientific outcomes are better when the industries being regulated are engaged in an appropriate way. If we can get the food industry to address fat, salt and now sugar in their products, why aren’t more policy-makers and health experts similarly engaging with our alcohol, tobacco/nicotine and drug/pharma companies? If reduced harm is clearly possible at the product development stage (e.g. e-cigarettes, reduced toxicant tobacco leaf, alcohol labelling, alcohol-light products etc.), scientists and health practitioners must surely mobilise to accelerate the incorporation of such evidence into policy-making.

Policy-makers need to embrace an inclusive, ’whole-of-society’ approach. On the other hand, powerful advocacy might, intentionally or unintentionally, result in the wrong scientific priorities. The informed public, including scientists, increasingly express themselves via special interest groups. Scientists are involved in public-private research or their own commercial endeavours – simply because they have to for funding. Knowledge of industrial research is more often a plus than a minus but you would hardly think so when you examine who is advising government on health. Inviting civil society and industrial representatives with the necessary skills onto scientific advisory panels should be less exceptional.

We need to redefine the voice of industrial partners and third parties with science, especially those actually dying from their addictions. We should hold our elected officials to the promises they make. Above all, those members of the scientific community who are genuine about supporting “evidence-based policies” (establish the addiction science first, then inform the policy) versus those supporting “policy-biased evidence” (establish the policy first, then find the science to support it) must make their voices better heard. We are not there yet.

Aidan Gilligan is the Founder & CEO of SciCom – Making Sense of Science. He is also a Euroscience Governing Board Member. Email: ag@sci-com.eu