Brian "Nick" Heather (born 1938) is a clinical psychologist, alcohol researcher and Emeritus Professor of Alcohol & Other Drug Studies at Northumbria University. [1] He was one of the pioneers of brief intervention techniques to reduce alcohol misuse, [2] [3] and has challenged the disease theory of alcoholism and has over five hundred research publications and books.
Nick Heather was born in London in 1938 and was the son of an off-license manager. Born and still officially named Brian Heather, in an interview for the Journal Addiction he explained after his birth his father remarked he looked like "old Nick" due to thick black hair. [4] In his late teens he joined the Royal Air Force under one of the last phases of National Service, posted mostly in Germany. After various jobs he decided he would take A-levels by correspondence course in an attempt to go to University and in 1965 he received a degree in Psychology and Statistics from University College London, followed by MSc at the University of Leeds and PhD at the University of Dundee.
In 1976 his first book was published 'Radical Perspectives in Psychology', [5] which critiqued psychiatry and some of the academic approaches to psychology at the time.
Heather has had a number of books published which present evidence and theories that intend to disprove the notion that alcoholism exists as a disease. In 1981 Heather co-authored a book on controlled drinking, which looked at a number of studies that found some dependent drinkers were able to return to problem free drinking. [6] In 1997 Heather's co-authored book 'Problem Drinking' [7] was published by Oxford Medical Publications. The book extensively explored alcohol problems and their interpretation through various research and debate, repeatedly setting out evidence to contest disease model interpretations of alcohol problems.
As well as evidence of controlled drinking in some formerly dependent drinkers, a wide variety of other evidence is set out to contest the disease model. One strong theme of the book is the complexity of alcohol problems, whereby dependence itself can vary greatly in severity. As such, Heather argues that there is no hard and fast line between 'alcoholics' and 'non-alcoholics', so the concept is inherently flawed. Also argued are that many people who do indeed develop alcohol dependence do recover, often spontaneously or without subscribing to any formal support. Dependence does not also mean an inevitable progression into worsening addiction and ultimately 'rock bottom', as is often claimed by disease model advocates.
Despite arguing that alcohol problems are in a large part attributable to social learning theory, Heather still recognises the role of genetics as an influencing risk factor for developing alcohol dependence. However whilst some people may have a genetic predisposition, there are a wide range of socio-psychological factors that also significantly influence risk of dependency, rendering disease model thinking simplistic and flawed. In the 2007 interview with the Addiction Journal, Nick Heather stated he was "depressed by the resurgence of the notion that there is something called ‘alcoholism’ which is a brain disease", which has "held us back from a proper understanding of alcohol problems and how they may be resolved in all kinds of ways".
Heather was also instrumental in establishing the 'New Directions in the Study of Alcohol Group' [lower-alpha 1] (NDSAG) in the 1970s, which allowed those working in the addictions field to come together to discuss and challenge notions such as the disease model. Heather remains Honorary President of the Group, which in 2016 holds its 40th annual conference.
The delivery of brief intervention for non-dependent drinkers is a key alcohol public health policy in many countries across the globe. Although some literature credits the early development of brief intervention to the United States, its true origins go back to the Scottish Highlands through work by Heather and colleagues.
By the 1980s Heather was becoming an experienced alcohol researcher, specifically focusing on work relating to 'controlled drinking'. In part, brief interventions came about because of difficulties recruiting dependent drinkers for studies meant Heather and colleagues sought other participants out through primary care. Heather collaborated with the Scottish Health Education Group to produce a screening and intervention pack for general practitioners called DRAMS (Drinking Responsibly and Moderately with Self-control). [8] Heather has stated the Scottish Health Education Group was an important and innovative group in the 1970s and 1980s but was closed down by the government for criticising government policy.
Although other researchers later delivered some of the research trials that more convincingly proved the effectiveness of brief intervention approaches, Heather has continued to play a significant and influential role in their continued development including involvement in many further research trials and journal articles.
Heather has over 500 publications, mainly peer reviewed journal articles and a number of book titles. Most recently he co-edited 'Addiction & Choice: rethinking the relationship' with Gabriel Segal, which includes a number of chapters by leading experts in the addiction field. [9] The book explores a 'multidisciplinary perspective from philosophy, neuroscience, psychiatry, psychology and the law, demonstrating to readers how diverse positions from varying academic and scientific disciplines can cohere to form a radically new perspective on addiction'. [10]
In 2017 Heather was awarded the Jellinek Memorial Award. [11] The award, in honour of E.M Jellinek, is an international award presented to scientists who have made an outstanding contribution to the advancement of knowledge in the alcohol addiction field.
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Alcoholics Anonymous (AA) is a global peer-led mutual aid fellowship begun in the U.S. and dedicated to abstinence-based recovery from alcoholism through their spiritually inclined twelve-step program. Besides stressing anonymity and offering membership to anyone wishing to stop drinking, AA's twelve traditions establish it as free to all, non-professional, non-denominational, apolitical and unaffiliated. In 2020 AA estimated its worldwide membership to be over two million with 75% of those in the U.S. and Canada.
Alcoholism is the continued drinking of alcohol despite negative results. Problematic use of alcohol has been mentioned in the earliest historical records, such as in ancient Egypt and in the Bible, and remains widespread; the World Health Organization (WHO) estimated there were 283 million people with alcohol use disorders worldwide as of 2016. The term alcoholism was first coined in 1852, but alcoholism and alcoholic are stigmatizing and discourage seeking treatment, so clinical diagnostic terms such as alcohol use disorder or alcohol dependence are used instead.
Alcohol abuse encompasses a spectrum of unhealthy drinking behaviors, ranging from binge drinking and alcohol dependence to addiction resulting in physical withdrawal symptoms when abruptly stopping the intake of alcohol for more than 24 hours.
Alcohol dependence is a previous psychiatric diagnosis in which an individual is physically or psychologically dependent upon alcohol.
Stanton Peele is a psychologist, attorney, psychotherapist and the author of books and articles on the subject of alcoholism, addiction and addiction treatment.
Gordon Alan Marlatt was a leading American-Canadian clinical psychologist in the field of addictive behaviors from the 1980s through the 2000s. He conducted pioneering research in harm reduction, brief interventions, and relapse prevention.
William Richard Miller is an American clinical psychologist, an emeritus distinguished professor of psychology and psychiatry at the University of New Mexico in Albuquerque. Miller and Stephen Rollnick are the co-founders of motivational interviewing.
Elvin Morton "Bunky" Jellinek, E. Morton Jellinek, or most often, E. M. Jellinek, was a biostatistician, physiologist, and an alcoholism researcher, fluent in nine languages and able to communicate in four others.
The modern disease theory of alcoholism states that problem drinking is sometimes caused by a disease of the brain, characterized by altered brain structure and function.
The Paddington alcohol test (PAT) was first published in the Journal of Accident & Emergency Medicine in 1996. It was designed to identify alcohol-related problems amongst those attending accident and emergency departments. It concords well with the Alcohol Use Disorders Identification Test (AUDIT) questionnaire but is administered in a fifth of the time.
The Natural History of Alcoholism Revisited (1995) is a book by psychiatrist George E. Vaillant that describes two multi-decade studies of the lives of 600 American males, non-alcoholics at the outset, focusing on their lifelong drinking behaviours. By following the men from youth to old age it was possible to chart their drinking patterns and what factors may have contributed to alcoholism. Another study followed 100 severe alcoholics from a clinic eight years after their detoxification. The National Review hailed the first edition (1983) as "a genuine revolution in the field of alcoholism research" and said that "Vaillant has combined clinical experience with an unprecedented amount of empirical data to produce what may ultimately come to be viewed as the single most important contribution to the literature of alcoholism since the first edition of AA's Big Book." Some of the main conclusions of Vaillant's book are:
Moderation Management (MM) is a secular non-profit organization providing peer-run support groups for anyone who would like to reduce their alcohol consumption. MM was founded in 1994 to create an alternative to Alcoholics Anonymous and similar addiction recovery groups for non-dependent problem drinkers who do not necessarily want to stop drinking, but moderate their amount of alcohol consumed to reduce its detrimental consequences.
Alcoholism in family systems refers to the conditions in families that enable alcoholism and the effects of alcoholic behavior by one or more family members on the rest of the family. Mental health professionals are increasingly considering alcoholism and addiction as diseases that flourish in and are enabled by family systems.
Binge drinking, or heavy episodic drinking, is drinking alcoholic beverages with an intention of becoming intoxicated by heavy consumption of alcohol over a short period of time, but definitions vary considerably.
Community reinforcement approach and family training (CRAFT) is a behavior therapy approach in psychotherapy for treating addiction developed by Robert J. Meyers in the late 1970s. Meyers worked with Nathan Azrin in the early 1970s whilst he was developing his own community reinforcement approach (CRA) which uses operant conditioning techniques to help people learn to reduce the power of their addictions and enjoy healthy living. Meyers adapted CRA to create CRAFT, which he described as CRA that "works through family members." CRAFT combines CRA with family training to equip concerned significant others (CSOs) of addicts with supportive techniques to encourage their loved ones to begin and continue treatment and provides them with defences against addiction's damaging effects on themselves.
The Center of Alcohol Studies (CAS) is a multidisciplinary research institute located in the Busch Campus of Rutgers University, which performs clinical and biomedical research on alcohol use and misuse. The center was originally at Yale University and known as the Yale Center of Alcohol Studies, before it moved to Rutgers in 1962. The CAS is also home to the peer-reviewed Journal of Studies on Alcohol and Drugs (JSAD), the oldest journal on alcohol studies; and a library of alcohol literature. Early research in the 1940s at the CAS helped support the disease model of addiction that helped change public perception on alcohol consumption.
Mark B. Sobell, Ph.D., ABPP, a professor at the College of Psychology of Nova Southeastern University in Fort Lauderdale, Florida, is a specialist in addiction. Dr. Mark Sobell is nationally and internationally known for his research in the addiction field. He is a Fellow of the American Psychological Association in Divisions 1, 3, 12, 25, 28, and 50, and is Board Certified in Cognitive and Behavioral Psychology by the American Board of Professional Psychology. He is the co-director of Healthy Lifestyles: Guided Self-Change at Nova Southeastern University.
Linda Carter Sobell, Ph.D., ABPP, is the President's Distinguished Professor at Nova Southeastern University (NSU) in Fort Lauderdale, Florida. She is a professor of clinical psychology, addiction specialist, co-director of NSU's Guided Self-Change clinic, a Motivational Interviewing Trainer, and is board-certified in cognitive and behavioral psychology.
Guided self-change (GSC) treatment has been accepted by American Psychological Association Division 12, Society of Clinical Psychology, as an empirically supported treatment.
Jalie A Tucker is a professor of Health Education and Behavior at the University of Florida. She is known for her research on impulsive and harmful behaviors, such as alcohol and substance use, the effect of the environment on addiction, and natural resolutions to risky behavior including alcohol misuse. She has received numerous awards for excellence in clinical psychology and addiction research, including the 2015 Award for Distinguished Scientific Contributions to Clinical Psychology from the Society of Clinical Psychology. She was honored by APA, Division 50 with the Presidential Award for Service to the Division in 2010 and 2012.
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