Whose Territory is it Anyway? Should Psychiatry own Alcohol and Drugs in Australia?

Abstract

Surely alcohol and drug matters in Australia should be regarded as the province of psychiatry? Decades before any other branch of medicine displayed any interest in the subject and long before alcohol and drugs were considered even remotely respectable, numerous Australian psychiatrists provided inspiration and leadership in this Cinderella field. Drs Bartholomew, Bell, Buchanan, Chegwidden, Dalton, Drew, Ellard, Lennane, Milner, Milton, Waddy and Pols are some of the best known among the many Australian psychiatrists who pioneered efforts to improve treatment for patients with alcohol and drug problems. The NHMRC Committee on Alcohol and Drug Dependence, which has a considerable potential for influencing the field in Australia, has always been dominated by psychiatrists. In the United Kingdom and the United States, countries which often serve as models for much of Australian medical and other practice, alcohol and drug matters are determined almost exclusively by psychiatrists. Is there any evidence that they have been held back by a psychiatric hegemony on alcohol and drug's? For many decades (and until quite recently), alcohol and drug matters were handled for the World Health Organisation by its Mental Health Division. Did we suffer globally because WHO placed alcohol and drugs under the control of psychiatry?