Alcohol Concern: beyond the dry month

Drink is a compelling topic – for its friends, for its enemies and for all those in-between. And in August a new name will join those flapping around the flame. But Richard Piper isn’t saying what it is yet.

Attempts to loosen his tongue by the coffee machine – “it’s not one of those made-up Latin words, is it?” – causes a smile to flicker across his lips, but they remain tight.

So we’ll have to keep calling it Alcohol Concern (AC) for now. 

Piper took over as chief executive of the body last September and is leading it through a period of significant change. After the government withdrew its funding, AC merged with Alcohol Research UK (ARUK) in April 2017, and next month its partners shall find out not only the name of the combined organisation but its strategic priorities. A full public launch will follow in November.

Thanks to a peculiar set of circumstances, ARUK enjoyed independent means that originally came from the drinks industry, the funds left over from a levy imposed to compensate publicans forced to close under the 1904 Licensing Act. 

You might say that AC married into money. Except that one of the main things that drew Piper, a man who has spent his whole career in the charity sector, to the alcohol question was the untapped potential to raise cash and support among the concerned.

“I saw the merger as an opportunity, in a professional sense, to take on a cultural challenge,” he says. “And I also saw huge potential to engage tens, perhaps hundreds, of thousands of people who care about alcohol harm. 

“This is almost a virgin field in terms of fundraising. At the moment people have nowhere to go to be activists, donors, and so on, if they want to get involved.”

The merger has, however, been controversial. Some prized ARUK’s independence and fear its research will now be skewed.

Piper doesn’t see it that way, though. For him it’s a way to “bring thinking and acting together”.

He says: “I see research and action as complementary, not contradictory. Thinking comes first, of course. Evidence-based policy has to be at the heart of what we do, and the sector needs a fiercely independent body to call out even allies like Public Health England and the Institute of Alcohol Studies if we think they’re wrong.”

A tough pragmatism is also at work here. How the evidence is deployed will depend on what he calls the “policy reality”.

“We will say what the evidence says but we need to be opportunistic. We’ve identified more than 30 key issues and only one or two of them may become flagship campaigns – when the evidence base is clear and there is a political opportunity, for instance a new national alcohol strategy.”

Nor will AC shy away from setting a research agenda. “Someone has to take a view and what we research is a strategic choice,” he says, unapologetically asserting that “the focus is on minimising alcohol harm”. 

“We’re not interested in alcohol per se, and though a research project could ask why people drink - and any drug undoubtedly provides benefits – it will always be in the context of harm.”

And he insists the scale of that harm remains “totally unrecognised”. 

This might surprise those in the drinks industry who have perceived a growth in the anti-alcohol lobby in recent decades, accompanied by scary media headlines about “binge Britain”. But Piper dismisses “stereotypes such as binge-drinking young people” that have dominated the debate.

“There’s always a safety valve that allows us to feel our own drinking is unproblematic. It’s part of a collective national denial about the scale of the problem, the number of people affected. If they’re not an alcoholic, people think they’re fine. They don’t seem to know that increasing deaths from liver disease is a problem.

“If you’re drinking 40 to 60 units a week it might feel unproblematic but you’re becoming subject to risk factors. You might not be able to stop yet be in denial about not being in control.

“This is a very important group to us. Some are able to actively pull back from harm but the mechanisms and pathways for doing that are poorly understood. There must be more we can do. 

“It’s a group I’ve been in myself in the past, drinkers with a lack of control and self-recognition. There have been periods in my life when I’ve drunk too much, and there’s a family history, too, I don’t want to go into,” he says.

The pie-eyed Piper may belong to the past, but he still drinks. He won’t say how much, but he counts his units and can tell me exactly how many dry days he’s had this year, and he’s looking forward to wearable technology that can track an individual’s alcohol consumption.

Knowledge and control

It’s a knowledge and control that Piper wants to give other drinkers.

“The point is you’ve got a choice. We are very pro-choice. We don’t tell anyone what to do. That’s a big straw man, a libertarian fallacy. We have no advice about what people should and shouldn’t be drinking – until they’re about to kill themselves, perhaps. But nor is it simply about giving people information. There is something between that and finger-wagging, an exciting sweet spot for us.”

Something the new organisation will continue to promote is Dry January, the campaign it’s most famous for and something Piper himself took part in before his current role even entered his mind. Yet he thinks it’s “been hugely misunderstood” and needs a repackaging. 

“It’s a victim of its own success, really. It’s not about a dry January, it’s about long-term moderation. Of the 100,000 people taking part that we survey, 72% are drinking less six months later and 8% continue to abstain.

“We have to start selling the benefits, not the features. ‘Dry January’ describes what it does, not what it’s for. It’s a period to experiment, to reflect and to learn, and while the tactics and techniques each uses are personal to them, they do it collectively. Not drinking can seem odd or weird, but when 5 million people are doing it, it feels OK for that month.”

Piper considers the “bespoke journey” to moderation offered by Dry January may be transferable to other campaigns, and AC will be trialling a range of initiatives in the coming months.

One campaign area where it’s already firmly planted a flag is alcohol treatment. A report published in May titled The Hardest Hit boldly called out a “crisis” in the services meant to help people with drink problems.

“I was slightly worried that using the word ‘crisis’ was going too far, but some said it isn’t strong enough – that it should be ‘meltdown’.

“We call for proper investment in alcohol treatment, and we want better use of resources. Alcohol is a case study in poor commissioning and we can be an honest broker on that issue.” 

There are things, too, that we’ve come to accept as standard practice among alcohol lobbyists that he sounds less than enthusiastic about. You might have noticed that the people he’s most keen on targeting are drinking way above the new guidelines of 14 units a week for men and women.

“The guidelines are useful up to a point,” he shrugs. “If you’re drinking 70 units a week they’re easy to dismiss, but at 45 units they may be the perfect message. 

“I don’t dispute the science behind them, but I’d like to see an alternative discourse. It’s a more significant risk reduction, for instance, if you cut your drinking from, say, 42 units to 28 units than it is to go from 28 to 14, so we’d like to focus more somewhere up the consumption curve.”

You won’t be hearing much about minimum unit pricing either. “Our activity around that is entirely through the Alcohol Health Alliance. Pricing is an important issue, but we don’t support MUP over other pricing mechanisms.” But he does add: “MUP is a smart, targeted pricing mechanism and, given the current evidence, we support its introduction across the UK. Our activity around that is through the AHA.”

And unlike certain other bodies campaigning around alcohol, AC is happy to listen to what the drinks industry has to say – with some caveats.

“There’s a danger of us being too arrogant. We want to invite people in, open ourselves up and listen. And yes, that includes the drinks industry. 

“We are interested in constructive engagement, hearing views, and we are open to debate. I don’t think the industry should fund research – the perception of a conflict of interest is too clear and it will have to climb the very high walls that protect our independence.

“It should also stay out of some elements of policy. But every industry influences policy-makers and it’s pie in the sky to think otherwise, as some do, including the World Health Organisation. The industry could have a policy role to play, but we have to ask whether it, too, is in denial over alcohol harm.”

Whether Piper and his organisation, whatever it might be called, become an uncompromising adversary of the drink trade or some common ground opens up and a useful dialogue takes place remains to be seen.

One way or another, though, Piper is likely to be a figure to be reckoned with over the next few years. He is serious, thoughtful and, above all, driven by a desire to do no less than change the world. Or at least the drinking bit.

“There has to be a social change aspect to whatever I do,” he says. “Something that will improve lives. Alcohol is attractive to me, too, as an intellectually challenging topic. It’s complex and fascinating – and there are lots of things you can do wrong. The stakes are high and they’re real.”  

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