Editorial

The Brisbane Conference : a Subject and an Idea

The eminent English novelist and essayist, E.M. Forster wrote (and surely he could have written similarly about a conference), "A course of lectures, if it is to be more than a collection of remarks, must have an idea running through it. It must also have a subject and the idea ought to run through the subject too. This is so obvious as to sound foolish, but anyone who has tried to lecture will realize that here is a genuine difficulty. A course like any other collection of words, gen- erates an atmosphere. It has its own apparatus - - a lecturer, an audience or provision for one ... it is announced by printed notices and it has its financial side, though this last is tactfully con- cealed. Thus it tends in a parasitic way to lead a life of its own, and it and the idea running through it are apt to move in one direction while the subject steals off in the other."

The conference of which this volume con- stitutes the Proceedings had both a subject - - alcohol and the brain - - and an idea - - cross- fertilization. It was possible because Brisbane had been chosen as the venue for the 7th AMSAD conference, while, within the same month, the 10th International Congress of Pharmacology was scheduled to take place in Sydney.

The subject of the Brisbane conference was not hard to choose: a number of researchers there have been investigating relationships between alcohol and brain damage for some years. In Australia, and perhaps particularly in Queen- sland, alcohol-related brain damage is known to be a substantial clinical problem, which may in part be preventable.

But the idea, cross-fertilization in this case, was much more ephemeral. For one thing, cross- fertilization has to compete with relevance. To consider only the immediate relevance of presen- tations which one chooses to attend at a con- ference or read about in the proceedings to what one is immediately concerned with as a biologist, a behavioural scientist, a clinician or whoever, can lead to conceptual sterility. If the only ideas to which one is exposed are ideas relating directly to one's own discipline, ideas from other disciplines are not likely to take root, let alone bear fruit. Two examples from the conference of reported

findings which might have wider application can be mentioned. The first was a biochemical finding which might have a bearing on treatment of alcohol dependence: the finding that altered cal- cium homeostasis is involved in dependence suggests the possibility of exploring the potential therapeutic role of calcium channel blockers. The second was a finding reported by two speakers independently: that alcohol misuse was less of a problem after a drinker had suffered the Wer- nicke-Korsakoff syndrome. This might be saying something useful about dependence in both anatomical and behavioural terms. But a caveat is needed : we were reminded of the need to keep a watchful eye on orders of magnitude. A bio- chemical finding of (say) minor enzyme inhibition at 0.5 M ethanol concentration or above is not likely to have much to offer the clinician working with patients exposed to blood levels of 0.025- O.O5 M.

As one might have expected, alcohol-related brain damage (ARBD) was a major conference theme. The spread of papers in this area was very wide. Some contributors focused on neuropath- ology, others on biochemical findings, others on clinical syndromes; two contributions looked at a major, and still very neglected, cause of mental retardation, the fetal alcohol syndrome. Others touched on neuropsychological abnormalities, the impact of these on daily living, and the value of treatment programmes for patients with ARBD.

Apart from brain damage itself, there were a number of other highlights at the Brisbane con- ference. One was clearly genetics. It is now clear the susceptibility to alcoholism can be genetically transmitted and that genetic factors are involved to a substantial extent in its expression - - proba- bly in the majority of cases. However, further research is clearly needed to help us better understand environmental contributions to the disorder and ways of preventing those at risk from using alcohol destructively. This will require a psychosocial and biomedical partnership, which brings us back to our theme idea.

Did the cross fertilization idea work? Probably not for everybody: no idea ever does. But the organizers hope that it worked for some of the

people some of the time. If it did, AMSAD may be encouraged to arrange similar conferences in the future. And by the same token those with biological interests - - the biochemists, geneticists and pharmacologists who came - - might be encouraged to widen their subsequent conferences to include contributions from clinical and be- havioural disciplines. John Price' and Brian Shanley 2

* Department of Psychiatry, University of Queensland, Clinical Sciences Building, Royal Brisbane Hospital, Herston, Queensland 4029.

2 Department of Biochemistry, University of Queensland, St. Lucia, Brisbane, Queensland 4067.

Acknowledgements The conference organizers gratefully acknowledge the assistance of the following sponsors:

Abbot Diagnostics Division Astra Pharmaceuticals Pty Ltd

Australian Airlines Australian Federal Government, Department of Arts, Sport, the Environment,

Tourism and Territories Australian Medical Society on Alcohol and Drug Related Problems

Beckman Instruments (Australia) Pty Ltd Coca-Cola (Brisbane) Ltd Glaxo Australia Pty Ltd

John Morris Scientific Pty Ltd Paul Ramsay Hospitals Pty Ltd

Queensland State Government, Department of Health and Environment (in particular for help with the costs of the Proceedings)

University of Queensland

The conference organizers gratefully acknowledge also the very considerable help received from members of the Queensland Alcohol & Drug Dependency Service and from the Administrative Officer, Department of Biochemistry, University of Queensland, Mr. Chris Hogan.