Getting drunk with Kettil Bruun
As lead author of the 1975 World Health Organisation report Alcohol Control Policies in Public Health Perspective, known in Britain as the Purple Book (on account of it being, er, purple), he set out the principles that have now become the familiar arguments of the public health lobby: that the level of alcohol harm is determined by the amount consumed across the whole population, and that the way to reduce that is by curtailing access, principally through higher pricing.
Less well known, even among alcohol policy geeks, is that Kettil Bruun was a frightful old drunk.
At least that’s what one veteran of the international alcohol and drugs conference circuit told me. Before he died, in 1985, Bruun apparently followed the Finnish tradition in his heavy post-conference drinking bouts. My source said he had Bruun plastered in the back of his car once, in such an unruly state that he had to be restrained by fellow delegates.
A case of Kettil calling the pot black, perhaps? And it would, indeed, be easy to put it down to simple hypocrisy. Far too easy for the Politics of Drinking. And too moralising. We’ve all been there, Kettil. So here’s a more elaborate theory.
Hunting in vain, and in probably the wrong place, for another source for the scandal I found an interesting analysis of the Bruun legacy on the Kettil Bruun Society website.
In it, Christoffer Tigerstedt argues that Bruun started from a liberal, even libertarian, position on the alcohol question, championing the freedoms of the ‘alcoholic’.
Indeed, as various treatments proved futile and the disease model of alcoholism began to break down, Bruun came to the conclusion that the category of the alcoholic was itself socially constructed, calling for it to be replaced by a theory of dependency, a job undertaken by his close colleague at the WHO, Griffith Edwards.
The strength of this was that it would enable drink problems to be seen as part of a continuum across a population, not only freeing the ‘alcoholic’ from the ghetto of treatment and persecution but opening the way to a public health perspective.
All that then needed to be done was to resurrect the Ledermann Curve from the dustbin of history and, hey presto, a new scientific paradigm is born.
But how can the policies that emerge from this, designed as they are to restrict availability, be consistent with liberalism?
As Tigerstedt explains, Bruun was working within a broader shift towards a ‘new public health’ in which a rejection of state control performs a kind of double movement, first transferring responsibility for health away from the welfare state to the individual and then away from the individual body to the “administration of social life and its risk factors”.
In Bruun this ‘administration’ takes a peculiarly strong form, but because the target of those measures is the whole population, individual freedom of choice is preserved.
So you can get drunk if you want to. Take it from Kettil Bruun.
