It was both inspiring and a real privilege to co-chair this year’s Managing Addictions in Primary Care conference in Liverpool, now in its 30th year.
Delivered in partnership between the Royal College of General Practitioners and Addiction Professionals, this conference has always been about more than presentations, it is an event where people involved with the sector talk about what works and what still needs to change.
As Executive Director of Addiction Professionals, and as someone who has co-chaired this conference alongside Dr Stephen Willott for over a decade, this anniversary felt particularly significant. Thirty years is long enough to look back with pride, but also long enough to ask what we still haven’t got right.
What struck me most over the two days was not just the depth of expertise but the staying power in the room. Many of the speakers and delegates have spent decades working in addiction medicine, inclusion health and public health. They have stayed with some of the most complex and politically contested areas of health and care, often through funding cuts and shifting policy priorities, and they are still pushing forward.
From a small GP forum to a national platform
This conference began three decades ago as a practical forum for GPs who were trying to support people using drugs and alcohol when there was very little formal training or guidance. Pioneers such as Dr Chris Ford, who later co-founded SMMGP (now Addiction Professionals), helped create an both an event and an organisation for sharing practice and building confidence. Baroness Clare Gerada has also been instrumental in carrying this agenda within the RCGP from the early days and gave a fascinating talk about the blurring lines between gaming and addiction.
Today, the landscape remains complicated. Addiction encompasses an even wider range of substances and behaviours, and it overlaps with homelessness, trauma, neurodiversity, criminal justice, mental health and deepening health inequalities. Across all that complexity, one message kept coming back: primary care matters.
Again and again, speakers highlighted the importance of accessible, relationship-based care. Professor Andrea Williamson, GP and Professor of Inclusion Health, spoke powerfully about “missingness” in healthcare and the need to reach people who fall through gaps. Professor Dominick Shaw described running a respiratory clinic for rough sleepers. Pip Smithson, Lead GP at Clocktower Surgery in Exeter, spoke about embedding substance use treatment within mainstream general practice for people experiencing homelessness. Anne Marie Ward, Chief Executive of Favor UK talked about the complex cases that society does not know how to answer ending up at the door of primary care.
Alcohol: evidence, economics and everyday conversations
Professor Sir Ian Gilmore, Chair of the Alcohol Health Alliance, reminded us that alcohol remains “our favourite drug” — socially normalised but responsible for enormous health harm. Later, Professor Colin Angus, Professor of Alcohol Policy at the University of Sheffield, carefully dismantled the idea that “economic growth” should be a licensing objective. Public health evidence, he argued, cannot be secondary to commercial interests.
Richard Piper, Chief Executive of Alcohol Change UK, introduced a new model for making every contact count, aimed at helping people cut back on alcohol in ways that feel realistic and human. Traditional Identification and Brief Advice (IBA) has a strong evidence base. But many practitioners know its practical limitations. It can feel formulaic. It doesn’t always reflect the reality of someone juggling stress, debt, trauma or poor housing. It tells you what to say, but not always how to say it in a way that feels natural. The discussion wasn’t about abandoning evidence, it was about making it workable.
Hepatitis C: proof that progress is possible
Professor Stephen Ryder, Consultant Hepatologist, reflected on the progress made in eliminating hepatitis C, a genuine public health success story. Coordinated action, investment, clinical leadership and partnership have delivered real results.
But he was also clear that the “liver war” continues. Alcohol-related liver disease and metabolic liver disease remain major challenges. The lesson wasn’t abstract. It was practical: when systems line up behind a goal, change happens.The challenge now is to bring that same focus to other areas of addiction.
Harm reduction coming of age
Harm reduction ran throughout the programme. Professor Fiona Measham, Chair in Criminology at the University of Liverpool and founder of The Loop, shared the encouraging news that drug checking services are expanding across the country. What once felt controversial is increasingly recognised as common-sense public health.
Dr Saket Priyadarshi, Associate Medical Director for Glasgow Alcohol and Drug Recovery Services, reflected on the first year of Scotland’s safer drug consumption facility. The conversation has moved from “should we?” to “how is it working?”
The next 30 years
Shared care, which grew rapidly after the turn of the century, as with other treatment provision in the sector, has experienced challenges and cuts. However there continues to be a commitment to providing good quality share care in years to come. Dr Linda Harris looked towards the future and discussed the development of an Extended Role for GPs working with drugs and alcohol, and she also highlighted the opportunities that the emphasis on neighbourhood teams can play. Addiction Professionals and the RCGP remain committed to supporting primary care practitioners in their work with addictions, and look forward to welcoming you back to our conference in 2027. And if you are a primary care practitioner and are interested in being involved in the RCGP community of practice which meets online, please email us.
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