A Broad Church: APSAD's Continuing Evolution in Governance, Leadership and Representation

Abstract

Professional societies evolve alongside the fields and membership base they serve, responding to new evidence, changing practice and emerging expertise. APSAD is no exception. One of the defining features of the Australasian Professional Society on Alcohol and Other Drugs (APSAD) over the past four and a half decades has been its willingness to adapt while remaining firmly anchored in its core commitment to science, clinical excellence and professional development. As APSAD approaches its fifth decade, it is timely to reflect on that history and consider the future.

In their 2007 account of APSAD's development, Ingrid van Beek, John Saunders and Ann Roche described the Society's journey ‘from a cottage industry to a regional player’. Their account highlights an organisation that repeatedly evolved in response to the changing needs of the alcohol and other drugs field. Far from being a story of fixed traditions, APSAD's history is one of ongoing adaptation as it has evolved [1].

APSAD's story began with the establishment of the Australian Medical Society on Alcohol and Other Drug Problems (AMSAD) in 1981. As the name suggests, AMSAD was created primarily as a medically oriented organisation, intended to meet the needs of medical practitioners working in the alcohol and other drugs field. This focus was entirely appropriate for its time. The founders recognised the need for professional leadership, scientific exchange and workforce development in what was then a relatively small and emerging discipline [1].

However, as the field matured, so too did the Society. Within its first decade, the Society's leaders recognised that alcohol and other drug treatment, research and policy were not the domain of any single profession. Effective responses required collaboration across disciplines. Psychologists, nurses, pharmacists, social workers, epidemiologists, public health practitioners, policy specialists, behavioural scientists and others were making substantial contributions to the evidence-based care of people who use alcohol and other drugs. In response, the society broadened its membership and changed its name, first to the Australian Medical and Professional Society on Alcohol and Other Drugs, and subsequently to the Australian Professional Society on Alcohol and other Drugs, reflecting a growing recognition that the future of the field depended upon multidisciplinary expertise. In 2004, the society changed its name yet again, reflecting a shift in focus from Australia to the Australasian region, including Aotearoa New Zealand and the Asia-Pacific region (now being named the Australasian Professional Society on Alcohol and other Drugs).

As noted by van Beek and colleagues [1], the establishment of the Australasian Chapter of Addiction Medicine was a result of APSAD and the Royal Australasian College of Physicians (RACP) working together, resulting in a Chapter of the College of Physicians that trains addiction medicine specialists. Importantly, this evolution was understood as a way of strengthening rather than a dilution of APSAD's mission, enhancing the Society's ability to respond to emerging treatment, research and policy issues. APSAD sought to provide a ‘broad and inclusive’ umbrella that could accommodate diverse perspectives while maintaining high standards of scholarship and practice [1].

These insights have proven to be true, and today few would question the value that the new disciplinary breadth brings to the Society. There was a time when formal inclusion of these disciplines represented a significant expansion beyond APSAD's original medical focus, but now that evolution appears both obvious and beneficial.

APSAD is once again approaching a time where changes are needed. Across health care, research and professional education, there has been increasing recognition that expertise comes in different forms. Alongside clinical, scientific and professional expertise, there is clear acknowledgement of the value of peer/lived-and-living experience expertise and leadership [2]. In parallel, the importance of First Nations leadership and partnership is reflected across contemporary health systems, research governance arrangements and statements by leading research and professional organisations [3]. As APSAD's official journal, Drug and Alcohol Review has also responded to these developments. As such, these changes are aligned with changes at Drug and Alcohol Review, which include the imminent publication of a statement on Indigenous involvement in research and dissemination, and the initiation of Lived and Living Experience Editorial Fellowships.

For many years, the National Health and Medical Research Council and other major research funders have encouraged, and now require, meaningful consumer and community involvement in health research [4]. Within the alcohol and other drugs field specifically, the contribution of people with lived-living experience has become increasingly recognised. The RACP's position statement on drug policy highlights the importance of lived experience involvement in the design, delivery and evaluation of services, noting that participation strengthens effectiveness and accountability to the communities those services serve. Recent accreditation requirements applied to the RACP [5]. illustrate this broader shift. Following its 2024 reaccreditation process, the College was required to develop mechanisms that embed consumer and community engagement and leadership in governance, decision-making and the co-design of education and training programs [6].

Similarly, health organisations across Australia and Aotearoa New Zealand are increasingly recognising the importance of Aboriginal and Torres Strait Islander and Māori leadership within governance, policy development, education and service delivery. The RACP's Indigenous Strategic Framework and associated governance structures reflect broader expectations across the health sector that Indigenous voices should be represented in leadership, decision-making and professional education [7].

Lived-living experience/peer-based drug user organisations have long and rightfully advocated for the meaningful involvement of people directly affected by alcohol and other drug use in shaping policy, services and systems, with the Australian Injecting & Illicit Drug Users League (AIVL) publishing its first statement on involvement in research more than 20 years ago [8]. First Nations organisations have similarly emphasised the importance of Indigenous leadership, partnership and self-determination in addressing alcohol and other drug harms. Together, these developments reflect a broader shift toward recognising that effective governance benefits from the inclusion of those with professional, cultural and lived-living expertise and a recognition that the development and strengthening of the peer/lived-living experience workforce now requires that they be properly recognised as part of APSAD, including being represented in its governance.

APSAD's identity as a professional society remains central to its purpose. Its commitment to evidence-based practice, scientific integrity, workforce development and clinical excellence remains as important today as it was in 1981. The question for APSAD is not whether these foundations remain important. The question is how best to ensure that the society continues to reflect the breadth of expertise that characterises contemporary alcohol and other drug practice, policy and research.

Throughout its history, APSAD has periodically reassessed how its structures, membership and leadership reflect the field it serves. The move from AMSAD to APSAD represented more than a change of name. It reflected a recognition that addressing alcohol and other drug-related harms requires diverse forms of knowledge and expertise. The society grew stronger because it was willing to broaden its conception of who contributes to our collective understanding of alcohol and other drug issues.

APSAD is not unique in considering these questions. The reflections on APSAD's history as described by van Beek et al. were that APSAD's development paralleled the development of the alcohol and other drug field itself [1]. As the field became more sophisticated, multidisciplinary and responsive to emerging evidence, so too did the society [1]. van Beek et al. noted that APSAD had succeeded and become stronger because it was able to accommodate diversity while maintaining scientific rigour and professional standards. Lengthy discussion on APSAD's future at the Council's most recent strategic planning day (in July 2026) made clear that the current Council feels that this observation remains relevant today. The strength of APSAD has been its willingness to evolve with the times, bringing together the perspectives necessary to address the increasingly complex challenges with emerging alcohol and other drug issues, while maintaining its strong commitment to evidence and professional excellence.

As APSAD approaches its next chapter, perhaps the most important lesson from its history is that inclusion and excellence have never been competing priorities. Our history demonstrates that they have evolved together and will continue to do so. A broad church has served APSAD well for decades, and our history suggests it will continue to do so in the years ahead. APSAD members are likely to see these principles increasingly reflected in the Society's governance, activities and future direction and we believe this will strengthen the society and the communities it serves.

S.N. drafted the version of the article, following discussions at the July APSAD Council Strategic planning day. All authors contributed to refinding of subsequent drafts.

S.N. is an NHMRC Leadership Fellow (L2, #2025894).

K.S. reports speaking honoraria from Camurus, unrelated to this work. P.M.D. receives payments from APSAD for travel to conferences and meetings related to Drug and Alcohol Review Editorial work. The Burnet Institute received funding from Navamedic to support P.M.D. travel to a conference on take-home naloxone in Europe unrelated to this work. All other authors report no conflicts related to this article.

Data sharing not applicable to this article as no datasets were generated or analysed during the current study.