What is the Scope of the Problem and its Impact on Health and Social Systems?

  • Constance Weisner

Abstract

Throughout the world, alcohol and drug problems are costly to societies and the health and social functioning of their citizens. In the early 1980’s, the World Health Assembly identified problems related to alcohol consumption as “among the world’s major public health concerns” (Jernigan, Monteiro, Room & Saxena, 2000). Since then, alcohol and drug use has increased in both developed and developing countries. As an introduction for the chapters which follow, this chapter provides a brief overview of the scope and cost of alcohol and drug problems in various parts of the world, discusses the limited capacity of specialty alcohol and drug agencies to treat them, and presents a case study which illustrates the impact of alcohol and drug problems on community agencies. A very sensible approach, emphasized throughout this book, is to implement prevention and treatment interventions within health and social agencies where individuals with these problems are naturally found, rather than focusing scarce resources in specialty settings that see far fewer individuals. Primary health care and criminal justice agencies deserve particular attention in this regard.

Keywords

Substance Abuse Criminal Justice Alcohol Dependence Health Service Research Alcohol Problem 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Bennett, L. A., Campillo, C., Chandrashekar, C. R. & Gureje, O. (1998). Alcoholic beverage consumption in India, Mexico, and Nigeria. Alcohol Health & Research World 22(4), 243–252.Google Scholar
  2. Caetano, R. & Weisner, C. (1988). Technical report for the study of dimensions of dependence.Alcohol Research Group.Google Scholar
  3. Cherpitel, C. J. (1988). Technical report for Contra Costa County casualty (Emergency Room and Coronor’s Office). Alcohol Research Group.Google Scholar
  4. Cherpitel, C. J. (1989). Technical Report for Primay Care Study, Technical Report. Alcohol Research Group.Google Scholar
  5. Eide, A. H. & Acuda, S. W. (1995). Drug use among secondary school students in Zimbabwe. Addiction 90, 1517–1527.PubMedCrossRefGoogle Scholar
  6. Eide, A. H. & Acuda, S. W. (1996). Cultural orientation and adolescents’ alcohol use in Zimbabwe. Addiction 91(6), 807–814.PubMedCrossRefGoogle Scholar
  7. European Monitoring Centre for Drugs and Drug Addiction. (2000). 2000 Annual Report on the State of the Drugs Problem in the European Union. European Monitoring Centre for Drugs and Drug Addiction, Lisbon, Portugal.Google Scholar
  8. Greenfield, T. K. & Weisner, C. (1995). Drinking problems and self-reported criminal behavior, arrests and convictions: 1990 U.S. alcohol and 1989 county surveys. Addiction 90(3), 361–373.PubMedCrossRefGoogle Scholar
  9. Gureje, O. (2000). Alcohol problems and responses: challenges for Africa. Journal of Substance Use 5, 56–61).CrossRefGoogle Scholar
  10. Hao, W. & Young, D. (2000). Drinking patterns and problems in China. Journal of Substance Use 5, 71–78).CrossRefGoogle Scholar
  11. Hurst, W., Gregory, E. & Gussman, T. (1997). International survey: alcoholic beverage taxation and control policies. Brewers Association of Canada.Google Scholar
  12. Institute of Medicine. (1990). Broadening the base of treatment for alcohol problems. National Academy Press, Washington, D.C.Google Scholar
  13. Jernigan, D. H. (1999). Country profile on alcohol in Zimbabwe. In: Alcohol and Public Health in 8 Developing Countries (edited by Riley, L. & Marshall, M.). World Health Organization, Geneva, 157–175.Google Scholar
  14. Jernigan, D. H. & Indran, S. K. (1999). Country profile on alcohol in Malaysia. In: Alcohol and Public Health in 8 Developing Countries (edited by Riley, L. & Marshall, M.). World Health Organization, Geneva, 61–73.Google Scholar
  15. Jernigan, D. H., Monteiro, M., Room, R. & Saxena, S. (2000). Towards a global alcohol policy: alcohol, public health and the role of WHO. Bulletin of the World Health Organization 78(4), 491–499.PubMedGoogle Scholar
  16. Klingemann, H., Takala, J. P. & Hunt, G. (1992). Cure, care or control: alcoholism treatment in sixteen countries. State University of New York Press, Albany, NY.Google Scholar
  17. Marshall, M. & Riley, L. (1999). Introduction. In: Alcohol and Public Health in 8 Developing Countries (edited by Riley, L. & Marshall, M.). World Health Organization, Geneva, 5–12.Google Scholar
  18. McCrady, B. S. & Miller, W. R. (1993). Research on Alcoholics Anonymous: Opportunities and alternatives. Rutgers Center of Alcohol Studies, New Brunswick, NJ.Google Scholar
  19. Medina-Mora, M. E., Carlini-Cotrim, B. & Madrigal, E. (2000). Alcohol policies in developing countries: Latin America. Journal of Substance Use 5, 47–55.CrossRefGoogle Scholar
  20. Mertens, J., Weisner, C. & Sterling, S. (2001). Disparities across treatment settings for the medically indigent: implications for substance abuse screening and interventions. FrontLines June, 6;8.Google Scholar
  21. Murray, C. J. L. & Lopez, A. D. (1996). Quantifying the burden of disease and injury attributable to ten major risk factors. In: The global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020 (edited by Murray, C. J. L. & Lopez, A. D.) 1. Published by the Harvard School of Public Health on behalf of the World Health Organization and the World Bank, Cambridge, MA, 295–324.Google Scholar
  22. National Institute on Alcohol Abuse and Alcoholism. (1997). Alcohol and health: ninth special report to the U.S. Congress. U.S. Department of Health and Human Services, Rockville, MD.Google Scholar
  23. National Institute on Drug Abuse. (1989). National Household Survey on Drug Abuse: Population estimates 1988. National Institute on Drug Abuse, Rockville, MD.Google Scholar
  24. Parry, C. D. H. & Bennetts, A. L. (1999). Country profile on alcohol in South Africa. In: Alcohol and Public Health in 8 Developing Countries (edited by Riley, L. & Marshall, M.). World Health Organization, Geneva, 135–156.Google Scholar
  25. Rice, D. P. (1999). Economic costs of substance abuse, 1995. Proceedings of the Association of American Physicians 111(2), 119–125.PubMedCrossRefGoogle Scholar
  26. Riley, L. & Marshall, M. (1999). Alcohol and Public Health in 8 Developing Countries. World Health Organization, Geneva, 179.Google Scholar
  27. Roizen, R. (1983). Alcohol dependence symptoms in cross-cultural perspective: a report of findings from the World Health Organization Study of Community Response to Alcohol-Related Problems, symposium on cross-cultural studies of drinking problems, Farmington, Connecticut.Google Scholar
  28. Roizen, R. (1991). Contra Costa County jail study of the Community Epidemiology Laboratory project: technical report. Alcohol Research Group.Google Scholar
  29. Room, R., Rehm, J., Trotter, R. T. I., Paglia, A. & Üstün, B. (2001). Cross-cultural views on stigma, valuation, parity and societal values towards disability. In: Disability and Culture: Universalism and diversity (edited by Üstün, B., Chatterji, S., Bickenbach, J. E., Trotter, R. T. I., Room, R., Rehm, J. & Saxena, S.). Hogrefe and Huber, Seattle, WA, 247–291.Google Scholar
  30. Saxena, S. (2000). Alcohol problems and responses: challenges for India. Journal of Substance Abuse 5, 62–70.Google Scholar
  31. Schmidt, L. (1991). Technical report: 1989 Community Epidemiology Laboratory survey of welfare recipients. Alcohol Research Group.Google Scholar
  32. Schmidt, L. & Roizen, R. (1988). Technical Report: Contra Costa County mental health client study of the Community Epidemiology Laboratory Project. Alcohol Research Group.Google Scholar
  33. Schmidt, L. & Room, R. (1999). Cross-cultural applicability in international classifications and research on alcohol dependence. Journal of Studies on Alcohol 60(4), 448–462.PubMedGoogle Scholar
  34. Schmidt, L. & Weisner, C. (1993). Developments in alcoholism treatment: a ten year review. In: Recent developments in alcoholism (edited by Galanter, M.) 11. Plenum, New York, 369–396.Google Scholar
  35. Schmidt, L., Weisner, C. & Wiley, J. (1998). Substance abuse and the course of welfare dependency. American Journal of Public Health 88(11), 1616–1622.PubMedCrossRefGoogle Scholar
  36. Tarn, T. (1997). Technical report on the Alcohol Treatment Utilization Study in Public and Private Sectors: within and across sector weights. Alcohol Research Group, Berkeley, CA.Google Scholar
  37. Tarn, T., Schmidt, L. & Weisner, C. (1996). Patterns in the institutional encounters of problem drinkers in a community human services network. Addiction 91(5), 657–669.CrossRefGoogle Scholar
  38. Trocki, K. & Roizen, R. (1993). Technical Report: The Contra Costa County General Population Survey. Alcohol Research Group.Google Scholar
  39. Weisner, C. (1987). The social ecology of alcohol treatment in the U.S. In: Recent developments in alcoholism (edited by Galanter, M.) 5. Plenum, New York, 203–243.Google Scholar
  40. Weisner, C. (1988). Community response to substance abuse problems: a survey of clients in drug treatment programs. Alcohol Research Group.Google Scholar
  41. Weisner, C. (1992). The merging of alcohol and drug treatment: a policy review. Journal of Public Health Policy 13(1), 66–80.PubMedCrossRefGoogle Scholar
  42. Weisner, C. (2001). The provision of services for alcohol problems: a community perspective for understanding access. Journal of Behavioral Health Services Research 28(2), 130–142.PubMedCrossRefGoogle Scholar
  43. Weisner, C, Mertens, J., Parthasarathy, S., Moore, C. & Lu, Y. (2001). Integrating primary medical care with addiction treatment: A randomized controlled trial. Journal of the American Medical Association 286(14), 1715–1723.PubMedCrossRefGoogle Scholar
  44. Weisner, C. & Schmidt, L. (1995a). The Community Epidemiology Laboratory: Studying alcohol problems in community and agency-based populations. Addiction 90(3), 329–342.PubMedCrossRefGoogle Scholar
  45. Weisner, C. & Schmidt, L. A. (1995b). Expanding the frame of health services research in the drug abuse field. Health Services Research 30(5), 707–727.PubMedGoogle Scholar
  46. WHO Expert Committee on Drug Dependence. (1998). Thirtieth Report [WHO technical report series, No. 873]. World Health Organization, Geneva, Switzerland, 50 p.Google Scholar
  47. World Health Organization Programme on Substance Abuse. (1993a). Approaches to Treatment of Substance Abuse [an ex-official publication]. World Health Organization, Geneva, Switzerland.Google Scholar
  48. World Health Organization Programme on Substance Abuse. (1993b). Factors influencing treatment. In: Approaches to Treatment of Substance Abuse [an ex-official publication]. World Health Organization, Geneva, Switzerland, 31–45.Google Scholar
  49. World Health Organization Programme on Substance Abuse. (1993c). Generalist responses to alcohol and other drug problems. In: Approaches to Treatment of Substance Abuse [an ex-official publication]. World Health Organization, Geneva, Switzerland, 53–67.Google Scholar
  50. Yanyi, Z. (1992). The alcoholism treatment system in China. In: Cure, Care or Control: Alcoholism treatment in sixteen countries (edited by Klingemann, H., Takala, J.-P . & Hunt, G.). State University of New York Press, Albany, NY, 269–275.Google Scholar

Copyright information

© Springer Science+Business Media New York 2002

Authors and Affiliations

  • Constance Weisner
    • 1
  1. 1.Department of PsychiatryUniversity of CaliforniaSan FranciscoUSA

Personalised recommendations