Substance Dependency: A Global Multi‐Dimensional Medical and Socio‐Economic Problem

Abstract

The World Medical Association (WMA, 2005) finds that alcohol use is deeply embedded in many societies and is a major contributor to the global burden of morbidity and mortality. Substance dependency, including alcohol, tobacco, and recreational drugs, continues to plague our society and snatch productive life. In many countries these substances provide a source of legal income through taxation. However, they also fuel an illicit economy, crime, absenteeism, and threaten communities and individual family well-being. Children and youth are not immune to alcohol, tobacco, and recreational drugs and are a vulnerable target for illegal trafficking. Alcohol users are more likely to smoke, or engage in the use of illicit or prescription drugs. Like tobacco and narcotics habituation, alcohol abuse interventions, treatments, and access to health services are also woefully inadequate worldwide (Limosin, 2014). Europe has the highest amount of alcohol consumption per capita, especially in Russia and surrounding countries. Islamic countries, regions of the Eastern Mediterranean, and Southeast Asia, predominantly India, experience lower rates of alcohol consumption. Globally, alcohol consumption has been estimated to be the cause of 3.8 percent of all deaths and 4.6 percent of the burden of disease (Rehm et al., 2009). In 2008 the global economic burden of alcohol alone was estimated at 0.45 to 5.44 percent of GDP (Thavorncharoensap, Teerawattananon, Yothasamut, Lertpitakpong, & Chaikledkaew, 2009). In the Americas, alcohol has been found to be an important contributor to the burden of disease, surpassing smoking, obesity, and hypertension (Rehm & Monteiro, 2005). A May 12, 2014 World Health Organization (WHO) report estimates that 3.3 million deaths in 2012 can be attributed to the harmful use of alcohol (WHO, 2014). The report also highlights that over 200 medical conditions, such as violence, road accidents, metabolic disorders, and liver cirrhosis, afflict a significant number of individuals. Many nations have developed policies to combat the spread, or at least limit the consequences, of the use of alcohol, tobacco, and substance dependencies. Outreach, education, and legal measures so far have not met expectations and markedly reduced the health and societal impacts of substance dependency. The 1961 Single Convention on Narcotic Drugs (SCND) and the 1999 Framework Convention on Tobacco Control (FCTC), are steps in the right direction; however, a Convention on Alcohol Control is still being debated. It is obvious that more comprehensive and stronger measures are required to reduce the health and societal burden of alcohol, tobacco, and narcotic drug use. Such global policy will require a complex set of international negotiations, advocacy, and political good will. However, the pay-off in terms of reduced suffering, lives saved, and socioeconomic gains should be worth the effort and perseverance. World Medical and Health Policy is pleased to dedicate this issue to the policy and politics of alcohol control and prevention. The Editors would like to thank all the contributors who responded to the call for papers for this special issue of the journal. Arnauld Nicogossian is distinguished research professor and Director of the Center for Study of International Medical Policies and Practices, at the School of Public Policy, George Mason University. Bonnie Stabile is research assistant and assistant director of the Center for Study of International Medical Policies and Practices in the School of Public Policy at George Mason University. Otmar Kloiber is Secretary General of the World Medical Association. Thomas Zimmerman is executive director of the International Society for Microbial Resistance.