American’s Leading Experts on Substance Abuse Outline New Research Agenda to Reduce Multi-Billion Dollar Burden on Health Systems and Society

With substance abuse now accounting for one in 14 hospital admissions in the USA and generating billions in health care costs, leading scientists held a briefing on Capitol Hill to outline the research agenda needed in treating and preventing the use and abuse of alcohol, drugs and tobacco.

Scientists affiliated with the Robert Wood Johnson Foundation’s (RWJF) Substance Abuse Policy Research Program (SAPRP) identified steps that federal, state and local governments could take now to reduce the $2 billion healthcare burden from alcohol, drugs, and tobacco use and abuse. They also provided a roadmap for research over the next five years to deal with future challenges in reducing substance abuse.

A. Thomas (Tom) McLellan, PhD, deputy director of the White House Office of National Drug Control Policy, moderated the briefing.

Policies to Prevent Alcohol Problems:

Harold Holder, PhD, Prevention Research Center, Pacific Institute for Research and Evaluation (PIRE), discussed research exploring prevention, availability and pricing initiatives designed to deter alcohol abuse. He pointed out that currently, federal funding for alcohol prevention programs is dispensed without requiring evidence of a program’s effectiveness.

Yet researchers have generated considerable evidence on the effectiveness of policies including minimum drinking ages, a tougher approach to drunk driving, and raising alcohol taxes,” he said.

For example, there is evidence that increasing alcohol taxes to keep pace with inflation would lead to a 19 percent reduction in heavy drinking by youth and a 6 percent reduction in high-risk drinking. Research has also shown that simply changing licensing provisions and modifying hours of service at establishments that sell alcohol can have a significant effect on drinking and drinking-related problems.

“What policymakers need now is research that helps them decide on the best mix of strategies that are likely to be most effective at preventing alcohol problems,” he said.

Policies to Prevent Alcohol Problems: A Research Agenda for 2010-2015

Holder and his colleagues suggest that the research agenda for alcohol prevention should be viewed within the context of the “prevention paradox.” This is the paradox that while alcohol dependent persons have the highest individual risk of alcohol problems, it is moderate and heavy nondependent drinkers who account for more total alcohol problems, especially those of an acute nature, because there are so many more of them. Therefore, a much wider public health perspective than alcohol dependence is essential for policy research, and the new identification of research priorities has therefore focused on alcoholinvolved problems or high-risk drinking where the individual drinkers have not been identified by the recovery, treatment, or health screening systems. The biggest future challenge for alcohol policy research, the authors say, is populationlevel alcohol problem prevention (a public health perspective).

The research agenda identifies five main themes for alcohol prevention policy research from 2010 to 2015 . While many priorities exist and much more needs to be understood about the effectiveness of specific alcohol policies, the alcohol policy research priorities cited here reflect new or underdeveloped areas of research that are judged to be highly relevant to needed policy change.

They are organized into domains identifying the highest alcohol policy research priorities at the international, national, state, provincial, and community levels.

I. International Trade Agreements

II. National/State/Provincial/Community Prevention

III. Retail Price of Alcohol

IV. Physical Availability of Alcohol

V. Prevention of Intoxication and Over-Service of Alcohol

The full report can be accessed at: http://saprp. tumblr.com/