Substance use: America’s number one health behavior problem — ctd.

The following is from a 2001 paper by Norman Miller and colleagues titled “Why Physicians are Unprepared to Treat Patients Who Have Alcohol- and Drug-Related Disorders“.

In the Epidemiological Catchment Area (ECA) study, a survey of mental health and substance disorders in almost 20,000 adult Americans, the lifetime prevalence of alcohol abuse/dependence was 13.5% in the general U.S. population in the 1980s. [41] A decade ago, the Institute of Medicine reported that approximately 6.4% of the U.S. population over the age of 12 probably need treatment for alcohol-use disorders. [42] During the same period, the lifetime incidence of alcohol and comorbid drug disorders affected approximately 20% of the population. [43] We see no evidence that these percentages have improved. […]

Surveys in the early 1990s showed that 5% of all deaths in the United States were directly attributable to alcohol-related problems. [44] Alcohol use and alcoholism also contributed to 60–90% of deaths from cirrhosis, [45] 40–50% of motor vehicle fatalities, [46–48] two million nonfatal motor vehicle injuries, [49] 16–67% of home and job injuries, drownings, and fire fatalities, [47,50,51] and 3–5% of deaths due to cancer. [50,52,53] One study estimates that alcohol use and alcoholism are responsible for 15% of the years of life lost before age 65. [54] In 1987, a total of 105,095 deaths were caused by alcohol, including 30,000 from unintentional injuries, 19,600 from digestive diseases (including cirrhosis), 17,700 from intentional injuries, and 16,000 from cancers. [55]

Again, is there a more recent treatment of these issues?

UPDATE: A follow-up is here.


41. Swift RM, Miller NS, Lewis DC. Addictive disorders. In: Goldman LS, Wise TN, Brody DS (eds). Psychiatry for Primary Care Physicians. Chicago, IL: American Medical Association, 1998.

42. Institute of Medicine. Broadening the base of treatment for alcohol problems. Washington, DC: National Academy Press, 1990.

43. Institute of Medicine. A study of the evolution, effectiveness and financing of public and private drug treatment systems. In: Gerstein DR, Harwood HJ (eds). Treating Drug Problems. Vol 1. Washington, DC: National Academy Press, 1990.

44. McGinnis JM, Foege WH. Actual causes of death in the United States. JAMA. 1993;270:2207–12.

45. Johannes RS, Kahane SN, Mendeloff AI, Kurata J, Roth HP. Digestive diseases. Am J Prev Med. 1987;3:83–8.

46. U.S. Preventive Services Task Force. Guide to Clinical Preventive Services: An Assessment of the Effectiveness of 169 Interventions. Baltimore, MD: Williams & Wilkins, 1989.

47. West LJ, Maxwell DS, Noble EP, Solomon DH. Alcoholism. Ann Intern Med. 1984;100:405–16.

48. McCoy GF, Johnstone RA, Nelson IW, Duthie RB. A review of fatal road accidents in Oxfordshire over a 2-year period. Injury. 1989;20: 65–8.

49. Rouse BA. Substance Abuse and Mental Health Statistic Sourcebook. Washington, DC: U.S. Department of Health and Human Services, 1965.

50. Milio N. Promoting health through public policy. Philadelphia, PA: F. A. Davis, 1981.

51. Smith GS, Falk H. Unintentional injuries. Am J Prev Med. 1987;3: 143–63.

52. Doll R, Peto R. The Causes of Cancer: Quantitative Estimates of Avoidable Risks of Cancer in the United States Today. New York: Oxford University Press, 1981.

53. Higginson J, Muir CS. Environmental carcinogenesis: misconceptions and limitations to cancer control. J Nat Cancer Inst. 1979;63:1291–8.

54. Amler RW, Eddins DL. Cross-sectional analysis: precursors of premature death in the United States. Am J Prev Med. 1987;3:181–7.

55. Centers for Disease Control. Alcohol-related mortality and years of potential life lost—United States, 1987. MMWR. 1990;39:173–8.

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