When is alcohol just another drug? Some thoughts on research and policy

AIM: To reflect on the divergence and overlap between alcohol and illicit drugs with respect to both current policies and policy research. RESULTS: For demand reduction, there is considerable overlap in programs and services for prevention and even more clearly for treatment. For supply controls there is mostly divergence, reflecting the difference in legal status. Research generally follows the same pattern. However, a cross-cutting research agenda on the supply side has merit. CONCLUSION: Even in a prohibition regime, law-enforcement agencies have considerable discretion. A systematic, pragmatic, 'evidence-based' use of that discretion to reduce harm is possible. It can be accomplished only by a continuing program of policy research that measures the harms of drug use and drug enforcement, assesses the effects of current policies on both these sources of social cost and explores alternative strategies. There is a similarly important project for alcohol and tobacco control policy. The goal for research on alcohol and tobacco is to document the extent to which supply controls can be effective in reducing harm; the additional goal for illicit drugs is to document just how much the current ideologically driven approach is costing the public.     

Psychological health and HIV transmission among female sex workers: a systematic review and meta-analysis

Current HIV prevention interventions for female sex workers (FSWs) have tended to target the cognitive factors in changing their behaviors, yet little attention has been paid to the psychological factors that influence the behavior of women in sex work. This review aimed to explore the associations between the psychological health of FSWs and HIV risk. A total of eight studies published in English before July 2013 were identified and reviewed. FSWs had reported psychological issues, including depression, suicidal thoughts as well as lower quality of life, and the pooled prevalence of probable depression was as high as 62.4%. The majority of studies showed that higher scores in psychological health problems were associated with increased HIV risk behavior, in particular inconsistent condom use, or sexually transmitted infections. Among the five studies which measured symptoms of depression, four documented that higher depression scores were significantly associated with inconsistent condom use among FSWs with their clients and/or partners. Meta-analysis using a fixed-effects model was performed to examine the association between depression and inconsistent condom use and found that higher scores in depression were significantly associated with inconsistent condom use (odds ratio?=?2.57, p?相似文献   

Alcohol dependence: a public health perspective

Aims To review epidemiological research on alcohol dependence and to propose a public health approach to address this problem. Design and setting The research under review is basically constituted by general population surveys. Participants Individuals in the community 18 years of age and older. Measurement Twelve‐month rates of alcohol dependence are estimated using DSM criteria. Findings The prevalence of alcohol dependence has been stable in the United States, at around 6% for men and 2% for women. The risk of alcohol dependence begins at low levels of drinking and increases linearly with alcohol consumption. Mean group level of consumption shows some relationship to prevalence of dependence. Alcohol‐dependent individuals are responsible for about 50% of the social, legal and interpersonal alcohol‐related problems in society. Conclusion Alcohol dependence is present at relatively high levels in the community. Alcohol‐dependent individuals are responsible for a fair proportion of alcohol‐related problems in society. A public health approach to this problem, emphasizing prevention and group level interventions to lower prevalence levels, is warranted.