2010: U.S. drug and alcohol policy, looking back and moving forward.

Since the early twentieth century, both moral perspectives and changing perceptions of the disease model of alcoholism and addiction have significantly influenced the formulation of U.S. domestic policy on drugs and alcohol. Some fluctuations have occurred in federal drug policy but overall a prohibitive, punitive approach has been emphasised. Racial and socioeconomic disparities have been exacerbated by the inequities of drug laws. Over the past 50 years, limited progress has been made in challenging and changing these unproductive policies. A great deal of progress has been made in research and treatment, and in the understanding of the process of recovery. For the upcoming generation to move policy in the direction shown to be effective by experienced addiction professionals will entail a wide spectrum of interdependent actions in substance abuse research, education, prevention and treatment, and continued cooperation between many stakeholders.

Health care equality and parity for treatment of addictive disease.

Substance abuse represents a significant underlying cause of the health issues faced in the United States, which severely impacts the nation's health care system and economy. Recently enacted parity legislation mandates that benefits for addiction and mental health treatment be provided on an equal footing with those for treatment for physical health. Diversion and abuse of prescription medications is growing in young people, with much of the diversion occurring between family and friends. Addiction has been accepted by mainstream medicine as a brain disease, and is associated with many other medical disorders. Early intervention and treatment for addiction provides extraordinary cost-benefit outcomes. Additional training for addiction professionals will be necessary. Stigmatization of substance abusers continues to exist at the state and federal levels, although research during the past 10 years indicates that patient compliance and relapse rates for substance abusers are not significantly different than those for individuals with other chronic diseases, e.g. diabetes, hypertension, and cardiac issues. While parity for addiction treatment has become policy at the federal level, great challenges lie ahead in funding access, facilities, and training, as well as redirecting societal perceptions and legislated penalties.