Alcohol, drugs and stigma.

Alcohol and drug-related problems are common in clinical populations but are often stigmatized by the public and the professions. These attitudes may interfere with patients obtaining effective help. The reasons for these barriers are explored, including the views that these problems are self-inflicted--and therefore less worthy of help--and the stereotypes and resistances that abound in working with those who have become addicted. Training and public education may go some way to improve this situation.

The relationship between alcohol dependence and depression.

Alcohol dependence is not a unitary or homogeneous disorder. There is substantial evidence to suggest that in both community and particularly in clinical samples, additional psychopathology is common. Although estimates of additional psychopathology differ according to the samples studied and the instruments used to classify disorders, up to two-thirds of clinical samples of patients with alcohol dependence are likely to have a lifetime diagnosis of another psychiatric disorder. Affective disorder and antisocial personality disorder appear to be the most commonly and consistently reported additional disorders. Women more than men appear to suffer from additional psychopathology, including secondary and primary depression, although this evidence is weakened by there being fewer studies carried out on mixed gender populations. Having an additional psychiatric diagnosis appears to alter the course of alcohol dependence: it may hasten the development of dependence on alcohol and may bring individuals to the attention of treatment agencies more quickly. More recent studies have examined the relationship between alcohol dependence and affective disorder in the current episode. There is consistent evidence to suggest that a diagnosis of depression in the current episode may change to one of alcohol dependence alone, once detoxification or abstinence has been achieved. The prognosis of those who continue to be depressed remains unclear.

The impact of alcohol on the acute hospital service: patient presentation, admission and the perception of alcohol use in such groups.

Patients presenting to an Emergency Department were assessed by a standard questionnaire and clinical examination as to the contribution that alcohol made to their presentation and the perception of their alcohol use. Patients under the influence of alcohol are more than twice as likely not to fill in simple questionnaires and not to perceive their alcohol consumption as different from non-drinking fellows. Emergency Departments are not the optimal site for the education and motivation of drinking patients to alter their future habits.

Réaction de la collectivité aux problèmes liés à la consommation d'alcool : compte rendu d'une étude internationale / E. B. Ritson

Dans cette brochure sont examinées les réponses de la collectivité face aux problèmes soulevés par l'augmentation globale de la production et de la consommation de boissons alcoolisées dans trois contextes très différents : au Mexique, en Ecosse et en Zambie. Les données présentées et analysées concernent le comportement du buveur et l'attitude à l'égard de la boisson et de l'ivresse : les types de réponses fournies par la collectivité dans les trois pays et des modèles d'intervention mieux appropriés aux situations locales sont examinés et évalués

Influence of an increase in excise duty on alcohol consumption and its adverse effects.

The excise duty on alcoholic beverages was increased in March 1981, causing the cost of alcohol to rise faster than other prices for the first time in 30 years. For this reason 463 "regular drinkers" in the Lothian region whose drinking habits had been established in 1978-9 were reinterviewed in 1981-2. Overall, their alcohol consumption had fallen by 18% and associated adverse effects by 16%. Heavy drinkers and suspected dependent drinkers both reduced their consumption at least as much as light or moderate drinkers and suffered considerably fewer adverse effects as a result. Increasing the excise duty on alcoholic beverages can therefore be an effective public health measure. Factors related to rising unemployment were responsible for about 20% of the overall reduction in consumption.