SUMMARY OF FINDINGS
* In spite of the complexity of alcohol and other drug problems, the literature on these subjects does offer up some guidance.
* In general, well-coordinated comprehensive strategies that combine regulation, taxation and community-wide campaigns tend to produce slow but positive results (see, for example, efforts to reduce smoking).
* Control policies such as increasing the minimum drinking age are effective in reducing alcohol-related fatalities. Restriction on the retail availability of alcohol, especially off-premise sales, are effective in reducing alcohol-related problems. Another positive measure is increases in the price of alcohol. Furthermore, programs that train servers in bars have proven their effectiveness in reducing intoxication, and drinking and driving among bar patrons.
* Community-wide interventions such as education and media campaigns appear to be most effective when directed towards changing social norms rather than fostering behaviour change.
* Early detection instruments, such as CAGE and AUDIT (the Alcohol Use Disorder Identification Test), are useful. It seems questioning people using such instruments can more accurately detect alcohol or other drug problems than using chemical analysis.
* Research supports the effectiveness of intervention programs that are oriented towards changing behaviour -- so long as they are brief. Longer-term interventions appear to be no more effective, and often are less effective.
* The effectiveness of psychotherapy is also not well-supported by an evaluation of the literature.
* The perceived effectiveness of self-help programs such as Alcoholics Anonymous (AA) is largely unsubstantiated by the literature; however, four out of five Canadians would prefer to seek help from such groups over professional counselling.
* With the exception of diazepan as an aid in alcohol detoxification, psychotropic drugs are not considered an effective treatment strategy for alcohol and other drug problems.
* Methadone, an antidisotropic drug, is the treatment of choice for opiate dependence, particularly since it is taken orally and thus reduces the risk of HIV infection through dirty needle use.
* Most studies on out-patient and home detoxification approaches have recorded positive results; long-term residential programs require more evaluation. The literature presently suggests out-patients programs are more successful and significantly more cost-effective.
.CAGE is an acronym for the four questions of the instrument: Need to cut down on drinking? Annoyed by criticism about your drinking? Guilty about drinking? Need a morning drink or Eye-opener?