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[1]
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.
[1].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?