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- Rehm, J., et al.
(författare)
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Addiction Research Centres and the Nurturing of Creativity. Substance abuse research in a modern health care centre : the case of the Centre for Addiction and Mental Health
- 2011
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Ingår i: Addiction. - : Wiley. - 0965-2140 .- 1360-0443. ; 106:4, s. 689-697
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Tidskriftsartikel (refereegranskat)abstract
- The Centre for Addiction and Mental Health is one of the premier centres for research related to substance use and addiction. This research began more than 50 years ago with the Addiction Research Foundation (ARF), an organization that contributed significantly to knowledge about the aetiology, treatment and prevention of substance use, addiction and related harm. After the merger of the ARF with three other institutions in 1998, research on substance use continued, with an additional focus on comorbid substance use and other mental health disorders. In the present paper, we describe the structure of funding and organization and selected current foci of research. We argue for the continuation of this successful model of integrating basic, epidemiological, clinical, health service and prevention research under the roof of a health centre.
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| 2. |
- Babor, T., et al.
(författare)
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Alcohol : No Ordinary Commodity – a summary of the second edition
- 2010
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Ingår i: Addiction. - : Wiley. - 0965-2140 .- 1360-0443. ; 105:5, s. 769-779
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Tidskriftsartikel (refereegranskat)abstract
- This article summarizes the contents of Alcohol: No Ordinary Commodity (2nd edn). The first part of the book describes why alcohol is not an ordinary commodity, and reviews epidemiological data that establish alcohol as a major contributor to the global burden of disease, disability and death in high-, middle- and low-income countries. This section also documents how international beer and spirits production has been consolidated recently by a small number of global corporations that are expanding their operations in Eastern Europe, Asia, Africa and Latin America. In the second part of the book, the scientific evidence for strategies and interventions that can prevent or minimize alcohol-related harm is reviewed critically in seven key areas: pricing and taxation, regulating the physical availability of alcohol, modifying the drinking context, drink-driving countermeasures, restrictions on marketing, education and persuasion strategies, and treatment and early intervention services. Finally, the book addresses the policy-making process at the local, national and international levels and provides ratings of the effectiveness of strategies and interventions from a public health perspective. Overall, the strongest, most cost-effective strategies include taxation that increases prices, restrictions on the physical availability of alcohol, drink-driving countermeasures, brief interventions with at risk drinkers and treatment of drinkers with alcohol dependence.
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| 4. |
- Rehm, J., et al.
(författare)
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The relation between different dimensions of alcohol consumption and burden of disease - an overview
- 2010
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Ingår i: Addiction. - : Wiley. - 0965-2140 .- 1360-0443. ; 105:5, s. 817-843
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: As part of a larger study to estimate the global burden of disease and injury attributable to alcohol: to evaluate the evidence for a causal impact of average volume of alcohol consumption and pattern of drinking on diseases and injuries; to quantify relationships identified as causal based on published meta-analyses; to separate the impact on mortality versus morbidity where possible; and to assess the impact of the quality of alcohol on burden of disease. METHODS: Systematic literature reviews were used to identify alcohol-related diseases, birth complications and injuries using standard epidemiological criteria to determine causality. The extent of the risk relations was taken from meta-analyses. RESULTS: Evidence of a causal impact of average volume of alcohol consumption was found for the following major diseases: tuberculosis, mouth, nasopharynx, other pharynx and oropharynx cancer, oesophageal cancer, colon and rectum cancer, liver cancer, female breast cancer, diabetes mellitus, alcohol use disorders, unipolar depressive disorders, epilepsy, hypertensive heart disease, ischaemic heart disease (IHD), ischaemic and haemorrhagic stroke, conduction disorders and other dysrhythmias, lower respiratory infections (pneumonia), cirrhosis of the liver, preterm birth complications and fetal alcohol syndrome. Dose-response relationships could be quantified for all disease categories except for depressive disorders, with the relative risk increasing with increased level of alcohol consumption for most diseases. Both average volume and drinking pattern were linked causally to IHD, fetal alcohol syndrome and unintentional and intentional injuries. For IHD, ischaemic stroke and diabetes mellitus beneficial effects were observed for patterns of light to moderate drinking without heavy drinking occasions (as defined by 60+ g pure alcohol per day). For several disease and injury categories, the effects were stronger on mortality compared to morbidity. There was insufficient evidence to establish whether quality of alcohol had a major impact on disease burden. CONCLUSIONS: Overall, these findings indicate that alcohol impacts many disease outcomes causally, both chronic and acute, and injuries. In addition, a pattern of heavy episodic drinking increases risk for some disease and all injury outcomes. Future studies need to address a number of methodological issues, especially the differential role of average volume versus drinking pattern, in order to obtain more accurate risk estimates and to understand more clearly the nature of alcohol-disease relationships.
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| 5. |
- Rehm, J., et al.
(författare)
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The relationship of average volume of alcohol consumption and patterns of drinking to burden of disease : an overview
- 2003
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Ingår i: Addiction. - : Wiley. - 0965-2140 .- 1360-0443. ; 98:9, s. 1209-1228
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Forskningsöversikt (refereegranskat)abstract
- Aims As part of a larger study to estimate the global burden of disease attributable to alcohol:• to quantify the relationships between average volume of alcohol consumption, patterns of drinking and disease and injury outcomes, and• to combine exposure and risk estimates to determine regional and global alcohol-attributable fractions (AAFs) for major disease and injury categories.Design, methods, setting Systematic literature reviews were used to select diseases related to alcohol consumption. Meta-analyses of the relationship between alcohol consumption and disease and multi-level analyses of aggregate data to fill alcohol–disease relationships not currently covered by individual-level data were used to determine the risk relationships between alcohol and disease. AAFs were estimated as a function of prevalence of exposure and relative risk, or from combining the aggregate multi-level analyses with prevalence data.Findings Average volume of alcohol consumption was found to increase risk for the following major chronic diseases: mouth and oropharyngeal cancer; oesophageal cancer; liver cancer; breast cancer; unipolar major depression; epilepsy; alcohol use disorders; hypertensive disease; hemorrhagic stroke; and cirrhosis of the liver. Coronary heart disease (CHD), unintentional and intentional injuries were found to depend on patterns of drinking in addition to average volume of alcohol consumption. Most effects of alcohol on disease were detrimental, but for certain patterns of drinking, a beneficial influence on CHD, stroke and diabetes mellitus was observed.Conclusions Alcohol is related to many major disease outcomes, mainly in a detrimental fashion. While average volume of consumption was related to all disease and injury categories under consideration, pattern of drinking was found to be an additional influencing factor for CHD and injury. The influence of patterns of drinking may be underestimated because pattern measures have not been included in many epidemiologic studies. Generalizability of the results is limited by methodological problems of the underlying studies used in the present analyses. Future studies need to address these methodological issues in order to obtain more accurate risk estimates.
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