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03-30-2007, 06:34 AM
Substance Use A Major Burden Of Disease For Adolescents - The Lancet Adolescent Health Series

Death, injury and illness caused by substance use are among the top ten contributors to global disease burden measured in disability-adjusted life-years - what was once seen by many in developing countries as the disease of industrialised nations is now a worldwide trend. Alcohol alone contributed to 27% of all deaths involving 15-29-year-olds in economically developed countries in 2002, and illicit drugs a further 4%.

John Toumbourou (Deakin University, Australia), Tim Stockwell (University of Victoria, Canada), and colleagues review approaches and strategies to prevent substance abuse in young people and state that rates of tobacco use, harmful alcohol use, and illicit drug use can be substantially reduced through the concerted application of a combination of regulatory, early-intervention, and harm-reduction approaches.

However, the authors note that the current state of knowledge about the extent of adolescent substance use, and what works in reducing problems, is restricted to knowledge from a few high-income countries. Furthermore, investigations to test the efficacy of interventions are scarce, and many interventions have yet to be evaluated in real-world settings.

In an accompanying Comment, Isidore Obot looks at substance-use interventions in developing countries and notes: "Although developing countries have something to learn from the experiences of industrialised countries, success in preventing substance use and reducing related harms will come not in the application of one strategy or group of strategies, but by addressing the issue within the context of developmental planning. These are countries faced with the reality of poverty; where drug policy is often limited to law enforcement, prevention is sporadic. . .resources are limited, and drugs and alcohol problems compete with what policymakers might regard as more immediate problems of survival".

Substance use a major burden of disease for adolescents
Professor Tim Stockwell, University of Victoria, Canada
Professor John Toumbourou, Deakin University, Australia