WHO report calls for new approach to substance dependence
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《英国医生杂志》
Scientists have recently gained vital new insights into drug, alcohol, and tobacco dependence, but this knowledge has not been translated effectively into public health policy, the World Health Organization said in a new report published on Thursday.
The report summarises new findings on how psychoactive substances mimic the effects of naturally occurring neurotransmitters and interfere with normal brain functioning by altering storage, release, and removal of these transmitters.
Substance dependence is determined by psychosocial, cultural, and environmental as well as biological and genetic factors and—although more is now known about this complex disorder—scientists are still unable to predict which individuals will become dependent before or after they take drugs, the report says.
Society too is harmed not only by substance dependence but by experimentation and harmful use by individuals who are not dependent—for example, in overdoses or the use of dirty needles to inject drugs, which can spread HIV—it says.
The report also found that many people who were addicted to drugs, alcohol, or tobacco had mental disorders and that health professionals should treat the conditions together.
It said an integrated approach was also needed to tackle dependence on legal psychoactive substances, such as tobacco and alcohol, as well as illegal ones—the most common being cannabis, followed by amphetamines, cocaine, and opium derivatives such as heroin.
The WHO report called on governments not to treat dependence on tobacco, alcohol, and drugs as a failure of will or strength of character, but more as a neurological or psychiatric disorder that may not be curable but can be treated effectively.
It advised governments not to stigmatise those with such problems and emphasised that effective treatments existed, such as the prescription of substitute drugs and psychosocial therapy aimed at changing patients' behaviour and reintegrating them into society.
"The health and social problems associated with use of and dependence on tobacco, alcohol and illicit substances require greater attention by the public health community and appropriate policy responses," WHO's director general, Dr Lee Jong-wook said, underscoring the report's findings.
The global burden of substance dependence and its threat to public health are considerable, the report said. Tobacco was fourth and alcohol fifth out of 10 leading risk factors in avoidable diseases cited in WHO's World Health Report 2002.
Tobacco and alcohol contributed 4.1% and 4.0% respectively to the global burden of ill health, which is measured in years lost through disability and deaths, and illicit substances—largely taken by males in Europe and North America—contributed 0.8%.(Geneva Fiona Fleck)
The report summarises new findings on how psychoactive substances mimic the effects of naturally occurring neurotransmitters and interfere with normal brain functioning by altering storage, release, and removal of these transmitters.
Substance dependence is determined by psychosocial, cultural, and environmental as well as biological and genetic factors and—although more is now known about this complex disorder—scientists are still unable to predict which individuals will become dependent before or after they take drugs, the report says.
Society too is harmed not only by substance dependence but by experimentation and harmful use by individuals who are not dependent—for example, in overdoses or the use of dirty needles to inject drugs, which can spread HIV—it says.
The report also found that many people who were addicted to drugs, alcohol, or tobacco had mental disorders and that health professionals should treat the conditions together.
It said an integrated approach was also needed to tackle dependence on legal psychoactive substances, such as tobacco and alcohol, as well as illegal ones—the most common being cannabis, followed by amphetamines, cocaine, and opium derivatives such as heroin.
The WHO report called on governments not to treat dependence on tobacco, alcohol, and drugs as a failure of will or strength of character, but more as a neurological or psychiatric disorder that may not be curable but can be treated effectively.
It advised governments not to stigmatise those with such problems and emphasised that effective treatments existed, such as the prescription of substitute drugs and psychosocial therapy aimed at changing patients' behaviour and reintegrating them into society.
"The health and social problems associated with use of and dependence on tobacco, alcohol and illicit substances require greater attention by the public health community and appropriate policy responses," WHO's director general, Dr Lee Jong-wook said, underscoring the report's findings.
The global burden of substance dependence and its threat to public health are considerable, the report said. Tobacco was fourth and alcohol fifth out of 10 leading risk factors in avoidable diseases cited in WHO's World Health Report 2002.
Tobacco and alcohol contributed 4.1% and 4.0% respectively to the global burden of ill health, which is measured in years lost through disability and deaths, and illicit substances—largely taken by males in Europe and North America—contributed 0.8%.(Geneva Fiona Fleck)