title: The limitations of control-of-supply models for explaining and preventing alcoholism and drug addiction.
abstract: The primary approach to eliminating drug abuse in America for most of the 20th century has been to prohibit the use and sale of certain drugs and to shut down drug supply lines. Yet drug abuse persists at high levels and the use of outlawed substances is a common feature of American life from high school on. The failure of drug policies has not discouraged, but seemingly fuels, renewed efforts of the same kind. Contrasting with this focus on the inherent dangers of the substance itself, the effort to control alcohol abuse has instead focused, since the end of Prohibition, on the characteristics of the individual alcoholic. In recent years, however, the public-health model of alcohol abuse and the psychophysiological formulation of alcohol dependence have emphasized that alcoholism is a consequence of the amount of alcohol available in the society and consumed by the individual drinker. In this way, alcohol and drug dependence (or addiction) formulations have coalesced: both assume that uncontrolled use results from regular or excessive consumption of these substances. This unified model of addiction based on exposure to a substance fails to account for substantial interindividual, intraindividual and cultural variability in patterns of use. The evidence is, moreover, that control-of-supply policies will never reduce substance abuse significantly and that such policies may backfire by propagating images of substances as being inherently overpowering.
mesh_terms: D000434:Alcoholic Beverages / Q000600:supply & distribution*; D000437:Alcoholism / Q000517:prevention & control*; D004335:Drug and Narcotic Control / Q000331:legislation & jurisprudence*; D006801:Humans; D009293:Opioid-Related Disorders / Q000517:prevention & control; D019966:Substance-Related Disorders / Q000517:prevention & control*; D013695:Temperance; D014481:United States