title: An agenda to combat substance abuse.
abstract: Despite their huge health toll, substance abuse disorders remain underappreciated and underfunded. Reasons include stigma, tolerance of personal choices, acceptance of youthful experimentation, pessimism about treatment efficacy, fragmented and weak leadership, powerful tobacco and alcohol industries, underinvestment in research, and difficult patients. Positive signs include declining prevalence rates, successful counter-marketing campaigns, changing public attitudes, new scientific discoveries that could yield new treatments, and effective new organizations. Further progress will require better treatment, more research, better education of health professionals, more nongovernmental support, and stronger leadership. Policy changes regarding each of the three substance groups are indicated, as are reforms in the criminal justice and educational systems.
authors: University of California, San Francisco, USA. Schroeder@medicine.ucsf.edu
authors: Steven A
authors: SA
authors: Schroeder
mesh_terms: D000437:Alcoholism / Q000150:complications / Q000453:epidemiology / Q000517:prevention & control*; D001294:Attitude to Health; D006291:Health Policy / Q000331:legislation & jurisprudence*; D006801:Humans; D007221:Industry / Q000331:legislation & jurisprudence*; D007857:Leadership; D011634:Public Health; D012109:Research Support as Topic; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D000074606:Smoking Prevention; D011049:Social Control Policies / Q000331:legislation & jurisprudence*; D012935:Social Justice; D012945:Social Values; D019966:Substance-Related Disorders / Q000150:complications / Q000453:epidemiology / Q000517:prevention & control*; D019460:Tobacco Industry / Q000331:legislation & jurisprudence; D014146:Training Support; D014481:United States / Q000453:epidemiology