PREFACE B ecause alcohol abuse and alcoholism have such a significant effect on so many parts of our soci ety, including our health care system, our social systems, and our economy, it is encouraging to see clearly documented in the Eighth Special Report to the U.S. Congress on Alcohol and Health the progress that continues to be made in understanding the causes of these often complex major public health problems and in developing scientifically sound methods of preventing them or mitigating their consequences. These consequences are many: For example, it is estimated that nearly one-fourth of all persons admitted to general hospitals have alcohol problems or are undiagnosed alcoholics being treated for the consequences of their drinking. Moderate to heavy consumption of alcohol is a major risk factor in injury and trauma, the fourth leading cause of death in the United States. Alcohol is widely recognized as a teratogen capable of inducing congenital defects, growth retardation, learning disabilities, and other behavioral disturbances in children exposed to it prenatally. Alcohol is typically found in the offender, victim, or both in about half of all homicides and serious assaults, as well as in a high percentage of sex-related crimes, robberies, and incidents of domestic violence, and alcohol-related problems are disproportionately found among both juvenile and adult criminal offenders. The annual health, social, and economic costs of alcohol abuse and alcoholism in the United States include 100,000 estimated deaths and some $86 billion. Because of these wide-ranging social, economic, and health effects, researchers study areas as diverse as cellular dysfunction and alcohol excise taxes. From basic studies on how alcohol affects the brain to studies on how to effectively prevent alcohol abuse through school-based education programs, the Eighth Special Report presents a comprehensive picture of what we have learned and how this knowledge will serve the ultimate goal of effectively preventing and treating alcohol-related problems. In addition to describing research advances, the Eighth Special Report, like its predecessors, serves as a major resource for a wide audience-scientists, primary health care workers, treatment providers, policymakers, and the general public. From this report, scientists can learn about progress across the many alcohol-related disciplines; primary health workers can learn to recognize and treat the many medical complications of alcohol abuse and alcoholism; treatment providers can learn about the latest advances in screening, diagnosis, and assessment so they can better determine the most effective treatment for each individual patient; and policymakers can learn the facts on which to base informed decisions on policies that affect broad segments of society. The Eighth Special Report documents the continued expansion of our knowledge about alcoholrelated problems and effectively communicates important research findings to a broad and diverse audience. I commend it to your attention. Philip R. Lee, M.D. Assistant Secretary for Health ACKNOWLEDGMENTS T his Eighth Special Report to the U.S. Congress on Alcohol and Health is the result of the cooperation of many people, whose combined efforts are reflected in the document's scientific accuracy and integrity. The Editorial Review Board conceptualized the chapters, scientists recommended research articles, and both groups reviewed drafts of the chapters and suggested new research areas for inclusion. Scientist writers active in each specialized area read and summarized thousands of articles to create the drafts and incorporated reviewers' changes in the final document. This was truly a collaborative effort of scientists and science writers, guided by the Editorial Review Board. The chief contributors include some of the world's most distinguished alcohol researchers and medical authorities, many of whom also contributed to previous reports. |