Alcohol Education, Prevention and Treatment—Creating a Climate of Trust

By Brian Lemay 1 comment

Creating a climate of trust so
that people feel safe in going to counselors and going to
sources of authority, going to treatment centers,
because all of these systems don’t work if people don’t trust
them. And how do you do that, in all
the research you’ve done what does it tell you about that
piece of it, Dr. Koob? Well, that’s one of the big
challenges we face at NIAAA if you really want to be honest
about it. So, one of the things I’ve
discovered is how little Americans know about alcohol. And so one of the things we’re
doing at NIAAA is we have a Web site called Rethinking Drinking,
which I always like to promote because you can go on there and
find out how much alcohol is in a mixed drink. You can figure out the number of
calories in a drink, you can find out how a
dose/effect function works out. But we have other—on our
website—we have other places where you can find out about
treatment and what are the options for treatment and how
that flow chart works. But I think a critical issue is
that we really need to not only promote education of the public
but we need to get it into medical education, we need to
get primary care physicians to ask the question of how much are
you drinking, how much are your friends
drinking. At an annual physical, for
example. I noticed the last time I had a
physical, that question was asked. But I didn’t see it
historically. The American College of
Pediatrics has gotten involved in this, the American Board of
Addiction Medicine has started a fellowship program for residents
in addiction medicine, so we’re making progress, but,
you know, I feel that that’s an area of
challenge for me and also the National Institute on Drug
Abuse, we want to have alcohol and
addiction training at every level in the medical community. And we know that brief
interventions work as a prevention, just asking that
question, how much do you drink, how much
do your friends drink— But on the way home, you say, well,
wait a minute, that guy in the white lab coat
with the tie who I’ve respected all my life, he’s been my doctor
for years, asked me how much I drink, maybe
I do put on too many on the weekend. I told him two drinks, but
really— And so, you know, these kind of brief
interventions work, we have more and more data to
suggest that they work, and we’re hoping to promote
these kind of prevention programs across the board in the
community. What have we learned from
Mothers Against Drunk Driving, as an institution, as an
organization that has taken one slice of this problem, but has
really raised public awareness on that one issue rather
effectively. Well, I mean it’s been
tremendous, we’ve decreased the number of
deaths on the highway from, at one point, I think it was
close 30-40,000 a year, it’s down now to about 15,000 a
year. So, it’s been since, believe it
or not, the Reagan administration
instituted the 21-year-old drinking age across the board in
the United States, there’s been a steady decline in
deaths in the highway due to alcohol. We’re not at bottom, we have
concerns about alcohol and marijuana now, so the two in
combination can’t be, you know— What did we learn from
their success? They got the word out, and we
instituted a law about— Underage drinking. Underage drinking. And communities affected
underage drinking. I can only speak to San Diego,
where I lived for 30 years, but on weekends they had police
checkpoints just random just all across North County. And that’s a very effective way
of intervening. And the other campaign that
seems to me has gotten some traction, that’s a comparable
public health issue is smoking. There is a significant decrease
in smoking, I see PSAs, public service ads
all the time. States have taken this on, New
York State being a very good example of one that is been very
aggressive. What about those campaigns, what
have we learned from them about how to tackle an issue like
this? Well, from my perspective, we’ve
learned that there’s been a cultural shift. It’s really no longer cool to be
smoking a cigarette. On the other hand, we’re
starting to see an increase in e-cigarettes, and so that’s
going to be a challenge for research to catch up and follow
what are the consequences of that. But I think if it’s no longer
cool or the in thing to be standing on a street corner
smoking a cigarette, I think we have to get to point
where it’s no longer cool or, you know, appropriate to be
drunk in Georgetown. I lived in Georgetown, and I can
tell you on Saturday mornings there’s a peculiar smell that
emanates from the sidewalks, and I think it’s time for all
Americans to understand that aspiring to a blackout is not
appropriate, it’s not useful, it’s not good
for you, it’s not good for your brain. And not good for your future. And not good for your future.

1 Comment


Dec 12, 2016, 4:25 pm Reply

Thank You.

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