The National Council on Alcoholism and Drug Dependence fights the stigma and the disease of alcoholism and other drug addictions.

Policy Statement:

Statement on the Prevention of Alcohol-Related Problems and Alcoholism

Principles and Goals

Preamble

---

The National Council on Alcoholism and Drug Dependence supports a variety of measures to prevent and reduce alcohol-related problems and alcoholism.

Prevention is defined as actions to prevent or to reduce the occurrence of alcohol-related problems or the disease of alcoholism and to minimize their detrimental effects. Prevention is categorized as primary, secondary and tertiary. Primary and secondary prevention programs and policies are usually far more effective than tertiary prevention (treatment) in reducing the level or prevalence of a problem in society; nonetheless, without effective and affordable treatment programs that reduce the suffering of individuals and that make the costs of alcohol problems and alcoholism to individuals and society more widely known, society is often uninterested in prevention. Both prevention and treatment are needed and we include treatment to reflect this relationship.

Common Goals

All three categories of prevention aim to:

• Promote health and well-being, and prolong life.
  
  
• Reduce the incidence and prevalence of alcohol-related problems and the disease of alcoholism in the general population.
  
  
• Reduce morbidity and mortality due to alcohol-related problems and the disease of alcoholism.
  
  
• Decrease the likelihood of long-term disability.

Primary Prevention

---

Primary prevention actions are directed toward prolonging life and promoting health for the general public by helping the public reduce or prevent the incidence of new cases of alcohol-related problems and alcoholism.

GOALS

The goals of health promotion, risk reduction and disease prevention include:

• Changing social norms regarding drinking and intoxication.
  
  
• Educating the public, specific populations and individuals about the health risks and social consequences associated with alcohol consumption.
  
  
• Reducing the risk of alcohol-related problems and alcoholism among groups at high risk (e.g. adolescents, children of alcoholics, underserved and/or disadvantaged populations, groups with minority status, and people with limited economic resources and limited access to a range of health-care options).
  
  
• Reducing drinking in high-risk situations (e.g. drinking and driving, drinking and sports, drinking during pregnancy, drinking in combination with other drug use, drinking to alleviate stress, etc.)
  
  
• Delaying the age of onset of drinking.
  
  
• Acknowledging abstinence as a drinking choice among all groups.
  
  
• Increasing public awareness that alcohol is a drug.

STRATEGIES

• Promote national and community-based age-appropriate education programs (e.g., media, schools, parents, server intervention, workplace, colleges), and alcohol- and other drug-free alternative activities for youth.
  
  
• Stimulate the development and implementation of specific education curricula for target groups (schools, teachers, parents, professional groups, etc.), using sound principles of health education or health promotion and determining whether these result in changes in knowledge, attitudes and pertinent behaviors.
  
  
• Identify high-risk groups for the development of alcohol-related problems and alcoholism (e.g. adolescents, children of alcoholics, underserved and/or disadvantaged populations, etc.) for the purpose of developing special programs.
  
  
• Advance advertising and marketing reforms for alcohol beverages, particularly those that impact on underage drinking.
  
  
• Promote greater focus on controlling the availability of alcohol (e.g. the number of retail outlets, etc.) as a prevention option.
  
  
• Advocate for consumer education (e.g. health and safety messages in advertising and on alcohol beverage containers, posters at point of purchase, counter-advertising and public information campaigns).
  
  
• Support uniform minimum drinking age laws.
  
  
• Advocate for equalized and inflation-indexed excise tax rates on alcoholic beverages.
  
  
• Urge community-based regulatory reforms (e.g. sales to minors, stadium sales, happy hours, dram shop laws, zoning affecting alcohol outlets).
  
  
• Support research and evaluation of primary prevention approaches based on outcome among the general population and specific populations.
  
  
• Encourage basic and applied research on alcoholism etiology.

Secondary Prevention

---

Secondary prevention focuses on early detection of alcohol-related problems or alcoholism, and intervention to arrest or interrupt the progression.

GOALS

The goals of early diagnosis and disability limitation include:

• Educating specific populations and individuals regarding the health risks associated with alcohol consumption.
  
  
• Reducing the prevalence of alcohol-related problems and alcoholism in individuals who are at risk when they drink.
  
  
• Reducing drinking in high risk situations (e.g. drinking and driving, drinking and sports, drinking during pregnancy, drinking in combination with prescription or any other drug use, drinking to alleviate stress, etc.)
  
  
• Reducing the prevalence of alcohol-related problems and alcoholism in high-risk groups (e.g. adolescents, children of alcoholics, underserved and/or disadvantaged populations, groups with minority status, and people with limited economic resources and limited access to a range of health-care options).
  
  
• Reducing stigma and promoting acceptance of alcoholism as a disease.

STRATEGIES

• Identify individuals for intervention and treatment.
  
  
• Identify high-risk groups for education and intervention (e.g. adolescents, children of alcoholics, underserved and/or disadvantaged populations, etc.)
  
  
• Promote community-based, culturally relevant, age and gender-specific education and intervention programs and coalitions (e.g., schools, parents, media, clergy, health clinics, DUI).
  
  
• Support twelve-step programs with AA, Al-Anon, Alateen or Children of Alcoholics groups.
  
  
• Encourage educationally sound training programs for service providers (e.g., physicians, nurses, psychologists, social workers, teachers, clergy).
  
  
• Further the availability of Employee Assistance Programs and Student Assistance Programs.
  
  
• Promote research and evaluation of education and intervention approaches based on outcome among individuals, specific populations and the general population.
  
  
• Support research to determine biological and psychological markers.
  
  
• Advocate for referral services for those in need of intervention.
  
  
• Urge education to alert the public, particularly specific at-risk populations or groups, about early signs of alcohol problems and alcoholism and of services available.

Tertiary Prevention

---

Tertiary prevention (treatment) is intervention after the development and obvious manifestation of the disease in order to arrest its progression and return the individual to a productive life.

GOALS

The goals of rehabilitation and disability limitation include:

• Arresting the disease of alcoholism in individuals.
  
  
• Reducing the incidence of relapse.
  
  
• Improving the quality of care for alcoholics and family members.
  
  
• Improving the quality of life for families with alcoholism.
  
  
  Reducing adverse consequences due to alcoholism (e.g., scholastic, job or family problems, homicide, suicide, fetal alcohol syndrome or effects, domestic violence, sexual abuse, unplanned pregnancies, risk of HIV/AIDS and alcohol-related trauma).
  
  
• Reducing the stigma of alcoholism and promoting the acceptance of alcoholism as a disease.

STRATEGIES

• Advocate for availability of affordable and effective inpatient and outpatient treatment services and appropriate continuum of care for alcoholics and their families (e.g., detoxification, rehabilitation, AA, Al-Anon, Alateen, Children of Alcoholics).
  
  
• Support a comprehensive continuum of care for individuals and families through both publicly and privately funded programs.
  
  
• Advance the provision of coverage for a comprehensive continuum of treatment services by both public and private insurers.
  
  
• Promote the availability of culturally-relevant treatment services for specific populations addressing differing needs arising from age, gender, culture, minority status, economic status, dual diagnosis or disability.
  
  
• Encourage research and evaluation of treatment modalities based on outcome among individuals and specific populations.
  
  
• Support patient and family education to facilitate the individual's and family's understanding of the disease.
  
  
• Further public education to increase awareness and sensitivity, and to decrease stigma.

(Approved by the Delegate Assembly and adopted by the NCADD Board of Directors on April 24, 1988; updated and approved by the Prevention and Education Committee of the NCADD Board on October 25, 1991.)

National Council on Alcoholism and Drug Dependence, Inc.

244 East 58th Street, 4th Floor, New York, NY 10022 phone: 212/269-7797   fax: 212/269-7510 email: national@ncadd.org   http://www.ncadd.org HOPE LINE: 800/NCA-CALL (24-hour Affiliate referral)