Reframing the science and policy of nicotine, illegal drugs and alcohol - conclusions of the ALICE RAP Project.
File(s)
Author(s)
Type
Journal Article
Abstract
In 2013, illegal drug use was responsible for 1.8% of years of life lost in the European Union, alcohol was responsible for 8.2% and tobacco for 18.2%, imposing economic burdens in excess of 2.5% of GDP. No single European country has optimal governance structures for reducing the harm done by nicotine, illegal drugs and alcohol, and existing ones are poorly designed, fragmented, and sometimes cause harm. Reporting the main science and policy conclusions of a transdisciplinary five-year analysis of the place of addictions in Europe, researchers from 67 scientific institutions addressed these problems by reframing an understanding of addictions. A new paradigm needs to account for evolutionary evidence which suggests that humans are biologically predisposed to seek out drugs, and that, today, individuals face availability of high drug doses, consequently increasing the risk of harm. New definitions need to acknowledge that the defining element of addictive drugs is 'heavy use over time', a concept that could replace the diagnostic artefact captured by the clinical term 'substance use disorder', thus opening the door for new substances to be considered such as sugar. Tools of quantitative risk assessment that recognize drugs as toxins could be further deployed to assess regulatory approaches to reducing harm. Re-designed governance of drugs requires embedding policy within a comprehensive societal well-being frame that encompasses a range of domains of well-being, including quality of life, material living conditions and sustainability over time; such a frame adds arguments to the inappropriateness of policies that criminalize individuals for using drugs and that continue to categorize certain drugs as illegal. A health footprint, modelled on the carbon footprint, and using quantitative measures such as years of life lost due to death or disability, could serve as the accountability tool that apportions responsibility for who and what causes drug-related harm.
Date Issued
2017-03-17
Date Acceptance
2017-03-01
Citation
F1000Research, 2017, 6
ISSN
2046-1402
Publisher
F1000Research
Journal / Book Title
F1000Research
Volume
6
Copyright Statement
© 2017 Anderson P et al. This is an open access article distributed under the terms of the Creative Commons Attribution Licence (https://creativecommons.org/licenses/by/4.0/),
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Data associated with the
article are available under the terms of the Creative Commons Zero "No rights reserved" data waiver (CC0 1.0 Public domain dedication) (https://creativecommons.org/publicdomain/zero/1.0/).
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Data associated with the
article are available under the terms of the Creative Commons Zero "No rights reserved" data waiver (CC0 1.0 Public domain dedication) (https://creativecommons.org/publicdomain/zero/1.0/).
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/28435669
Subjects
alcohol
evolutionary biology
governance
health footprint
illegal drugs
margins of exposure
nicotine
well-being
Publication Status
Published online
Coverage Spatial
England
Article Number
ARTN 289