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Article

Flavio F. Marsiglia, David Becerra, and Jaime M. Booth

Prevention is a proactive science-based process that aims to strengthen existing protective factors and to diminish or eliminate other factors that put individuals, families, and communities at risk for substance abuse. Prevention is important because alcohol and drug abuse are a leading cause of morbidity, mortality, and health expenditures in the United States. Alcohol and other drug abuse is also associated with infectious diseases, chronic diseases, emergency room visits, newborn health problems, family violence, and auto fatalities. The comorbidity of drug and alcohol abuse with mental health disorders and HIV adds urgency to the development, evaluation, and implementation of comprehensive and effective prevention interventions. The social work profession plays a key role in substance abuse prevention, as it not only targets the use and abuse of alcohol and other drugs but also aims at reducing the related negative health and psychosocial outcomes and economic burden they produce on individuals and society at large.

Article

Issues associated with athletics, alcohol abuse, and drug use continue to be salient aspects of popular culture. These issues include high-profile athletes experiencing public incidents as a direct or indirect result of alcohol and/or drug use, the role that performance-enhancing drugs play in impacting outcomes across a variety of professional and amateur contests, and the public-health effects alcohol abuse and drug use can have among athletes at all competitive levels. For some substances, like alcohol abuse, certain groups of athletes may be particularly at-risk relative to peers who are not athletes. For other substances, participating in athletics may serve as a protective factor. Unique considerations are associated with understanding alcohol abuse and drug use in sport. These include performance considerations (e.g., choosing to use or not use a certain substance due to concerns about its impact on athletic ability), the cultural context of different types of sporting environments that might facilitate or inhibit alcohol and/or drug use, and various internal personality characteristics and traits that may draw one toward both athletic activity and substance use. Fortunately, there are several effective strategies for preventing and reducing alcohol abuse and drug use, some of which have been tested specifically among athlete populations. If such strategies were widely disseminated, they would have the potential to make a significant impact on problems associated with alcohol abuse and drug use in sport and athletics.

Article

Stuart Linke and Elizabeth Murray

Alcohol-use disorders are widespread and associated with a greatly increased risk of health-related and societal harms. The majority of harms associated with consumption are experienced by those who drink above recommended guidelines, rather than those who are alcohol dependent. Brief interventions and treatments based on screening questionnaires and feedback have been developed for this group, which are effective tools for reducing consumption in primary care and in other settings. Most people who drink excessively do not receive help to reduce the risks associated with excessive consumption. Digital versions of brief and extended interventions have the potential to reach populations that might derive benefit from them. Digital interventions utilize the same principles as do traditional face-to-face versions, but they have the advantages of availability, confidentiality, flexibility, low marginal costs, and treatment integrity. The evidence for the feasibility, acceptability, costs, and effectiveness of digital interventions is encouraging, and the evidence for effectiveness is particularly strong in studies of student populations. There are, however, a number of unresolved questions. It is not clear which components of interventions are required to maximize effectiveness, whether digital versions are enhanced by the addition of personal contact from a facilitator or a health professional, or how to increase take up of the offer of a digital intervention and reduce attrition from a program. These questions are common to many online behavior-change interventions and there are opportunities for cross-disciplinary learning between psychologists, health professionals, computer scientists, and e-health researchers.

Article

Elizabeth C. Pomeroy, Danielle Parrish, Angela M. Nonaka, and Kathleen H. Anderson

This article reviews existing knowledge on the assessment of children with fetal alcohol spectrum disorders (FASD) and available screening, prevention, and intervention services. The wide range of preventable conditions associated with FASD throughout the life cycle is described, along with associated high-risk maternal behaviors. In addition, cultural and social determinants are discussed, in an effort to inform social work practice. The differentiation of FASD and protective factors that have been identified as reducing negative outcomes for children and their families affected by prenatal alcohol exposure are also explained. Finally, multidisciplinary and culturally appropriate prevention services are emphasized as well as early diagnosis and strength-based intervention strategies.

Article

The indigenous peoples of Europe and Russia comprise the Inuit in Greenland, the Sami in northern Norway, Sweden, Finland and Russia and forty officially recognized ethnic minority groups in northern Russia plus a few larger-population indigenous peoples in Russia. While the health of the Inuit and Sami has been well studied, information about the health of the indigenous peoples of Russia is considerably scarcer. The overall health of the Sami is in many aspects not very different from that of their non-indigenous neighbors in northern Scandinavia; the health of the Inuit is similar across Greenland and North America and far less favorable than that of Denmark, southern Canada and the lower 48 American states, respectively; the health of the indigenous peoples of the Russian north is poor, partly due to poverty and alcohol.

Article

Shulamith Lala Ashenberg Straussner and Richard Isralowitz

Most social workers will encounter individuals and families who have problems resulting from excessive use of tobacco, alcohol, and other drugs, commonly referred to as substance abuse or, increasingly, as substance misuse problems. This article provides an overview of problems related to substance use worldwide, focusing on the United States population and selected subpopulations, such as young people, the elderly, women, ethnic and racial minorities, and the lesbian, gay, bisexual, and transsexual communities. It discusses the DSM-5 diagnostic criteria for Substance Use Disorders, evidence-based treatment approaches, and relevant policy issues relating to substance use problems. The roles of social workers in addressing these problems are identified.

Article

Dimitri van Limbergen

Grape cultivation reached Greece towards the end of the 3rd millennium bce, and Italy around the beginning of the 1st millennium bce. From the 8th century bce onward, systematic viticulture expanded, and wine became deeply embedded in Greco-Roman society at all levels. It was the beverage of choice for both the wealthy and the poor, a major intoxicant in the ancient world, and an essential source of energy in the daily diet. Wine was widely used in religion, feasts, and medicine, and was considered a key marker of civilized culture. Combined with the vine’s high productive potential and its low agronomic needs, all this made wine a primary feature of the agrarian economy and an important product of (inter)national trade. Literature, iconography, and archaeology sketch a picture of significant Greek and Roman realizations in vine-growing techniques and winemaking technology, thus testifying to a level of scientific expertise unmatched until the 19th century. The consumption of wine was stratified and diversified, with the market divided between premium vintages for the rich, ordinary wines for the masses, and winery drinks for the lower classes.

Article

Travis Rupp

Beer was a staple of ancient diets, extending from the ancient Near East to Egypt and from the Greek Aegean to Rome. The brewing process developed in Anatolia, Mesopotamia, Syria, and Israel, while industrialized production of beer continued in Egypt. However, in Greek and Roman culture, discussions and acceptance of beer are not as prevalent in the composed texts of the elite populace. These authors avoid or degrade the topic. Though no one word for beer universally translates in ancient Greek and Latin languages, further examination has demonstrated that beer was a nutritional necessity and was produced in Greek and Roman history; yet, the resilience of beer is largely attributed to peoples living on or beyond the boundaries of Greek and Roman dominion. Their direct contact with Rome’s legions compelled beer’s development even without a full embrasure from aristocratic elites. Combining art, architecture, archaeology, and literature, a comprehensive story for the existence and permanence of beer is told from 9500 bce to 500 ce.

Article

This article provides an overview of screening adolescents for substance use, misuse, and substance use disorders. It covers the practical and empirical considerations when working with youth around issues of drugs and alcohol. Four reliable and valid screening tools are discussed: Alcohol Use Disorders Identification Test (AUDIT), CRAFFT, Rutgers Alcohol Problem Index (RAPI), and Problem-Oriented Screening Instrument for Teenagers (POSIT). The tools and techniques are drawn from evidence-based theoretical frames and practices, including close attention to the recent adolescent (Screening, Brief Intervention, Referral, and Treatment (SBIRT) resources.

Article

Yvonne Asamoah

Clara Hale (1905–1992) set up the first not-for-profit child care agency — Hale House — serving children born addicted to drugs or alcohol or with AIDS. In 1985, she was appointed to President Reagan's American Commission on Drug-Free Schools.

Article

Japan has a local, centuries-old tradition of brewing sake from rice and distilling spirits from ingredients such as grain and sweet potatoes, but pioneering entrepreneurs began producing imported “Western liquors” (yōshu) in the late 19th century. This Western liquor marketplace was driven chiefly by beer brewing and whisky distilling. Western liquors were marketed, advertised, and consumed with rising popularity through the early 20th century, as living standards rose and ordinary Japanese came to afford them regularly. Following the Second World War (1939–1945), these Western commodities were no longer viewed as foreign imports, and were instead broadly regarded as domestic, if not indigenous, products. The impact of wartime rationing transformed beer into a lighter-tasting beverage that became very popular with women and young people, and whisky advertising focused closely on professional “salarymen” seeking increased prestige as well as escape from their demanding jobs.

Article

H. Paul Thompson Jr.

The temperance and prohibition movement—a social reform movement that pursued many approaches to limit or prohibit the use and/or sale of alcoholic beverages—is arguably the longest-running reform movement in US history, extending from the 1780s through the repeal of national prohibition in 1933. During this 150-year period the movement experienced many ideological, organizational, and methodological changes. Probably the most widely embraced antebellum reform, many of its earliest assumptions and much of its earliest literature was explicitly evangelical, but over time the movement assumed an increasingly secular image while retaining strong ties to organized religion. During the movement’s first fifty years, its definition of temperance evolved successively from avoiding drunkenness, to abstaining from all distilled beverages, to abstaining from all intoxicating beverages (i.e., “teetotalism”). During these years, reformers sought merely to persuade others of their views—what was called “moral suasion.” But by the 1840s many reformers began seeking the coercive power of local and state governments to prohibit the “liquor traffic.” These efforts were called “legal suasion,” and in the early 20th century, when local and state laws were deemed insufficient, movement leaders turned to the federal government. Throughout its history, movement leaders produced an extensive and well-preserved serial and monographic literature to chronicle their efforts, which makes the movement relatively easy to study. No less than five national temperance organizations rose and fell across the movement’s history, aided by many other organizations also promoted the message with great effect. Grass roots reformers organized innumerable state and local temperance societies and fraternal lodges committed to abstinence. Temperance reformers, hailing from nearly every conceivable demographic, networked through a series of national and international temperance conventions, and at any given time were pursuing a diverse and often conflicting array of priorities and methodologies. Finally, during the Progressive Era, reformers focused their hatred for alcohol almost exclusively on saloons and the liquor traffic. Through groundbreaking lobbying efforts and a fortuitous convergence of social and political forces, reformers witnessed the ratification of the Eighteenth Amendment in January 1919 that established national prohibition. Despite such a long history of reform, the success seemed sudden and caught many in the movement off guard. The rise of liquor-related violence, a transformation in federal-state relations, increasingly organized and outspoken opposition, the Great Depression, and a re-alignment of political party coalitions all culminated in the sweeping repudiation of prohibition and its Republican supporters in the 1932 presidential election. On December 5, 1933, the Twenty-first Amendment to the Constitution repealed the Eighteenth Amendment, returning liquor regulation to the states, which have since maintained a wide variety of ever changing laws controlling the sale of alcoholic beverages. But national prohibition permanently altered the federal government’s role in law enforcement, and its legacy remains.

Article

Women in the United States have drunk, made, bought, sold, and organized both against and for the consumption of alcohol throughout the nation’s history. During the second half of the 20th century, however, women became increasingly visible as social drinkers and alcoholics. Specifically, the 1970s and 1980s marked women’s relationship to alcohol in interesting ways that both echoed moments from the past and ushered in new realities. Throughout these decades, women emerged as: (1) alcoholics who sought recovery in Alcoholics Anonymous or a lesser-known all-women’s sobriety program; (2) anti-alcohol activists who drew authority from their status as mothers; (3) potential criminals who harmed their progeny via fetal alcohol syndrome; and (4) recovery memoirists who claimed their addictions in unprecedented ways.

Article

Marjorie R. Sable and Patricia J. Kelly

Reproductive health includes family planning, prenatal care, and the broader scope of primary care. Because a woman's health status at conception is as important as prenatal care, genetic screening and 20th century medical technology, reproductive health includes “the preconceptual and interconceptual periods and the menopause, and finally, not only reproductive tract problems but the wide range of risk factors that influence a woman's health in general.” Quantitative indicators of reproductive outcomes are useful for summarizing progress in reproductive health. Important indicators are discussed and reveal significant racial disparities.

Article

David Carey Jr.

Dating from the earliest times in Latin America, alcohol has played a crucial social, economic, political, and cultural role. Often reserved for politico-religious leaders, alcohol was a conduit through which power flowed in many pre-contact indigenous societies; indigenous drinkways (production, commerce, and consumption habits) were associated with communal ritual events and social prestige. Introduced to the Americas by Europeans, distillation profoundly altered the potency of alcoholic drinks for people who were accustomed to fermentation. Even as the social and cultural practices of alcohol consumption changed over time, alcohol continued to have political and economic implications in the colonial and national periods in Latin America. Fearing that inebriation bred disorder and recognizing that moonshining undercut their own revenues, colonial and national governments alike sought to regulate, if not control, the production, sale, and consumption of alcohol. In nations as diverse as Mexico, Bolivia, Peru, and Guatemala, indigenous women came to play integral roles in the (oftentimes illicit) sale and production of alcohol. A cash nexus for moving labor and land and a crucial component of the economic system by which (often unscrupulous) labor brokers recruited workers, alcohol was a currency of local economies. As a commodity of local, national, and international significance, alcohol shaped the fate of nation-states. People’s class, ethnic, race, and gender identities all played into their access to alcohol. Although a person’s choice of libation could define their position, some of the more fascinating histories of alcohol are punctuated with women and men who used alcohol to disrupt social conventions. Through the consumption of alcohol, rituals and ceremonies created and reconstituted community both within and across ethnic groups. Imbibing could also divide people. Even while they sipped their cognacs and brandies, elites portrayed indigenous people, the poor, and other marginalized people getting drunk on moonshine to discount and denigrate them. Often associated with (particularly violent) crime, alcohol was seen as a vice by many and excoriated during temperance movements. Yet defendants across Latin America took advantage of judicial systems that considered alcohol a mitigating circumstance in many crimes. As 20th-century evangelical sects that preached abstinence as the route to wealth and marital bliss grew to unprecedented numbers, traditional healers and biomedical practitioners continued to tout alcohol’s medicinal value. In short, alcohol was a marker of social position and cultural identity, a crucial component in community and state building, and a commodity around which different cultural traditions, healing practices, and policing policies developed and evolved.

Article

For the last 20 years, research based on the idea that opportunities for crime are related to specific times and places has informed crime-control policies in nighttime entertainment districts. In order to examine crime in these areas, many studies have relied on large data sets that associate city- and neighborhood-level factors with crime and delinquency. These studies have helped us understand the importance of environmental and situational factors, as well as the impact of changes in legislation and regulations to control alcohol availability (e.g., reducing the density of alcohol outlets and trading hours) and the implementation of interventions in licensed premises to reduce intoxication and disorder. However, when informing crime-control policies, the use of alternative methods to examine entertainment districts, such as naturalistic observations, can be vital. Because nighttime entertainment districts are extremely complex environments, observation is useful to examine and identify situational factors and local dynamics that increase or decrease the opportunities for crime in specific places. Observational methods can be particularly useful to understand the context in which criminal behavior and aggressive incidents occur, the interplay of situational risk factors specific to a public drinking environment, and the social and cultural factors (e.g., the relationship between police, staff, and customers) that can facilitate or challenge the implementation of crime-control strategies in these multifaceted contexts. Naturalistic observation is a data-collection method that involves accessing the field to systematically record and describe features of the space, people’s characteristics and patterns of movement, individual behaviors, and exchanges between actors in natural settings. It can be used in both quantitative and qualitative designs, although in different ways. In entertainment districts, researchers have used this method to understand crimes that are underreported and underregistered, such as sexual harassment, and to study patrons’ behaviors in licensed premises and surrounding streets, as well as staff management practices and control strategies. While they have some limitations, such as the fact that information is filtered by what observers see and how they interpret events, observation methods can uniquely contribute to the development of crime-control policies in entertainment districts by focusing on specific situational and cultural factors relating to violence and crime at a local level, as well as suggesting differentiated responses to the types of incidents that take place in these settings.

Article

Stephen J. Bright

In the 21st century, we have seen a significant increase in the use of alcohol and other drugs (AODs) among older adults in most first world countries. In addition, people are living longer. Consequently, the number of older adults at risk of experiencing alcohol-related harm and substance use disorders (SUDs) is rising. Between 1992 and 2010, men in the United Kingdom aged 65 years or older had increased their drinking from an average 77.6 grams to 97.6 grams per week. Data from Australia show a 17% increase in risky drinking among those 60–69 between 2007 and 2016. Among Australians aged 60 or older, there was a 280% increase in recent cannabis use from 2001 to 2016. In the United States, rates of older people seeking treatment for cocaine, heroin, and methamphetamine have doubled in the past 10 years. This trend is expected to continue. Despite these alarming statistics, this population has been deemed “hidden,” as older adults often do not present to treatment with the SUD as a primary concern, and many healthcare professionals do not adequately screen for AOD use. With age, changes in physiology impact the way we metabolize alcohol and increase the subjective effects of alcohol. In addition, older adults are prone to increased use of medications and medical comorbidities. As such, drinking patterns that previously would have not been considered hazardous can become dangerous without any increase in alcohol consumption. This highlights the need for age-specific screening of all older patients within all healthcare settings. The etiology of AOD-related issues among older adults can be different from that of younger adults. For example, as a result of issues more common as one ages (e.g., loss and grief, identity crisis, and boredom), there is a distinct cohort of older adults who develop SUDs later in life despite no history of previous problematic AOD use. For some older adults who might have experimented with drugs in their youth, these age-specific issues precipitate the onset of a SUD. Meanwhile, there is a larger cohort of older adults with an extensive history of SUDs. Consequently, assessments need to be tailored to explore the issues that are unique to older adults who use AODs and can inform the development of age-specific formulations and treatment plans. In doing so, individualized treatments can be delivered to meet the needs of older adults. Such treatments must be tailored to address issues associated with aging (e.g., reduced mobility) and may require multidisciplinary input from medical practitioners and occupational therapists.

Article

Media literacy describes the ability to access, analyze, evaluate, and produce media messages. As media messages can influence audiences’ attitudes and behaviors toward various topics, such as attitudes toward others and risky behaviors, media literacy can counter potential negative media effects, a crucial task in today’s oversaturated media environment. Media literacy in the context of health promotion is addressed by analyzing the characteristics of 54 media literacy programs conducted in the United States and abroad that have successfully influenced audiences’ attitudes and behaviors toward six health topics: prevention of alcohol use, prevention of tobacco use, eating disorders and body image, sex education, nutrition education, and violent behavior. Because media literacy can change how audiences perceive the media industry and critique media messages, it could also reduce the potential harmful effects media can have on audiences’ health decision-making process. The majority of the interventions have focused on youth, likely because children’s and adolescents’ lack of cognitive sophistication may make them more vulnerable to potentially harmful media effects. The design of these health-related media literacy programs varied. Many studies’ interventions consisted of a one-course lesson, while others were multi-month, multi-lesson interventions. The majority of these programs’ content was developed and administered by a team of researchers affiliated with local universities and schools, and was focused on three main areas: reduction of media consumption, media analysis and evaluations, and media production and activism. Media literacy study designs almost always included a control group that did not take part in the intervention to confirm that potential changes in health and risk attitudes and behaviors among participants could be attributed to the intervention. Most programs were also designed to include at least one pre-intervention test and one post-intervention test, with the latter usually administered immediately following the intervention. Demographic variables, such as gender, age or grade level, and prior behavior pertaining to the health topic under study, were found to affect participants’ responses to media literacy interventions. In these 54 studies, a number of key media literacy components were clearly absent from the field. First, adults—especially those from historically underserved communities—were noticeably missing from these interventions. Second, media literacy interventions were often designed with a top-down approach, with little to no involvement from or collaboration with members of the target population. Third, the creation of counter media messages tailored to individuals’ needs and circumstances was rarely the focus of these interventions. Finally, these studies paid little attention to evaluating the development, process, and outcomes of media literacy interventions with participants’ sociodemographic characteristics in mind. Based on these findings, it is recommended that health-related media literacy programs fully engage community members at all steps, including in the critical analysis of current media messages and the production and dissemination of counter media messages. Health-related media literacy programs should also impart participants and community members with tools to advocate for their own causes and health behaviors.