ABSTRACT

Of the major public health concerns of the 20th century, alcoholism and drug addiction certainly are among the most insidious and devastating. However defi ned, excessive use of alcohol and other drugs is an all-too-common problem, not only in the United States but across the globe. For example, the National Survey on Drug Use and Health reports more than half of the U.S. population, aged 12 and older, uses alcohol. Of these, 30% engage in binge drinking (i.e., drinking fi ve or more drinks on the same occasion at least once in the past month), and more than 10% are heavy drinkers (U.S. Offi ce of Applied Studies, 2003). Although the prevalences of other drug use disorders are much lower than alcohol, they are sizable by nearly any standard. For illicit psychoactive substances, the lifetime prevalence of drug abuse or dependence is roughly 6% in the United States, with lifetime cannabis abuse (i.e., 4.6%) being the most common aft er alcohol (e.g., Haynes, 2002). Th e World Health Organization estimates that 28 million people worldwide incur signifi cant health risks by using psychoactive substances other than alcohol (Uchtenhagen, 2004).