23 October 2008
Alcohol Causes 2 Million Deaths Annually; Many Preventable
U.S., international health organizations researching causes, treatments
Washington — There are more than 2 million alcohol-related deaths worldwide each year — a staggering but preventable statistic. To address this issue, the World Health Organization (WHO) is holding a Web-based public hearing October 3 to October 31.
Everyone interested in reducing the global burden of alcohol abuse is invited to contribute views to the hearing. The WHO will use this information to develop a global strategy on combating alcohol abuse.
Dr. Benedetto Saraceno, director of WHO’s Department of Mental Health and Substance Abuse, said in a press release that the organization especially is interested in “integrated approaches that can protect at-risk populations, young people and those affected by harmful drinking by others.”
Alcoholism, a physical dependence on alcohol, is a chronic disease. There are four main features that people with alcoholism share, according to the U.S. National Institutes of Health (NIH): craving (a need to drink), loss of control (being unable to quit after starting to drink), physical dependence (evidenced by withdrawal symptoms), and tolerance (the need to drink increasing amounts of alcohol to feel its effects).
The risk for alcoholism is linked to both genetic and environmental factors. Alcoholism is considered genetically complex, involving the interactions of numerous genes as opposed to a single gene. There are treatments available for alcoholism, which include therapy and medications, but no cure.
In addition to its toll on health, alcohol abuse has a high financial cost. In 2002, the WHO estimated, costs related to alcohol abuse were between $210 billion and $665 billion.
Some research suggests that alcohol consumption in small quantities is healthy; however, excessive drinking can wreak havoc on the body. Alcohol accounts for 3.7 percent of total global deaths and 4.4 percent of global disease, according to the WHO, and 140 million people throughout the world suffer from alcohol dependence.
In addition, alcohol abuse is responsible for more than 60 types of disease and injury. The WHO estimates that 20 percent to 30 percent of esophageal cancers, liver cancers, and cirrhosis of the liver, homicides, epilepsy and motor vehicle accidents are alcohol related. Alcoholism is also a risk factor for one of the top killers worldwide: cardiovascular disease.
UNDERSTANDING THE PROBLEM
The National Institute for Alcohol Abuse and Alcoholism (NIAAA), a branch of the NIH, is the U.S. agency charged with reducing alcohol-related problems through supporting research, disseminating findings and collaborating with other institutions, nationally and internationally.
One NIAAA grant, for the International Research Collaboration on Alcohol and Alcoholism, aims to foster collaborations between U.S. and international alcohol-research scientists. For its next grant cycle, the NIAAA intends to commit $1 million to fund three to five collaborative projects.
The Division of Intramural Clinical and Biological Research is the internal research branch of the NIAAA. According to its mission statement, it employs a number of investigators to do “basic and applied alcohol research, including metabolic, preclinical and clinical investigations, on the multiple determinants and processes of alcoholism and other alcohol-related problems and in the areas of prevention, diagnosis, treatment and rehabilitation.”
In addition, the NIAAA promotes external research on alcohol abuse through the creation of NIAAA-funded alcohol research centers and programs. As of May 2007, there were 18 research centers set up at universities and institutes throughout the United States.
One example of a NIAAA-supported research program is the Collaborative Studies on Genetics of Alcoholism (COGA). Established in 1989, COGA aims to identify susceptibility genes for alcoholism. The program has enlisted the help of more than 300 families with a high tendency toward alcoholism. Family members have undergone a series of cognitive, genetic and biochemical tests in hopes that researchers can understand the biology of alcoholism better. This data is distributed to researchers who request it.
COGA researchers have found “hot spots” for alcoholism risk on several chromosomes. At least one protective area — associated with a lower risk for alcoholism — has been located on a chromosome near the gene for alcohol dehydrogenase, the enzyme in the body responsible for metabolizing alcohol.
TREATING THE PROBLEM
The WHO is using other methods — population data and policy — to reduce worldwide alcohol problems. The WHO has initiated the Global Information System on Alcohol and Health, which is a resource that contains information about worldwide alcohol use, problems and policies. The source data comes from epidemiological surveillance efforts, published data and information provided by WHO member states.
In a March 2008 report, the WHO reported strategies to reduce the harmful use of alcohol. The suggestions, based on numerous studies and data, include raising awareness, seeking political commitment, screening measures, community action and addressing public policies about drunk driving, alcohol availability, marketing, pricing and illegal production. In response to this report, member states mandated the drafting of a global strategy for the reduction of alcohol abuse.
With the current Web-based hearing and future consultation plans, the WHO is well on its way to meeting the goal of submitting a draft of the strategy to the World Health Assembly in 2010.
Comments may be submitted to the public hearing on the Web site http://www.who.int/substance_abuse/activities/hearing/en/index.html in Arabic, Chinese, English, French, Russian and Spanish.
