Abstract
Despondency about the efficacy of both diagnosis and treatment for alcohol-related problems is common. Several major causes of morbidity and mortality in our community are characterised by under-diagnosis in the community, under-diagnosis on presentation, lack of highly effective treatment or poor delivery of treatment to those most in need. Similar problems are encountered in the delivery of treatment to individuals with alcohol-related problems in the community. Most alcohol-related problems in the community are associated with only moderately elevated alcohol consumption, although the small number of individuals with exceptionally high intake have a higher relative risk of developing problems. The number of individuals exposed to a low risk of problems will be disproportionately influenced by changes in mean alcohol consumption. Approaches to prevention follow socio-cultural, public health, or consumption models. Compelling evidence closely links indices reflecting harm to changes in alcohol consumption. The challenge of prevention of alcohol-related problems is to devise measures which are acceptable to the entire population, yet also deal with problems associated with a small minority.
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Notes on contributors
A.D. Wodak
Both authors formerly Public Health Officers, Eastern Sydney Area Public Health Unit Previously general practitioner, Orange NSW, Australia.