SUBSTANCE ABUSE NUMBER ONE HEALTH PROBLEM IN US

NEW YORK (Reuters Health) - Drug abuse remains the number one health
problem in the US, according to a report released Friday by The Robert Wood
Johnson Foundation in Washington, DC.

About 430,700 deaths each year are attributed to tobacco abuse and more
than 100,000 deaths are caused by alcohol abuse. Illicit drug use causes
nearly 16,000 deaths each year.

"Substance abuse is a huge and devastating problem for American society,"
Dr. Constance Horgan of Brandeis University in Waltham, Massachusetts, told
Reuters Health.

Horgan is the lead investigator of the report, which includes data from
hundreds of studies on substance abuse conducted over the last 30 years.

The news is not all bad, Horgan said. Overall, the US saw declines in
smoking rates beginning in the mid 1960s, in drug use from the late 1970s
and in alcohol consumption from the early 1980s.

The declines are most likely due to an increased awareness of the risks of
substance abuse, an increase in government intervention and prevention
programs, bans on smoking, and grassroots efforts to decrease substance abuse.

"We've made substantial progress in attacking youth drug use," Dr. Alan
Leshner, director of the National Institute on Drug Abuse, told Reuters
Health. "But every time we say that people let up." He added, "the minute
we let up the problem reappears."

In spite of the successes, the report found that 52% of adolescents have
consumed alcohol, 41% have smoked cigarettes, and 20% have used marijuana
by the eighth grade. In adolescents, there has been a slight decline in
tobacco use and illicit drug use, with the exception of the drug ecstasy,
Horgan noted. "But alcohol abuse remains a large problem with adolescents,"
she said.

Substance use and abuse is pervasive in popular culture, according to the
report. Alcohol appeared in 93% of the 200 most popular movie rentals in
1996 and 1997. Tobacco appeared in 89%, while illicit drugs were seen in
22% of these movies.

During the same time period, an analysis of the 1,000 most popular songs
showed that 27% referred to alcohol or illicit drugs. The report also
states that the tobacco industry spent more than $6 billion on advertising
in 1998.

"There is no question that this report spells out the complexity and the
pervasiveness of the problem in American society," Leshner told Reuters
Health. "There will be no simple solutions," he added.

More than 18 million Americans who use alcohol and 5 million who use
illicit drugs need treatment, but fewer than one-fourth will get the
treatment they need. Yet the report indicates that more than half of the
Americans polled strongly believe that drug treatment should be more available.

Leshner believes that treatment and prevention programs are needed as much
as efforts to control the flow of illicit drugs into the US.

"But substance abuse is not just the responsibility of the federal
government," Leshner said. "All drug abuse problems are local by their very
nature," he noted, adding that comprehensive strategies are needed at all
levels.

Horgan agreed, stating that "multifaceted approaches are the way to
dissolving the problem."