Alcohol, Drugs and Addictive Behaviours

A forum on alcohol, drugs and addictive behaviours, organized in Geneva by WHO

By Elena Goti – This first Forum on Alcohol, Drugs and Addictive Behaviour convened by the WHO was organized under a mandate issued by UNGASS 2016. That directive urged implementing and strengthening public health interventions in pursuit of the Sustainable Development Goals (SDG) 2030.

SDG 3 includes several objectives related to psychoactive substance policies: SDG 3.5 aims to improve drug prevention and treatment; SDG 3.4 aims to improve the prevention and treatment of non-communicable diseases and to promote mental health; and SDG 3.8 urges universal health coverage.

The Forum focused on three areas: (1) controlling and reducing alcohol consumption, (2) the public health dimension of the drug problem, and (3) the public health consequences of addictive behaviours.

Three factors affect all of these areas: (A) funding mechanisms, (B) monitoring progress toward SDG 2030, and (C) including substance abuse and addictive behaviours in the 11th revision of the International Classification of Diseases, which is being prepared.

Elena GotiVladimir Pozniak, Management Coordinator for Substance Abuse, Mental Health and Substance Abuse Behaviours, directed preparations for the forum. His team invited various groups working in this field to form collaborations, networks, and partnerships. These efforts serve to expand the medical environment in which the WHO operates. The WHO currently focuses mainly on epidemiology, vaccines, medical campaigns, medications, etc.

The UNGASS mandate was issued under the current International Classification of Diseases, ICD-10, which only includes alcohol and psychoactive drugs.

Coincidentally, the update to ICD-11 is well underway. Many experts are lobbying to include gambling in ICD 11, a step forward in addressing addictive behaviours. It is notable in this context that the DSM IV (the Diagnostic and Statistical Manual of Mental Disorders, published in the USA) has included gambling and other addictive behaviours since 1984.

WHO experts need to recognize these three decades of experience with gambling, and the resulting rigorous literature. Academic researchers and scientists have conducted a large body of multidisciplinary and longitudinal studies. Including this experience in the new ICD will serve as the basis for adding other addictive behaviours, such as addictions to gaming and ICT, sex addiction, etc.

Another crucial issue of great interest during the Forum was FASD (Fetal Alcohol Spectrum Disorders). Research has consistently shown the harmful short- and long-term effects of alcohol on fetuses. Consequently, concern about FASD is growing, as the data is so convincing. There are already discussions of how to create prevention programmes for women before they become pregnant.