Abstracts of some of Robin Room's
papers - 3
Room R; Weisner C. Financing and ideology in human services: The
alcohol treatment system as a case study. 10th World Congress of the International
Sociological Association, Mexico City, Mexico: 16-21 Aug 1982. 20 p.
Shifts in the scope, structure, and financing of alcohol and mental
health services which emerged in response to ideological and material shifts
both in the specific fields of alcohol and mental problems and in society
at large are discussed. It is contended that these shifts in human services
have had deep effects on the ideology and practice of the treatment enterprise
in its daily functioning. Some of these changes, as they have occurred
in alcohol treatment agencies in California, are outlined. 52 Ref.
Room R. "Reverence for strong drink": The lost generation and the
elevation of alcohol in American culture. American Sociological Association,
San Francisco, CA: 8 Sep 1982. p. 9.
The literary works of writers born in the late 1880s and the 1890s are
examined, and an apparent link is seen between great American writers and
alcoholism. Some explanations offered for this link include focus on the
intrinsic loneliness of writing and some other artistic activities, with
loneliness seen as both lending itself to solitary drinking and as leading
to compensatory drinking for general well being. Alternative explanations
emphasize alcohol's properties as a psychoactive drug, under the influence
of which the writer or artist can envision an alternative reality or be
opened to creative urges. It is contended that, at the very least, the
writings of this generation of writers have helped to crystallize the position
which alcohol has continued to occupy in American culture for almost a
half-century since the repeal of prohibition. 23 Ref.
Room R. Alcohol and crime: alcohol and criminal behavior and events.
1982. p. 18.
An overview is presented of literature that explores relationships between
the use of alcohol and criminal events. The proportion of drunken events
which involve criminal activity are also examined. The cumulation of studies
on alcohol in criminal events allows for substantial comparisons of the
rate of occurrence of alcohol factors by type of crime, by sex and age,
and by ethnicity. A large portion of all reported crimes are accounted
for by two alcohol-specific types of crime: (1) drunk driving, and (2)
public inebriation. This discussion, however, is concerned with alcohol's
role in nonalcohol-specific crimes. 84 Ref.
Room R. Legislative strategies and the prevention of alcohol problems.
Berkeley, CA: Alcohol Research Group, 1982. p. 8.
Legislative strategies to reduce alcohol-related problems, those which
seek to limit or shape the individual's drinking or behaviors associated
with drinking, either directly by influencing the individual drinker or
indirectly by influencing those around the drinker, are examined. Examples
of laws attempting a direct influence are public drunkenness and drunk
driving laws. Those laws with indirect influence are alcohol control and
dramshop laws. Attention in this paper is focused on public drunkenness,
drunk driving, and alcohol control laws. Primary consideration is given
to the public health and public order functions of these laws.
Room R. Concepts of alcohol problems and their relation to policy.
1982. 3 p.
In recent years there has been an emergence in American sociology of
a self-conscious tradition of "historical social constructionist" or "
constructivist" analysis of social problems, with alcohol sociology playing
an important role in this emergence. This tradition focuses explicitly
on the social processes or definition of a field of conditions or behaviors
as a problem, in an historical perspective particularly interested in changes
in these definitions. Several articles are cited in a review of how alcohol
problems have been analyzed from this constructivist perspective, noting
the transition from a moral to a medical model (i.e., from crime to illness)
to wider social models. Ways in which these social models have been employed
in policy discussions are described. It is concluded that, in reconciling
these different traditions, it is important to relate the shifts in dominant
conceptualizations to changes in the material organization of societies
and in the objective alcohol condition.
Room R. Editor's introduction: Alcohol availability and public health
in an international perspective. Contemporary Drug Problems, 11(4):493-499,
1982.
Alcohol trade and production is viewed in an international public health
perspective. Research data, in recent years, have shown that the rates
of disease and mortality related to alcohol tend to respond directly to
changes in overall consumption levels in a population. Thus, alcohol availability
has become a substantial public health concern. The World Health Organization
(WHO) and others have pointed with increasing urgency to the public health
considerations of expanded alcohol production and trade. The WHO has recognized
the need to develop a solid foundation of research and analysis into these
areas, and to give close attention to existing and future trade policies
and agreements affecting the availability of alcoholic beverages. 9 Ref.
Bunce R; Cameron T; Collins G; Morgan P; Mosher J; Room R. California's
alcohol experience: Stable patterns and shifting responses. In: E. Single,
et al., Eds., Alcohol, Society, and the State (2), Toronto, Ontario, Canada:
ARF, 1981. 200 p. (pp. 159-197).
Relationships between alcohol consumption, control, and alcohol-related
problems, and their relationships in turn, to California State policies,
and to the social, political, and economic milieu, are outlined. Between
1950 and 1979, policies concerned with both alcohol-related problems and
alcoholic beverage controls were shaped by common political and economic
forces and shifts in public values, but they were addressed to different
audiences and did not exert influence one over the other. Changes in control
policies favored increasing availability and the spread of consumption,
a stable marketing climate for the growth of the alcohol beverage industry,
and increased revenues to the state of California. The shift in policy
on alcohol-related problems during this time from a moral model to a medical
one was accompanied by a significant increase in expenditures on alcohol-related
problems. 84 Ref.
Makela K; Room R; Single E; Sulkunen P; Walsh B. Alcohol, society,
and the state: A comparative study of alcohol control. Toronto, Ontario,
Canada: Addiction Research Foundation, 1981. 146 p.
In order to understand the social dynamics of the post war increase
in alcohol consumption and to study the control measures in their historical
context, this project was carried out as a series of comparative case studies.
The results of this project are drawn together in this report and its companion
volume. This first volume is an international discussion of the post war
(1950-1975) experiences of seven societies: the United States, Canada,
Poland, Switzerland, Finland, Netherlands, and Ireland. Issues included
are alcohol consumption, production, and trade, alcohol-related problems,
and alcohol control policies. Each of the seven case studies are summarized
in the second report. 247 Ref.
Room R. Case for a problem prevention approach to alcohol, drug,
and mental problems. Public Health Reports, 96(1):26-33, 1981.
The concepts of disease prevention and health promotion are discussed
in relation to alcohol, drug, and mental problems. In a discussion of preventive
efforts for children, the author contends that the primary rationale for
the focus on children is the assumption that the mental illness or mental
health of adults is determined largely by what happens during childhood;
thus, improving the experience of childhood is seen as resulting not only
in happier children in the short run but in mentally healthier adults in
the long run. A disaggregative approach to the prevention of alcohol problems
is proposed. This approach, it is felt, would be an improvement on a disease
prevention strategy in that it avoids the constraints of a nosology designed
for purposes other than prevention, and is also preferable to an exclusive
health promotion approach, which tends to focus on specific strategies
of persuasion and education about behavior that is commonly difficult to
change. 22 Ref.
Room R. Sketches for realistic pitches to heavy drinkers. Journal
of Alcohol and Drug Education, 26(3):37-40, 1981.
The author contends that little of the current public information material
on alcohol problems addresses itself to the realities of " serious drinkers,"
i.e., people who "know their way around" in bars and get drunk every now
and then without regarding it as a problem. Some lines of argument regarding
drinking behavior that might be listened to by such an audience are described.
It is noted that these sketches have not been tested in any way, and are
intended only to provide further thought about possible efforts in this
direction.
Room R. Farewell to alcoholism? A commentary on the WHO 1980 Expert
Committee Report. British Journal of Addiction, 76:115-123, 1981.
A commentary on the World Health Organization (WHO) 1980 Expert Committee
report concerning alcohol-related issues is presented, noting the change
in concerns and analysis from previous WHO reports. 26 Ref.
Room R. International study of alcohol control experiences in perspective.
Contemporary Drug Problems, 10(2):145-153, 1981.
An overview of the papers drawn from work connected with the International
Study of Alcohol Control Experiences (ISACE) is presented. This compilation
of papers is intended to be complementary to the two ISACE volumes by presenting
a series of analyses, not otherwise available in English. Most of the range
of topical areas and styles of analysis in the ISACE project are covered.
14 Ref.
Bunce R; Cameron T; Morgan P; Mosher J; Room R. California's alcohol
control experience, 1950-1975. 3rd Conference of the International Study
of Alcohol Control Experiences, Warsaw, Poland: Apr 1980. 37 p.
The historical development of alcohol beverage control and alcohol-
related problems policies is outlined, and their relationship to each other
and to their social, political, and economic milieu in California from
1950 to 1975 is examined. A brief socioeconomic and political overview
of California is presented, followed by an outline of popular sentiment
on drinking and drinking problems in California, including a discussion
of ways alcohol control policy and actions toward problems were presented
in the media. An analysis of developments in the alcohol beverage market
in California is presented, including production, advertising, and retailing.
Alcohol consumption in California is addressed both in terms of overall
patterns and trends, and in terms of aggregate consumption. Alcohol-related
problems, alcohol treatment, alcohol-related arrests, accidents, and mortality,
are analyzed in terms of both the problems themselves and the state's role
in addressing those problems. 75 Ref.
Room R; Mosher J F. Out of The Shadow of Treatment: A Role For Regulatory
Agencies in the Prevention of Alcohol Problems. Alc. Hlth Res. World, 4
(No. 2): 11-17, 1979-80.
A series of proposals are made concerning the reduction or stabilization
of alcoholic beverage consumption in the interest of public health in the
United States. State or local alcoholism authorities should be actively
involved in forming alcoholic beverage control (abc) policies, and enforcement
practices should be reformed. When violations are detected, the abc agency
should offer the offending licensee training or educational programs; such
alternatives could be offered after an administrative hearing, rather than
at the point of detection, and special restrictions or requirements could
be imposed in lieu of license suspension or revocation. Other proposals
include focusing pilot prevention programs on drunken driving to generate
public support, developing training materials for abc enforcement personnel
on means of educating licensees who have served persons later arrested
for drunken driving, encouraging licensees to train their employees to
recognize and deter potential drunken drivers, encouraging insurance companies
to lower dram shop liability premiums for such licensees and providing
educational material for bar patrons. The more generally-oriented voluntary
reforms proposed include serving free or low-cost food or nonalcoholic
beverages in bars, providing forms of entertainment to slow the drinking
rate, providing drinking and nondrinking sections, house limits on the
number of drinks allowed in a given period and introducing mandatory bartender
training on how to handle problem drinkers as a licensing requirement.
Room R. Introduction: Drug and alcohol problems, social control and
normative patterns. Journal of Drug Issues, 10(1):1-5, 1980.
Literature is cited and discussed in an introduction to articles in
the Journal of Drug Issues (Winter 1980) on drug and alcohol problems,
their social control and normative patterns. This issue is a project of
the Society for the Study of Social Problems, the primary American organization
for those interested in sociological studies of alcohol and other drugs.
18 Ref.
Room R. Treatment-seeking populations and larger realities. In: G.
Edwards, and M. Grant, Eds., Alcoholism Treatment in Transition, London,
England: Croom Helm, 1980. 327 p. (pp. 205-224).
The issue of numbers of alcoholics within a population, and the issues
that it raises are addressed, including the relation between a treatment
system and those who might need its services. The following topics are
discussed: (1) the alcoholism movement and the treatment establishment
in the US; (2) general population studies and the issue of numbers; (3)
general population alcohol problems versus clinical alcoholism; (4) problems
in defining and measuring the need for services; (5) some features of the
US treatment system; (6) finding clients to fill the beds (treatment slots);
and (7) problems with too much treatment. 51 Ref.
Room R. New curves in the course: A comment on Polich, Armor and
Braiker, 'The Course of Alcoholism'. British Journal of Addiction, 75(4):351-360,
1980.
This article critiques the reports of a series of NIAAA contracts for
follow-up studies of samples of clients drawn from eight treatment centers
(NAPIS monitoring system), who were reinterviewed eighteen months after
(Rand Report), and then four years (Course of Alcoholism) after entry into
treatment. 41 Ref.
Room R. Concepts and strategies in the prevention of alcohol-related
problems. Contemporary Drug Problems, 9(1):9-47, 1980.
The author contends that as current thinking about alcohol policy turns
away from treatment and toward a broader policy mix including prevention,
it is crucial to be clear in the conceptualizations of alcohol problems
and their prevention. Concepts and strategies are presented in a discussion
of the following topics: (1) types and characteristics of alcohol-related
problems; (2) American drinking patterns and problems in relation to prevention;
(3) the policy environment for alcohol problems prevention; and (4) "natural
alliances" in the prevention of alcohol problems. It is concluded that,
for the foreseeable future, the task of any government agency concerned
with alcohol problems can be described as managing and perhaps minimizing
the problems of alcohol rather than preventing them; what is needed is
to study systematically all organized alcohol prevention efforts, whether
they are formally funded or spontaneous occurrences, to find out what happens.
Room R. Case for a problem prevention approach to alcohol, drug and
mental problems. 1979. 20 p.
It is noted that both disease prevention and health promotion strategies
are well rooted in each of the three fields of alcohol, drug, and mental
health problems. The author contends that in the alcohol field the dominance
of alcoholism movement conceptualization has until recently directed attention
away from prevention, and that in the drunk driving field primary emphasis
has been on "disease prevention", while for youthful drinking "health promotion"
has predominated. As a way of transcending the health promotion and/or
disease prevention debate, a reconceptualization of aims is suggested,
in terms of a disaggregated focus on specific alcohol, drug, and mental
problems. 19 Ref.
Room R; Cameron T; Friedman J; Smith D; Wallack L. Profile of policies
and programmes for the prevention of alcohol- related problems: United
States of America. May 1979. 24 p.
This paper presents profiles of policies and programs for the prevention
of alcohol-related problems in the United States. It was prepared for the
World Health Organization Project on Prevention of Alcohol-Related Problems.
60 Ref.
Room R. Treatment seeking populations and larger realities. 1979.
26 p.
The issue of numbers of alcoholics and other related issues, generally,
the relation between a treatment system and those who might need its services,
are addressed. Research studies are cited in an overview of the alcoholism
movement in the US. Statistics on drinking problems in clinical populations
of alcoholics are compared to those found in the general populations, and
it is concluded that alcohol problems outside the clinic are not simply
the projection onto a larger population of alcohol problems inside the
clinic. The following four kinds of responses to the problem of filling
treatment slots in the public and private sectors are discussed: (1) to
make the treatment more attractive to the clients; (2) to seek out new
" underserved" demographic segments of the population and provide special
alcoholism treatment services for them; (3) diversification into treatment
of specific problem areas; (4) compulsory treatment in one form or another.
It is concluded that perhaps the most astonishing thing about the American
alcoholism treatment system and its social ecology (where its clients come
from, under what conditions, and who and what it misses) is how little
has been studied. 44 Ref.
Room R. Alcohol as an instrument of intimate domination. 1979. 11
p.
The way that drugs, particularly alcohol, have been used as an instrument
of domination, i.e., as an excuse or explanation for physical violence
or other aggressive action on the part of the dominant is outlined. The
author contends that the use of alcohol in this manner is related to two
cultural conditions on alcohol use: (1) the tendency for alcohol use, and
particularly drunkenness, to be prerogative of statuses with full citizenship
rights in a society, i. e., for alcohol to be denied to slaves, women,
servants, native populations, children, and other such subservient estates;
and (2) the cultural belief that alcohol causes "disinhibition," thus that
drinking or drunkenness explains violent, vicious or otherwise unconscionable
behavior. The use of alcohol for domination in the family situation is
discussed. 26 Ref.
Room R. Trends in Neighborhood Drinking Characteristics in the U.S.,
1964-1970. Drinking & Drug Pract. Surveyor, Berkeley,, No. 14, pp.
13-15, 1979.
Two studies of the same 100 neighborhood clusters in the United States,
one conducted in 1964 (D. Cahalan et al.) and the other conducted in 1970
(G. D. Mellinger et al.) were compared. The clusters were classified as
''dry'' (if 50 percent of the respondents were abstainers), ''wet'' (if
33 percent or more had drunk at least 5 drinks at some occasions during
the past year) or ''medium.'' There were 23 dry, 56 medium and 21 wet clusters
in 1964 vs 21, 24 and 55 in 1970. When the u.s. was split into drier and
wetter regions on the basis of historical and present-day patterns, it
was found that the tendency to become wetter between 1964 and 1970 was
stronger in the wetter regions. When the data were split by urbanization,
increased wetness was found in two-thirds of the urban vs one-third of
the rural neighborhoods whose wetness could increase (i.e., that were dry
or medium in 1964). The changes were heaviest in the wet-region towns (2500-50,000
population) for clusters which were in the medium category in 1964 (9 out
of 11 changed to wet in 1970) and in the dry-region cities (5 out of 7
changed from medium to wet). The proportion of dry rural areas remained
the same. the historical split in the u.s. between wetter and drier regions
thus tended to be refocused onto a widening gap between the cities and
countryside in the traditionally drier regions.
Room R. Priorities in social science research in alcohol. J. Stud.
Alc.,, Suppl. 8, pp. 248-268, 1979.
The priorities in social science research on alcohol are discussed including
the diversity of populations and aspects of alcohol studied; influence
of social science research, social science research and alcoholism movement
and funding. The current research agenda indicates studies of the normative
and ecological structure of drinking behaviors and problems, studies of
drinking careers and the natural history of drinking problems, community
response to alcohol problems and formal and informal treatment processes,
and studies of the formation and effects of alcohol controls and policies.
The section on trends in design and methods includes disaggregation, convergent
methodologies, time and history, change and natural experiments and policy
relevance. The lack of organization and group consciousness among social
scientists is noted.
Room R. Evaluating the effect of drinking laws on drinking. In: J.A.
Ewing and B.A. Rouse, Eds. Drinking: Alcohol in American Society, Chicago,
IL: Nelson-Hall, 1978. 444 p. (pp. 267-289).
Current efforts to evaluate the relationship between drinking laws and
drinking behavior are reviewed, and a number of barriers which inhibit
the evaluation process are discussed. Three hypotheses which attempt to
explain the relationship between drinking laws and drinking practices are:
(1) that there is no relationship ("null" hypothesis); (2) that the proportion
of excessive drinkers in a population directly depends on the amount of
drinking in the population ("constant proportion" theory); and (3) that
the proportion of excessive drinkers can be reduced by increasing the proportion
of the population practicing certain styles of moderate drinking (" innoculation"
theory). Implications and assumptions of the three theories are discussed
and evaluated as to how well they fit the available evidence.
Room R. Priorities in alcohol social science research. Alcoholism
Digest, 8(4):1-9, 1978.
Nonexperimental social psychology literature is cited in a discussion
of the priorities in alcohol social science research. The following topics
are addressed: (1) growth and scope of the literature; (2) the influence
of alcohol social science research; (3) social science research and the
alcoholism movement; (4) funding of alcohol social science research; (5)
current agendas for social science research; (6) trends in research design
and methods; and (7) organization of alcohol studies. 16 Ref.
Odonnell John A; Voss Harwin L; Clayton Richard R.; Slatin, G.T.;
Room, R. Young Men and Drugs - A Nationwide Survey: NIDA Research Monograph
No. 5. Rockville, MD: National Institite on Drug Abuse, 1976. 144 P.
The preliminary report on a study of nonmedical use of psychoactive
drugs among 2510 young men in the United States, conducted between October
1974 and May 1975, is presented. Lifetime use and current use statistics
are reported for nine drug categories: cigarettes, alcohol ( 97 percent
and 92 percent respectively), marijuana, psychedelics, stimulants, sedatives,
heroin, opiates, and cocaine.
Room R. Governing Images and the Prevention of Alcohol Problems.
Preventive Medicine, 3:11-23, 1974.
Three major governing images of alcohol problems are reviewed -alcohol
as an irresistably attractive but dangerous substance, alcohol as the cause
of disruptive and compulsive social behavior, and alcoholism as a specific
disease of unknown but preexisting etiology. Although the three images
focus on different aspects of alcohol problems, each involves a disease
concept. yet, according to the author, these assumptions do not always
fit the empirical data of drinking patterns and problems in the general
population. It is concluded that governing images have distorted and limited
discussions on the prevention of alcoholism and created a cultural ambivalence
toward the subject. Measures to encourage nondrinking behavior are suggested.
41 ref.
Moore R A; Dewes P B; Dumont M P; Room R. Comment on "The Alcohologist's
Addiction". Quarterly Journal of Studies on Alcohol, 33(4):1043-1059, Des.
1972.
A consensus of opinion by four authorities is offered on the need to
reestablish the criteria for alcoholism diagnosis, especially as regards
the medical profession. The authors express the need for a more responsible
approach by the medical profession in classifying alcoholism as a disease.
The consensus of opinion is that the " disease" concept of alcoholism might
allow the patient to escape responsibility by becoming overly dependent
on the clinician. The clinician needs to reformulate his conception of
disease and to renounce his exclusive jurisdiction over its control. By
assigning " sick role" properties to the condition of alcoholism, the medical
professional may preclude the necessary social, and self imposed curative
processes required by the alcoholic person for rehabilitation. We need
to develop social procedures that allow a person remission of responsibility
without the necessity for a medical label. 40 ref.
Room R. The relation between alcohol control policies and individual
behaviour. In: Proc. 30th International Congress on Alcoholism and Drug
Dependence, volume 1, 39, 1972.
The relationship between drinking laws and drinking behavior is analyzed.
Three hypotheses are discussed: That drinking laws have no effect on behavior,
that any factor raising or lowering consumption of alcohol will raise or
lower the rate of alcoholism, and that the number of excessive drinkers
can be reduced by policies aimed at responsible drinking. Not much evidence
is available in support or denial of these hypotheses. Further study is
recommended.
Room, R.,
Giesbracht, N., Graves, K., & Greenfield, T. (1995). Trends in
public opinion about alcohol policy initiatives in Ontario and the US
1989‐91. Drug and alcohol review, 14(1), 35-47.
Trends in public opinion about 11 possible alcohol policy
initiatives are analysed in probability surveys of adults in the United
States and in Ontario in 1989, 1990 and 1991. In both sites, public
opinion is fairly conservative on alcohol policies, with majorities
favoring either the status quo or decreased availability on such
dimensions as tax levels, opening hours, sale of alcoholic beverages in
corner stores and the minimum legal drinking age. Between 1989 and
1991, the most substantial net change in attitudes was in favor of
warning labels in Ontario, although it was in the United States and not
in Canada that warning labels were introduced after the 1989 surveys.
For some other alcohol policies, public support for restrictions tended
to decline in Ontario but not in the United States. In logistic
regressions predicting attitudes on each policy with gender, age,
education, drinking pattern, study site and year of study, the strong
and consistent secular trend for support for warning labels held up;
the only other significant and consistent secular trend was against
increased efforts to prevent drunken customers being served. Since
public support for alcohol controls is crucial to their effectiveness
and long-term viability, regular tracking of public opinion on them is
needed, along with efforts to increase their public understanding and
support.
Room, R., &
Greenfield, T. (1993). Alcoholics anonymous, other 12‐step movements
and psychotherapy in the US population, 1990. Addiction, 88(4), 555-562.
Based on the 1990 US National Alcohol Survey, this note provides the
first available comprehensive findings on self-reported utilization of
a variety of sources of personal support and counselling for alcohol
and other problems. Respondents were queried about lifetime attendance
and number of times they went to identified sources of help in the
prior year. Twelve-step groups included Alcoholics Anonymous, Al-Anon,
Adult Children of Alcoholics, and other non-alcohol-oriented groups
like Gamblers Anonymous, Narcotics Anonymous, and Overeaten Anonymous;
additional questions inquired about support or therapy groups and
individual counselling for non-alcohol problems. Of the US adult
population, 9% have been to an AA meeting at some time, 3.6% in the
prior year, only about one-third of these for problems of their own.
About half these percentages, mostly women, have attended Al-Anon. Of
the same population, 13.3% indicate ever attending a 12-step meeting
(including non-alcohol-oriented groups), 5.3% in the last year. During
the prior year a further 2.1% used other support/therapy groups and
5.5% sought individual counseling/therapy for personal problems other
than alcohol. In contrast to this high reported utilization, only 4.9%
(ever) and 2.3% (12-months) reported going to anyone including AA for a
problem (of their own) related to drinking.
Room, R. (1991).
Drug policy reform in historical perspective: movements and
mechanisms. Drug and alcohol review, 10(1), 37-43.
The use of psychoactive drugs is regarded by many as a basic
human drive, but it is one that induces a variety of societal responses
to curb it. The present review examines two aspects of government
policy on drugs: first, the influence of social movements on drug
policy; and secondly, the choices for constraining drug use as an
alternative to total prohibition. Addiction is essentially a repeated
behaviour which is viewed as excessive or harmful. As such, it has many
similarities with a wide range of human behaviours. With the concept of
addiction becoming progressively banalized, there is the possibility of
a more natural debate about decriminalization and legalization of drugs
in terms of a balance between harm and benefits. The current public
debate may create a climate for serious political consideration of the
strategies.
Room, R. (1992). The impossible dream?—Routes to reducing alcohol problems in a temperance culture.
Two main prescriptions are offered for reducing rates of alcohol
problems in English-speaking and Nordic cultures: a “dry” solution of
reducing the physical and cultural availability of alcohol, and a “wet”
solution of reducing problems of intoxication by better integrating
drinking into the culture. Empirical evaluations of change in
particular cultures have tended to support the dry, and not the wet,
solution. But such studies focus on relatively short-term effects, and
there is evidence that long-run effects may be weaker or may even be
reversed from short-term effects. Some particular societies that have
been put forward as examples of the long-term success of wet strategies
are considered. The most likely success from this perspective is the
Netherlands, which is also an exceptional society in terms of the
wetness of its drug policies. In the light of these cases,
consideration is given to some issues concerning the criteria for
evaluating the success of one or the other solution. It is argued that
alcohol policy discussions need to recognize that intoxication has a
particular social position in our societies, in terms of
characteristics of the drinker and of the occasion, in terms of
intoxication's cultural significance, and in terms of its entrenchment
in social worlds of heavy drinking. Some implications for policy are
noted.
Room,
R. (1990). Recent research on the effects of alcohol policy
changes. Journal of Primary Prevention, 11(1), 83-94.
As the agenda of alcohol problems prevention has broadened, new
traditions of research have emerged: of experimental studies at the
community or the societal level, of “natural experiment” studies of the
effects of sudden changes such as strikes or new legislation, and of
sophisticated time-series analyses of the effects of sudden and of
long-term changes. While it has been shown that control measures can
influence alcohol problems rates, substantial change seems to require
changes in the political status quo, often also involving popular
movements. Except for taxes, raising the drinking age and
drinking-driving countermeasures, the political will to restrict
availability has been lacking in market-oriented industrial societies
in the modern era, so that the modern experience of the effects of
other control measures is based on centrally-planned or non-industrial
economies.
Room, R.
(1989). Alcoholism and Alcoholics Anonymous in US films, 1945-1962: the
party ends for the" wet generations". Journal of Studies on
Alcohol, 50(4), 368-383.
At least 34 Hollywood films were made between The Lost Weekend
(1945) and Days of Wine and Roses (1962) with an alcoholic as a major
character; six depicted an Alcoholics Anonymous-like self-help
organization. Presentations of alcoholism's origin as mysterious
competed with psychodynamic interpretations and situational
explanations, often in the same film and sometimes concerning the same
character. Will-power and mutual help were each frequently shown as
paths to recovery, whereas neither professional treatment nor AA's
spiritual side were often shown. For the women alcoholics (17 of 39
depicted), drinking went with sexuality, but for men it replaced it.
"Creative" occupations were hugely overrepresented among screen
alcoholics, in part reflecting the personal struggles with drinking of
the movies' creators. These writers, actors and directors were drawn
from the "wet generations" of middle-class youth, who had adopted heavy
drinking in their college years as a generational revolt against
"Victorian morality." Alcoholics Anonymous was founded and peopled by
members of these same cohorts as a generational solution to their
eventual life-problems. The flurry of alcoholism films represented a
parallel and overlapping generational response.
Room, R. (1990). Symposium on experiences with community action projects held in Toronto. Addiction, 85(4), 577-578.
A Symposium on Experiences with Community
Action Projects for the Prevention of Alcohol and
Other Drug Problems was held in Scarborough, a
suburb of Toronto, on March 12-16, 1989. The
meeting was co-sponsored by Health and Welfare
Canada, by the US Office of Substance Abuse
Prevention (OSAP), and by the Addiction Research
Foundation (ARF) of Ontario, and was hosted by
Norman Giesbrecht and other ARF staff. Members
of the planning committee included: Peter Conley,
Robert Denniston, Louis Gliksman, Norman Giesbrecht
(chair), Harold Holder, Robin Room, Irving
Rootman and Martin Shain. The symposium was a
thematic meeting of the Kettil Bruun Society for
Social and Epidemiological Research on Alcohol.
Room, R. (1989).
Drugs, consciousness and self-control: popular and medical
conceptions. International Review of Psychiatry, 1(1-2),
63-70.
Psychoactive drugs alter human consciousness, but the meaning
and results of the alteration are mediated by cultural and individual
expectations. Industrialization has greatly increased the availability
of drugs, while bringing new expectations of self-control and
concentration. There are recurrent scenarios of entrenchment and
‘disentrenchment’ of drugs, and for alcohol, at least, there is enough
cyclicality to speak of ‘long waves of consumption’. Popular ideas of
addiction arose with the 19th century temperance movement as an
explanation of life failure: the loss of control is double, not only
over the drug use, but also over one's life. The emergence of the Adult
Children of Alcoholics movement suggests the continuing vitality of a
linkage between life failures and drug use. In medical thought, the
‘loss of control’ formulation was applied only to the drug use; while
loss of control used to be the ‘pathognomic symptom’ of alcoholism,
such cognitive and experiential symptoms have been marginalized in
recent diagnostic criteria. Disjunctive criteria of dependence (e.g. 3
out of 9 symptoms) expand the numbers defined as dependent; where much
treatment is coercive, they expand the scope of treatment as social
control. The retention of an element of consciousness as a necessary
element in dependence definitions would impede the link with coercion.
Room,
R. (1989). The US general population's experiences of responding to
alcohol problems. Addiction, 84(11), 1291-1304.
Respondents in a 1984 national adult sample report on the
experiences of treatment for alcohol problems, of talking to someone
about an alcohol problem of their own, and of others' suggestion that
the respondent cut down. Most who have been treated (3.4% on a lifetime
basis, 1.3% within the last year) have also encountered informal
pressures. A majority of respondents have pressured others to cut down
their drinking; such efforts do not appear to be clustered in a few
‘control specialists’, and heavier drinkers are about as likely as
lighter drinkers to pressure others. Within the family, the flow of
pressure is from older to younger generations, and from women to men,
but a heavy-drinking woman is as likely to be pressured as a
heavy-drinking man. Somewhat more men than women report applying
pressure on friends.
Room, R. (1988). Shifting perspectives in studies of alcohol in the media. Contemp. Drug Probs., 15, 139.
The subtitle of this thematic issue might be "beyond counting
sips and mentions." In the last decade or so, international
research on representations of alcohol in the media,
particularly on television, has included a number of thorough
studies coding well-designed samples of media material in
terms of distributions of drinking acts and mentions of
alcohol (see references in Hansen, in this issue). These
studies, several of which were performed by authors represented
in this issue, have contributed considerable information
to policy discussions, and have also taught us something
about the distribution of drinking in media representations
by such factors as demography, situation, and role. But when
a conference on "cultural studies of drinking" in Helsinki in
1985 (Paakkanen and Sulkunen, 1987) brought together
researchers from several countries who had performed such
content analyses, it became apparent that they no longer
found such studies sufficient in themselves. This impatience
can also be seen in Howard Blane's article (1988) in the
preceding issue of this journal.
Room, R. (2005). Banning smoking in taverns and
restaurants—A research opportunity as well as a gain for public
health. Addiction, 100(7), 888-890.
In jurisdiction after jurisdiction, bans on cigarette smok-
ing in pubs, bars and restaurants are coming into effect.
This is no longer just a phenomenon of north American
cities, where the trend started. Ireland and Norway
changed last year, Italy last January, Sweden this June.
The Publican
, a British trade journal, carries forebodings
that even England is likely to follow suit before too long.
Taverns and restaurants are places of public accom-
modation, and in many places just about the last enclosed
public space where smoking has been still allowed. Ten
years ago banning smoking in taverns seemed unthink-
able, in large part reflecting an unspoken recognition that
drinking and smoking have been strongly associated
behaviours. The winning arguments, in political terms,
have been the effects on the health of others, and partic-
ularly on those for whom the tavern or restaurant is their
workplace.
In many jurisdictions, taverns have also ended up
being the main place where gambling machines have
been placed. There was already an age limit on the drink-
ing, so drinking places were a convenient location for
lawmakers to specify where an age limit on gambling
might be enforced.
In jurisdiction after jurisdiction, bans on cigarette smoking
in pubs, bars and restaurants are coming into effect.
This is no longer just a phenomenon of north American
cities, where the trend started. Ireland and Norway
changed last year, Italy last January, Sweden this June.
The Publican, a British trade journal, carries forebodings
that even England is likely to follow suit before too long.
Taverns and restaurants are places of public accommodation,
and in many places just about the last enclosed
public space where smoking has been still allowed. Ten
years ago banning smoking in taverns seemed unthinkable,
in large part reflecting an unspoken recognition that
drinking and smoking have been strongly associated
behaviours. The winning arguments, in political terms,
have been the effects on the health of others, and particularly
on those for whom the tavern or restaurant is their
workplace.
In many jurisdictions, taverns have also ended up
being the main place where gambling machines have
been placed. There was already an age limit on the drinking,
so drinking places were a convenient location for
lawmakers to specify where an age limit on gambling
might be enforced.
PAGLIA, R. R. A.
(1999). The international drug control system in the post-Cold War era.
Managing markets or fighting a war?. Drug and Alcohol
Review, 18(3), 305-315.
The core institutions and scope of the international drug
control system are described. The system has grown in participation and
particularly in scope and ambitions since it was studied in the early
1970s by Bruun and colleagues. Its premises are notably in conflict
with the currently dominant ideologies of a free-market global economy
although, as earlier, the United States plays a dominant role in the
drug control system. At a time when it is seen as a failure in its
primary aims both from inside and from outside, defenses of the system
have ranged from rousing rhetorical appeals to efforts to
"de-sensationalize" the issues.
Room, R. (2018).
Relevant to all disciplines and professions but central to none: How
may social alcohol and drug research flourish?. Nordic Studies on
Alcohol and Drugs, 35(2), 104-107.
This commentary is written from my experience as a sociologist who has
worked primarily in alcohol research, and also off and on in drug and
gambling studies, in five countries: the US, Canada, Norway, Sweden and
Australia (Room, 2007). All of these are “temperance cultures” (Levine,
1993) with strong temperance movements in the past, of which the
comparatively strong commitment to social research on alcohol problems
could be seen as a “residual legatee” (Room, 1990). The countries north
of the Baltic, in particular, have long stood out in social alcohol
research; as young alcohol sociologists in California in the 1970s, we
thought of Helsinki as devout Catholics might think of Rome.
Room, R. (2017).
Prevention of alcohol-related problems in the community
context. Preventing Alcohol-Related Problems: Evidence and
Community-based Initiatives, 19-32.
Many problems from alcohol occur within the community, impinge on others in the
community, and often are responded to – whether informally or formally -- by community
members and institutions.
1
The community is thus a primary locus for policies, actions and
efforts to prevent the problems occurring.
The Northern Territory (NT) stands out compared with
the rest of Australia in terms of rates of alcohol-related
harms. A dramatic example is the rate of deaths attribut-
able to alcohol—3.5 times as high as the national rate,
including twice as high for the non-Indigenous popula-
tion [1]. An intrinsic element in the problem is that the
level of alcohol consumption per person aged 15+ years
in the NT is higher than elsewhere in Australia. In 2014,
NT consumption, at 12.30 l of pure alcohol per year [2],
was the highest in any Australian jurisdiction—26.7%
higher than the 9.71 average for Australia as a whole [3].
Room, R. (2017).
The case for government‐run liquor stores in the Australian Northern
Territory: Looking outside the box in regulating the supply of
alcohol. Drug and alcohol review, 36(5), 575-577.
The Northern Territory (NT) stands out compared with
the rest of Australia in terms of rates of alcohol-related
harms. A dramatic example is the rate of deaths attribut-
able to alcohol—3.5 times as high as the national rate,
including twice as high for the non-Indigenous popula-
tion [1]. An intrinsic element in the problem is that the
level of alcohol consumption per person aged 15+ years
in the NT is higher than elsewhere in Australia. In 2014,
NT consumption, at 12.30 l of pure alcohol per year [2],
was the highest in any Australian jurisdiction—26.7%
higher than the 9.71 average for Australia as a whole [3].
The Northern Territory (NT) stands out compared with the rest of
Australian in terms of the rates of alcohol-related harms. A dramatic
example is the rate of deaths attributable to alcohol - 3.5 times as
high as the national rate, including twice as high for the
non-Ingifenous population [1]. An intrinsic element in the problem is
that the level of alochol consumption per person ages 15+ yeats in the
NT is higher than elsewhere in Australia. In 2014, NT consumption, at
12.30 1 of pure alcohol per year [2], was the highest in any Australian
jurisdiction - 26.7% higher than the 9.71 average for Australia as a
whole [3].
Room, R. (2016).
Pekka Sulkunen and international alcohol sociology. Beyond the
Sociological Imagination: A Festschrift in Honour of Professor Pekka
Sulkunen, 97-99.
Finland held a special attraction for sociologists elsewhere who
became involved in alcohol studies in the 1960s or early 1970s. In
Finnish society, unlike elsewhere, sociological perspectives on
alcohol problems really mattered. And, for that matter, Finnish
alcohol sociology looked outwards -- was engaged with the world.
My first connections with Pekka reflected these frames. He and I
were invited at different times onto the team led by Kettil Bruun
which produced the ‘purple book’, the slim volume which became
the core document of a new international public health paradigm
for alcohol problems (Bruun et al., 1975). Behind the purple book
stood a much fatter ‘brown book’ (Sulkunen & Lumio, 1977), which
Pekka played a large role in producing, and which may be seen as
the founding document for what is now the World Health
Organization’s Global Information System on Alcohol and Health
Room, R., & Livingston, M. (2017). The
distribution of customary behavior in a population: The total
consumption model and alcohol policy. Sociological
Perspectives, 60(1), 10-22.
This paper is concerned with a particular strand of thinking that has been interwoven in sociological
alcohol research for half a century and has, in some times and places, had a strong influence
on policy. We will describe the inception and development of the model, the political context
in which it emerged and was fought over, and various strands of development building on the
model over the decades. The paper then proceeds to consider some limits and anomalies in the
model as they have emerged and been debated over the years. It is concluded that the model has
always been inherently sociological in its framing, being concerned with change both at the level
of interpersonal interaction and at the level of patterns in a society as a whole and with the relationship
between changes at the different levels.
Room, R. (2016).
Book review - Virginia Berridge, Demons: Our Changing Attitudes to
Alcohol, Tobacco, and Drugs. Social History of Alcohol and Drugs 28(2):
199-200.
This book, by a leading historian of opium and other public health matters, considers the
history of conceptions, behaviours and policies about tobacco, alcohol and other drugs
(particularly opiates) in the last two centuries. Britain is in the centre of the picture, but the
US history is also discussed, often in comparison to Britain’s, and there are also briefer
discussions of particular contrasting patterns in Europe, and occasional references to patterns
elsewhere.
Room, R. (2016).
Building social and population science in alcohol and other drug
studies. Addiction, 111(8), 1326-1327.
The arena of knowledge covered by Addiction is not
central to any traditional profession or academic discipline. As Jim
Rankin once put it, ‘the drug and alcohol field does not fit into any
single professional area: it is truly interdisciplinary, and therein
lies both its professional strength and its political weakness’ 1.
In medicine, for instance, efforts to gain coverage of alcohol issues
in the basic medical curriculum, even when successful, tend to be
abandoned when the next ‘reform’ comes along. For other professional
schools, whether of welfare, public health or criminology, our arena is
also peripheral. In academic departments, it is a rare undergraduate
curriculum which has more than a few lectures specifically on alcohol,
tobacco or drugs. For biosciences, while alcohol and drugs is an arena
from which much research funding is sought, again it is not at the
heart of any discipline. Specialists in our arena are thus not required
for the teaching faculty either in professional schools or in academic
departments; we have ‘not managed to acquire an established tag and
compartment in the system’ 2.
Room, R. (2016). Integrity without extinction: Paths forward for gambling research. Addiction, 111(1), 11-12.
Livingstone & Adams 1 are
responding to what is apparent to anyone with some familiarity with the
gambling literature: that for much of the research the orientation and
research questions have been constrained by the influence of the
funding sources. In countries which I know well the gambling field is
unusual in the high proportion of its funding which comes from agencies
or interests with a vested interest in the gambling market. There are
two main reasons for this imbalance. First, gambling is not a central
interest of primary research funding bodies, and of the academic
establishments they serve: it is peripheral to medical research, and on
the fringes of concerns of academic social science. Therefore (even
more than for alcohol and other drugs), it is difficult to gain funding
through general research support mechanisms. Secondly, gambling
research money comes from bodies which are connected strongly to
organizations involved in promoting or preserving the market. It has
almost always been a form of ‘conscience money’, often as a
counterbalance in the course of legalizing previously prohibited forms
of gambling. However, despite this provenance the funding bodies,
including government authorities (e.g. 2, 3), have often exerted control on what research is conducted, defining research agendas in ways compatible to market interests.
Room, R.
(2015). Portraying the alcoholic: Images of intoxication and addiction
in American alcoholism movies, 1931-1962. Substance use & misuse,
50(4), 503-507.
Around 1980, Pekka Sulkunen, Juha Partanen and others around the
Social Research Institute of Alcohol Studies in Helsinki conducted a project on
the portrayal of drinking and intoxication in Finnish movies (Partanen, 1980).
The project attracted the interest of social alcohol researchers elsewhere; for
instance, Sulkunen played a role in stimulating a French project on portrayals
in French films (Steudler, 1987). In Berkeley, California, inspired by the Finnish
project, Denise Herd and I were the main movers in a group project which set
out to study the role of alcohol in American feature films. Our methodology
might most kindly be described as "eclectic". We asked film buffs and
historians for leads on interesting films. We were interested in normalised as
well as in problematised drinking. The normalised drinking was sometimes in
the foreground, particularly towards the end of the Prohibition period, but was
more often a taken-for-granted part of the background. Indeed, we found that
film buffs, working from memory, could much more readily guide us to films
with problematised than those with normalised drinking. We examined
indexes, plot summaries, reviews and content analyses, as well as some of the
enormous hagiographic literature on filmmakers and films; we made detailed
notes on films as and after we watched them; Herd also undertook a more
formal, shot-by-shot analysis of a few films. As a way of pushing the enterprise
forward, we arranged for four evening film programs to be shown under the
rubric "Images of Alcohol in American Films" at the Pacific Film Archive in
Berkeley (Herd and Room, 1982).
Room, R. (2015). Public health, the public good, and drug policy. Nordic Studies on Alcohol and Drugs, 32, 367-370.
Ole Rogeberg’s commentary critiques
what he takes to be “the public health approach”
to drug policy, offering in counterpoint
what he identifies as four “lessons”
from drug policy reform movements. He
takes as his exemplar of the public health
approach a book, Drug Policy and the Public
Good (Babor et al. 2010), which has
twelve co-authors, including myself. As
authors, we owe Rogeberg thanks for the
compliment of being taken seriously.
Medina-Mora, M. E.,
Monteiro, M., Room, R., Rehm, J., Jernigan, D., Sánchez‑Moreno, D.,
& Real, T. (2016). Alcohol Use and Alcohol Use
Disorders. Disease Control Priorities, 4, 127-43.
Alcohol is one of the most important risk factors for premature
mortality and disability. Premature mortality disproportionatley
affects low- and middle-income countries (LMICs) (WHO 2011a); more than
85 percent of all deaths attributable to alcohol occur in these nations
(Room and others 2013; WHO 2011a). This chapter updates the chapter on
alcohol in Disease Control Priorities in Developing Countries,
2nd ed. (DCP2) (Regm and others 2006), with new scientific evidence for
interventions based on population, community, and individuals with an
emphasis on evidence from LMIC's.
Room, R., Sankaran, S., Schmidt, L.A., Mäkelä, P. & Rehm, J. (2015) Addictive substances and
socioeconomic development. In: Anderson, P., Rehm, J. & Room, R., eds. Impact of Addictive
Substances and Behaviours on Individual and Societal Well-Being, pp. 189-213. Oxford, etc.: Oxford
University Press.
This chapter considers the interplay of socioeconomic factors with a set of habit-forming behaviours,
and the social and health problems that may result from them. The behaviours for consideration, as
in the rest of this book, include the use of alcohol, tobacco, and other psychoactive substances.
While the patterns we discuss are also often applicable to gambling and other behavioural
addictions, the main focus of this chapter will be on psychoactive substances, for which populationbased
research findings are globally available and robust. The socioeconomic factors to be
considered include the relative penury or affluence of a society, and the socioeconomic status of
people and families within a given society. These factors are set in a context of consideration of
socioeconomic development at a global level—of rising though unevenly distributed standards of
living globally—and the implications for addictive behaviours and for population rates of social and
health problems arising from those behaviours.
Giesbrecht, N.,
& Room, R. (2015). Alcohol–Wide-Ranging Problems, Inadequate
Responses. The Handbook of Drugs and Society, 15-52.
Alcohol is greatly valued, deeply integrated into social and cultural contexts, used
extensively, or its consumption banned or distribution strongly controlled-- depending on the
era and socio-cultural contexts. In many western countries it is currently a very popular
drug, with 70-80% of adults having consumed alcohol in the past year. In many countries,
on the other hand, its use is uncommon, with dramatic differences in prevalence and average
consumption between men and women (WHO, 2014).
Room,
R. (2015). The UN Drug Conventions: Evidence on Effects and Impact.
In Textbook of Addiction Treatment: International
Perspectives (pp. 1377-1385). Springer Milan.
The three international drug treaties cover many psychoactive
substances (“drugs”), although not tobacco (now under a separate
treaty) or alcohol. They include a penal regime to enforce the
limitation of use to medical or scientific purposes, a trade regime
concerning drugs for medical use, and a planning scheme to ensure
adequate supplies of medical opiates. The system, initiated in 1912,
had shifted its main focus by the 1988 treaty to combating the illicit
markets which accompany a prohibitory system. The place of the drug
treaties in the United Nations system and the bodies which compose the
system are briefly characterized. Nearly every country has signed each
treaty, though often with reservations. The option this involves of
denouncing and reacceding with reservations has now been successfully
used by Bolivia concerning coca leaves. The system has assured access
to pain medication in most high-income countries, but not in much of
the world, where the system’s emphasis on law enforcement has often
indirectly but effectively cut off supplies. In terms of controlling
legal medical markets, the system has had mixed success. But the system
has mostly failed in cutting off the illicit drug trade. In a system
which has been committed to a prohibitory approach, there are recent
signs of change, particularly in the Americas, which are briefly
discussed.
Room, R.
(2015). Cultural aspects and responses to addiction. Textbook of
addiction treatment: international perspectives, 107-114.
The use of psychoactive substances and our interpretations of the
effects of the
substances are affected by culture, defined broadly to include social
worlds and
subcultures as well as tribal, societal, and linguistic groupings.
Prototypical
patternings of use include medicinal use, customary regular use, and
festival
and other intermittent uses (where the psychoactivity is most attended
to).
A fourth pattern, addictive or dependent use, was a conceptualization
arising
after the Enlightenment. Cultural norms may both encourage and
discourage use
and heavy use and may make the use more or less problematic. Cultural
factors
also shape responses to substance use, including the social handling of
problematic
situations and persons. Thus, there are characteristic differences
between
cultures in the institutional and professional location of the handling
of substance
use problems. In the modern world, there is substantial diffusion of
practices and understandings between cultures, and in multicultural
societies, drinking or drug use patterns often serve as markers of
cultural distinctions.
Despite all the diffusion, there are persisting cultural differences in
thinking
about, patterns of, and responses to psychoactive substance use.
Room, R. (2015).
The history of psychoactive substance use and problems and of social
responses to them. Addiction Medicine: Principles and Practice,
3-8.
Psychoactive substances have been used throughout recorded human history.1 The most widely used
are alcoholic beverages of one type or another.2 These were commonly used before European contact
everywhere except in Australia, Oceania and North America north roughly of the United States–
Mexico border, and even in such areas there may have been some pre-contact use.
3 Other
psychoactive substances were derived in many cultures from a wide variety of organic materials. Very
few human societies have used no psychoactive substances, and in various parts of the world today
there are widespread folk traditions of use of leaves of khat, coca and tobacco; nuts, seeds and pods of
betel, cola, coffee and opium; and roots of kava.
Room, R. (2014) Regulating Australian alcohol markets for public health and safety. In:
Manton, E., Room, R., Giorgi, C. & Thorn, M., eds., Stemming the Tide of Alcohol: Liquor
Licensing and the Public Interest, pp. 3-8. Canberra: Foundation for Alcohol Research and
Education, in collaboration with the University of Melbourne.
This book is concerned with the regulation of retail marketing of alcoholic beverages in Australia.
This is approached from the public-interest perspective of preserving public health and safety, with
attention also to broader issues of community amenity. These issues are usually discussed as ‘liquor
licensing’, and the book includes much attention to legislation and regulation under that heading.
But the book also attends to other laws and regulations which govern or affect the retail marketing
of alcoholic beverages, such as community planning laws, criminal laws and sanitary and noise
regulations. The aim is to provide a handbook for policymakers, public health advocates,
researchers, and community groups and members which is informative about historical and current
trends – how we got here, the current situation and where things are going – and about the state of
research evidence on what is effective in what circumstances for public health purposes, and on
what is not.
Published in Finnish as: Room, R. (2014) Kansainvälinen tutkija ([Klaus Mäkelä and] international
research). In Hakulinen, A. & Jaakola, R., eds. Klaus Mäkelän: Tekstit, Teot ja Elämä (Klaus Makela:
Texts, Actions and Life), pp. 165-168. Helsinki: Sosialipoliittisen Yhdistyksen Tutkimuksia.
From early in his research career, Klaus was involved in collaborative international research, in a
variety of different capacities. As a leader and manager in Finnish alcohol studies, he played an
important role in making and facilitating arrangements for study visits to and from Finland, and for
Finnish participation in cross-national collaborative studies. He was an active and productive
participant in the “purple book” (Alcohol Control Policies in Public Health Perspective) and a project
on Alcohol in Developing Societies. And he organised and led two important international
collaborative and comparative projects, the study of Alcohol Control Experiences (ISACE) and the
international Alcoholic Anonymous study (ICSAA), which were not only collaborative but also
comparative.
Room, R., &
Örnberg, J. C. (2014). . THE GOVERNANCE OF ADDICTIONS AT THE
INTERNATIONAL LEVEL. Reframing addictions: policies, processes and
pressures, 45.
This chapter considers the governance of addictions in an international perspective,
focusing on structures and actions at a global level and within the European Union
(EU) in the fields of drugs, pharmaceuticals, alcohol, tobacco and gambling. Both at a
global level and within the EU, there is great disparity between different addictive
substances and behaviours in the extent of and priorities in international governance
of markets and their customers. Nonmedical use of psychoactive substances under
international drug control treaties is subject to a strict prohibitory regime, and at the
EU level implementing that regime has been a political project of unification. In
contrast, alcohol and gambling are subject to no public health-oriented international
regulation, and trade treaties and agreements have been used as instruments to
weaken national and local control regimes. Tobacco and psychopharmaceuticals
(along with other medications under prescription regimes), are at intermediate
positions. At the EU level, court decisions on trade and national control issues have
paid substantial attention to considerations of public health and interest. But at the
global level, international trade and investment law has fairly systematically operated
to undercut control for public health or in the public interest in all areas other than
the drug prohibition treaties. Particularly globally, there has been a tendency toward
a Manichean system where an addictive commodity either is forbidden entirely or is
subject to free-market rules with diminishing restrictions on the market and
promotion.
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