Snbstance use and
dependence cause a slgnificant burden to indMduals and societies throughout the world. The World Health
Report 2002 indlcated that 8.9% of the total burden of disease comes from the use of psychoactive
substances. The report showed that tobacco accounted for 4.1%, alcohol 4%, and llllclt drugs 0.8% of the burden of disease In 2000. Much of the burden attrlbutable to
Substance use and dependence is the result of a wlde variety of health and social problems, lncludlngHIV/AIDS, whlch is driven in many countries by Injectlng drug use.
Thls neurosclence report Is the first attempt by WHO to provlde a comprehensive overview of the blologlcal factors related to substance use and dependence by summarizing the vast amount of knowledge galned in the last 20-30 years. The report highlights the current state of knowledge of the mechanisms of action of different types of psychoactive substances, and explains how the use of these substances can lead to the development of dependence syndrome.
Tliough the focus is on brain mechanisms, the report nevertheless addresses the social and environmental factors which influence substance use and dependence. It also deals with neuroscience aspects of interventions and, in particular, the ethical implications of new biological intervention strategies.
The various health and social problems associated with use of and dependence on tobacco, alcohol and illicit substances recjuire greater attention by the public health community and appropriate policy responses are needed to address these problems in different societies. Manygaps remain to be filled in our understanding of the issues related to substance use and dependence but this report shows that we already know a great deal about the naturę of these problems that can be used to shape policy responses.
This is an important report and I recommend it to a wide audience of health care professionals, policy makers, scientists and students.