A major national goal is to improve our health and advance our opportunities to pursue happiness. Simulta neously, there are increasing health care costs and increasing demands to accomplish more with less financial support. Treatment costs can be reduced and health improved by preventing the toxic effects of drugs. This first volume of our new series, Drug and Alcohol to reduce the use and Abuse Reviews, focuses on stategies abuse of common compounds known to cause major damage to health: alcohol, tobacco, and illicit drugs such as cocaine and heroin. With the number of deaths attributable to the consumption of alcohol in the US at about 100,000 per year, the annual cost of addictions will be $150 billion by 1995. A variety of approaches to preventing drug abuse are being applied by governmental agencies and health care providers to reduce costs. These include school-based inter ventions, driver education programs, media interventions, health warning labels, physician guidance, economic dis incentives, restricted availability, punishments and penalties, environmental protections, and social-support approaches. With such a range of options, it becomes critical to evaluate and choose the most effective systems for a given population. We feel that the present collection of critical survey articles constitutes a thorough examination of the issues and strategies associated with prevention, and trust that readers will find the book exceedingly helpful in under standing and planning what needs to be done."

Alcohol and other drugs of abuse are major contributing factors to liver disease and its pathology. Alcoholic cirrhosis causes thousands of deaths each year in the United States, and encourages liver replacement. A better understanding of the mechanisms of liver pathology will significantly aid basic researchers and physicians in treating and preventing liver damage. This book is designed especially for those researchers wishing to understand alcoholic liver disease. Therefore the role of alcohol in changing nutrition and its nutritional effects on liver disease are reviewed. The generation of free radicals during alcohol use has been found to be an important cause of membrane changes, of cancer development, and of lipid alterations-and thus of liver pathology. In addition to alcohol, other drugs of abuse, including morphine, cocaine, marijuana, and caffeine have also been shown to be significant contributors to liver pathology. The prevalence of drug and alcohol use and abuse today means that liver disease will continue as a major social and medical problem. The explanation of its biological origins cannot fail to help us better understand and treat the disease in the years to come.

Alcohol and other drugs of abuse cause significant physi ological changes, especially during development. The effects on the infant and child range from severe mental retardation to mild changes in activity and neurological functions. Although the level of intake needed to cause fetal damage is not clear, the magnitude of the problem is significant, with many long-term sequelae. As a result, it becomes critical to better diagnose and manage drug and alcohol use during pregnancy. This must involve special training for health care professionals. In addi tion, recognition of the psychosocial factors affecting alcohol use, especially by youth and young adults, is critical to modi fying behavior, and thus reducing fetal alcohol exposure. Cultural considerations can also come into play in modi fying alcohol and drug use by women so as to reduce fetal damage. The trends in alcohol and drug use by youth forecast rising levels of damage to infants. These children will need extensive medical and educational care for years to decades. Clearly, understanding of the role women must take in modifying their alcohol and drug use during pregnancy will facilitate changes in our cultural and educational practices that will help reduce fetal trauma from alcohol.

Alcohol and other drugs of abuse are major contributing factors to liver disease and its pathology. Alcoholic cirrhosis causes thousands of deaths each year in the United States, and encourages liver replacement. A better understanding of the mechanisms of liver pathology will significantly aid basic researchers and physicians in treating and preventing liver damage. This book is designed especially for those researchers wishing to understand alcoholic liver disease. Therefore the role of alcohol in changing nutrition and its nutritional effects on liver disease are reviewed. The generation of free radicals during alcohol use has been found to be an important cause of membrane changes, of cancer development, and of lipid alterations-and thus of liver pathology. In addition to alcohol, other drugs of abuse, including morphine, cocaine, marijuana, and caffeine have also been shown to be significant contributors to liver pathology. The prevalence of drug and alcohol use and abuse today means that liver disease will continue as a major social and medical problem. The explanation of its biological origins cannot fail to help us better understand and treat the disease in the years to come.

A major national goal is to improve our health and advance our opportunities to pursue happiness. Simulta neously, there are increasing health care costs and increasing demands to accomplish more with less financial support. Treatment costs can be reduced and health improved by preventing the toxic effects of drugs. This first volume of our new series, Drug and Alcohol to reduce the use and Abuse Reviews, focuses on stategies abuse of common compounds known to cause major damage to health: alcohol, tobacco, and illicit drugs such as cocaine and heroin. With the number of deaths attributable to the consumption of alcohol in the US at about 100,000 per year, the annual cost of addictions will be $150 billion by 1995. A variety of approaches to preventing drug abuse are being applied by governmental agencies and health care providers to reduce costs. These include school-based inter ventions, driver education programs, media interventions, health warning labels, physician guidance, economic dis incentives, restricted availability, punishments and penalties, environmental protections, and social-support approaches. With such a range of options, it becomes critical to evaluate and choose the most effective systems for a given population. We feel that the present collection of critical survey articles constitutes a thorough examination of the issues and strategies associated with prevention, and trust that readers will find the book exceedingly helpful in under standing and planning what needs to be done."

A major national goal is to improve the health of the populace while advancing our opportunities to pursue happiness. Simulta neously, there are both increasing health costs and increasing demands that more be accomplished with less financial support. With the number of deaths attributable to drug abuse, especially of tobacco, in the US at about 250,000 per year, the annual cost of drug addiction is over $150 billion. Improved treatment methods can both reduce these costs and improve health by preventing the continued exposure of abusers to the toxic effects of alcohol and other drugs. This fourth volume of Drug and Alcohol Abuse Reviews focuses on the strategies currently thought best for the treatment of drugs of abuse. A variety of approaches to drug abuse treatment employ those psychosocial factors that are known to influence drug use in youth and adults. Although the main emphasis is on the treatment of illicit drug use, a major cofactor in damaging the health of drug users is nicotine (tobacco) addiction, whose treatment is also reviewed. And the roles of learning and outpatient services are shown to affect treatment significantly. Thus, the problems confronted and solutions used in drug abuse treatment have here been analyzed in concise reviews that deal with the evidence for today' s best hypotheses and conclusions. Some emphasis is also placed on reviewing new compounds used to prevent cocaine and opioid dependence."

Alcohol and other drugs of abuse cause significant physi ological changes, especially during development. The effects on the infant and child range from severe mental retardation to mild changes in activity and neurological functions. Although the level of intake needed to cause fetal damage is not clear, the magnitude of the problem is significant, with many long-term sequelae. As a result, it becomes critical to better diagnose and manage drug and alcohol use during pregnancy. This must involve special training for health care professionals. In addi tion, recognition of the psychosocial factors affecting alcohol use, especially by youth and young adults, is critical to modi fying behavior, and thus reducing fetal alcohol exposure. Cultural considerations can also come into play in modi fying alcohol and drug use by women so as to reduce fetal damage. The trends in alcohol and drug use by youth forecast rising levels of damage to infants. These children will need extensive medical and educational care for years to decades. Clearly, understanding of the role women must take in modifying their alcohol and drug use during pregnancy will facilitate changes in our cultural and educational practices that will help reduce fetal trauma from alcohol."