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  1. Naegle, Madeline A. PhD, CNS-PMH, FAAN

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The challenges of the American health care policy scene can often make it seem that we are laboring against impossible odds when it comes to support for education, research, and practice in treatment of addictions. Recent legislation like the 21st Century Cures Act (2016) and the Comprehensive Addiction and Recovery Act (2016), which designates $1 billion for prevention, treatment, recovery, law enforcement, criminal justice reform, and overdose reversal, support prescription drug monitoring, treatment accessibility, and the education of health care professionals, which signifies progress. Like so many countries in the world, however, expanded efforts to decrease harmful consequences of alcohol, tobacco, and other drugs (ATODs), our resource allocations have not matched such expansion. These allocations are insufficient to address the scope of drug and alcohol problems. In the United States, however, they are more positive when evaluated against those of many countries whose representatives attended the forum described here.


Organized by the World Health Organization (WHO) Department of Mental Health and Substance Abuse, the forum brought over 300 representatives from over 50 WHO member states, nongovernmental organizations, WHO Collaborating Centers, Expert Panel Advisory Board members, the International Council of Nurses, and members of the WHO Secretariat to an exchange on educational projects, research findings, policy initiatives, and progress under the WHO policy framework. WHO has worldwide visibility for long-standing initiatives on infectious disease control and disaster response, but efforts to address ATOD issues have increased since the 1990s. In 2010, WHO identified chronic illness as the primary contributor to the Global Burden of Disease (a metric that quantifies the burdens of major causes of death and disability) and risk factors disaggregated by geographic regions and various age-gender groups (WHO, 2017). The UN General Assembly in 2016 further reviewed political progress on the World Drug Problem, recognizing that the chronicity of addiction contributes to the mortality and morbidity rates for every country. Alcohol use and tobacco dependence are the highest contributors.


The WHO Forum on Alcohol, Drugs and Addictive Behaviors seeks to strengthen partnerships and collaboration among public-health-oriented organizations, networks, and institutions in service of achieving the WHO Sustainable Development Goals (SDGs) 2030 (WHO, 2017). Target 3.5 of the SDGs sets a commitment by governments to strengthen the prevention and treatment of substance abuse and to prevent and treat noncommunicable diseases and promote mental health (WHO, 2017).


A variety of forum topics were organized around three themes:


[white square] Alcohol control and implementation of the Global Strategy to Reduce the Harmful Use of Alcohol


[white square] Public health dimensions of the world drug problem with a focus on health-related operational recommendations endorsed UN General Assembly Special Session (UNGASS, 2000) on the world drug problem


[white square] Public health implications of addictive behaviors


[white square] Funding mechanisms for prevention and treatment of substance use and addictive behavioral disorders


[white square] Monitoring progress on relevant SDG 2030 targets



A 2004 seminal article (Nkowane & Saxena, 2004) empha sized the importance of developing the 3.3-million-member global nursing and midwifery workforce, providing tools and training to facilitate their implementation of screening for ATOD use in particular, using the WHO sanctioned Screening, Brief Intervention, and Referral to Treatment. A 2010 WHO publication (Watson, Munro, Wilson, Kerr, & Godwin, 2010) further explicated this recommendation.


The WHO Forum was a first opportunity to convene stakeholders in discussions on the current state of research, education, and policy around alcohol, drugs, and addictive behaviors. Although few nurses were in attendance, the presence and comments of Dr. Howard Catton of the International Council of Nurses, and the author stressed the potential resources that WHO member states can mobilize by developing substance-use-disorder-focused skills training for nursing personnel. Biennial conventions of this group would be a very positive outcome, and hopefully, our nursing presence and our voices will bring significant workforce perspectives.




Nkowane A. M., Saxena S. (2004). Opportunities for an improved role for nurses in psychoactive substances: A literature review. International Journal of Nursing Practice, 10(3), 102-111. [Context Link]


Watson H., Munro A., Wilson M., Kerr S., Godwin J. (2010). The involvement of nurses and midwives in screening and brief intervention for hazardous and harmful use of alcohol and other psychoactive substances. Retrieved from http://WHO/HRH/HPN/10-6whqlibdoc.who.int/hq/2010/WHO_HRH_HPN_10.6_eng.pdf?ua=1[Context Link]


WHO. (2017). Health statistics and information systems, Global Health Estimates (GHE). http://www.who.int/healthinfo/global_burden_disease/en/[Context Link]