Almost everyone knows someone who has a substance abuse problem, and there is no mistaking the negative effect of that problem on the quality (and often even length) of an addicted person's life. Many people are also aware of the emotional toll that alcoholism and drug abuse can take on the parents, spouse, children, and friends of an alcoholic or drug addict. What they may not realize, however, is that the impact of addiction disorders reaches far beyond the family circle; substance abuse is everyone's problem.

According to a study by the Lewin Group for the National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism, the estimated total economic cost of alcohol and drug abuse in the year 1992 was $245.7 billion. This cost estimate included substance abuse treatment, prevention, and other health care services; reduced job productivity and lost earnings; and other social costs such as crime and social welfare.

One abused substance not considered in the above study is tobacco, which is estimated to be responsible for at least an additional $75 billion in health care costs and $82 billion in related costs like loss of worker productivity and smoking-related fires. Smoking, the most common preventable cause of death in the U.S., serves as a delivery system for the highly addictive drug nicotine. In fact, the addiction rate for smoking (the percentage of users who eventually become habitual users) is higher than the addiction rates for either alcohol or cocaine.

Tonight, Dr. Dennis C. Daley will discuss various types of substance use disorders (SUDs) and the different types of substances that are frequently abused. Dr. Daley will also address the effects of SUDs on individuals, their families, and society in general; how physicians assess and treat SUDS; what people can do if they or a loved one has an SUD; and the process of recovering and maintaining sobriety.

Dr. Kenneth A. Perkins will focus on a particularly pervasive SUD in his presentation on nicotine dependency and smoking cessation. He will explain how smoking behavior has been encouraged and supported by historic and economic factors as well as by mass media and advertising. He will also show us the results of clinical studies that explain how patterns of nicotine absorption create a particularly insidious physical addiction-an addiction which, in turn, is effectively reinforced by social and environmental cues.

Most importantly, Dr. Perkins will offer a concrete example of the process of SUD recovery by examining the mental and physical aspects of the process of overcoming nicotine dependence, with a special emphasis on the role and responsibility of the physician in facilitating this important health care decision.

Dennis C. Daley, Ph.D.
Associate Professor of Psychiatry, School of Medicine
Associate Professor of Social Work, School of Social Work

Dr. Daley is chief of Addiction Medicine Services (AMS) at Western Psychiatric Institute and Clinic and director of the Center for Psychiatric and Chemical Dependency Services. He received his doctorate in psychology from California Coast University in Santa Ana, California.

Dr. Daley has developed several treatment programs for addiction and dual disorders (mental illness and addiction). He has been involved in providing services to patients and their families, as well as the development and management of treatment programs for more than 25 years. He has consulted with numerous treatment programs in the U.S. and Europe, and has presented workshops and lectures in more than 30 states as well as in Canada and Europe. Dr. Daley has also authored recovery materials for children, adolescents, and families, including the popular Living Sober video series. More than two million copies of Dr. Daley's materials are in print, and several have been translated into foreign languages.

Dr. Perkins earned both his master's and doctoral degrees in clinical psychology from the University of Iowa. His well-funded research is aimed at explaining why tobacco use is addictive, focusing on the acute subjective, behavioral, and physiological effects of nicotine and/or smoking in humans. Individual differences in these effects, such as the influence of sex, personality, and genetics, are of increasing interest to Dr. Perkins as he explores the best approach to working with patients towards smoking cessation.

Dr. Perkins has served on several committee and advisory boards for the National Institutes of Health (NIH) and other federal and state grant review committees and advisory boards. He is a past president of the Society for Research on Nicotine and Tobacco and has published more than 130 scientific papers.

www.alcoholics-anonymous.org
www.na.org
Alcoholics Anonymous (AA), Narcotics Anonymous (NA), and other substance-specific 12-step programs are free, anonymous, and available in almost every community in the U.S and in many places around the world. The sites for these organizations offer connections to meeting schedules as well as a wealth of information designed to support drug and alcohol abusers in their quests for recovery.

www.al-anon.org
www.naranon.com
The goal of Al-Anon and Nar-Anon is to help the families and friends of alcoholics and drug addicts recover from the effects of living with the problem drinking or drug abuse of a relative or friend. As with AA and NA, these groups are free, anonymous, and widely available.

www.hazelden.org
Hazelden is a nonprofit organization devoted to helping individuals, families, and communities struggling with addiction to alcohol and other drugs through treatment and continuing care services, education, research, and publishing.

www.county.allegheny.pa.us/achd/
This list of Tobacco Control Resources for Allegheny County is a great place to start if you or a family member need local assistance with smoking cessation.

www.health.org: National Clearinghouse for Alcohol & Drug Information
www.niaaa.nih.gov: National Institute on Alcohol Abuse and Alcoholism
www.nida.nih.gov: National Institute on Drug Abuse
The sites for these National Institutes of Health agencies are excellent sources of information for drug and alcohol patients and their families as well as for clinicians and researchers.

www.samhsa.gov
The Substance Abuse and Mental Health Services Administration (SAMHSA) is an agency of the U.S. Department of Health and Human Services. SAMHSA's goal is to improve the quality and availability of prevention, treatment, and rehabilitative services in order to reduce illness, death, disability, and cost to society resulting from substance abuse and mental illnesses.

www.quitnet.com
QuitNet, which operates in association with Boston University School of Public Health, is an interactive site that allows individuals to create their own quit plan and provides them with access to nicotine addiction experts as well as other "quitters."