Karasov Ariela O, Ostacher Michael J
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, USA.
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, USA; Department of Psychiatry, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA.
Handb Clin Neurol. 2014;125:649-57. doi: 10.1016/B978-0-444-62619-6.00038-0.
Society has had an interest in controlling the production, distribution, and use of alcohol for millennia. The use of alcohol has always had consequences, be they positive or negative, and the role of government in the regulation of alcohol is now universal. This is accomplished at several levels, first through controls on production, importation, distribution, and use of alcoholic beverages, and second, through criminal laws, the aim of which is to address the behavior of users themselves. A number of interventions and policies reduce alcohol-related consequences to society by regulating alcohol pricing, targeting alcohol-impaired driving, and limiting alcohol availability. The legal system defines criminal responsibility in the context of alcohol use, as an enormous percentage of violent crime and motor death is associated with alcohol intoxication. In recent years, recovery-oriented policies have aimed to expand social supports for recovery and to improve access to treatment for substance use disorders within the criminal justice system. The Affordable Care Act, also know as "ObamaCare," made substantial changes to access to substance abuse treatment by mandating that health insurance include services for substance use disorders comparable to coverage for medical and surgical treatments. Rather than a simplified "war on drugs" approach, there appears to be an increasing emphasis on evidence-based policy development that approaches alcohol use disorders with hope for treatment and prevention. This chapter focuses on alcohol and the law in the United States.
数千年来,社会一直关注对酒精生产、分销和使用的控制。酒精的使用总会产生后果,无论其是积极的还是消极的,而政府在酒精监管方面所起的作用如今已普遍存在。这是通过几个层面来实现的,首先是对酒精饮料的生产、进口、分销和使用进行管控,其次是通过刑法,其目的在于规范饮酒者自身的行为。一些干预措施和政策通过调节酒精价格、针对酒后驾车行为以及限制酒精供应,来减少与酒精相关的社会后果。法律体系在酒精使用的背景下界定刑事责任,因为很大比例的暴力犯罪和交通事故死亡都与酒精中毒有关。近年来,以康复为导向的政策旨在扩大对康复的社会支持,并改善刑事司法系统内物质使用障碍治疗的可及性。《平价医疗法案》,也被称为“奥巴马医改”,通过强制要求医疗保险涵盖与医疗和外科治疗覆盖范围相当的物质使用障碍服务,对物质滥用治疗的可及性做出了重大改变。相较于简单的“禁毒战争”方式,现在似乎越来越强调基于证据的政策制定,即以治疗和预防为希望来应对酒精使用障碍问题。本章聚焦于美国的酒精与法律。