8 - Community-level alcohol problem prevention

Summary

Introduction

The goal of prevention is to reduce the future occurrence of alcoholinvolved problems, which (as defined in this book) are the natural products (output) of the community system. How to develop effective long-term interventions or changes in this complex, open, and adaptive system is neither simple nor obvious. As an adaptive system, the community will not be affected by prevention programs or efforts that make no changes in the system's structure or processes. Furthermore, the system will adjust to and compensate for prevention efforts that do alter its natural arrangements. Such community system adjustments hamper the potential long-term effectiveness of any prevention intervention and are the most serious obstacle to cost-effective alcohol problem prevention in the long term.

For example, consider what happens in the community if enforcement against drinking and driving is increased, and, as a result of publicity about increased enforcement, drivers believe their chance of being detected and arrested for driving under the influence (DUI) is now much higher (i.e., perceived risk of arrest increases). If the actual risk of arrest has increased only slightly (so that it is much lower than the new perceived risk), then, over time, drivers will learn that their perceived risk is much too high. As a result, they will naturally return to their prior drinking and driving behavior, and little or no long-term reduction in alcohol-involved crashes will result. Similarly, consider the effects of increasing the retail prices of alcoholic beverages, say by 10%.