Alcohol abuse or misuse is a modifiable behavior that has been found out to cause preventable diseases and deaths just like other behaviors such as smoking. There are dozens of risk factors that play a critical role in the development of addiction to alcohol. The risk factors interact in different ways, where they include internal factors such as genetics and external factors such as the family environment (Schwartz et al., 2010). The Healthy People 2020 assessed the behavioral risks of alcoholism and found out that 30% of adults over the age of 18 are alcoholics, while 35% of the adolescents in grade nine through twelve take alcohol. According to the National Institute on Alcohol and Alcoholism (NIAAA), alcohol contributes to the deaths of more than 80,000 people in the US annually ( Kovner & Knickman, 2011) . These deaths are attributed to direct infections from chronic diseases and other indirect deaths such as alcohol-related automobile deaths.
The individual-level downstream interventions have been evaluated with sufficient evidence showing that the use of pharmacotherapies will increase the effectiveness ( Kovner & Knickman, 2011) . The best downstream measure that can be undertaken to reduce the risk factors of alcohol use is the use of opioid antagonists such as naltrexone, which is known to reduce the levels of craving for alcohol both when consumed and in response to the cues when the substance is not consumed. On the other hand, the midstream population-based programs should be focused on screening and brief interventions in healthcare facilities as well as the managed care organizations (Schwartz et al., 2010). Many elementary and middle schools in Arkansas have implemented the Drug Abuse Resistance Education (DARE) programs as midstream interventions meant to prevent the use of alcohol. Consequently, upstream interventions are national or state interventions meant to strengthen social norms. The best upstream intervention is the application of policies such as increasing the tax on all alcoholic products to reduce the demand for the product among consumers.
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References
Kovner, A. R., & Knickman, J. R. (Eds.). (2011). Health care delivery in the United States (10th ed.) . New York, NY: Springer Publishing.
Schwartz, S. M., Ireland, C., Strecher, V., Nakao, D., Wang, C., & Juarez, D. (2010). The economic value of a wellness and disease prevention program. Population health management , 13 (6), 309-317.
