Hello, Adam, here is a cultural strategy of substitution from the Caribbean
that was written about in 1972 in the UNODC Bulletin on Narcotics:

Details

Author: Raymond PRINCE , Rochelle GREENFIELD , John MARRIOTT
Pages: 1 to 9
Creation Date: 1972/01/01
Cannabis or alcohol?
Observations on their use in Jamaica
M.D. Raymond PRINCE *
M.Ed Rochelle GREENFIELD **
M.D John MARRIOTT ***

One of the striking features of the patient population of Bellevue, the
large mental hospital in Kingston, Jamaica, is the infrequency of
disturbances associated with alcohol. Of 600 admissions to one typical ward
over a two-year period, less than 2 % suffered such problems; not a single
case of chronic brain syndrome associated with alcoholism was seen and we
encountered neither delirium tremens nor alcoholic hallucinosis. The few
alcohol-linked disturbances that did occur were, moreover, in patients who
contrasted sharply with the predominantly low-income ward population in that
they were from higher income levels or were highly acculturated, having
spent several years in England or the United States or Canada.

This picture is unexpected first because in Jamaica, a major sugar producing
country, rum is relatively cheap; and second, because it is in marked
contrast with what we know of most other Caribbean islands. For example,
annual returns indicate some 47% of admissions to mental hospital in Nassau
and 53% in Martinique are alcohol-linked [ 1] . Murphy and Sam-path [ 6]
found 50% of admissions in St. Thomas (to general hospital psychiatric unit
in an area without a mental hospital) were related to alcohol use. These
figures may be compared to Chafetz's [ 3] estimate of 30% alcohol-linked
admissions to American mental hospitals and 40 % to mental hospitals in
Santiago, Chile [ 4] . Although many of these statistics are approximate,
such a gross contrast with Jamaica's 2 % of alcohol-linked admissions calls
for some attempt at explanation. The hypothesis we wish to explore here is
one that has already been hinted at by Beaubrun [ 2] . In his pioneer field
survey of alcohol consumption in five Kingston suburbs, he found that heavy
drinking was more prevalent in higher income groups. He suggested that for
low-income groups "... ganja (marihuana) smoking is widespread ... and may
play a role as an alcohol substitute." Our hypothesis is that the use of
ganja as a euphoriant by low-income Jamaicans is a benevolent alternative to
alcohol and may protect them against the consequences of' alcohol
consumption - alcohol addiction, delirium tremens, chronic brain syndromes,
Korsakoff psychosis and physical sequelae such as cirrhosis of the liver.

Rest here:
http://www.unodc.org/unodc/bulletin/bulletin_1972-01-01_1_page002.html


-Sunil


-----Original Message-----
From: Social Determinants of Health [mailto:[log in to unmask]] On Behalf Of Adam
P. Coutts
Sent: Thursday, May 10, 2007 5:39 AM
To: [log in to unmask]
Subject: [SDOH] International examples of alcohol reduction strategies?

Dear List members,

I was wondering if anyone could direct me to successful or unsucessful 
examples of alcohol harm reduction strategies/interventions, i.e., to 
prevent binge drinking amongst certain segments of the population: 18-24 
years olds?

Best wishes,
Adam Coutts.

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