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date: 16 July 2019

Abstract and Keywords

This chapter examines ethical principles that guide public health intervention to reduce the harms of alcohol and other drugs, including justice-based concerns regarding intervention. While many egalitarian moral theories support public health measures to reduce these harms, and thereby protect individual capability and opportunity, there are opposing arguments to limit public health intervention based on either individual liberty or personal responsibility. The chapter also reviews ethical issues related to prevention, treatment, harm reduction, and decriminalization/legalization. Prevention through education is politically appealing, but is not always evidence-based and can be stigmatizing. Treatment can be highly cost-effective, but some approaches are controversial, such as legally coerced treatment. Harm reduction approaches, such as needle exchange, can reduce many of the negative health consequences of alcohol and drug use, but they require a more direct government role in illicit behaviors. Marijuana legalization is a growing movement in the United States, but it poses complex regulatory challenges.

Keywords: alcohol and other drugs, public health ethics, justice, treatment, prevention, harm reduction, decriminalization, public health intervention, personal responsibility, needle exchange, marijuana legalization

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