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Child and adolescent mental health
Assessing the European impact of alcohol misuse and illicit drug dependence research: clinical practice guidelines and evidence-base policy
  1. Elena Pallari1,2,
  2. Tayana Soukup2,
  3. Andri Kyriacou3,
  4. Grant Lewison4
  1. 1 Medical Research Council Clinical Trials Unit, University College London, London, UK
  2. 2 Department of Health Service and Population Research, King’s College London, London, UK
  3. 3 Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
  4. 4 Cancer Studies, King’s College London, London, UK
  1. Correspondence to Elena Pallari, MRC Clinical Trials Unit at UCL, London WC1V 6LJ, UK; elena.pallari{at}


Background Despite alcohol and illicit drug dependence being one of the most common diagnoses in Europe, there is heterogeneity of research evidence used in policy and practice.

Objective We sought to (1) evaluate European research outputs on alcohol misuse and drug addiction in 2002–2018 in the Web of Science, (2) compare these with their burden of disease and (3) determine their impact in several ways.

Methods A bibliometric research was undertaken including an assessment of the citation counts, the influence of research on members of national health advisory committees, and their contribution to the evidence base of clinical practice guidelines (CPGs).

Findings There were 3201 analysed references cited in 28 CPGs across 11 European Countries on alcohol misuse and illicit drug abuse. Research conducted in the USA dominated both sets of CPGs, while many European countries were overcited relative to their research presence. The illicit drug research appeared to be adequate relative to the evidence of harm in Europe. However, alcohol misuse research appeared grossly inadequate to the harm it causes by a factor of 20.

Conclusions The volume of research on illicit drug addiction is commensurate to the European burden, whereas alcohol misuse is far below what is needed to curb a significant source of harm.

Clinical implications The research asymmetries call for attention to the causes of the problem. Development of research-based solutions to a serious social harm is needed, including minimum pricing and collaborative work to harmonise efforts on disease management and treatment practices across European countries.

  • clinical practice guidelines
  • illicit drug dependence
  • alcohol misuse
  • research
  • Europe
  • impact

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  • Contributors EP carried out the main analyses of the impacts of the research and drafted the paper. TS provided the policy-context. AK provided the background context and GL had overall responsibility for the study. All authors take accountability for the submitted work.

  • Funding .EP is supported by the Medical Research Council. TS was supported by the JDRF and the Wellcome Trust. Specific funding for this work was provided under the European Commission project EC/FP7/602536. GL was supported by the UK Research and Innovation GCRF RESEARCH FOR HEALTH IN CONFLICT (R4HC-MENA); developing capability, partnerships and research in the Middle and Near East (MENA) ES/P010962/1

  • Disclaimer The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health. None of the funding sources had any role in the study design, data collection, analysis or interpretation of the data and preparation of, or decision to publish, the manuscript.

  • Competing interests There are no conflicts of interest.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available in a public, open access repository. All data relevant to the study are included in the article or uploaded as supplementary information.