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showed: 'high school level and pretentious'. Andnothing more.

However in my opinion the gap in communi-cation involves other factors besides language. Atleast in Brazil, researchers rather prefer to quotenon Latin American literature (Calil & Carlini,1985). Thus, I am not particularly enthusiasticabout the suggestion by Caetano of a LatinAmerican journal of studies on alcohol. Perhapssome Latin Americanists will read it and amongthem those interested in alcohol. My colleagues'experiences as well as my own, with publications inthe journal Acta Psiquiatrica y Psicologica deAmerica Latina show that their communicationvalue as measured either through reprint requests orquotations is nil.

An imponant point raised by Caetano is thatrealities such as poverty, illiteracy, malnutrition andan (unpayable) external debt must be taken intoaccount when alcohol research in Latin Americancountries are being discussed. I would only add theneed to consider the importance of discussingproblems due to coexistence within the same societyof large and sophisticated technological (local orimported) resources in some places and extremelack of both in others. This describes the situation inBrazil including the alcohol field, as reflected by themost luxurious private clinics as compared todestituted state services. The common denominatorbeing that none is able to provide treatmentevaluation data.

Summing up, in the sense considered by Caetano,that is epidemiological research, it may well be thatthe cup is half full. However, considering researchas a whole, encompassing basic and clinical work, atleast for Brazil the cup is still half empty.

JANDIRA MASUR

Departmento de Psicobiologia,Escola Paulista de MedicinaC.P. 20399,04034 Sao Paulo-SP,Brazil

ANDRADE, A. G. , BERNIK, M . A., BRUNFENTRINKER, P. &NEGRO JR., J. (1988) Dados de confiabilidade sobre umaentrevista semi-estmturada para avalia9ao de tratamen-tos de alcoolistas: escala de severidade de alcolismo

(EAS), Revista da AssociafSo Brasileira de Psiquia-tria/Associafdo Psiquiatrica de la America Latina, 10,pp. 1-4.

CALIL, H . M . & CARLINI, E . A. (1985) BiologicalPsychiatry in Latin America, Proceedings of the IVthWorld Congress of Biological Psychiatry, Philadelphia,Pennsylvania, 8-13 September (New York, Blsevier).

CARLINI, B . H . , PIRES, M . L . N . , FERNANDES, R. & MASVR,J. (1986) Alcohol use among adolescents in Sao Paulo,Brazil, Drug and Alcohol Dependence, 18, pp. 235-246.

MASUR, J., DEL-PORTO, J. A., SHIRAKAWA, A. J. M. &GATTAZ, D . (1981) Nonmedical treatment of alcohol-ism with emetic drugs and disulfiram in Brazil, Journalof Studies on Alcohol, 42, pp. 814-817.

MASUR, J. & JORGE, M . R. (1985) Alcohol-related data inBrazil: a review. Presented at the meeting on: AlcoholUse in Latin America: cultural realities and policyimplications. Brown University, Providence, RhodeIsland, 11-12, October.

MOLL, J. K. & NARIM, F . (1977) Characterization of thealcohol research literature. Journal of Studies on Alco-hol, 38, pp. 2165-2180.

SANCHEZ-CRAIG, M . (1986) The hitchhikers' guide toalcohol treatment, British Journal of Addiction, 81, pp.597-560.

SANTANA, V. S. & ALMEIDA FILHO, N . (1987) PrevaWnciade alcoolismo e consumo de alcool em um bairro deSalvador I. Varidveis demograficas, Revista Brasileira deSaude Mental, 1, pp. 7-17.

Alcohol Research and the Realities of LatinAmericaProm Dr Eduardo Medina (Ministry of Health ofChile)This editorial emphasizes two important points, firstabout the pessimistic attitudes of researchers fromdeveloping countries when they attend specializedmeetings with colleagues from developed ones, andsecond on the increasing quality that has beencharacterizing epidemiological and sociocultural in-vestigations in Latin America.

I too had the opportunity of participating inthe two meetings that Raul Caetano relates, and Iagree with him about that on such ocassions, wheninvestigators from developed and developing coun-tries get together, shortcomings are easier identifiedthan achievements, because reports of the formerkinds of colleagues are inevitably transformed in theframe of reference of the latter. But there is anotherpoint which is important to add in this respect,about common labor circumstances of the resear-cher in developing countries: he or she frequentlyneeds to overburden himself with public and privateclinical or educational daily journeys in comparisonwith the parallel worker in the developed world,who usually can work full time in research. It isimportant to consider the difference in resources as

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well as the different amount of personal time. Thissituation will obviously be reflected in distinctquality average of papers from each type of country.

So, it is doubly interesting that Latin Americancountries have been able to maintain during aconsiderable period some path of investigation onalcoholism and other addictions, not only in epide-miological but also in sociocultural aspects. DrCaetano offers some very valid reasons for thistradition, but it is possible to add others. First, awider perspective on Public Health conditions ofeach investigator's own country, in comparison withthe much more specialized clinical orientation whichwas common in the 6O's. Second, the usual contribu-tion of psychologists and social scientists to healthteams, and the frequent fact of a number of healthprofessionalists who have done postgraduate inter-disciplinary studies. Third, an increasingly national-istic awareness of the important role of investiga-tors, carrying out their inquiries inside their respec-tive national boundaries and going beyond thecommon use of foreign paradigms. Finally, theapplication of social sciences in the analysis not onlyof common public health activities but also to thenature of health institutions; as a corollary, the usualmedical models are questioned and discussed both interms of their effectiveness and ideological assump-tions.

When the Latin American panorama on alcohol-ism over the last four decades is observed, someinevitable scepticism appears. A lot of efforts andresources have been oriented to prevention, treat-ment and rehabilitation, but alcohol-related prob-lems seem not to improve. What are some of thehidden explanations about these dynamics? Maybethe excess of alcohol supply, the low price ofalcoholic beverages, the lack of effective controls onsales and advertisement, the clandestine productionor, as Raul Caetano points out, a series of chararac-teristics associated with the underdeveloped condi-tion. But this situation can be analysed from areverse perspective. Alcohol and other drugs con-sumption can be seen as combining with socialmarginality, not as cause or consequence, but as aninadequate and possibly destructive manner ofgetting some form of individual satisfaction forimportant groups of our populations in the midst ofso many needs and problems. If this is true, theclassic inverse relationship between abnormal con-sumption and socioeconomic level would be thereflection of deep lacks and wants which we canscarcely imagine but we must try to understand.Here we have a completely unexplored field, whose

answers we need to find out by investigations insideour respective countries.

Latin America is a special and fascinating world,not only for its dimensions but also for its compo-sition. Despite language barriers with the developedworld, as Dr Caetano suggests, it is important topersuade researchers in rich countries as to thenecessity of their being alert to the significance ofour reality. Then we will be sure about the cup beingmore than half full.

EDUARDO MEDINA

Psychiatrist,Master in Social Anthropology,Mental Health Advisor,Ministry of Health of ChileBlaise Cendrars 6736,Santiago 10, Chile

Alcohol Research in Latin America: a cupwhich is bubblingFrom Enrique Madrigal Segura (Pan-AmericanHealth Organization, Washington)It is indeed most welcome that Dr Caetano hasundertaken the task of reviewing in a reflectivefashion, without abandoning his usual well docu-mented sources, some important aspects related toalcohol research in Latin America. I may stilldisagree with his assertion that the InteramericanWorkshop on Legislative Approaches for the Pre-vention of Alcohol Related Problems, organized bythe Institute of Medicine in June 1982 in Washing-ton D.C., dealt with those aspects of research thatmay be deemed as characteristic of the relevantresearch endeavor in Latin America, as it may bewrongly inferred.

Dr Dwight Heath, for example, has been quitecritical about this workshop, due to his allegationthat it missed the purpose of translating relevantinsights brought up by research advisors into cogentrecommendations on alcohol policy making, as wasinferred by the caption of the ensuing report. Hispaper on Latin American Studies published inAugust 1987, gives the reader a good review of thestate of research in some Latin American countries,but it is not representative of the region for obviousreasons such as the absense of important key figuresat that meeting.

It is work mentioning that there had not beenadvisory meetings on alcohol research in the Regionof the Americas since the late sixties in San Jose,Costa Rica, when Drs Adis, Marconi, Mariategui