According to estimates of the Global Burden of Disease and Injury Study from 2010, alcohol is fifth out of a total of 67 evaluated risk factors. Alcohol consumption is responsible worldwide for 2.7 million deaths and 3.9 % of all disability adjusted life years (DALY) (Lim et al., 2012).


Globally, tobacco use, including passive smoking is the second highest risk factor, after high blood pressure, for premature death and the loss of healthy life years due to death, disease or impairment. In industrialised countries, tobacco is the leading risk factor (Lim et al., 2012).

Illicit drugs

The use of illicit drugs is in eighteenth place worldwide in respect of the number of deaths and the loss of healthy life years out of a total of 67 risk factors examined (Lim et al., 2012).


In contrast to a dependence on drugs and alcohol, pharmaceutical dependence, which is often described as the "silent addiction", is hardly noticed in public. The problematic use of pharmaceuticals often represents an underestimated problem, in particular amongst older adults.


In Germany, 0.3-0.6% of adults fulfil the criteria of pathological gambling. A large proportion of pathological gamblers also exhibit comorbid mental disorders.


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