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[Harmful alcohol consumption: prevalence, trends, health burden, reduction strategy].

INTRODUCTION
Harmful alcohol consumption constitutes a significant cause of the global burden of disease, causing more than 200 different diseases, 5.9% of all deaths worldwide, causing substantial medical and social costs, major economic loss, slowing progress towards the strategic goals of human development.


THE AIM
to substantiate approaches to the formation of a national strategy to combat the harmful use of alcohol in Ukraine based on the analysis of the prevalence of alcohol consumption and related health and social problems and international experience and recommendations of WHO.


MATERIAL AND METHODS
The study was based on analysis of the extent and patterns of alcohol consumption in Ukraine, levels, structure and dynamics of morbidity and mortality from diseases associated with alcohol abuse; investigation of preventive activities in primary healthcare, the existing problems and doctors' needs for prevention alcohol abuse, national and international experience on this problem.This work usesbibliosemantic, medical, statistical, sociological, epidemiological methods. The information base are: European Health for All Database (HFA-DB)for 2000-2012,Center of Medical Statistics, Ministry of Health of Ukraine for 2000-2015, questionnaire survey of physicians in primary care, strategic and policy documents of WHO, WHO Regional Office for Europe.


RESULTS
In Ukraine, as in most countries in the WHO European Region prevalence of alcohol is high. In the ranking of the WHO European Region Ukraine ranks fifth in alcohol consumption per capita. The structure of consumption of alcoholic drinks is dominated by strong spirits (48%). There has been a negative trend for this indicator from 5.4 liters in 2002 to 15.6 liters in 2012.The dominant pattern of alcohol consumption is characterized by early onset of alcohol consumption, significant frequency, large doses, mostly strong alcohol beverages, with significant share of low-quality alcohol. This factor contributes to high levels of morbidity. A total of546.3 thousandpeople with mental and behavioral disorders due to use of psychoactive substances wereregistered in health care facilities in 2014. Standardized mortality rate from causes related to alcohol in Ukraine (185.4 per 100 thousand.) is one of the largest in Europe, with only Kazakhstan (308.4) and Belarus (187.9) being behind. Regular work aiming at prevention of alcohol abuse is carried out by 49.4% of primary care professionals; 21.3% of physiciansinsist on reducing alcohol use on occasion.


CONCLUSION
Alcohol abuse is a major factor of morbidity, epidemic of noncommunicable diseases in Ukraine, causing significant medical and social costs and economic losts.Ukraine ranks fifth in alcohol consumption per capita among WHO European Region countries. High level and unhealthy patterns of alcohol consumption in the population causes high morbidity and mortality from noncommunicable diseases, accidents, exceeding pan-European indices and indicators in the European Union. Primary health care facility staff has insufficient knowledge, skills and gaps in professional training regarding the prevention of harmful use of alcohol.There is a high need for effective strategies to reduce the prevalence of this risk factor in Ukraine. In developing the National Action Plan to reduce the harmful use of alcohol, a national context and WHO recommendationsshould be considered, including improving the efficiency of health services, high-quality prevention and effective treatment of disorders caused by alcohol, countermeasures on driving drunk, limiting the sale and availability of alcohol, prevention the spread of manufacturing and marketing of alcoholbeverages produced illegally, including falsification, the revitalization of local communities, weakening the impact of marketing of alcohol beverages.