Dear Editor,

I read with interest your article "Public Health Tackles Emerging Diseases" [Spring/Summer 2004]. Indeed, I read with interest most editions of Northwest Public Health and commend the efforts of all contributors.

I'm writing you, today, because of a question/comment I have. It is my opinion that one of the greatest public health issues facing our state has to do with the issues around chemical dependency. I realize I'm not familiar with hard data to support this contention, but if I'm correct, the fact that the issue is discussed rather uncommonly in public health circles is striking. In the past I've been aware of educational efforts toward nicotine dependency and secondhand smoke. Also, I recall some educational efforts regarding driving while under the influence of alcohol.

My overall impression is that the chemical dependency problem appears to be almost entirely off of the public health radar screen. I recognize that this is an area of health where, historically, public health has played a minor role. If, however, I am correct as to the enormity of the public health consequences, why is there amongst us such little study and discussion of the problem?

James K. Rotchford, MD, MPH
Port Townsend, Washington