국가 중독예방관리 정책 및 서비스 전달체계 개발

보건복지부 정신건강정책과
가톨릭대학교 산학협력단

2012.12.

주관연구기관명:가톨릭대학교 산학협력단
책임연구원 :이 해 국
연 구 원 :정 슬 기
연 구 원 :조 근 호
연 구 원 :최 삼 욱
연 구 원 :김 현 수
연 구 원 :이 인 혜
연 구 원 :이 형 초
연구보조원 :이 보 혜
연구보조원 :김 지 은

자문위원 명단

총괄
김정훈 (연세대학교 의과대학 생리학과)
서정석 (건국대학교 의과대학 정신건강의학과)

알코올
김광기 (인제대학교대학원)
기선완 (가톨릭대학교 인천성모병원)
방형애 (대한보건협회)
오홍석 (용인정신병원)
윤명숙 (전북대학교 사회복지학과)
이계성 (국립서울병원)
천성수 (삼육대학교 보건관리학과)

마약
김계남 (한국마약퇴치운동본부)
박성수 (세명대학교 경찰행정학과)
조성남 (을지대학교 중독재활복지학과)
천영훈 (다사랑병원)

도박
김교헌 (충남대학교 심리학과)
신영철 (강북삼성병원 정신건강의학과)
우종민 (인제대학교 서울백병원 정신건강의학과)
전영민 (경기 도박중독예방치유센터)
한창우 (계요의료재단 계요병원 정신건강의학과)

인터넷 윤홍균 (온세병원)

목 차
PART Ⅰ.중독 국가종합대책 총론
Ⅰ.추진배경 ······································································
1.중독 문제현황 ··························································································
2.개입현황과 문제점 ·················································································
3.4대 중독별 개입현황 및 문제점 요약 ··············································
Ⅱ.국가종합대책의 구성 ···············································
Ⅲ.추진전략 및 개발모델 ·············································
1.중독 국가종합대책 추진전략 ·······························································
2.중독 국가종합대책 개발 모델 ·····························································
3.수준별 중독개입 및 관리체계 구축 ··················································
4.4대 중독 국가 거버넌스 구축 ·····························································
Ⅳ.4대 중독 국가종합대책 ···········································
1.4대 중독 중독국가종합대책
·································································
2.4대 중독 개입현황 및 개선방향 ·························································
3.정책영역별 종합대책 ·············································································
4.주요 대책 요약 ························································································
<부 록 1>중독의 정의 ··················································································
<부 록 2>중독이 뇌에 미치는 영향 ·························································
PART Ⅱ.각 중독별 국가종합대책
Ⅰ.알코올 ··········································································
제1장.문제정의 ····························································································
제2장.문제현황 ····························································································
제3장.개입현황 및 문제점 ·······································································
제4장.종합대책 추진모델 ·········································································
제5장.국가종합대책 ···················································································
Ⅱ.마약 ··············································································
제1장.문제정의 ····························································································
제2장.문제현황 ····························································································
제3장.개입현황 및 문제점 ·······································································
제4장.종합대책 추진모델 ·········································································
제5장.국가종합대책 ···················································································
Ⅲ.도박 ··············································································
제1장.문제정의 ····························································································
제2장.문제현황 ····························································································
제3장.개입현황 및 문제점 ·······································································
제4장.종합대책 추진모델 ·········································································
제5장.국가종합대책 ···················································································
Ⅳ.인터넷 ··········································································
제1장.문제정의 ····························································································
제2장.문제현황 ····························································································
제3장.개입현황 및 문제점 ·······································································
제4장.종합대책 추진모델 ·········································································
제5장.국가종합대책 ···················································································
<부록 3>자문위원 명단 ·············································································
<표 목차>
표14대 중독의 중독자 수와 사회적비용
············································································2
표2범부처 협력 구조의 문제점·························································································10
표3각종 사행산업 관련 법령 및 주관부서
········································································10
표4우리나라 알코올규제정책 및 관련법
········································································11
표5중독분야별 관리현황 ····································································································11
표9마약류 중독자 치료보호 의뢰 실적
(2003~2011).··················································22
표10대상문제의 규모와 특성
······························································································32
표11개입의 강도에 따른 서비스 내용과 담당기관
························································33
표12각 부처별 역할 ············································································································36
표13정신장애 일년유병율 및 추정환자 수
······································································70
표14남편의 음주정도별 아내폭력발생률
··········································································74
표15국민건강증진법 시행령 제10조(별표1)주류광고의 제한기준 ······························77
표16현행 소매면허의 종류 및 사업범위
··········································································79
표17알코올 치료 수강명령 부과현황
················································································85
표18정신장애군별 정신의료서비스*이용비율
·································································87
표19파랑새플랜 2010목표와 추진실적 비교
··································································88
표20알코올 사업관련 예산현황
··························································································89
표21우리나라의 알코올규제정책 및 관련법
····································································90
표22마약류 물질에 대한 법률 규정
················································································131
표23생리적 작용에 따른 마약류 물질 분류
··································································132
표24의학적 용도에 따른 마약류 물질의 분류
······························································132
표25최근 3년간 향정류의 취급,보관등과 관련된 의료기관의 처분 내역 ·············138
표26연도별 마약류 사범의 재발율
··················································································144
표27마약류 중독에 의한 사회적 비용
············································································144
표282010년 이후 마약류 관리 실태 조사 결과 (식약청)············································147
표29마약류 폐해 및 치료보호 관련 보건복지부 2011~2012년 홍보 예산 ··············149
표30마약류 중독자 치료보호 의뢰 실적
(2003~2011).················································155
표31재활교육조건부 기소유예프로그램 현황 (2009~2011)·········································157
표32마약류 중독자 치료 감호 현황
················································································159
표33보호관찰소 수강명령 프로그램 운영 현황
····························································160
표34도박중독 수준 및 분류 통합기준표(사행산업통합감독위원회,2009,2011)····189
표35도박중독의 공존병리 유병률에 관한 11개 연구 메타분석(‘98~’10)·················192
표36도박중독의 사회·경제적 비용 추이
·······································································193
표37경제지표별 순매출 비중 비교(2008년
기준)··························································198
표38문화체육부 소관 사행산업 총량 초과액 현황
····················································200
표392011년 사행산업 업종별 매출 총량 준수여부
····················································200
표40장외발매소 이용객의 한 달/하루 평균 지출금액과 도박중독 수준 ················201
표41사행산업 이용실태 종합표
························································································204
표42연도별 도박 관련 질병 진료현황
············································································211
표432007년 대비 2011년 도박 관련 질병 진료 증감 현황 ········································211
표44병적도박 진료 현황 ····································································································212
표45건강보험료 분위별 도박 관련 질병의 진료현황
··················································212
표46영업정지 및 영업장 폐쇄에 관한 제재 조치 예정안 ··········································221
표47인터넷 중독으로 인한 행동 특성
············································································251
표48인터넷 중독에 따른 학습 기회 손실의 사회적 비용 ··········································255
표492008년 사이버범죄 발생현황(건)··············································································257
표50게임물 등급 분류 기준
······························································································262
<그림 목차>
그림1알코올사용에 의한 정신행동장애(F10)로 인한 진료실인원 ·································7
그림2알코올사용에 의한 정신행동장애(F10)로 인한 진료비 ·········································7
그림3병적도박(F63.0.)으로 인한 진료실인원
·····································································8
그림4병적도박(F63.0.)으로 인한 진료비
·············································································8
그림5중독 개입의 문제점 ······································································································9
그림6사행산업 이용객 추이 ································································································12
그림7국가중독종합대책의 구성
··························································································25
그림84대중독의 개발모델 ····································································································31
그림9중독문제 중증도에 따른 수준별 치료개입의 강도와 개입기관 ························32
그림10음주로 인한 폐해의 모형(Boboretal.,2010)·····················································62
그림112006-2010년 주류출고량(수입분
포함)··································································64
그림12국가별 고위험음주율 비교
······················································································65
그림13월간음주율 추이 ········································································································65
그림14청소년 위험음주율 추이
··························································································66
그림15청소년의 평생음주경험율 및 월간음주율
····························································67
그림1620대와 30대의 고위험음주율 추이
········································································68
그림17음주관련질환의 총 진료비 지출현황
····································································69
그림18국가별 알코올사용장애유병율 비교
······································································69
그림19음주관련 사망률 추이
····························································································70
그림20음주로 인한 사회경제적 비용 추이
······································································71
그림21음주운전 교통사고 발생건수 및 사망자수
··························································72
그림22음주관련 강간 및 강제추행 등 성범죄 현황
······················································72
그림23공공장소 모니터링 결과
··························································································80
·················································140
그림25국가별 도박중독 유병률 비교(2010년,CPGI기준)·········································190
그림26일반인과 이용객의 시계열적 유병률 비교
························································191
그림276대 사행산업에서 국민이 잃은 금액의 연간 추이 ··········································193
그림28연간 원정도박 지출규모
(사감위,2011)·····························································194
그림29강원지역 자살자 수 시계열적 비교
····································································196
그림30불법 사행산업 규모 추정
····················································································203
그림31인터넷 중독의 유병율
····························································································253
그림32연도별 대상별 인터넷 중독률
··············································································253