Suchergebnisse

Drug abuse hit the national headlines during the last half of the 1960s. By 1971 it had become "public enemy number one" and an all-out war was declared. Although there were a few notable successes—including one temporary triumph which was prematurely labeled a victory in 1973—by 1977 it had become clear that this war, like the War in Vietnam and the War Against Poverty, was not to be won. A new objective, more in keeping with the skepticism of the 1970s, was indeed needed. Drug abuse prevention was not like waging a war; it was like weeding a graden. The question remained, "What crop was to be harvested in the 1980s?"

A central task in a study of occasional, moderate, and stable nonmedical drug use was to distinguish such "controlled" use from destructive using patterns. A search of the literature revealed the lack of objective and precise definitions of drug abuse and the extent to which this had hampered efforts at treatment, prevention, and research. Popular conceptions of abuse ignored the variability of drug-using styles and tended to reflect the social acceptability of various drugs and Puritanical values. Purportedly scientific definitions, including those of the World Health Organization, proved vague, inconsistent, and culturally biased. Users' self-evaluation of their drug-taking and quantitative measures also proved inadequate. Given these difficulties, we conclude that "drug abuse" and similar terms should be replaced by more accurate descriptions of the actual drug-using situation and, if possible, illustrated with case material.

The stereotypic view of the drug addict as a ne'erdo-well who cannot cope with the real world is challenged and a "career" model explicated. The similarities of drug careers to professional careers, particularly those of physicians, are noted. The analysis also delineates the developmental stages of the drug career: initiation, escalation, maintenance, discontinuation and renewal. More positive approaches to the prevention of substance abuse are recommended.