Suchergebnisse

The discipline of epidemiology utilizes the constructs of agent, host, vector, and environment to study the incidence and prevalence (i.e., the nature, extent, distribution, correlates) and the contexts, and consequences of drug abuse in the United States. This paper provides a selected review of the results of 40 years of epidemiological study of drug abuse using surveillance systems, general population surveys, ethnography and qualitative research approaches. It then addresses the challenges in conducting research on drug abuse epidemiology. The paper concludes with some missed opportunities and lessons learned in four decades of a large portfolio of research studies conducted by an impressive array of distinguished scientists.

Many of the papers in this theme issue originated as presentations at a conference entitled "Reflections on 40 Years of Drug Abuse Research." At the conference, leaders in the drug abuse field presented their work, as well as their visions and concerns for the future of drug abuse research, and many of those presentations are included as papers in this issue of the Journal of Drug Issues. At the end of the conference, and after hearing presentations from senior researchers in the field, several mid-career investigators were invited to reflect on the conference and on the field of drug abuse research at this time in its history. This brief article offers reactions to the conference, in terms of its meaning for the future of drug abuse research.

In 1962, Thomas Kuhn wrote "The Structure of Scientific Revolutions" and popularized the concept of "paradigm shift." Kuhn commented that scientific advancement is not evolutionary, but involves "a series of peaceful interludes punctuated by intellectually violent revolutions." It is during these revolutions that "one conceptual world is replaced by another." The presentations of the researchers at this conference represent the shifting paradigm of drug abuse research. The presentations at "40 Years of Drug Abuse" Research" will prompt future researchers to integrate the collective work of distinguished epidemiologists, ethnographers, neurobiologists, pharmacologists, as well as prevention, treatment, services, and policy researchers. As the next generation, we are called to use methods that are both transdisciplinary and translational. A transdisciplinary and translational future will require next generation drug abuse researchers to apply knowledge of basic science to prevention or treatment strategies.

Pesquisas reconhecem a presença de drogas psicotrópicas nas escolas e abuso dessas substâncias entre alunos. Apontam a necessidade de melhorar a formação de professores em prevenção ao consumo de drogas. Estudos demonstram que o contexto da sala se aula e a atuação do professor são elementos determinantes para assegurar o interesse e o entusiasmo na aprendizagem. O objetivo desse trabalho foi investigar se as atuais práticas docentes são apropriadas à demanda do abuso de drogas entre estudantes. Realizou-se uma intervenção pedagógica entre professoras (23) de educação básica fundamentada no método dialético: tese, antítese e síntese. No presente estudo, o planejamento e a estruturação da intervenção tiveram como foco criar um clima que viabilizasse a motivação para aprender dos professores participantes. Os resultados mostram que a construção de um ambiente de aprendizagem estimulante está associado à motivação de quem aprende. Além disso, sugerem que as propostas inconsistentes do início da intervenção foram se redefinindo até a formulação de propostas novas e adequadas ao contexto social, evidenciando articulação de conhecimentos sobre prevenção ao uso de drogas.

Objective: The purpose of this research was to evaluate the effectiveness of a comprehensive, strengths-based model of case management for clients in drug abuse treatment. Method: 503 volunteers from residential or intensive outpatient treatment were randomly assigned to one of three conditions of Iowa Case Management (ICM) plus treatment as usual (TAU), or to a fourth condition of TAU only. All were assessed at intake and followed at 3, 6, and 12 months. Results: Clients in all four conditions significantly decreased substance use by 3 months after intake and maintained most gains over time. However, the addition of ICM to TAU did not improve substance use outcomes. Conclusion: Overall, the addition of case management did not significantly improve drug treatment as hypothesized by both researchers and clinicians. Some results were mixed, possibly due to the heterogeneous sample, wide range of case management activities, or difficulty retaining participants over time.

AbstractDespite the significant cost of prescription (Rx) drug abuse and calls from policymakers for effective interventions, there is limited research on the effects of policies intended to limit such abuse. This study estimates the effects of prescription drug monitoring (PDMP) programs, which constitute a key policy targeting access to non‐medical use of Rx drugs. Based on objective indicators of abuse as measured by substance abuse treatment admissions and mortality related to Rx drugs, estimates do not suggest any substantial effects of instituting an operational PDMP. We find, however, that mandatory‐access provisions, which raised PDMP utilization rates by actually requiring providers to query the PDMP prior to prescribing a controlled drug, are significantly associated with a reduction in Rx drug abuse. The effects are driven primarily by a reduction in opioid abuse, generally strongest among young adults (ages 18 to 24), and underscore important dynamics in the policy response. Robustness checks are consistent with a causal interpretation of these effects. We also assess potential spillovers of mandatory PDMPs on the use of other illicit drugs and find a complementary reduction in admissions related to cocaine and marijuana abuse.

Substance abuse is marginalized both as an activity and as an area of study. Substance abuse research is a relatively new field, and in the early days faculty members engaging in such research found it difficult to obtain tenure track positions at universities. Funding for substance abuse study was limited, depending mainly on the National Institute on Drug Abuse for grants. This article describes one professor's role in the institutionalization of substance abuse research in academia and the benefits of a career in this field.

Over the past twenty-five years, tremendous progress has been made in the area of drug abuse prevention research. The accumulated findings from longitudinal studies of adolescents regarding the factors associated with vulnerability to the substance use and abuse and trends from national surveys of substance use showing their association to societal perceptions of the harmfulness resulting from the use of these substances have informed the development of effective innovative prevention strategies. The 1990s saw a reversal in the perception of the value and importance of drug abuse prevention research with recognition of the field's approach to intervention development and implementation and its scientific rigor in demonstrating intervention impact. This paper reflects on this history anticipating both the positive and negative aspects of the future for the field.