Developments in the epidemiology of drug use and drug use disorders
Developments in the epidemiology of drug use and drug use disorders
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DOI：
10.1176/appi.ajp.162.8.1494
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发表时间：
2005-08-01
影响因子：
17.7
通讯作者：
Colliver, JD
中科院分区：
文献类型：
--
作者：
Compton, WM;Thomas, YF;Colliver, JD
过去30年来，对吸毒、吸毒障碍和艾滋病毒等相关疾病的流行病学研究为了解这些疾病提供了重要的信息。毒品使用在1970年代后期达到高峰，在1980年代下降，在1990年代增加，在过去几年中保持稳定。在这一广泛的格局中，查明并追踪了快克可卡因、苯丙胺、俱乐部毒品（如摇头丸）、海洛因和处方类阿片的特定流行病以及与之相关的艾滋病毒和其他传染病的流行病。除了在监测方面取得的重大成就外，药物使用和药物使用障碍的流行病学传统上侧重于识别个人（遗传因素，高危行为），家庭（虐待儿童），邻里（药物的高可用性）和社会（政策和法律）水平的风险因素，作为影响领域，而不是相互关联的过程的组成部分。研究包括仔细的横向和纵向观察研究以及临床流行病学实验，其中预防干预措施测试特定的病因学理论。在这一背景下，吸毒和吸毒病症流行病学的下一个挑战将是通过使用多层次方法将个人脆弱性与具体环境因素联系起来。例如，有哪些环境因素与个人的脆弱性相互作用，造成吸毒成瘾和艾滋病毒等毒品后果？遗传流行病学的研究表明，遗传和环境因素的相互作用的研究的潜力。该领域需要专注于将科学与流行病学联系起来，以便在理解这些复杂的健康状况方面取得进展。
The past 30 years of research on the epidemiology of drug use, drug use disorders, and related conditions, such as HIV, has provided major insight into these conditions. Drug use peaked in the late 1970s, decreased across the 1980s, increased in the 1990s, and has remained stable during the past few years. Within this broad pattern, specific epidemics of crack cocaine, amphetamines, club drugs (such as Ecstasy), heroin, and prescription opioids and associated epidemics of HIV and other infectious diseases have been identified and tracked. Besides major accomplishments in surveillance, the epidemiology of drug use and drug use disorders has traditionally focused on identifying risk factors at the individual (genetic factors, high-risk behaviors), family (child abuse), neighborhood (high availability of drugs), and societal (policies and laws) levels as domains of influence, not as components of interrelated processes. Research includes careful cross-sectional and longitudinal observational studies as well as clinical epidemiological experiments in which prevention interventions test specific etiological theories. Building on this background, the next challenges for the epidemiology of drug use and drug use disorders will be to link individual vulnerabilities with specific environmental factors by using multilevel methodological approaches. For example, what are the environmental factors that interact with individual vulnerabilities to produce drug addictions and drug consequences such as HIV? Research in genetic epidemiology has demonstrated the potential for studies of interactions of genetic and environmental factors. The field needs to focus on linking science with epidemiology to make progress in understanding these complex health conditions.