A socio-cultural view of trends in drug use indicators.
A socio-cultural view of trends in drug use indicators.
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对吸毒指标趋势的社会文化观点。
DOI：
10.1111/add.12813
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发表时间：
2015
期刊：
影响因子：
--
通讯作者：
Bennett,AlexS
中科院分区：
文献类型：
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作者：
Golub,Andrew;Elliott,Luther;Bennett,AlexS
正如Caulkins等人所指出的那样，非法药物使用的普遍程度经常被视为国家毒品问题规模的总体指标[例2]，年度变化经常被用作政策有效性的绩效衡量标准，但通过检查更丰富的指数集，可以更好地理解药物滥用的真实成本。为此目的，他们计算并审查了四种非法药物的长期使用者人数和其他综合措施。我们对研究药物使用趋势背后的潜在社会过程有着长期的兴趣，并从这个角度阅读了Caulkins等人的最新贡献。我们对发现慢性可卡因使用者的流行率从2008年开始持续下降感到特别兴奋。然而，这个好消息必须与更充分地考虑其他药物相调和，包括Caulkins等人指出的慢性海洛因使用的适度增加，以及他们的文章中未讨论的处方阿片类药物的广泛滥用。随着越来越多的个人和政府机构改变了他们对大麻的医疗功效和娱乐用途安全性的理解，报告中频繁使用大麻的人数增加的解释就更加复杂了。因此，对于大麻的使用甚至频繁使用是否一定是公共健康问题，存在分歧。显然，这将是一个需要进一步研究和对话的话题。我们的工作建立在研究传统的基础上，即发现药物使用趋势往往会形成流行病。我们发现毒品流行通常会经历四个不同的阶段：潜伏期、扩张期、平稳期和衰退期。孵育阶段通常从参与特定社会环境（如下班后俱乐部、嘻哈运动或锐舞）的高度有限的亚群体中开始使用。在扩大阶段，先驱者将这种做法介绍给更广泛的人群，从而呈指数级传播。稳定广泛使用的平台期出现在每个面临新药实践风险最大的人已经开始使用或至少有机会这样做的时候。在此期间，
As Caulkins et al.[1] note, the prevalence of illegal drug use is often cast as an overall indicator of the size of the national drug problem [eg 2], the annual change is often used as a performance measure of policy efficacy, but the true costs of drug abuse can be better understood by examining a richer set of indices. To this end, they calculated and examined the number of chronic users and other aggregate measures for four illegal drugs. We have had a longstanding interest researching the underlying social processes behind drug use trends [3] and read Caulkins et al.’s latest contribution from this perspective. We are especially excited about the finding of a sustained decline in the prevalence of chronic cocaine users starting in 2008. However, this good news must be tempered with fuller consideration of other drugs including the modest increase in chronic heroin use as indicated by Caulkins et al. and the widespread misuse of prescription opioids not discussed in their article. The increase in frequent marijuana users reported is more complex to interpret, as more individuals and government agencies shift their understanding of marijuana’s medical efficacy and safety for recreational use [4]. Thus, there is disagreement as to the extent that marijuana use and even frequent use is necessarily a public health concern. Clearly, this will be a topic of much further research and dialogue.Our work builds on the research tradition that finds drug use trends tend to form epidemics [5]. We have found drug epidemics typically pass through four distinct phases: incubation, expansion, plateau and decline. The incubation phase typically starts with use among a highly limited subpopulation participating in a specific social context such as after-hours clubs, the hip-hop movement, or raves. During the expansion phase, the pioneering drug users introduce the practice to the broader population where it spreads exponentially. The plateau phase of steady widespread use appears when everyone most at risk of the new drug practice either has initiated use or at least had the opportunity to do so. During this period,