An analytical focus on drugs per se is a simplification necessary for clarity, brevity, and efficiency in the present task of informing the scientific agendas of research agencies specifically concerned with prevention.
It is beyond the scope of this report to deal with all the complexities of the drug problem we take it as a cardinal point of reference, however, that issues of morality, health, crime, and economics are inextricably linked to both the perception and the reality of the problem. They complicate-and are complicated by-other major concerns such as the rising costs of health care, the AIDS epidemic, racial divisions, and violent crime. Their significance is compounded by the fact that drug problems do not stand alone. Regardless of the priority that the public, political leaders, and the media attach to drug problems at particular points in time, drugs are unquestionably a significant social problem for the United States in the 1990s. Concerns about criminal enterprises and moral commitments, fear of an uncertain future, and promotions broadcast by industrial advertisers and political activists compete powerfully with clinical observations and epidemiologic estimates in guiding the hand of prevention research and practice. But present hazards to public health are not necessarily the values lodged uppermost in the public account. Students of public health are acutely aware that the premature mortality, epidemiologic sequelae, and economic costs of illness presently associated with alcohol or tobacco separately greatly outweigh the comparable measures for cocaine, heroin, and all other drugs combined (Harwood et al., 1984 Rice et al., 1990). The subsequent focus on the war in the Persian Gulf, the disintegration of the Soviet empire, economic concerns, and presidential politics resulted in even lower rankings of the drug problem. Perceptions about public issues are volatile, often affected by such factors as political campaigning, presidential initiatives, and competing dramatic events in the media (Rogers, 1983) these, far more than the prosaic conditions of everyday life, determine the perception of "America's number one problem." Thus, by July 1990, less than a year after 64 percent of the public had rated drugs as the number one problem, only 10 percent rated it that high ( New York Times, 1990). The rise and fall of public preoccupation with drugs correlate in complex ways with shifts in patterns and levels of drug use (Duster, 1970 Lidz and Walker, 1980 Courtwright, 1992). As one measure of importance attached to this issue, in fiscal 1992 the federal government spent $12 billion on antidrug efforts, and state and local agencies together spent roughly the same amount (White House, 1992). Respondents to such surveys during that period typically rated crime and AIDS as the number two and number three problems-both of which are associated with drugs. After President George Bush's televised address in September 1989 (his first as President) on a national drug control strategy, 64 percent of respondents to a New York Times-CBS poll rated drugs as the nation's number one problem ( New York Times, 1990). The 1980s saw the emergence of cocaine, particularly crack cocaine, as a new focus of concern. In 1971, President Nixon called drugs, especially heroin, America's public enemy number one. It is a serious and many-faceted problem" (President's Advisory Commission on Narcotics and Drug Abuse, 1963:1). In the early 1960s, a presidential commission stated: ''The concern and the distress of the American people over the national problem of drug abuse is expressed every day in the newspapers, the magazines, scientific journals, public forums and in the home. The use of illegal drugs has been a long-standing problem in American society, a problem that has taken on a particular urgency in the last 30 years.
0 kommentar(er)
