Drug abuse epidemiology: an overview*

The field of drug abuse epidemiology is a relatively new one and recognition of drug abuse as a phenomenon amenable to study within the field of epidemiology is still forthcoming. Reviews of programmes for meetings of epidemiologic research societies rarely highlight drug abuse, even in association with the transmission of, human immunodeficiency virus (HIV), hepatitis C virus (HCV) or hepatitis B virus (HBV), despite the high rates of prevalence of those infections among drug-abusing populations. The “diagnosis” of drug dependence or addiction and identification of affected populations relies heavily on data concerning problems associated with drug abuse. Both the Diagnostic and Statistical Manual and the International Classification of Diseases, for example, use behavioural criteria to define abuse and dependence. However, most surveys of general and special populations do not include measures that reflect these criteria, but limit themselves to the type of drug used and the frequency of use within a specified time period. With the progress in the development of more biological and medical tools, improved measures of abuse that combine both behavioural and physical assessments will be available to study more carefully the various forms of drug abuse and dependence. The present article has two purposes. The first is to set a framework that describes the current state of the field of drug abuse epidemiology. The second is to provide a synthesis and overview of the articles in the present issue and in vol. LV, Nos. 1 and 2 (2003), of the Bulletin, which represent work from several countries. The excitement of this emergent field is reflected in each of the articles. The study of drug abuse epidemiology is both challenging and rewarding. As more groups become aware of the global nature of this public health problem and its impact on the political, social and health situations of communities, countries and regions, we hope that drug abuse epidemiology will receive the attention it deserves by policy makers, researchers and, in particular, newly trained social scientists and epidemiologists.