A socio-cultural view of trends in drug use indicators.

Abstract

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 and the annual change is often used as a performance measure of policy efficacy, but the true costs of drug abuse can be understood more clearly 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 long-standing interest researching the underlying social processes behind drug use trends, 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 paper. 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. 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. [1] Caulkins J., Kilmer B., Reuter P., Midgette G. Cocaine's fall and marijuana's rise: questions and insights based on new estimates of consumption and expenditures in US drug markets. Addiction 2015; 110: 728-36. Language: en