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Mental, neurological, and substance use disorders are common, highly disabling, and associated with significant premature mortality. The impact of these disorders on the social and economic well-being of individuals, families, and societies is large, growing, and underestimated. Despite this burden, these disorders have been systematically neglected, particularly in low- and middle-income countries, with pitifully small contributions to scaling up cost-effective prevention and treatment strategies. Systematically compiling the substantial existing knowledge to address this inequity is the central goal of this volume. This evidence-base can help policy makers in resource-constrained settings as they prioritize programs and interventions to address these disorders.
Drug overdose, driven largely by overdose related to the use of opioids, is now the leading cause of unintentional injury death in the United States. The ongoing opioid crisis lies at the intersection of two public health challenges: reducing the burden of suffering from pain and containing the rising toll of the harms that can arise from the use of opioid medications. Chronic pain and opioid use disorder both represent complex human conditions affecting millions of Americans and causing untold disability and loss of function. In the context of the growing opioid problem, the U.S. Food and Drug Administration (FDA) launched an Opioids Action Plan in early 2016. As part of this plan, the FDA asked the National Academies of Sciences, Engineering, and Medicine to convene a committee to update the state of the science on pain research, care, and education and to identify actions the FDA and others can take to respond to the opioid epidemic, with a particular focus on informing FDA's development of a formal method for incorporating individual and societal considerations into its risk-benefit framework for opioid approval and monitoring.
The 2019 World Drug Report will include an updated overview of recent trends on production, trafficking and consumption of key illicit drugs. The Report contains a global overview of the baseline data and estimates on drug demand and supply and provides the reference point for information on the drug situation worldwide.
Heroin is universally considered the world's most harmful illegal drug. This is due not only to the damaging effects of the drug itself, but also to the spread of AIDS tied to its use. Burgeoning illegal mass consumption in the 1960s and 1970s has given rise to a global market for heroin and other opiates of nearly 16 million users. The production and trafficking of opiates have caused crime, disease, and social distress throughout the world, leading many nations to invest billions of dollars trying to suppress the industry. The failure of their efforts has become a central policy concern. Can the world heroin supply actually be cut, and with what consequences? The result of a five-year-long research project involving extensive fieldwork in six Asian countries, Colombia, and Turkey, this book is the first systematic analysis of the contemporary world heroin market, delving into its development and structure, its participants, and its socio-economic impact. It provides a sound and comprehensive empirical base for concluding that there is little opportunity to shrink the global supply of heroin in the long term, and explains why production is concentrated in a handful of countries--and is likely to remain that way. On the basis of these findings, the authors identify a key set of policy opportunities, largely local, and make suggestions for leveraging them. This book also offers new insights into market conditions in India, Tajikistan, and other countries that have been greatly harmed by the production and trafficking of illegal opiates. A deft integration of economics, sociology, history, and policy analysis, The World Heroin Market provides a rigorous and vital look into the complex--and resilient--global heroin trade.
Why do the vast majority of heroin users live in cities? In his provocative history of heroin in the United States, Eric C. Schneider explains what is distinctively urban about this undisputed king of underworld drugs. During the twentieth century, New York City was the nation's heroin capital—over half of all known addicts lived there, and underworld bosses like Vito Genovese, Nicky Barnes, and Frank Lucas used their international networks to import and distribute the drug to cities throughout the country, generating vast sums of capital in return. Schneider uncovers how New York, as the principal distribution hub, organized the global trade in heroin and sustained the subcultures that supported its use. Through interviews with former junkies and clinic workers and in-depth archival research, Schneider also chronicles the dramatically shifting demographic profile of heroin users. Originally popular among working-class whites in the 1920s, heroin became associated with jazz musicians and Beat writers in the 1940s. Musician Red Rodney called heroin the trademark of the bebop generation. "It was the thing that gave us membership in a unique club," he proclaimed. Smack takes readers through the typical haunts of heroin users—52nd Street jazz clubs, Times Square cafeterias, Chicago's South Side street corners—to explain how young people were initiated into the drug culture. Smack recounts the explosion of heroin use among middle-class young people in the 1960s and 1970s. It became the drug of choice among a wide swath of youth, from hippies in Haight-Ashbury and soldiers in Vietnam to punks on the Lower East Side. Panics over the drug led to the passage of increasingly severe legislation that entrapped heroin users in the criminal justice system without addressing the issues that led to its use in the first place. The book ends with a meditation on the evolution of the war on drugs and addresses why efforts to solve the drug problem must go beyond eliminating supply.
Drug abuse persists as one of the most costly and contentious problems on the nation's agenda. Pathways of Addiction meets the need for a clear and thoughtful national research agenda that will yield the greatest benefit from today's limited resources. The committee makes its recommendations within the public health framework and incorporates diverse fields of inquiry and a range of policy positions. It examines both the demand and supply aspects of drug abuse. Pathways of Addiction offers a fact-filled, highly readable examination of drug abuse issues in the United States, describing findings and outlining research needs in the areas of behavioral and neurobiological foundations of drug abuse. The book covers the epidemiology and etiology of drug abuse and discusses several of its most troubling health and social consequences, including HIV, violence, and harm to children. Pathways of Addiction looks at the efficacy of different prevention interventions and the many advances that have been made in treatment research in the past 20 years. The book also examines drug treatment in the criminal justice setting and the effectiveness of drug treatment under managed care. The committee advocates systematic study of the laws by which the nation attempts to control drug use and identifies the research questions most germane to public policy. Pathways of Addiction provides a strategic outline for wise investment of the nation's research resources in drug abuse. This comprehensive and accessible volume will have widespread relevanceâ€"to policymakers, researchers, research administrators, foundation decisionmakers, healthcare professionals, faculty and students, and concerned individuals.
In this completely revised and updated third edition of his highly successful book, Hamid Ghodse presents a comprehensive overview of substance misuse and dependence. There is a particular emphasis on practical, evidence-based approaches to the assessment and management of a wide range of drug-related problems in a variety of clinical settings, and he has written an entirely new chapter on alcohol abuse. He defines all the terms, and describes the effects of substance misuse on a patient's life. Epidemiology, and international prevention and drug control policies are covered to address the global nature of the problem, and the appendix provides a series of clinical intervention tools, among them a Substance Misuse Assessment Questionnaire. This will be essential reading for all clinicians and other professionals dealing with addiction, from counsellors and social workers to policy makers.
This report offers one of the most comprehensive insights into global trends in international culture, production, seizure and price of illicit drugs. It examines trends in the world's four major markets: opium and heroin, coca and cocaine, cannabis, and amphetamine-type stimulants. This edition provides an in-depth examination of the link between transnational organized crime and drug trafficking. A detailed statistical appendix on production, prices and consumption completes this book, which gives the reader a comprehensive picture of the world's drug problem.