Program Director, Michigan State University College of Human Medicine
The Council is administered jointly by both Academies and the Institute of Medicine foods lower bad cholesterol fast zetia 10 mg online. In the 1980s cholesterol lowering foods in gujarati order zetia 10 mg mastercard, other research agencies of the federal government cholesterol reduction medication discount 10 mg zetia visa, such as the Centers for Disease Control, the Department of Education, and the Department of Justice, have intensified their interest in this topic. Moreover, a number of private foundations and state and local government agencies have committed very significant resources to new drug abuse prevention activities that entail research or program evaluation components. That request led to the formation of the Committee on Drug Abuse Prevention Research and to this report of the committee. The charge to the committee was not an open-ended or comprehensive review of the broad front of prevention policies and strategies. Review methodological issues regarding drug abuse prevention strategies: • Identify major design and methodology problems in existing prevention strategies (i. The charge to the committee specified that it should focus on illicit drug problems. The committee therefore considered research on prevention of alcohol and tobacco abuse only to the extent that this research is relevant to preventing illicit drug problems. The fact that alcohol and tobacco are generally illicit for minors creates an irreducible overlap in prevention concepts and interventions for young people. We note that a committee at the Institute of Medicine of the National Academy of Sciences has completed a separate study of research needs and opportunities on alcohol problems (Prevention and Treatment of Alcohol Problems: Research Opportunities, Institute of Medicine, 1989), which provided much more comprehensive attention to alcohol abuse prevention as such. The role of community channels and settings for drug abuse prevention seemed to us valuable in illuminating an important direction of research in which an expanded, methodologically sophisticated increment of attention is needed. With the partial exception of research on cigarette smoking, there has not been much attention in drug abuse research to the literature on community health education. We therefore include here an appendix on community strategies of health promotion and disease prevention, emphasizing the importance of implementation planning in making prevention programs sustainable. The committee owes much to the Commission on Behavioral and Social Sciences and Education, particularly Eugenia Grohman, associate director of reports, who provided administrative guidance and support; Christine McShane, editor without peer, who groomed the text and brought it through the final stages of preparation; Linda Kearney, administrative coordinator of the study; and Elaine McGarraugh, who served throughout as assistant study director— compiling and organizing research materials, drafting parts of the report, and generally ensuring its progress and completion. Margaret Cargo, research assistant at the University of British Columbia, assisted in the final rounds of bibliographic and data compilation. Its purpose is threefold: • Assess the self-designated drug abuse prevention strategies that have been subjects of evaluation research, which are limited largely to a few domains of health-oriented interventions; • Consider the explicit theoretical basis and methodological adequacy of these evaluation findings and assess their applicability to diverse population segments; and • Proffer minimum methodological standards for future evaluation projects. The literature reviewed in this report is devoted nearly entirely to studies of youth under age 20 and psychoactive drugs that are illegal for young people to purchase: the fully illicit drugs such as marijuana, heroin, and crack cocaine; the "prescription-only" drugs such as barbiturates and amphetamines; and the "adults-only" drugs, cigarettes and alcohol. Review the current status of drug abuse prevention research; assess the theoretical basis for preventive interventions as derived from etiologic research. Research on drug abuse prevention is haunted by a double vision that emerges from epidemiologic studies. In one world, that of relatively low-intensity consumption (drug use) among individuals who can be found in schools and households, drug experience is selfreported more frequently by the wealthy than the less wealthy and by whites than Hispanics or blacks. In this world, there have been steady and cumulatively very marked declines in the prevalence of marijuana use since the late 1970s and of cocaine since the middle 1980s, and heroin use is so rare as to be barely measurable. In another world, that of emergency rooms, morgues, drug clinics, juvenile detention centers, jails, and prisons, in which indicators of intensive drug consumption (abuse and dependence) are collected: the poor predominate, blacks and Hispanics appearing in numbers much higher than their household or school proportions; marijuana and heroin use are common (though less so in some areas than in the 1970s); and cocaine use increased explosively throughout the 1980s and simply leveled off at high levels in the 1990s. The validity of the data that define each of these worlds, although subject to some degree of error and drift, is beyond knowledgeable dispute. Reconciling the two worlds in terms of theoretical understanding and empirical mechanisms, however, is a major research issue. To some degree these discrepancies may represent time lags, as tidal changes in the social acceptability and marketing of illicit drugs work their way through age-specific multiyear developmental pathways that lead from more or less common experimental use to a much smaller residual core of chronic drug dependence.
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