Reflections on the Meaning of Drug Epidemics

• Author: Dale D. Chitwood,Sheigla Murphy,Marsha Rosenbaum
• Date: 01 January 2009
• DOI: 10.1177/002204260903900104
• Published date: 01 January 2009
• Subject Matter: Article

© 2009 BY THE JOURNAL OF DRUG ISSUES

JOURNAL OF DRUG ISSUES 0022-0426/09/01 29-40

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Dale D. Chitwood, Ph.D., Professor of Medical Sociology in the Departments of Sociology, Epidemi-

ology & Public Health, and Psychiatry & Behavioral Sciences, University of Miami, conducts multi-

disciplinary research on the epidemiology and consequences of illicit drug and alcohol misuse, HIV/

AIDS, HIV risk reduction, health care utilization, and health services research. Sheigla Murphy, PhD,

Director, Center for Substance Abuse Studies at the Institute for Scientif‌i c Analysis in San Francisco

has conducted federally funded research projects on heroin use, needle sharing, needle exchange,

cocaine use and sales, natural recovery from drug use, drug users and health services, women’s drug

use, pregnancy and violence and drug markets. Marsha Rosenbaum, Ph.D., is a medical sociologist,

former National Institute on Drug Abuse grantee, and director of the Safety First Project and the San

Francisco off‌i ce of the Drug Policy Alliance. She specializes in teen and parent drug education and

drug policy reform.

REFLECTIONS ON THE MEANING OF DRUG EPIDEMICS

DALE D. CHITWOOD, SHEIGLA MURPHY, MARSHA ROSENBAUM

Fluctuations in the use of many drugs at one time or another have been characterized

as drug epidemics. The depiction of drug use as an epidemic, as in the recent cases

of methamphetamine and crack use, is a proven mechanism for communicating

that a problem exists, but such depictions are not without risk. When the public

characterization of drug use as an epidemic represents more than its epidemiological

meaning of “unusually elevated occurrence,” panic is often substituted for reasoned

action. Such declarations are likely to truncate objective investigation, generate fear

rather than understanding, and stimulate reactive measures that exacerbate drug

misuse. This article discusses the epidemiological origin and meaning of epidemic,

documents how media headlines have sensationally depicted methamphetamine

use, and recommends that alternative strategies for describing an increase in the

incidence and prevalence of use may be more successful in directing researchers

and policy makers toward effective strategies for reducing misuse.

INTRODUCTION

Since the 1960s, the measurement of psychoactive substance use in the United

States has expanded extensively. Today governmental and other cooperative

organizations routinely generate off‌i cial statistics about drug use and produce data

through such systematic programs as the Drug Abuse Warning Network (DAWN)

and the Drug and Alcohol Services Information System (DASIS). Other statistics

are gathered to estimate the incidence and prevalence of drug use through annual

national surveys, such as the National Survey on Drug Use and Health (NSDUH) and