John B. White

Using Internet-based surveys to reach hidden populations: case of nonabusive illicit drug users.

OBJECTIVE To examine the potential of surveys delivered via the World Wide Web (WWW) as a method for reaching hidden populations such as that of nonabusive users of illicit drugs. METHODS Past and current approaches to collecting data from hidden populations were reviewed. RESULTS A number of approaches have been used in the past efforts to reach drug users but the use of the WWW has produced the largest sample of successful illicit drug users ever surveyed. CONCLUSION Further application of this approach (WWW) is recommended when hidden populations are surveyed.

The Baby Boomer Effect: Changing Patterns of Substance Abuse Among Adults Ages 55 and Older

Between now and 2030, the number of adults aged 65 and older in the United States will almost double, from around 37 million to more than 70 million, an increase from 12% of the U.S. population to almost 20%. It was long held that, with only a few isolated exceptions, substance abuse simply did not exist among this population. In light of the impact of the baby boom generation, this assumption may no longer be valid. The authors examined admissions of persons 55 years and older (n = 918,955) from the Treatment Episode Data Set (1998–2006). Total admissions with a primary drug problem with alcohol have remained relatively stable over this time. Admissions for problems with a primary drug other than alcohol have shown a steady and substantial increase. Clearly, data from the Treatment Episode Data Set indicate a coming wave of older addicts whose primary problem is not alcohol. The authors suspect that this wave is led primarily by the continuing emergence of the baby boomer generation.

Drugnet: A Pilot Study of Adult Recreational Drug Use via the WWW

This study was intended (1) to explore the potential of using the World Wide Web (WWW) of the Internet to sample hidden populations and (2) to collect exploratory data on the hidden population of nonabusive, recreational users of illicit drugs. The survey modules were designed to assess demographics and lifestyle, drug experiences (including absence of DSM-IV criteria for abuse or dependence), legal history (drug-related arrests, etc.), and mental health as measured by the General Well-Being Schedule (GWBS). The survey was completed by 276 persons, aged 18 to 62, with a mean age of 32.34. The sample was predominantly white (93%), male (78%), college educated (75%), and employed full-time (76%). The WWW is a useful tool for reaching hidden populations but is likely to impose a bias toward male, better educated, and more computer-involved samples on the respondents reached. This survey further documents the existence of a nonclinical population of drug users which is generally healthy, well-adjusted, and productive.

The general well-being of recreational drug users: a survey on the WWW

American drug policy is predicated upon a dichotomy between legal drugs and illegal drugs - good drugs that enhance health and bad drugs which damage health. The fact of psychiatric co-morbidity between substance misuse disorders and other mental disorders is commonly taken to mean that drug use is damaging to mental health. The purpose of this study was to examine the mental well-being of a sample of occasional, recreational drug users. DRUGNET was an on-line survey of recreational drug use by non-deviant adults via the WWW. Volunteer subjects (n=906) completed the survey over the internet between March and September 1997. Mental health was assessed utilizing the General Well-being Schedule (GWBS). A complete demographic profile of the sample was taken. The GWBS correlated with frequency of use, intoxication levels and types of drugs consumed. This study demonstrates the existence of healthy, normally functioning adults who occasionally use psychoactive drugs.

Is recreational drug use normal

The purpose of this paper is to define drug use and differentiate this behaviour from drug abuse. We argue that one fundamental principle of the War on Drugs, namely that all use of illicit drugs is harmful and must be prohibited, is invalid. Statistically, clinically, and socio-culturally, drug use is normal behaviour. Current drug policy is based on the flawed premise that any use of illicit drugs is unhealthy. A public health model emphasizing demand reduction (as opposed to supply reduction), individual freedom, reason, and tolerance is recommended.

Substance Use and Social Identity in the Lesbian Community

SUMMARY Although the study results report discrepancies in the rates of substance abuse in the lesbian community, the general consensus in the field of gay and lesbian studies is that these individuals, as a whole, have a higher rate of substance use. For this study, data were collected via the Internet on the use of drugs and alcohol, level of self-esteem, and degree of social identity in the lesbian community. A correlation analysis was used to determine if negative social identity within the lesbian community leads to low self-esteem that is reflected in higher rates of substance abuse. Though a positive relationship between social identity and self-esteem was determined, no significant correlation between negative social identity, low self-esteem, and substance use was determined. However, it is important to consider that respondents with higher levels of self-esteem reported more frequent use of specific drugs. That outcome in itself is an implication for further investigation.

Focusing on abuse, not use, in drug education

How societies deal with drug use is premised on how drug abuse is defined and on distinguishing disordered drug abuse from non-disordered drug use. The Epidemiologic Catchment Area Study revealed that only 20.27% of consumers of illicit drugs in the United States experienced a period of abuse at some time during their drug use history, whereas among illicit drug users the current prevalence of substance abuse disorders was 4.19%. The persistent failure to differentiate use from abuse where currently illicit drugs are concerned undermines effective primary prevention of the addictive disorders we are really concerned with. Typical programmes have ignored this reality, which helps explain the failure of most drug education. Adolescents soon recognize the inaccuracies and exaggerations, which undermines the credibility of drug education and limits its effectiveness. The purpose of this article is to offer a more realistic strategy for drug education that focuses on the prevention of abuse rather than prevention of any and all use.

PARENTS WHO REPORT USING ILLICIT DRUGS: FINDINGS AND IMPLICATIONS FROM THE DRUGNET STUDY'

In recent years, a national discussion has emerged concerning what parents should tell their children about their own past drug use. DRUGNET is an ongoing, on-line survey of successful, healthy, adults who occasionally use illicit drugs. This paper reviews data from a subset of this survey, namely, those respondents who were parents with self-reported use of at least one illicit drug. The sample (n = 325) was predominantly white men who reported having above average education and household incomes. Their mental health as measured by the General Well-being Schedule was similar to the national norm. Respondents reported using drugs to manage parental stress and expressed concerns over how to communicate with their children and legal risks related to their own drug use. The limitations and the implications of these data are discussed.

Focusing on abuse, not use: A proposed new direction for US drug policy

How professionals and societies deal with drugs and drug consumption is premised on how abuse is defined. The “War on Drugs” approach promotes the belief that “any use is abuse” where the currently illicit drugs are concerned. Regrettably, any distinction between use and abuse has been notably absent from most public policy decisions on drug issues. Even a cursory review of both supply and demand reduction policies of the past century reveals a startling lack of awareness of this distinction. The failure of differentiation undermines prevention, treatment, and the criminal justice system. Treatment, thus, tends to show a bias toward ineffective models such as “boot camps” and “tough love”. It has contributed to controversy over maintenance treatments, such as methadone, buprenorphine, and heroin, which have proven to be highly effective for some addicted persons. It leads to treatment options for the addictions being far more limited and constrained than is typical in other areas of health care. Admittedly, studying non-problematic drug use has been a challenge, but clearly the use of illegal drugs is often not harmful, any more than is moderate alcohol use. Addiction is a fatal disease for some and that disease should be the focus of our policies.

A Brief History of Prohibition and Treatment Solutions for Substance Abusers

The predominant policy of prohibition (i.e. “War on Drugs”) emerged in the early Twentieth Century. It has been expanded on since that time to become the primary thrust of drug policy in almost every nation today. We will examine how this came about and the ways in which it has contributed to the maltreatment of substance abuse disorders.