This article examines changing patterns in the use and misuse of various types of drugs, with attention to socio-cultural factors that influence the emergence of epidemics in the use of a particular drug type.
The general outcome of this analysis supports the continued tracking of numerous drug indicators, their interpretation from a socio-cultural perspective, and directed field research that informs the multi-faceted drug policy developed by the Nation's Office of National Drug Control Policy (ONDCP). The work underlying this perspective builds on research that has found drug-use trends tend to produce epidemics that typically consist of four phases. These phases are incubation, expansion, plateau, and decline. The incubation phase typically consists of the use of a particular drug among a limited sub-population in the context of a particular social environment, such as after-hours clubs, the hip-hop movement, or raves. During the expansion phase, the initial sub-population of users introduces the use of the drug to the broader population, causing the drug's use to spread exponentially. The plateau phase of the epidemic consists of a period of steady widespread use, which tends to perpetuate the drug's use among youth coming of age in social environments where the drug is popular. In the decline phase, the use of a particular drug can go out of favor among drug users. In this phase, many existing users persist in their drug-use habits, but decreasing percentages of youth become new users. This epidemic model is applied to the rise and fall of the use of crack cocaine in the midst of socio-cultural changes, as well as to the marijuana epidemic of the early 1990s and the current widespread misuse of prescription opioids. 12 references