Drugs and Public Health: Issues and Answers

Since shortly after the turn of the century, drug abuse in the United States has been defined and treated, at least in part, as a public health issue requiring the intervention and services of the federal government. Thus, over the years the government has developed a broad spectrum of specialized agencies and activities to deal with the drug problem. These range from the creation of a "Narcotics Farm" in 1935 to the establishment of the National Institute on Drug Abuse in 1973; from the study of mari huana use and its effects to the sponsorship of narcotic antagonist research; from the training of professional and paraprofessional treatment and rehabilitation personnel to the conduct of multi-modality field trials of heroin addict rehabili tation programs. Clearly, the principal weakness in the national public health approach to narcotic addiction and drug abuse lies in the area of primary prevention, particularly as it is directed to high risk adolescents. The intent of this paper is to highlight some of the drug abuse activities and accomplishments of the National Institute of Mental Health within the Public Health Service of the Department of Health, Education and Welfare; to examine some of the significant issues and demands of the national drug program in recent years; and to indicate the directions that have been pursued in an effort to find solutions to drug abuse problems.