Though from the medical point of view the problem of addiction appears to be limited in scope and dearth, its implication for society is vast. The use of drugs is responsible for the lack of safety in the community, violence on the streets, increase in the price of goods due to loss of billions in shoplifting, and reduction in productivity. In one study reported by a Philadelphia group, each addict of this group of 237 committed about 192 crimes yearly.

 

The acuteness of the drug problem is reflected in the continuous increase in the use of drugs by the high school population. Thirty-seven percent of the seniors in high school are marijuana users and 11% use it daily. One and a half million teenagers between 12 and 17 have used PCP. This is an increase of 50% over 1976 statistics. In addition, 4.2 million young adults between 18 and 25 are experimenting with PCP, while 21% of the age group 12-25 have used amphetamines. The young population, compared to the adult population, shows a higher rate of use of all types of drugs.

 

This alarming spread of drugs is not being checked by comparable means of treatment and prevention. Our knowledge about the prevention and method of treatment appears to be insufficient to cope with the abuse of drugs, which has become almost impossible to contain. All research related to either treatment or prevention has proved to be inconclusive.

 

Our knowledge about the abuse of drugs is fragmented and contradictory. Our approach to it lacks consistency. If we have been successful in treating the problem of withdrawal medically, we have failed utterly in maintaining the ex-addict free of drugs in the community. Eighty percent of all heroin abusers are relapsing within 12 months of the termination of treatment. The problem of drug addiction surpasses the medical perimeters of concern and projects itself into the very essence of the societal conflicts of our time.

 

It is a part of a pervasive social sickness. Society has become highly hedonistic, drug oriented, and non-achievement directed (until recently). The drug problem can be partially prevented by control of the smuggling of drugs, or by better and more creative means of educating the public. Its true elimination depends on a reevaluation of our social aims and aspirations and redefinitions of the values and meaning of life for the individual. It is a fact that our tolerant approach to deviant behavior, be it criminal or drug abuse, didn't work out well for society. In general, the socially deviant did not become more socially integrated, less violent, or less hedonistically oriented by our permissiveness. On the contrary, they abused permissiveness, using it for their own deviant needs and self gratification. The leniency toward crime resulting from drug addiction, the emphasis of the medical model that drug addiction is only a mental and physical illness and not also a social problem, promoted indirectly the abuse of drugs by making the individual feel not responsible for his actions.

 

This book attempts to define a new approach to drug addiction based on a biopsychosocial mOdel in which all the components of human interaction with the environment are integrated and attacked simultaneously. The individual has to feel that society will help him solve his problems but will not carry him on his hedonistic terms because he labelled himself as such and acts out as a drug user.

 

We believe the book will stimulate new approaches, while evaluating the efficacy of the present one, with the result of pushing forward our knowledge in this complex field.

 

GEORGE SERBAN, M.D. Medical Director International Anti-Drug Abuse Foundation New York, New York

 

ACKNOWLEDGMENTS

 

The international symposium "Drug Abuse: Social and Medical Issues," upon which this book is based, was sponsored by the International Anti-Drug Abuse Foundation, and held on April 27-29, 1981, at Vista International Hotel, World Trade Center, through the courtesy of Mr. Eddy J.M. Florijn, General Manager.

 

Special thanks are due also to Aviva Najar, International Chairman of the International Anti-Drug Abuse Foundation, and L. Howard Samuels, New York Chairman.