Drug use and abuse in five US communities.
Data from the five-site Epidemiologic Catchment Area study (ECA), a probability sample of 18,571 adults, were used to describe the prevalence of drug abuse in the United States and to evaluate the hypothesis that multiple prescription regulations are effective in reducing drug abuse and drug diversion. The five sites surveyed were New Haven, Connecticut; Baltimore, Maryland; St. Louis, Missouri; Durham, North Carolina; and Los Angeles, California. The California triplicate prescription law was established in 1939 and is the longest continuously running triplicate prescription program in the country (Schedule II drugs). None of the other ECA sites had multiple prescription regulations in effect at the time the study was conducted. In general, the rates of drug use, abuse, and dependence were significantly higher in Los Angeles as compared with the other sites, both before and after controlling for sociodemographic differences. The proportion of users who go on to become abusers was consistent across sites (about 20%). The vast majority of those with a DSM-III diagnosis of abuse of prescription drugs reported that they obtained the drugs from a source other than their physician, suggesting that "diversion" of prescriptions from legal channels occurred at all sites. Limitations of the study design with respect to conclusions are discussed.
Weissman
M M
MM
Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York State Psychiatric Institute, New York 10032.
Johnson
J
J
D011307:Drug Prescriptions; D004335:Drug and Narcotic Control / Q000331:legislation & jurisprudence; D006801:Humans; D009017:Morbidity; D019966:Substance-Related Disorders / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology