Translational Biomedicine

Introduction

Despite substantial national efforts, drug abuse remains a serious public health problem for a sizable proportion of the population. Interventions aimed at securing a drug-free workplace are justified instead largely on safety and productivity grounds. The data obtained in worker population studies, however, do not provide clear evidence of the deleterious effects of drugs other than alcohol on safety and other job performance indicators. This does not mean there are no deleterious effects; it may reflect the paucity of relevant data and the quality of the research done to date. The extent to which impaired worker performance due to drug use can affect safety and productivity in the workplace is not well understood, although a substantial amount of laboratory research has been carried out evaluating the effects of single doses of various abusable drugs on cognitive and psychomotor performance. The results of such research cannot be extrapolated directly to the workplace because the effects of drugs on workplace performance are a complex function of the interaction between the dynamic workplace environment and the multiplicity of other variables impinging on the worker.

A myriad of laboratory performance studies have been carried out to test the effects, under controlled conditions, of such drugs as stimulants, marijuana, sedatives, benzodiazepines, and alcohol. Although the doses studied are sometimes (but not always) the same as those being used by drug users in the work force, patterning of drug use comparable to that of many drug users (multiple doses, periodically repeated doses, etc.) has not been adequately addressed. To further complicate the picture, there has been little effort to model the subject population in laboratory studies after the work force population.

The most frequently used research subject is a college student, paid to participate in a research project, or expected to participate in order to fulfill a course requirement. Behavioral histories are seldom taken into account in laboratory research. Other common weaknesses of experimental design include inattention to doses used, time points for measurements, and contingencies in maintaining behavior. Despite these problems, however, a few generalizations can be drawn about the likely effects of different classes of drugs on performance. Prepared for the world summit for social development, which was held at Copenhagen in March 1995, the paper that follows analyses social aspects of many of the principal issues involved in drug abuse and drug control that are of concern to organizations of the United Nations system and other intergovernmental organizations. The paper was originally commissioned by the United Nations International Drug Control Programme (UNDCP) and drafted by an independent consultant, Jean Paul Smith, former consulting psychologist and senior policy analyst at the national institute on drug abuse, Washington. The purpose of the paper is twofold: first, to examine the social and economic impact of drug abuse from a broad international perspective. Secondly, based on that analysis, to suggest how problems of drug abuse prevention and control can be addressed in a constructive, coordinated manner.

The paper concerns primarily narcotic drugs and psychotropic substances but also includes, where appropriate, information on problems related to the abuse of other addictive substances such as alcohol and tobacco. It is divided into four main sections. Part one describes the nature of the drug problem, in particular the chain of drug production, distribution and consumption. It also provides information on the economics of this chain, including statistics and comparative data by country and geographical area; on how changes in the global economy have affected these developments; and on the monitoring of drug abuse by various agencies.