Abstract
Research on substance abuse has a long history in the United States. This chapter seeks to examine the development of the field, beginning with the latter part of the nineteenth century to present. While establishing an accurate historical timeline for the field’s development during this period is somewhat difficult, there are some clear chronological benchmarks that can be reasonably ascertained, with important methodological advancements generally mirroring methodological improvements shaping and advancing the field of epidemiology overall. Other factors have also influenced the science of addiction research. Specifically, the field of substance abuse research in the U.S. has been shaped by social and political understandings of addiction, which have shifted over time between more criminological standpoints to medical/disease orientations. Choice of orientation has had important implications for scholarly productivity, as well as the speed of advancement of the science. While not necessarily linear, historical advancements in research methods have built upon one another, greatly expanding our understanding of addiction and informing policy and practice solutions.
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Notes
- 1.
Personal communication with Stanley Einstein, Founding Editor (1965–2013) of Substance Use & Misuse, November 2016.
- 2.
Initial funding for the review was from a grant from the Carnegie Corporation. Designated as the Classified Abstract Archive of Alcohol Literature (CAAAL), the collection was maintained and updated until 1978 and is comprised of approximately 20,000 abstracts.
- 3.
This shift recognizing alcoholism as a treatable medical condition occurred despite the corresponding loss of faith that narcotics addicts could be similarly treated; a view that persisted into the 1960s, with implications for research.
- 4.
For a discussion of the various drugs tested by the CDAN, as well as Committee composition, see the detailed narrative history of the Committee on Problems of Drug Dependence by May and Jacobson (1989).
- 5.
The new agency adopted a model approach to mental disorders, including addiction, which stressed the interrelatedness of research, training, and services. As a result, the research portfolio of the NIMH differed significantly from other NIH institutes. In addition to basic and clinical biomedical research, NIMH strongly supported behavioral research and some social science research. The three-pronged approach, however, did create inherent tension, as the combination of research and service in a single agency left advocates for each side concerned that they may not be receiving equal prioritization of funding and support. This tension would remain until being resolved in later decades.
- 6.
Also contributing were favorable research studies funded by tobacco companies and/or comments by scientific experts discounting the evidence that were part of a broader marketing and public relations campaign designed to challenge evidence that smoking caused disease (Cummings et al. 2007).
- 7.
The WHO’s new definitions facilitated their increased responsibility, as established by international treaties, to control narcotics. In the 1950s, the presence of physical dependence was emphasized, with the WHO primarily concerned with differentiating between psychic dependence and physical dependence. In 1969, the WHO abandoned efforts to differentiate habits from addictions and adopted terminology designating as dependence “those syndromes in which drugs come to control behavior.” They further recognized that dependencies on different classes of drugs (such as alcohol, opiates, cocaine) can differ significantly.
- 8.
The National Commission on Marijuana and Drug Abuse’s second report is entitled Drug Use in America: Problem in Perspective (NCMDA 1973).
- 9.
The creation of NIDA in 1974 was a major step forward in the promotion of addiction research, as previous work had been folded into the larger portfolio of the National Institute on Mental Health (Kreek et al. 2004; Sloboda 2012). The new institute focused exclusively on drug research. In 1992, NIDA became part of the National Institutes of Health.
- 10.
NIDA also funds drug and crime research. Examples include the NIDA funded research conducted by the National Development and Research Institutes examining the relationship between drugs and criminality (Lipton and Johnson 1998). Today, NIDA is increasingly focused on medical interventions and brain science research.
- 11.
Prior to the establishment of NIAAA, research on alcohol addiction was conducted within the National Institute of Mental Health (NIMH). Since 1974, NIAAA has been an independent Institute of the National Institutes of Health (Warren and Hewitt 2010).
- 12.
NIDA supports research on nicotine addiction and funds some studies of cessation programs. The CDC’s Office of Smoking and Health is the lead Federal agency for comprehensive tobacco prevention and control. The AHRQ supports Cochrane Collaboration Reviews, as well as systematic reviews and meta-analyses.
- 13.
In 2001, Surgeon General David Satcher stated that, “Women not only share the same health risk as men, but are also faced with health consequences that are unique to women, including pregnancy complications, problems with menstrual function, and cervical cancer.”
- 14.
Overall, expansion of addiction research occurred in recent decades to include a broader range of target at-risk populations than previously studied, including women, veterans, homeless, LGBTI populations, and the elderly.
- 15.
State governments also support research; however, most of this funding also comes from the Federal government, which is passed through state agencies.
- 16.
Within the NIDA Division of Epidemiology and Prevention Research, areas of emphasis include, but are not limited to (1) development of new theoretical approaches to epidemiology, services, and prevention research, (2) determination of intrapersonal, environmental, and genetic factors important in the development of drug abuse/addictions, and (3) development of effective strategies to ensure that evidence-based practices are optimally utilized in the development of services to prevent and treat drug abuse/addictions (Cázares 1994).
- 17.
While conclusion of prisoner studies is often linked to the release of the Tuskegee Report in 1972, research in prisons was still possible. It did become increasingly difficult, however, following the American Correctional Association’s (ACA) release of its first informed consent protocol for correctional institutions in 1972 and the placing of prisoners in the category of vulnerable dependents (Campbell 2010). The ACA later moved to eliminate prison research entirely by withholding accreditation from facilities where it was conducted (Campbell 2010).
- 18.
Not all studies support the use of ACASI to improve self-report. For example, a study by Fendrich et al. (2005) found self-report sensitivity estimates for tobacco use in a drug use survey to be well below the 90% level. Other studies have noted mixed effects of ACASI (Couper et al. 2003; Gribble et al. 2000; Turner et al. 2005).
- 19.
According to Fendrich et al. (2004), the utility of testing for surveys depends on both the type of substance being examined and the type of test employed, with multiple tests generally having more utility than a single test.
- 20.
The Institute of Medicine has broadly called for a shift to research that engages investigators from multiple fields and disciplines to better capitalize on rapidly expanding knowledge of how genetic, social, and environmental factors impact health (Hernandez and Blazer 2006).
- 21.
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The authors thank Drs. Peggy and Richard Stephens for their helpful comments on earlier drafts of the chapter.
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VanGeest, J.B., Johnson, T.P., Alemagno, S.A. (2017). History of Substance Abuse Research in the United States. In: VanGeest, J., Johnson, T., Alemagno, S. (eds) Research Methods in the Study of Substance Abuse. Springer, Cham. https://doi.org/10.1007/978-3-319-55980-3_1
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