The National Institute on Drug Abuse (NIDA) is pleased to provide this special issue of the American Journal of Preventive Medicine on “Understanding the Social Epidemiology of Drug Abuse and HIV/AIDS.” Understanding the social epidemiology of drug abuse and HIV/AIDS is a central part of the mission of the National Institute on Drug Abuse (NIDA), and particularly of NIDA's Division of Epidemiology, Services, and Prevention Research (DESPR). Achieving this mission requires an abiding dedication to improving the nation's public health, and NIDA does this in large part by promoting integrated approaches to understand interactions between individuals and their environments that give rise to problems associated with drug abuse and addiction.
This special issue exemplifies the history of NIDA's support of epidemiology, which through its tools of surveillance, cross-sectional and longitudinal designs, epidemiologic modeling, and clinical epidemiological experiments, and in combination with ethnography, medical sociology and medical anthropology, has advanced our knowledge of the determinants and correlates of drug abuse and its consequences, specifically HIV/AIDS, as well as other infectious diseases. Moreover, it shows us how important multi-level methodological approaches can be for identifying the diverse pathways linking individuals to their environments and to health and disease.
Social epidemiology has informed our continuing recognition of the need to understand individual risk behaviors, not simply as the behaviors of one person alone, but as the behaviors of one or more persons together in the context of often changing social, cultural, and environmental factors. DESPR's interest in social epidemiology has increased in recent years, in parallel with the growing recognition that social epidemiologic approaches give rise to new ways for understanding (and thereby, potentially predicting and intervening with) patterns of drug abuse and HIV/AIDS in relation to varying social determinants, norms, and mores, geographic settings, and socioeconomic and cultural conditions. Drug abuse and HIV/AIDS are the adverse outcomes of human behaviors that are themselves shaped by a complexity of interactions among genetic, biologic, viral, familial, social, and environmental factors. The steady progress being made in understanding the social epidemiology of drug abuse and HIV/AIDS demonstrates that we have long passed the beginning and are now, in fact, realizing the promise this field offers for advancing our capacity to discover, predict, and change complex social contextual determinants of health and disease.
The papers in this special issue expand the bounds of traditional epidemiology and its focus on time, place, and person by considering how social interconnections, interactions, and interrelationships in the social environment can influence drug abuse and its adverse outcomes in individuals, their families and peer networks, and their communities. From these papers, we learn that understanding drug use and its effects within and across populations requires us to consider an array of genetic, biological, social, and contextual factors that interact and influence drug abuse and related disorders. Moreover, they lead us to recognize how various pathways can link exposures to social and environmental characteristics with genetic and familial vulnerabilities, and with developmental processes and trajectories that lead to drug use initiation, progression, addiction, and disease. Ultimately, we learn that social epidemiology can enhance our capacity to improve public health by helping us to identify opportunities for more effective implementation of prevention, intervention, services, and treatment strategies.
Acknowledgments
No financial conflict of interest was reported by the authors of this paper.
Footnotes
Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.