samples of illicit drugs, to gather and analyze intelligence on illicit traffic, and to analyze the relationships between enforcement activity, judicial actions and the price and availability of illicit drugs.

Until these gaps are filled, our policies and strategies must be considered tentative and subject to revision.

The national commission summarized its urgent call for research in the following words (National Commission on Marihuana and Drug Abuse, 1973:367–370):

Throughout this report, we have pointed out numerous gaps in knowledge about the causes, consequences and control of drug-using behavior…. While research cannot answer all of the questions, much more information is urgently needed, not only to develop more rational policy for the future, but also to implement effectively the policies we now have….

Even a partial listing of the unanswered questions is startling. We do not know: why people choose to use drugs in spite of criminal laws against use and obvious dangers of dependence and disruption; why some individuals who use drugs with high dependence liability become dependent and others do not; why some populations seem much more susceptible to use or to dependence than others; what social forces precipitate the periodic “epidemics” of drug use and what causes the lulls between these increases; how drug law enforcement operates and what effect it has on use and distribution; how, in terms of effectiveness, the various treatment modalities compare and why each seems to work well for some users, and not at all for others; what is the impact of information on the decisions to use or not use drugs. We do not even know the incidence or prevalence of various patterns of drug use…even though this knowledge is essential to sensible planning.

Important steps were taken over the next several years to generate the data and research needed to fill the large gaps in knowledge identified by these two major reports in 1973. These initiatives created an infrastructure for monitoring trends in drug use, enhancing understanding of the determinants and consequences of drug use, and evaluating new prevention and treatment programs. All of the information systems described in Chapter 3 used to monitor trends in drug use were created during the 1970s.

Most significantly, a separate research agency, the National Institute on Drug Abuse (NIDA), was created in the National Institutes of Health to establish and maintain an infrastructure of both extramural and intramural research. Over the past 25 years, NIDA funding, which supports 85 percent of the world’s research on drug abuse and addiction (Institute of Medicine, 1996), has underwritten substantial advances in the understand-

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