Every year, epidemiologic researchers from around the world get together to share the latest data they have gathered on the patterns, trends, and consequences of drug abuse. The most recent joint meeting of researchers in the U.S. Community Epidemiology Work Group (CEWG) and the International Epidemiology Work Group (IEWG) on Drug Abuse was held in Washington, D.C., last summer. At the meeting, a panel of representatives from national and international agencies and organizations discussed ways to increase the impact of epidemiologic data on drug abuse research, public health policy, and drug abuse prevention and treatment.
At the IEWG meeting, panelist Diane Jacovella of the Office of Alcohol, Drugs, and Dependency Issues in Canada emphasizes the ability of epidemiologic monitoring systems to assess drug abuse and related issues rapidly.
The CEWG is a network of epidemiologists and public health officials from 21 major metropolitan areas in the United States. The NIDA-sponsored work group has been meeting semiannually for the last 21 years to review current and emerging substance abuse problems. Modeled on the CEWG, the IEWG is a rapidly growing network of drug abuse researchers from other countries and regions of the world that has met annually for the past 3 years. At the summer 1997 meeting, researchers from both work groups presented the latest available data on drug abuse problems in their countries and in areas of the world.
NIDA Director Dr. Alan I. Leshner, who cochaired an international panel discussion on the effective uses of epidemiologic data, noted a growing interest around the world in obtaining data on drug use for decisionmaking and for examining drug abuse trends and problems from an international perspective. "We are developing a growing international community looking at drug abuse trends and problems," he said. "Now, we need to determine how to use the data you are collecting to address drug abuse problems before they get worse." To make drug abuse data more useful, epidemiologists must answer several interrelated questions, Dr. Leshner said:
- What information do policymakers need to make decisions?
- How can researchers gather that information?
- How can researchers get the information out quickly?
- In what form should researchers disseminate the information to enable policymakers to make informed decisions?
Policymakers at all levels want and need valid data about drug abuse trends and patterns to make rational decisions about allocating resources to address these issues, a number of panelists noted. However, it is important for research to generate information not only about emerging drug abuse issues but also about the effectiveness of interventions to determine factors in those interventions that may have contributed to changes in trends, said Diane Jacovella, manager of the Office of Alcohol, Drugs, and Dependency Issues in Canada. Because the priorities of policymakers are often based on economic concerns, research also must provide them with data that tell them what works and what is cost-effective, said Frank Kahn, chairman of the South African Drug Advisory Board and Attorney General for the Western Cape.
Since drug abuse patterns and trends are constantly changing within countries and globally, timely information is particularly important to policymakers who need to respond quickly to emerging problems, several panelists noted. The growing network of international monitoring systems that make up the IEWG can provide current data on drug trafficking and use patterns that can help policy-makers address drug abuse problems in a more timely fashion, according to several panelists. The flexibility of these epidemiologic systems and their ability to rapidly assess drug abuse and related issues in specific geographic areas are critical to their usefulness, Jacovella said.
Improving the ways in which researchers present drug abuse data to policymakers was also the subject of much discussion. "Policymakers don't just want data, they want solutions," said Dr. Vis Navaratnam of the University of Science of Malaysia. They need information on how to develop policies that produce strategies and programs to deal with the problem effectively, he said. The problem is that policymakers do not know how to assess a lot of raw data on drug abuse issues, said one participant. Therefore, researchers who originate these data also must provide analysis and policy options that policymakers want and need to make decisions.
Dr. Vis Navaratnam of the University of Science of Malaysia stresses that policy-makers need accurate information to develop drug abuse policies.In the group discussion that followed the formal panel presentations, a number of meeting participants noted that drug abuse monitoring, such as that conducted through the CEWG and the IEWG, and traditional epidemiologic research, such as large, cross-sectional surveys and longitudinal studies that examine factors involved in drug abuse, are needed to provide useful information for policy and program development. While monitoring systems can provide the most up-to-date data on which policymakers can base immediate responses to emerging drug abuse problems and trends, longer-term research provides information needed to better interpret surveillance data and develop prevention and treatment interventions to solve the problems, they noted.
"We have good systems of drug abuse data collection ranging from individual studies through epidemiologic networks and surveys," said Nick Kozel of NIDA's Division of Epidemiology and Prevention Research. "Now we are striving to connect research with policy to ensure that the scientific data we are generating are used by policymakers to make sound decisions in addressing drug abuse problems."