Nicholi A M
N Engl J Med. 1983 Apr 21;308(16):925-33. doi: 10.1056/NEJM198304213081604.
The current widespread nontherapeutic use of psychoactive drugs began among a small group of college students in the early 1960s. It spread with explosive force into an epidemic of extraordinary scope involving all regions of the country, all socioeconomic classes, and all age groups. This article reviews the drugs currently used and identifies those who use them. It discusses the complex, rapidly changing patterns of use and the consequences of this epidemic for both the individual and the society. The inhalants, phencyclidine, cocaine, heroin, the psychotherapeutics (methaqualone and amphetamine), and marijuana are the most widely used drugs. Recent clinical and laboratory research indicates that these drugs pose serious hazards to physical and mental health. Marijuana is the most widely used illicit drug; one quarter of the entire U.S. population have used the drug, and 20 million people use it daily. The short-term and long-term adverse effects of marijuana have important social implications. Recent data suggest that drug users possess limited inner resources to cope with psychological stress and that they take drugs to fill a moral and spiritual void and to meet intense emotional needs. It is proposed that these character traits and emotional conflicts of drug users may reflect recent changes in child rearing and family stability.
当前精神活性药物的广泛非治疗性使用始于20世纪60年代初的一小群大学生中。它以爆发性的力量蔓延成一场范围异常广泛的流行,涉及该国所有地区、所有社会经济阶层和所有年龄组。本文回顾了当前使用的药物,并确定了使用这些药物的人群。它讨论了复杂且迅速变化的使用模式以及这场流行为个人和社会带来的后果。吸入剂、苯环己哌啶、可卡因、海洛因、精神治疗药物(甲喹酮和苯丙胺)以及大麻是使用最广泛的药物。近期的临床和实验室研究表明,这些药物对身心健康构成严重危害。大麻是使用最广泛的非法药物;全美四分之一的人口使用过这种药物,且有2000万人每天都在使用。大麻的短期和长期不良影响具有重要的社会意义。近期数据表明,吸毒者应对心理压力的内在资源有限,他们吸毒是为了填补道德和精神上的空虚以及满足强烈的情感需求。有人提出,吸毒者的这些性格特征和情感冲突可能反映了近期育儿方式和家庭稳定性的变化。