Newmeyer J A, Johnson G R
Int J Addict. 1976;11(3):417-38. doi: 10.3109/10826087609056161.
Much attention has recently been focused on the question of the extent of heroin use in America. In a worthwhile effort to call public attention to the problem, many estimates of its size have evidenced a tendency toward exaggeration and aggrandizement. This paper presents methods of estimation of the extent of heroin addiction which, when carefully employed, should effectively correct such distorted estimates. Two general types of estimation are employed, incidence and prevalence. Incidence estimates are concerned with new cases of heroin addiction that occur in a specific population within a given amount of time. These estimates are based upon self-report data from addicts regarding date of first addiction. When corrected for the "lag phase" (that period of time between onset of first addiction and eventual visit to a treatment program), these data permit accurate retrospective charting of incidence trends. Prevalence estimates focus on all known cases of heroin addiction in a specific population within a given amount of time. Three separate types of prevalence estimates from three separate sources are outlined in this article: estimates based on overdose death data, estimates based on crime statistics, and estimates of "unknown" addicts. In outlining these methods, this article describes the fluctuations in heroin addiction in one major American city, San Francisco, California. After analyzing data gathered from a sample of 2,367 addicts contacted over a 3-year period, this study suggests that the incidence of heroin addiction seems to have declined after 1970. Possible factors underlying this apparent decline in heroin addiction are then discussed, including the post-1970 maturation of the "population at risk," the effectiveness of antidrug media messages, the changing drug fashions in the heroin subculture, and the gradual deterioration of the quality and potency of street heroin.
最近，人们的大量注意力都集中在美国海洛因使用的程度问题上。为了唤起公众对这个问题的关注，人们做出了有价值的努力，但许多对其规模的估计都有夸大和夸张的倾向。本文介绍了估计海洛因成瘾程度的方法，若谨慎使用，这些方法应能有效纠正此类失真的估计。采用了两种一般类型的估计方法，即发病率和流行率。发病率估计关注在给定时间内特定人群中出现的新海洛因成瘾病例。这些估计基于成瘾者关于首次成瘾日期的自我报告数据。在对“滞后阶段”（首次成瘾开始到最终进入治疗项目之间的时间段）进行校正后，这些数据允许对发病率趋势进行准确的回顾性绘制。流行率估计关注在给定时间内特定人群中所有已知的海洛因成瘾病例。本文概述了来自三个不同来源的三种不同类型的流行率估计：基于过量用药死亡数据的估计、基于犯罪统计数据的估计以及对“未知”成瘾者的估计。在概述这些方法时，本文描述了美国一个主要城市加利福尼亚州旧金山海洛因成瘾情况的波动。在分析了从三年期间接触的2367名成瘾者样本中收集的数据后，本研究表明，1970年后海洛因成瘾的发病率似乎有所下降。然后讨论了海洛因成瘾明显下降背后的可能因素，包括1970年后“高危人群”的成熟、反毒品媒体信息的有效性、海洛因亚文化中不断变化的毒品时尚以及街头海洛因质量和效力的逐渐下降。
