Alcohol & Drug Abuse: Population Thinking as an Adjunct to the Clinical Trial Perspective

Details

Author(s):
  • Robert MacCoun
Publish Date:
May 1, 2004
Publication Title:
55 Psychiatric Services 509
Format:
Journal Article
Citation(s):
  • Robert MacCoun, Alcohol & Drug Abuse: Population Thinking as an Adjunct to the Clinical Trial Perspective, 55 Psychiatric Services 509 (2004).

Abstract

The great evolutionist Ernst Mayr coined the term “population thinking” to encourage biologists to shift their focus from prototypical individual organisms toward the parameters that characterize populations as a whole. Economists are trained to cultivate a similar mind-set, as captured by concepts like “general equilibrium.” Clinicians in psychiatry and psychology may question the relevance of such aggregate-level concepts for their work. But in my research on the analysis of national substance abuse policies, I've come to appreciate that population thinking is a valuable adjunct to the more traditional clinical focus on the client or patient. Clinical treatment innovations can have broader social effects, both desirable and undesirable. The clinical trial paradigm is a tremendously powerful engine for medical progress, but as I hope to illustrate through the following brief case studies, this paradigm is not always well suited for exploring these broader consequences.