“The Change That You Wish to See in the World”

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Notes

¹ This new term, introduced into the recent intervention literature (Samuel R. Friedman, Diana Rossi, Peter L. Flom. (2006). “Big events” and networks: Thoughts on what could be going on. Connections 27(1): 9–14), refers to major events such as mega –disasters, natural, as well as man-made, famine, conflict, genocide, disparities in health, epidemics, mass migrations, economic recessions, etc. which effect adaptation, functioning and quality-of-life of individuals as well as systems. Existential threat, instability and chaos are major dimensions and loss of control over one's life is experienced. The necessary conditions for the operation of the noted “big event,” and its temporary or more permanent effects, at various levels and qualities, and what can be done to prevent or to minimize such effects, have yet to be sufficiently assessed. Editor's note.

² The reader is referred to the following thought provoking positions: (1) Rittel and Horst suggested that problems can and should be usefully categorized into two types: “tame problems” and “wicked problems.” The former are solved in a linear, traditional known and tried “water fall paradigm”; gather data, analyze data, formulate solution, implement solution. The latter “wicked problems” can only be responded to individually, each time anew, with no ultimate, repeatable solution. Rittel, Horst, and Melvin Webber, (1973) Dilemmas in a General Theory of Planning”. Policy Sciences, Vol. 4, pp 155-169. (2) The cyberneticist Heinz Von Foerster posited that there are two types of questions; legitimate and illegitimate ones. The former are those for which the answer is not known and is, perhaps, even unknowable during a given state of knowledge and technology –the effective control of man's “appetite” for a range of psychoactive substances, whatever their legal status An illegitimate question is one for which the answer is known, or, at the very least consensualized. The asking of illegitimate questions has been, and remains, by and large, the acculturated norm. Heinz Von Foerster, Patricia M. Mora, and Lawrence W. Amiot, “Doomsday; Friday, 13 November, A.D, 2026,” Science, 132, 1960. pp. 1291–1295. The reader is referred to Pablo Neruda's The Book of Questions for a poetic exploration of legitimate questions. Editor's note.

³ With the advent of artificial science and its theoretical underpinnings (chaos, complexity, and uncertainty theories), it is now posited that much of human behaviour is complex, dynamic, multidimensional, level/phase structured, nonlinear, law-driven, and bounded (culture, time, place, age, gender, ethnicity, etc.). The use, misuse, “abuse” or nonuse of any “drugs,” whatever their legal and social status, and the range of interventions (reatment, prevention, controls, research, etc.) implemented to affect such use, of however any of these are defined and delineated would be such a behaviors and processes. This is not a semantic issue. It relates to and is, rather, and on-going flaw in the field. There are two important issues to consider and which are derived from this: (1) using linear models/tools to study nonlinear processes/phenomena can and does result in misleading conclusions and can therefore also result in inappropriate intervention as well as the wasting of limited human and non-human resources; (2) the concepts prediction and control have different meanings and dimensions than they do in the more traditional linear “cause and effect” paradigms. [Buscema, M. (1998), Artificial Neural Networks, Substance Use & Misuse, 33(1–3)]. Editor's note.

⁴ There are many disease models; not just one. These include, among others, bio-chemical based models, actuarial, functional, experiential, social, political, religious-spirit-animism, and economic- and consumer-based models. Secondly, each have their own critical definitions, criteria, goals and agendas, constituencies, indicated and contraindicated techniques and services, “healers” and change agents, preferred sites for intervention, temporal parameters, and stake holders. Each have their unique ethical associated issues. The recent “medicalization” of “drug use” (substance use disorder) in the fourth and fifth DSM “secular Bible,” does not sufficiently serve basic diagnostic purposes of gathering relevant, needed information in order to make a needed decision nor give the minimum of needed evidence-based information: etiology, process, and prognosis. The aforementioned can and do represent on-going flaws affecting intervention planning, implementation, and assessment. The reader is referred to the growing literature about “disease mongering” as an additional facet of the “diseasing” process. Editors note.

⁵ The reader is reminded that the concepts of “risk factors,” “vulnerabitilities” as well as “protective factors,” are often noted in the literature, without adequately noting their dimensions (linear, nonlinear; rates of development and decay; anchoring or integration, cessation, etc.), their “demands,” the critical necessary conditions (endogenously as well as exogenously; from a micro to a meso- to a macrolevel) which are necessary for these processes to operate (begin, continue, become anchored and integrate, change as de facto realities change, cease, etc.) or not to and whether their underpinnings are theory-driven, empirically based, individual and/or systemic stake holder bound, based upon “principles of faith doctrinaire positions, “personal truths,” historical observation, precedents and traditions that accumulate over time, conventional wisdom, perceptual and judgmental constraints, “transient public opinion,” or what. This is necessary to consider and to clarify if these term are not to remain as yet additional shibboleths in a field of many stereotypes, tradition-driven activities, “principles of faith,” stakeholder objectives and on-going flaws. Editor's note.

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Allaman Allamani

Allaman Allamani, M.D., Psychiatrist; Family Therapist; Researcher. He has been coordinator of the Alcohol Centre, Florence Health Agency (1993–2009); he has been consultant to the Region of Tuscany Health Agency for research on social epidemiology and prevention policy since 2009. First non-alcoholic trustee of Italian Alcoholics Anonymous (1997–2003). He is a member of the editorial board of “Substance Use and Misuse.” Coordinator of a number of Italian projects about alcohol prevention and policies, he has colead work package 3 of the European Commission-funded AMPHORA project. Author and coauthor of several articles, editor, and coeditor of a number of books and monographs.