The current cocaine problem is the fifth epidemic of stimulant abuse in our history (Gawin & Ellinwood, 1988). The first epidemic of cocaine abuse was in the 1890s and the second in the 1920s. In the early 1950s and late 1960s, amphetamine and methamphetamine were abused. Now, it is powder and crack cocaine. The seriousness of the current "drug problem" is apparent in this country in the birth of drug-affected children and the growing numbers of young black males in prisons, and abroad in the deaths of combatants over drug empires. National concern has provoked four principal responses: interdiction of drugs from outside the United States, punishment of drug sellers and users, treatment, and prevention (Fraser & Kohlert, 1988). None of these responses so far has resolved the drug problem. Social and health services professionals tend to put faith in the latter two approaches.

......