Substance abuse

Substance abuse refers to the overindulgence in and dependence on a stimulant, depressant, or other chemical substance, leading to effects that are detrimental to the individual's physical or mental health, or the welfare of others.{{fn|1}}

Related Topics:
Stimulant - Depressant - Chemical substance - Mental health

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The disorder is characterized by a pattern of continued pathological use of a medication, non-medically indicated drug or toxin, that results in repeated adverse social consequences related to drug use, such as failure to meet work, family, or school obligations, interpersonal conflicts, or legal problems. There are on-going debates as to the exact distinctions between substance abuse and substance dependence, but current practice standard distinguishes between the two by defining substance dependence in terms of physiological and behavioral symptoms of substance use, and substance abuse in terms of the social consequences of substance use.{{fn|2}}

Related Topics:
Non-medically indicated drug or toxin - Substance dependence

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Substance abuse may lead to addiction or substance dependence. Medically, dependence requires the development of tolerance leading to withdrawal symptoms. Both abuse and dependence are distinct from addiction which involves a compulsion to continue using the substance despite the negative consequences, and may or may not involve chemical dependency. Dependence almost always implies abuse, but abuse frequently occurs without dependence, particularly when an individual first begins to abuse a substance. Dependence involves physiological proceses while substance abuse reflects a complex interaction between the individual, the abused substance and society. http://www.mclean.harvard.edu/research/adarc/

Related Topics:
Tolerance - Withdrawal - Addiction - Compulsion - Chemical dependency - Physiological

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Substance abuse is sometimes used as a synonym for drug abuse, drug addiction, and chemical dependency, but actually refers to the use of substances in a manner outside sociocultural conventions. All use of illicit drugs and all use of licit drugs in a manner not dictated by convention (e.g., according to physician's orders) is abuse according to this definition, however there is no universally accepted definition of substance abuse.

Related Topics:
Drug abuse - Drug addiction - Chemical dependency - Illicit drug

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In the early 1950s, the first edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders grouped alcohol and drug abuse under Sociopathic Personality Disturbances, which were through to be symptoms of deeper psychological disorders or moral weakness.

Related Topics:
American Psychiatric Association - Diagnostic and Statistical Manual of Mental Disorders - Sociopathic Personality Disturbances

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The third edition, in the 1980s, was the first to recognise substance abuse (including drug abuse) and substance dependance as conditions separate from substance abuse alone, bringing in social and cultural factors. The definition of dependance emphasised tollerance to drugs, and withdrawal from them as key components to diagnosis, whereas abuse was defined as "problematic use with social or occupational impairment" but without withdrawal or tollerance.

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In 1987 the DSM-IIIR category "psychoactive substance abuse", which includes former concepts of drug abuse is defined as "a maladaptive pattern of use indicated by...continued use despite knowledge of having a persistent or recurrent social, occupational, psychological or physical problem that is caused or exacerbated by the use (or by) recurrent use in situations in which it is physically hazardous". It is a residual category, with dependence taking precedence when applicable. It was the first definition to give equal weight to behavioural and physiological factors in dignosis.

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By 1988, the DSM-IV defines substance dependance as "a syndrome involving compulsive use, with or without tolerance and withdrawal"; whereas substance abuse is "problematic use without compulsive use, significant tolerance, or withdrawal".

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The fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) issued by the American Psychiatric Association defines substance abuse as:{{fn|3}}

Related Topics:
Diagnostic and Statistical Manual of Mental Disorders - American Psychiatric Association

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:*A. A maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by one (or more) of the following, occurring within a 12-month period:

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::#Recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home (e.g., repeated absences or poor work performance related to substance use; substance-related absences, suspensions or expulsions from school; neglect of children or household)

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::#Recurrent substance use in situations in which it is physically hazardous (e.g., driving an automobile or operating a machine when impaired by substance use)

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::#Recurrent substance-related legal problems (e.g., arrests for substance-related disorderly conduct

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::#Continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance (e.g., arguments with spouse about consequences of intoxication, physical fights)

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:*B. The symptoms have never met the criteria for Substance Dependence for this class of substance.

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