6_Definition of Substance Use Disorders
Definition of substance use disorders
A substance use problem may be said to exist when the client experiences
any kind of difficulty related to the ingestion of a mood-altering
substance. These difficulties can be in any area of the client’s
biopsychosocial functioning. Substance abuse and dependence are clinical
diagnoses used when the problematic use of substances meets specific
DSM-IV-TR criteria, which includes psychological, physiological, and
behavioural, elements.
It is the responsibility of the clinician to distinguish between substance
use, abuse, and dependence.
Substance Use
Substance use can be defined as: “The ingestion of psychoactive
substances in moderate amounts that does not significantly interfere with
social, educational, or occupational functioning” (Barlow, 2005, p381).
Substance Abuse
The DSM-IV-TR (2000) defines substance abuse in terms of how
significantly it interferes with someone’s life, NOT in terms of how much
of a given substance is actually ingested.
DSM-IV-TR Criteria for Substance Abuse (DSM-IV-TR, 2000):
A. A maladaptive pattern of substance use leading to clinically
significant impairment or distress, as manifested by one (or
more) of the following during the same 12-month period:
6_Definition of Substance Use Disorders
1. Recurrent substance use resulting in a failure to fulfil 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)
2. 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)
3. Recurrent substance-related legal problems (e.g. arrests for
substance-related disorderly conduct)
4. 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)
B. The symptoms have never met the criteria for Substance Dependence
for this class of substance
Substance Dependence
Addiction, or substance dependence, has been defined as: “A chronic,
relapsing disease, characterised by compulsive drug seeking and use,
which is accompanied by functional and molecular changes in the brain”
(NIDA, 2005).
Substance dependence can be defined as: “A cluster of cognitive,
behavioural, and physiological symptoms indicating that the individual
continues use of the substance despite significant substance-related
problems. A diagnosis can be applied to every class of substances.
Craving is likely to be experienced by most individuals with substance
dependence” (DSM-IV, 1994, p176).
6_Definition of Substance Use Disorders