Talk:Substance abuse

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wat[edit]

why does the first sentence in the signs and symptoms paragraph say drug misuse instead of drug abuse? Is it because the definition of drug misuse is above it? I'm going to change it, if you have any problem with it go ahead and change it back but tell me why here 96.233.211.160 (talk) 16:13, 12 August 2010 (UTC)

Responsible drug use[edit]

I'd like to make the following notes, though not sure what if any additions I can personally make above and beyond. More secificaly, my notes may be jurisdiction dependant.

1: The Majority of chemical drugs are not 'illegal' they are prohibited. for instance: Heroin is actually proscribed to some people, and not just for people who are dependant on it. 2: The misuse of drugs act [UK] (which came out of an international treaty) is based on 'misuse' being not of medical use, and so defines 'recreational' as not of medical use. Legal cases in the UK have been based on the idea of medical necessity, that is there was no suitable alternative available. and that serious harm would otherwise be caused. 3: I don't know anyone who's been coded this way for nicotine dependence, nor food dependence / abuse. —Preceding unsigned comment added by 217.171.129.68 (talk) 19:34, 22 November 2010 (UTC)

Nonsense[edit]

Substance abuse is simply another euphemism for addiction. Tobacco for example has an 85% acquire rate which means for every 100 who smoke 1 cigarette will become dependent on tobacco. Ethanol is the active ingredient in beer, wine and spirits and the cessation rate is dismal at about 1 in 36.

This article smacks of prohibition when addiction should be recognized as a medical problem. Addiction is hard to treat, a jail cell is not treatment. My IQ >> 160 (talk) 01:23, 21 March 2011 (UTC)

Please use Wikipedia talk pages to improve the article. Are there verifiable and reliable sources to improve the article to show various points of view, while maintaining a neutral point of view? tedder (talk) 01:28, 21 March 2011 (UTC)

‘Substance’ use[edit]

The article’s use of ‘substance’ strikes me as bizarre
Does it represent denial that ethanol and nicotine are drugs, and generally muddled thinking about drug use by supposed authorities?
Or am I a substance abuser, within the meaning intended by the article, because air and water are substances?
Laurel Bush (talk) 14:43, 16 August 2011 (UTC)

"Substance" is usually shorthand for "psychoactive substance" or "drug", but casts a broader net because there are many people who abuse non-psychoactive substances (e.g., performance enhancing drugs)...In addition, "substance" is preferred by some over "drug" because the latter is more of a loaded term. While I have no idea if you abuse air or water, there is some discussion of this nomenclature in the article (though it could use more clarity) that would strongly suggest your possible issues with air and water, short of hyponatraemia or psychogenic polydipsia, aren't in the category of disorders discussed in the present article. — Scientizzle 16:25, 16 August 2011 (UTC)


Seems to me:

  • The article is really about drug abuse, meaning reckless or pathological use of a substance as a drug, and includes such use of substances which may not be recognised as drugs by drug and medicines control legislation, or in common discourse (with alcohol as an example of a substance which may be abused without being recognised as a drug)
  • ’Drug substance abuse’ might be a better article title, but would create, in my mind, a quandary as to what Drug substance should be or point to
  • The title should be Drug abuse (except Drug misuse might be better)

Laurel Bush (talk) 11:36, 24 August 2011 (UTC)

Drug misuse is a different concept than drug abuse (though I'm sure one could easily ID a demarcation problem between misuse and abuse), and more commonly associated with prescription drugs rather than illegal narcotics[1], so that would not be a good title. Substance abuse or Substance abuse disorder are the only proper titles based on the family of psychiatric disorders found in the DSM IV, in my opinion, and the former is simpler. — Scientizzle 14:00, 24 August 2011 (UTC)


See http://www.legislation.gov.uk/ukpga/1971/38/contents
Laurel Bush (talk) 09:35, 25 August 2011 (UTC)

I can certainly admit that my perspective of this topic has been formed in the United States and specifically influenced by NIDA. "Drug misuse" appears to have a different usage and meaning in the UK--completely synonymous with "drug abuse" rather than slightly different...like I said above, the terms are unfortunately somewhat ambiguous. However, the title of this article should come from an evaluation of the most prominent and relevant sources. There are two distinct questions here: "substance" vs. "drug" and "abuse" vs. "misuse" vs. "use". The article presently uses "substance abuse" as the preferred term, but synonymizes (is this even a word?) it with "drug abuse" right in the opening sentence. To determine what the reliable, authoritative sources currently use as terminology. Here's what I've found thus far...
  • DSM[2]-"Substance-Related Disorders" and specific DSM coding for "abuse"
  • MeSH[3][4]-Synonymous use of "substance abuse" and "drug abuse"
  • ICD[5]-"Mental and behavioural disorders due to psychoactive substance use"
  • NICE[6]-"Drug Misuse"
  • Australian National Drug Strategy seems to prefer "abuse"[7] over "misuse"[8] and "drug abuse" generally
  • Royal College of General Practitioners[9]-"Substance misuse" & "drug misuse"(see also doi:10.1093/innovait/inq113 in which almosst every variation of "substance/drug misuse/abuse" is used almost interchangeably)
  • There's some good discussion of terminology by the WHO[10]

    misuse, drug or alcohol Use of a substance for a purpose not consistent with legal or medical guidelines, as in the non-medical use of prescription medications. The term is preferred by some to abuse in the belief that it is less judgmental.

    and

    abuse (drug, alcohol, chemical, substance, or psychoactive substance) A group of terms in wide use but of varying meaning. In DSM-IIIR, "psychoactive substance 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 physical1y hazardous". It is a residual category, with dependence taking precedence when applicable. The term "abuse" is sometimes used disapprovingly to refer to any use at all, particularly of illicit drugs. Because of its ambiguity, the term is not used in ICD-10 (except in the case of non-dependence-producing substances- see below); harmful use and hazardous use are the equivalent terms In WHO usage, although they usually relate only to effects on health and not to social consequences. " Abuse" is also discouraged by the Office of Substance Abuse Prevention (OSAP, now CSAP - Center for Substance Abuse Prevention) in the USA, although terms such as "substance abuse" remain in wide use in North America to refer generally to problems of psychoactive substance use.

    In other contexts, abuse has referred to non-medical or unsanctioned patterns of use, irrespective of consequences. Thus the definition published in 1969 by the WHO Expert Committee on Drug Dependence was "persistent or sporadic excessive drug use inconsistent with or unrelated to acceptable medical practice"

If anyone else wants to find more sources, I'd love to see them...
My take on what I've seen thus far is that "substance" & "drug" are widely and presently treated as synonymous and interchangeable, but the DSM & ICD use of substance over drug probably justifies substance being the preferred term over drug. That is, the way the opening sentence is structured right now is perfectly fine.
The question of "abuse" vs. "misuse" vs. "use" is a little trickier. It looks to me like there's a general abandonment of any distinction between misuse and abuse and the winds may be favoring the politically correct adoption of misuse over abuse. I think there's probably enough sourcing presented right here to adequately discuss the variations in terminology. Redirects for every major term, and bolded acknowledgment in the lede is probably warranted. — Scientizzle 15:02, 26 August 2011 (UTC)



Thanks
I have read through some but not yet all of the material you have presented
It looks interesting

Meanwhile:
You say the winds may be favouring ‘misuse’ over ‘abuse’
I feel it blowing somewhat the other way in UK mass media, although my personal sense of English as a language is more comfortable with ‘misuse’ (with ‘abuse’ perhaps meaning deliberate or culpable misuse, and thus a category of misuse) Still, my local NHS board does continue to employ ‘substance misuse practitioners’, and has not rebranded them as ‘abuse practitioners’
Re ‘substance’ and ‘abuse’, I guess current DSM and ICD fashion must be respected, although I see use of ‘substance’ instead of ‘drug’ as denial, or pandering to denial, that ethyl alcohol and prescribed medicines are drugs
Or perhaps it is just that we are in an area littered with semantic traps (and perhaps the article should carry a warning to this effect)

I listed ‘Drug’ in Substance a while back

Laurel Bush (talk) 10:04, 29 August 2011 (UTC)

I have twigged
since writing the above
that substance abuse is usually code
or a morally prejudiced label
for intoxication
and that drug abuse is usally code for intoxication with 'drug'-stigmatised intoxicants
of which most are easily recognised as 'abuse'-stigmatised medicines
Reminds me of homosexuality used as a diagnosis
Laurel Bush (talk) 09:53, 27 October 2012 (UTC)

This article and the one on substance use disorder should not be merged. Substance use and substance use disorder are two different issues. Also, there are further differences between substance use, substance abuse, substance dependence, and substance withdrawal. So, again, these two are separate issues and the articles should not be merged. Daniellagreen (talk) 02:41, 20 February 2014 (UTC)

What about the third one, substance-related disorder? All seems the same to me. InedibleHulk (talk) 23:14, August 16, 2014 (UTC)