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On 2 October 2023, it was proposed that this article be moved to Substance use and misuse. The result of the discussion was not moved. |
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)
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)
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)
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)
Seems to me:
Laurel Bush (
talk) 11:36, 24 August 2011 (UTC)
See
http://www.legislation.gov.uk/ukpga/1971/38/contents
Laurel Bush (
talk) 09:35, 25 August 2011 (UTC)
andmisuse, 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.
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"
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)
I have come up with an addition for this section addressing substance abuse in older adults and how they tend to transition into alcohol and prescription drug abuse. It discusses how this group (65+) is responsible for one-third of prescription drug sales and how these drugs can be abused. In addition, this group can be more susceptible to withdrawal symptoms and additional side-effects due to the mixing of alcohol and drugs. Any suggestions or problems? — Preceding unsigned comment added by Sankaria14 ( talk • contribs) 22:34, 7 December 2014 (UTC)
I've just trimmed quite a bit, but this article still looks very much as if someone was paid "by the word" to pad it out. Keep it tight and on track people! Snori ( talk) 18:25, 4 February 2015 (UTC)
The DSM section of this article needs to be updated in that substance abuse is no longer a diagnosis according to DSM-5. Abuse and dependence have been merged as 'Substance Use Disorder.' The introduction should probably mention this with a wikilink to the Substance Use Disorder page. To the first paragraph a sentence such as:
According to the recently published DSM-5 substance abuse is no longer a specific diagnosis but under the category of Substance Use Disorder, combined with Substance Dependence.
I also suggest updating the DSM criteria for diagnosis. I do not have access to that information at the time of this edit. Ktwagner ( talk) 12:57, 13 October 2015 (UTC)
The last paragraph/phrase in that subsection (about risk for lungs when inhaling) looks odd. It is not in the same style than the rest. The whole section is not about harm but about special populations. The harm to lungs from aspiration/inhalation should IMHO be mentioned elsewhere. — MFH: Talk 00:43, 13 January 2016 (UTC)
Ref does not appear to support
Extended content
|
---|
Scientist's began to study addiction in 1930, and concluded that addiction was a moral shortcoming and lack of willpower, developing a strong stigma towards what caused the addiction in the first place. Those conclusions influenced society’s view on addiction, but those conclusions are no longer valid because of groundbreaking information found by scientists in the past ten years that indicate addiction is a brain disease that affects both the brain and behavior. [1] |
Doc James ( talk · contribs · email) 07:13, 2 December 2015 (UTC)
{{
cite journal}}
: |first1=
has generic name (
help)CS1 maint: numeric names: authors list (
link). I checked the article and could not find 127 (as in 127,000) nor 53 (as in 53,000) nor anything else quickly scanning that supported this statement. It may be there, but I didn't find it in the 5-10 minutes I spent skimming and searching.Most addictive drug is agreed by pharmacology authorities to be tobacco. Cannabis is not physically harmful at all. LSD is probably the least addictive substance that ever existed; it's practically impossible to form dependence even if one tries (due to tolerance etc). Amphetamine is infinitely more harmful than heroin. It's like it was randomly made by an idiot who has no knowledge at all about pharmacology. I won't remove it right now because I don't have the time to add the references to support my edit, but someone who has the time and the knowledge please look into this. — Preceding unsigned comment added by 31.216.105.154 ( talk) 07:53, 12 February 2016 (UTC)
It is common for individuals that abuse or misuse drugs to have other psychological diagnoses. Depression, anxiety, and psychosis are all common comorbidities. However, it is difficult to determine if the substance abuse is a primary disorder or a result of the comorbid psychological disorder. Looking at family history, onset of the substance abuse and psychological disorder symptoms, and previous treatment, can all aid in determining the primary disorder.
Individuals who have a comorbid psychological disorder often have a poor prognosis.
Additionally, substance abuse may produce symptoms that lead to a false diagnosis. For this reason, it is important that an individual maintain abstinence for 2 weeks before a psychiatric diagnosis is made.
It is common for individuals that abuse or misuse drugs to have other psychological problems. [2] The terms “dual diagnosis” or “co-occurring disorders,” refer to having a mental health and substance use disorder at the same time. According to the British Association for Psychopharmacology (BAP), “symptoms of psychiatric disorders such as depression, anxiety and psychosis are the rule rather than the exception in patients misusing drugs and/or alcohol.” [3]
Individuals who have a comorbid psychological disorder often have a poor prognosis if either disorder is untreated. [2] Historically most individuals with dual diagnosis either received treatment only for one of their disorders or they didn’t receive any treatment all. However since the 1980’s, there has been a push towards integrating mental health and addiction treatment. In this method, neither condition is considered primary and both are treated simultaneously by the same provider. [3] Permstrump ( talk) 11:18, 9 March 2016 (UTC)
It is common for individuals that misuse drugs...or
It is common for individuals with substance use disorders... to have other psychological problems."? The original wording was probably clunky, but the source is talking specifically about people with disordered use. I don't believe the statement applies to everyone who uses drugs/alcohol in general. PermStrump (talk) 04:11, 15 March 2016 (UTC)
symptoms of psychiatric disorders such as depression, anxiety and psychosis are the rule rather than the exception in patients misusing drugs and/or alcohol."? It's not that I'm so attached to the wording of that part of that one sentence, but I would have worried that it was misrepresentation of the source. If you think still think "use" is close enough compared to the direct quote, then I'll trust your opinion. I used that quote later in the same paragraph, so maybe that's qualification enough. PermStrump (talk) 04:32, 15 March 2016 (UTC)
References
I'm working on an Esperanto translation of this article and find it important to raise this issue without getting into any sort of debate about drug abuse: I am unable to understand the relevance of the statistic about the number of people who use illicit substances. The diagnosis of substance abuse is independent of legality, and can include legal drugs like alcohol. If someone can justify the statistic, please feel free to. Jan sewi ( talk) 18:07, 10 January 2017 (UTC)
Perhaps something could be said about how the cultural patterns of drug use are associated with the values, beliefs, and norms that a society assigns a drug. For example, the attitudes towards alcohol in the U.S., where the drinking age is 21, may influence behaviors of binge drinking in adolescence where as in some southern European countries, rates of binge drinking may be lower. Perhaps a different Wikipedia article altogether for this topic would be best. Courtlee214 ( talk) —Preceding undated comment added 20:48, 26 January 2017 (UTC)
Dear @ Doc James:, thanks for reaching out.
I think that photo has potential to mislead patients about the efficacy of psycho-stimulants which could hold back patients like ADHD to take medications they need. -- It's gonna be awesome!✎ Talk♬ 03:04, 5 October 2017 (UTC)
The consensus is to use the second image, File:Rational scale to assess the harm of drugs (mean physical harm and mean dependence).svg.
Which of the two images should we use? Doc James ( talk · contribs · email) 01:19, 30 October 2017 (UTC)
Ashcanpete ( talk) 17:47, 2 November 2017 (UTC)
Why can't we keep using both? They're both in the article right now. WhatamIdoing ( talk) 02:36, 30 October 2017 (UTC)
@
Doc James and
Sizeofint: See below. I've left-aligned the table on this page since the images take up too much space on the right at the moment. In the article, this table should be right-aligned.
Also, can someone please check to make sure that I didn't make a clerical error while copying the table values? I had to do this manually. Seppi333 ( Insert 2¢) 19:56, 30 October 2017 (UTC)
Drug | Drug class | Physical harm |
Dependence liability |
Social harm |
Total harm |
---|---|---|---|---|---|
Heroin | Opioid | 2.78 | 3.00 | 2.54 | 2.77 |
Cocaine | CNS stimulant | 2.33 | 2.39 | 2.17 | 2.30 |
Barbiturates | CNS depressant | 2.23 | 2.01 | 2.00 | 2.08 |
Methadone | Opioid | 1.86 | 2.08 | 1.87 | 1.94 |
Alcohol | CNS depressant | 1.40 | 1.93 | 2.21 | 1.85 |
Ketamine | Dissociative anesthetic | 2.00 | 1.54 | 1.69 | 1.74 |
Benzodiazepines | Benzodiazepine | 1.63 | 1.83 | 1.65 | 1.70 |
Amphetamine | CNS stimulant | 1.81 | 1.67 | 1.50 | 1.66 |
Tobacco | Tobacco | 1.24 | 2.21 | 1.42 | 1.62 |
Buprenorphine | Opioid | 1.60 | 1.64 | 1.49 | 1.58 |
Cannabis | Cannabinoid | 0.99 | 1.51 | 1.50 | 1.33 |
Solvent drugs | Inhalant | 1.28 | 1.01 | 1.52 | 1.27 |
4-MTA | Designer SSRA | 1.44 | 1.30 | 1.06 | 1.27 |
LSD | Psychedelic | 1.13 | 1.23 | 1.32 | 1.23 |
Methylphenidate | CNS stimulant | 1.32 | 1.25 | 0.97 | 1.18 |
Anabolic steroids | Anabolic steroid | 1.45 | 0.88 | 1.13 | 1.15 |
GHB | Neurotransmitter | 0.86 | 1.19 | 1.30 | 1.12 |
Ecstasy | Empathogenic stimulant | 1.05 | 1.13 | 1.09 | 1.09 |
Alkyl nitrites | Inhalant | 0.93 | 0.87 | 0.97 | 0.92 |
Khat | CNS stimulant | 0.50 | 1.04 | 0.85 | 0.80 |
Notes about the harm ratings
The Physical harm, Dependence liability, and Social harm scores were each computed from the average of three distinct ratings.
[1] The highest possible harm rating for each rating scale is 3.0.
[1] Physical harm is the average rating of the scores for acute binge use, chronic use, and intravenous use. [1] Dependence liability is the average rating of the scores for intensity of pleasure, psychological dependence, and physical dependence. [1] Social harm is the average rating of the scores for drug intoxication, health-care costs, and other social harms. [1] Total harm was computed as the average of the Physical harm, Dependence liability, and Social harm scores. |
References
This graph sould be removed from the lede, it just repeats the old anti-benzo prejudices. There's no evidence whagtsoever than benzos are at the same level of such extremely harmful drugs as alcohol, see also: [12]. Miacek (talk) 21:31, 15 May 2018 (UTC)
This needs to be converted to inline references Doc James ( talk · contribs · email) 00:00, 31 August 2018 (UTC)
"St Louis Epidemic
The overdose rate has risen in St Louis by 79 percent from 2010 to 2016 (Saint Louis County Department of Public Health, 2018). This increase could be explained by number of opioid prescription and quantity of pills issued to patients. Prescription Drug Monitoring Programs (PDMP) could directly influence the number of prescriptions written. Analysis was performed and determined that PDMP’s are not effective in reducing prescription rates unless physicians were required to access the program prior to writing the prescription (Ayres & Jalal, 2018). Additionally, Research has shown that patients receiving opioids to relieve chronic pain are 77 percent more likely to abuse drugs than those who do not (Banerjee et al., 2016). Education programs could be implemented to combat the overdoses as well. Historically, overdoses have decreased nine to 11 percent due to the Good Samaritan Laws that grant immunity to users that try and prevent an overdose (Ayres & Jalal, 2018). If citizens and more importantly, users, knew about law and other like it, the overall overdose rate could be positively impacted. Lastly, Naloxone has been available for many years but only to first responders and EMTs. Overdoses cost Missouri $12.6 billion annually (Missouri Department of Health, 2018). Research has shown, through the use of naloxone, overdose death rates decreased by 50 percent (Frank, Mateu-Gelabert, Guarino, Bennett, Wendel, Jessell, & Teper, 2015). The overdoses in St Louis continue to rise. By implementing PDMPs to monitoring prescriptions, educating the population about laws in place to combat overdoses and a cheaper more effective Naloxone prescription could reduce the number of drug related overdoses in the St Louis Area.
References:
Ayres, I. & Jalal, A. (2018). Opioids, law & ethics. The Journal of Law, Medicine & Ethics, 46(2018), 387-403. doi:10.1177/1073110518782948
Banerjee, G., Edelman, E.J., Barry, D.T, Becker, W.C, Cerda, M., Crystal, S., Gaither, J.R., … Marshall, B.D. (2016). Non-medical use of prescription opioids is associated with heroin initiation among U.S. veteran: A prospective cohort study. Society for the Study of Addiction, 111(11), 2021-2031. doi:10.1111/add.13491 Frank, D., Mateu-Gelabert, P., Guarino, H., Bennett, A., Wendel, T., Jessell, L., & Teper, A. (26, January 2018).
High risk and little knowledge: Overdose experiences and knowledge among young adult nonmedical prescription opioid users. International Journal of Drug Policy., 26(1), 84-91. doi: 10.1016/j.drugpo.2014.07.013 Missouri Department of Health. (2018). Good Samaritan law. Official Missouri State Website. Retrieved from: https://health.ml.gov/living/lpha/phnursing/goodsamaritan.php
Saint Louis County Department of Public Health. (June, 2018). Drug overdose deaths St. Louis County, Missouri. Retrieved from: https://www.stlouisco.com/Portals/8/docs/Health/Health%20Data/Drug_Poisoning_Profil e_Adapted_from_Heroin_Deaths_profile_2017_Final.pdf"
The current lede reads "The exact cause of substance abuse is not clear, with the two predominant theories being: either a genetic disposition which is learned from others, or a habit which if addiction develops, manifests itself as a chronic debilitating disease." with a citation to an obsolete ref. I suggest that it would be clearer to acknowledge that there is complex causation, with many genetic, epigenetic, and developmental factors. See for instance https://www.nature.com/articles/522S48a LeadSongDog come howl! 18:02, 2 January 2019 (UTC)
There have been efforts, such as in the article on Ozzy Osbourne, to refer to substance use rather than abuse in an attempt to use more neutral and non-judgmental language. Should this now be renamed Substance use?-- Egghead06 ( talk) 15:46, 4 March 2021 (UTC)
This article was the subject of a Wiki Education Foundation-supported course assignment, between 9 September 2021 and 18 November 2021. Further details are available on the course page. Student editor(s): Nicolekha.
Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT ( talk) 10:22, 17 January 2022 (UTC)
This article was the subject of a Wiki Education Foundation-supported course assignment, between 28 March 2022 and 30 May 2022. Further details are available on the course page. Student editor(s): Zebang Chen ( article contribs).
An editor has identified a potential problem with the redirect Illegal drug use and has thus listed it for discussion. This discussion will occur at Wikipedia:Redirects for discussion/Log/2022 May 11#Illegal drug use until a consensus is reached, and readers of this page are welcome to contribute to the discussion. Sangdeboeuf ( talk) 01:15, 11 May 2022 (UTC)
The result of the move request was: not moved per consensus below. ( closed by non-admin page mover) Extraordinary Writ ( talk) 16:31, 24 July 2022 (UTC)
Substance abuse →
Substance addiction – I think the name of this page should be moved to 'Substance addiction'. I feel like the name 'Substance abuse' is biased and implies the person dependent on drugs has done something wrong by being addicted. Furthermore, my concerns are supported by a lot of sourced information already in the article which recommended avoiding the term 'abuse' in contexts like this. Renaming the article and replacing 'abuse' with 'addiction' in similar instances is a good idea from my perspective - not only preventing victim-blaming for people with drug addiction but also making the page neutral - considering the multiple paragraphs talking about criticisms of terms like 'substance abuse'. However, I'm also open to hearing different terms the article should be renamed to that also prevent victim-blaming. Someone might suggest a term better and more medically recommended than the one I've proposed.
Stephanie921 (
talk) 14:59, 17 July 2022 (UTC)
This article was the subject of a Wiki Education Foundation-supported course assignment, between 22 August 2022 and 16 December 2022. Further details are available on the course page. Student editor(s): Abenaowusua3 ( article contribs).
— Assignment last updated by Gillind ( talk) 17:34, 5 October 2022 (UTC)
I noticed that previously there was a request to move this page to "substance addiction", which failed, but what I would suggest is that instead this article should be merged with the "substance use disorder" page. As noted in the article, the DSM-V does not use the terminology "substance abuse", neither does the WHO. Health Canada also recommends switching from "substance abuse" to "substance use disorder" (SUD) (see here), and the National Institute on Drug Abuse (NIDA) has been trying to change its name to the "National Institute on Drugs and Addiction" because it finds the language of abuse biased and stigmatizing. This page contains a lot of interesting information, but it is overall very confused.
It feels like a lot of workarounds have been written into the article in order to differentiate it from SUD. The article notes that substance abuse is a form of substance-related disorders, but there is no clarity as to how they are different throughout the article, and there are consistent slippages between substance use, abuse and substance use disorder. If this article is about substance use, then it should be about substance use, and would require major revisions to include things like history, culture etc. If it is about the term that was substance abuse, but now is substance use disorder it should be merged. For it to stay as it is, there should be a real definition of what classifies abuse in the article, and what differentiates it from use & SUD.
Merging, rather than moving (as described before) would allow for people to still search "substance abuse", they would just be sent to substance use disorder. A lot of the controversy that is on this page would still work really well on the substance use disorder page, as substance abuse is the historical term described. I think it would make the substance use disorder page more enriched by including a lot of the content that is currently here.
I am open to other proposals as well, or possible clarifications. ADrugResearcher ( talk) 21:25, 25 October 2022 (UTC)
The result of the move request was: not moved. ( non-admin closure) - 🔥 𝑰𝒍𝒍𝒖𝒔𝒊𝒐𝒏 𝑭𝒍𝒂𝒎𝒆 (𝒕𝒂𝒍𝒌)🔥 13:38, 9 October 2023 (UTC)
Substance abuse → Substance use and misuse – This is a great article, but it has a title with which the article itself seems to be unhappy. The problem is that “abuse” is a stigmatizing term, but up until now it has not been clear what was to be done. On 24 July 2022, it was decided that the article would not be moved to “substance addiction” because this article descibes risky use which is non-habitual in nature. There is also a recent yet seemingly inactive discussion about whether to merge substance abuse into substance use disorder, again misguided for the same reason ( Talk:Substance use disorder).
Available editorial guidance is clear on this issue. Since 2017, the Associated Press Stylebook has advised authors and editors to avoid stigmatizing words such as “abuse” or “problem” and to instead use “risky,” “unhealthy,” “excessive,” “heavy,” or “misuse,” depending on context ( link). Further, since 2021, the U.S. National Institute on Drug Abuse (NIDA) has advised against using the stigmatizing term “abuse.” NIDA has advised using the word “use” for non-legal drugs and “misuse” for the use of medically available drugs in a way which deviates from the prescriber’s explicit intent ( link).
As written, this article pertains to the use of both legal and non-legal drugs, it mentions that the term “drug abuse” is not preferred, and it even has a section devoted to “drug misuse” which is consistent with NIDA’s recommendations. With the above in mind, I propose this article be moved to “Substance use and misuse.” HussainHx ( talk) 01:01, 2 October 2023 (UTC)
substance abuse, also known as drug abuse, is the use of a drug in amounts or by methods that are harmful to the individual or others; this is by definition what "abuse" means. Perceived "stigmatization" is not a good reason. For "substance use", see recreational drug use or self-medication. -- WikiLinuz ( talk) 19:00, 6 October 2023 (UTC)
References
{{
cite journal}}
: CS1 maint: PMC format (
link)
"The term ‘abuse’ is sometimes used disapprovingly to refer to any use at all, particularly of illicit drugs. The term is not used in ICD-10 because of its ambiguity and to avoid including social consequences in the definition of a diagnosis. Harmful use is the closest equivalent in ICD-10. 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’. The term drug use is often preferred as it is non-judgemental." [1]
References
This is the
talk page for discussing improvements to the
Substance abuse article. This is not a forum for general discussion of the article's subject. |
Article policies
|
Find medical sources: Source guidelines · PubMed · Cochrane · DOAJ · Gale · OpenMD · ScienceDirect · Springer · Trip · Wiley · TWL |
This
level-5 vital article is rated B-class on Wikipedia's
content assessment scale. It is of interest to the following WikiProjects: | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
Ideal sources for Wikipedia's health content are defined in the guideline
Wikipedia:Identifying reliable sources (medicine) and are typically
review articles. Here are links to possibly useful sources of information about Substance abuse.
|
On 2 October 2023, it was proposed that this article be moved to Substance use and misuse. The result of the discussion was not moved. |
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)
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)
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)
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)
Seems to me:
Laurel Bush (
talk) 11:36, 24 August 2011 (UTC)
See
http://www.legislation.gov.uk/ukpga/1971/38/contents
Laurel Bush (
talk) 09:35, 25 August 2011 (UTC)
andmisuse, 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.
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"
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)
I have come up with an addition for this section addressing substance abuse in older adults and how they tend to transition into alcohol and prescription drug abuse. It discusses how this group (65+) is responsible for one-third of prescription drug sales and how these drugs can be abused. In addition, this group can be more susceptible to withdrawal symptoms and additional side-effects due to the mixing of alcohol and drugs. Any suggestions or problems? — Preceding unsigned comment added by Sankaria14 ( talk • contribs) 22:34, 7 December 2014 (UTC)
I've just trimmed quite a bit, but this article still looks very much as if someone was paid "by the word" to pad it out. Keep it tight and on track people! Snori ( talk) 18:25, 4 February 2015 (UTC)
The DSM section of this article needs to be updated in that substance abuse is no longer a diagnosis according to DSM-5. Abuse and dependence have been merged as 'Substance Use Disorder.' The introduction should probably mention this with a wikilink to the Substance Use Disorder page. To the first paragraph a sentence such as:
According to the recently published DSM-5 substance abuse is no longer a specific diagnosis but under the category of Substance Use Disorder, combined with Substance Dependence.
I also suggest updating the DSM criteria for diagnosis. I do not have access to that information at the time of this edit. Ktwagner ( talk) 12:57, 13 October 2015 (UTC)
The last paragraph/phrase in that subsection (about risk for lungs when inhaling) looks odd. It is not in the same style than the rest. The whole section is not about harm but about special populations. The harm to lungs from aspiration/inhalation should IMHO be mentioned elsewhere. — MFH: Talk 00:43, 13 January 2016 (UTC)
Ref does not appear to support
Extended content
|
---|
Scientist's began to study addiction in 1930, and concluded that addiction was a moral shortcoming and lack of willpower, developing a strong stigma towards what caused the addiction in the first place. Those conclusions influenced society’s view on addiction, but those conclusions are no longer valid because of groundbreaking information found by scientists in the past ten years that indicate addiction is a brain disease that affects both the brain and behavior. [1] |
Doc James ( talk · contribs · email) 07:13, 2 December 2015 (UTC)
{{
cite journal}}
: |first1=
has generic name (
help)CS1 maint: numeric names: authors list (
link). I checked the article and could not find 127 (as in 127,000) nor 53 (as in 53,000) nor anything else quickly scanning that supported this statement. It may be there, but I didn't find it in the 5-10 minutes I spent skimming and searching.Most addictive drug is agreed by pharmacology authorities to be tobacco. Cannabis is not physically harmful at all. LSD is probably the least addictive substance that ever existed; it's practically impossible to form dependence even if one tries (due to tolerance etc). Amphetamine is infinitely more harmful than heroin. It's like it was randomly made by an idiot who has no knowledge at all about pharmacology. I won't remove it right now because I don't have the time to add the references to support my edit, but someone who has the time and the knowledge please look into this. — Preceding unsigned comment added by 31.216.105.154 ( talk) 07:53, 12 February 2016 (UTC)
It is common for individuals that abuse or misuse drugs to have other psychological diagnoses. Depression, anxiety, and psychosis are all common comorbidities. However, it is difficult to determine if the substance abuse is a primary disorder or a result of the comorbid psychological disorder. Looking at family history, onset of the substance abuse and psychological disorder symptoms, and previous treatment, can all aid in determining the primary disorder.
Individuals who have a comorbid psychological disorder often have a poor prognosis.
Additionally, substance abuse may produce symptoms that lead to a false diagnosis. For this reason, it is important that an individual maintain abstinence for 2 weeks before a psychiatric diagnosis is made.
It is common for individuals that abuse or misuse drugs to have other psychological problems. [2] The terms “dual diagnosis” or “co-occurring disorders,” refer to having a mental health and substance use disorder at the same time. According to the British Association for Psychopharmacology (BAP), “symptoms of psychiatric disorders such as depression, anxiety and psychosis are the rule rather than the exception in patients misusing drugs and/or alcohol.” [3]
Individuals who have a comorbid psychological disorder often have a poor prognosis if either disorder is untreated. [2] Historically most individuals with dual diagnosis either received treatment only for one of their disorders or they didn’t receive any treatment all. However since the 1980’s, there has been a push towards integrating mental health and addiction treatment. In this method, neither condition is considered primary and both are treated simultaneously by the same provider. [3] Permstrump ( talk) 11:18, 9 March 2016 (UTC)
It is common for individuals that misuse drugs...or
It is common for individuals with substance use disorders... to have other psychological problems."? The original wording was probably clunky, but the source is talking specifically about people with disordered use. I don't believe the statement applies to everyone who uses drugs/alcohol in general. PermStrump (talk) 04:11, 15 March 2016 (UTC)
symptoms of psychiatric disorders such as depression, anxiety and psychosis are the rule rather than the exception in patients misusing drugs and/or alcohol."? It's not that I'm so attached to the wording of that part of that one sentence, but I would have worried that it was misrepresentation of the source. If you think still think "use" is close enough compared to the direct quote, then I'll trust your opinion. I used that quote later in the same paragraph, so maybe that's qualification enough. PermStrump (talk) 04:32, 15 March 2016 (UTC)
References
I'm working on an Esperanto translation of this article and find it important to raise this issue without getting into any sort of debate about drug abuse: I am unable to understand the relevance of the statistic about the number of people who use illicit substances. The diagnosis of substance abuse is independent of legality, and can include legal drugs like alcohol. If someone can justify the statistic, please feel free to. Jan sewi ( talk) 18:07, 10 January 2017 (UTC)
Perhaps something could be said about how the cultural patterns of drug use are associated with the values, beliefs, and norms that a society assigns a drug. For example, the attitudes towards alcohol in the U.S., where the drinking age is 21, may influence behaviors of binge drinking in adolescence where as in some southern European countries, rates of binge drinking may be lower. Perhaps a different Wikipedia article altogether for this topic would be best. Courtlee214 ( talk) —Preceding undated comment added 20:48, 26 January 2017 (UTC)
Dear @ Doc James:, thanks for reaching out.
I think that photo has potential to mislead patients about the efficacy of psycho-stimulants which could hold back patients like ADHD to take medications they need. -- It's gonna be awesome!✎ Talk♬ 03:04, 5 October 2017 (UTC)
The consensus is to use the second image, File:Rational scale to assess the harm of drugs (mean physical harm and mean dependence).svg.
Which of the two images should we use? Doc James ( talk · contribs · email) 01:19, 30 October 2017 (UTC)
Ashcanpete ( talk) 17:47, 2 November 2017 (UTC)
Why can't we keep using both? They're both in the article right now. WhatamIdoing ( talk) 02:36, 30 October 2017 (UTC)
@
Doc James and
Sizeofint: See below. I've left-aligned the table on this page since the images take up too much space on the right at the moment. In the article, this table should be right-aligned.
Also, can someone please check to make sure that I didn't make a clerical error while copying the table values? I had to do this manually. Seppi333 ( Insert 2¢) 19:56, 30 October 2017 (UTC)
Drug | Drug class | Physical harm |
Dependence liability |
Social harm |
Total harm |
---|---|---|---|---|---|
Heroin | Opioid | 2.78 | 3.00 | 2.54 | 2.77 |
Cocaine | CNS stimulant | 2.33 | 2.39 | 2.17 | 2.30 |
Barbiturates | CNS depressant | 2.23 | 2.01 | 2.00 | 2.08 |
Methadone | Opioid | 1.86 | 2.08 | 1.87 | 1.94 |
Alcohol | CNS depressant | 1.40 | 1.93 | 2.21 | 1.85 |
Ketamine | Dissociative anesthetic | 2.00 | 1.54 | 1.69 | 1.74 |
Benzodiazepines | Benzodiazepine | 1.63 | 1.83 | 1.65 | 1.70 |
Amphetamine | CNS stimulant | 1.81 | 1.67 | 1.50 | 1.66 |
Tobacco | Tobacco | 1.24 | 2.21 | 1.42 | 1.62 |
Buprenorphine | Opioid | 1.60 | 1.64 | 1.49 | 1.58 |
Cannabis | Cannabinoid | 0.99 | 1.51 | 1.50 | 1.33 |
Solvent drugs | Inhalant | 1.28 | 1.01 | 1.52 | 1.27 |
4-MTA | Designer SSRA | 1.44 | 1.30 | 1.06 | 1.27 |
LSD | Psychedelic | 1.13 | 1.23 | 1.32 | 1.23 |
Methylphenidate | CNS stimulant | 1.32 | 1.25 | 0.97 | 1.18 |
Anabolic steroids | Anabolic steroid | 1.45 | 0.88 | 1.13 | 1.15 |
GHB | Neurotransmitter | 0.86 | 1.19 | 1.30 | 1.12 |
Ecstasy | Empathogenic stimulant | 1.05 | 1.13 | 1.09 | 1.09 |
Alkyl nitrites | Inhalant | 0.93 | 0.87 | 0.97 | 0.92 |
Khat | CNS stimulant | 0.50 | 1.04 | 0.85 | 0.80 |
Notes about the harm ratings
The Physical harm, Dependence liability, and Social harm scores were each computed from the average of three distinct ratings.
[1] The highest possible harm rating for each rating scale is 3.0.
[1] Physical harm is the average rating of the scores for acute binge use, chronic use, and intravenous use. [1] Dependence liability is the average rating of the scores for intensity of pleasure, psychological dependence, and physical dependence. [1] Social harm is the average rating of the scores for drug intoxication, health-care costs, and other social harms. [1] Total harm was computed as the average of the Physical harm, Dependence liability, and Social harm scores. |
References
This graph sould be removed from the lede, it just repeats the old anti-benzo prejudices. There's no evidence whagtsoever than benzos are at the same level of such extremely harmful drugs as alcohol, see also: [12]. Miacek (talk) 21:31, 15 May 2018 (UTC)
This needs to be converted to inline references Doc James ( talk · contribs · email) 00:00, 31 August 2018 (UTC)
"St Louis Epidemic
The overdose rate has risen in St Louis by 79 percent from 2010 to 2016 (Saint Louis County Department of Public Health, 2018). This increase could be explained by number of opioid prescription and quantity of pills issued to patients. Prescription Drug Monitoring Programs (PDMP) could directly influence the number of prescriptions written. Analysis was performed and determined that PDMP’s are not effective in reducing prescription rates unless physicians were required to access the program prior to writing the prescription (Ayres & Jalal, 2018). Additionally, Research has shown that patients receiving opioids to relieve chronic pain are 77 percent more likely to abuse drugs than those who do not (Banerjee et al., 2016). Education programs could be implemented to combat the overdoses as well. Historically, overdoses have decreased nine to 11 percent due to the Good Samaritan Laws that grant immunity to users that try and prevent an overdose (Ayres & Jalal, 2018). If citizens and more importantly, users, knew about law and other like it, the overall overdose rate could be positively impacted. Lastly, Naloxone has been available for many years but only to first responders and EMTs. Overdoses cost Missouri $12.6 billion annually (Missouri Department of Health, 2018). Research has shown, through the use of naloxone, overdose death rates decreased by 50 percent (Frank, Mateu-Gelabert, Guarino, Bennett, Wendel, Jessell, & Teper, 2015). The overdoses in St Louis continue to rise. By implementing PDMPs to monitoring prescriptions, educating the population about laws in place to combat overdoses and a cheaper more effective Naloxone prescription could reduce the number of drug related overdoses in the St Louis Area.
References:
Ayres, I. & Jalal, A. (2018). Opioids, law & ethics. The Journal of Law, Medicine & Ethics, 46(2018), 387-403. doi:10.1177/1073110518782948
Banerjee, G., Edelman, E.J., Barry, D.T, Becker, W.C, Cerda, M., Crystal, S., Gaither, J.R., … Marshall, B.D. (2016). Non-medical use of prescription opioids is associated with heroin initiation among U.S. veteran: A prospective cohort study. Society for the Study of Addiction, 111(11), 2021-2031. doi:10.1111/add.13491 Frank, D., Mateu-Gelabert, P., Guarino, H., Bennett, A., Wendel, T., Jessell, L., & Teper, A. (26, January 2018).
High risk and little knowledge: Overdose experiences and knowledge among young adult nonmedical prescription opioid users. International Journal of Drug Policy., 26(1), 84-91. doi: 10.1016/j.drugpo.2014.07.013 Missouri Department of Health. (2018). Good Samaritan law. Official Missouri State Website. Retrieved from: https://health.ml.gov/living/lpha/phnursing/goodsamaritan.php
Saint Louis County Department of Public Health. (June, 2018). Drug overdose deaths St. Louis County, Missouri. Retrieved from: https://www.stlouisco.com/Portals/8/docs/Health/Health%20Data/Drug_Poisoning_Profil e_Adapted_from_Heroin_Deaths_profile_2017_Final.pdf"
The current lede reads "The exact cause of substance abuse is not clear, with the two predominant theories being: either a genetic disposition which is learned from others, or a habit which if addiction develops, manifests itself as a chronic debilitating disease." with a citation to an obsolete ref. I suggest that it would be clearer to acknowledge that there is complex causation, with many genetic, epigenetic, and developmental factors. See for instance https://www.nature.com/articles/522S48a LeadSongDog come howl! 18:02, 2 January 2019 (UTC)
There have been efforts, such as in the article on Ozzy Osbourne, to refer to substance use rather than abuse in an attempt to use more neutral and non-judgmental language. Should this now be renamed Substance use?-- Egghead06 ( talk) 15:46, 4 March 2021 (UTC)
This article was the subject of a Wiki Education Foundation-supported course assignment, between 9 September 2021 and 18 November 2021. Further details are available on the course page. Student editor(s): Nicolekha.
Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT ( talk) 10:22, 17 January 2022 (UTC)
This article was the subject of a Wiki Education Foundation-supported course assignment, between 28 March 2022 and 30 May 2022. Further details are available on the course page. Student editor(s): Zebang Chen ( article contribs).
An editor has identified a potential problem with the redirect Illegal drug use and has thus listed it for discussion. This discussion will occur at Wikipedia:Redirects for discussion/Log/2022 May 11#Illegal drug use until a consensus is reached, and readers of this page are welcome to contribute to the discussion. Sangdeboeuf ( talk) 01:15, 11 May 2022 (UTC)
The result of the move request was: not moved per consensus below. ( closed by non-admin page mover) Extraordinary Writ ( talk) 16:31, 24 July 2022 (UTC)
Substance abuse →
Substance addiction – I think the name of this page should be moved to 'Substance addiction'. I feel like the name 'Substance abuse' is biased and implies the person dependent on drugs has done something wrong by being addicted. Furthermore, my concerns are supported by a lot of sourced information already in the article which recommended avoiding the term 'abuse' in contexts like this. Renaming the article and replacing 'abuse' with 'addiction' in similar instances is a good idea from my perspective - not only preventing victim-blaming for people with drug addiction but also making the page neutral - considering the multiple paragraphs talking about criticisms of terms like 'substance abuse'. However, I'm also open to hearing different terms the article should be renamed to that also prevent victim-blaming. Someone might suggest a term better and more medically recommended than the one I've proposed.
Stephanie921 (
talk) 14:59, 17 July 2022 (UTC)
This article was the subject of a Wiki Education Foundation-supported course assignment, between 22 August 2022 and 16 December 2022. Further details are available on the course page. Student editor(s): Abenaowusua3 ( article contribs).
— Assignment last updated by Gillind ( talk) 17:34, 5 October 2022 (UTC)
I noticed that previously there was a request to move this page to "substance addiction", which failed, but what I would suggest is that instead this article should be merged with the "substance use disorder" page. As noted in the article, the DSM-V does not use the terminology "substance abuse", neither does the WHO. Health Canada also recommends switching from "substance abuse" to "substance use disorder" (SUD) (see here), and the National Institute on Drug Abuse (NIDA) has been trying to change its name to the "National Institute on Drugs and Addiction" because it finds the language of abuse biased and stigmatizing. This page contains a lot of interesting information, but it is overall very confused.
It feels like a lot of workarounds have been written into the article in order to differentiate it from SUD. The article notes that substance abuse is a form of substance-related disorders, but there is no clarity as to how they are different throughout the article, and there are consistent slippages between substance use, abuse and substance use disorder. If this article is about substance use, then it should be about substance use, and would require major revisions to include things like history, culture etc. If it is about the term that was substance abuse, but now is substance use disorder it should be merged. For it to stay as it is, there should be a real definition of what classifies abuse in the article, and what differentiates it from use & SUD.
Merging, rather than moving (as described before) would allow for people to still search "substance abuse", they would just be sent to substance use disorder. A lot of the controversy that is on this page would still work really well on the substance use disorder page, as substance abuse is the historical term described. I think it would make the substance use disorder page more enriched by including a lot of the content that is currently here.
I am open to other proposals as well, or possible clarifications. ADrugResearcher ( talk) 21:25, 25 October 2022 (UTC)
The result of the move request was: not moved. ( non-admin closure) - 🔥 𝑰𝒍𝒍𝒖𝒔𝒊𝒐𝒏 𝑭𝒍𝒂𝒎𝒆 (𝒕𝒂𝒍𝒌)🔥 13:38, 9 October 2023 (UTC)
Substance abuse → Substance use and misuse – This is a great article, but it has a title with which the article itself seems to be unhappy. The problem is that “abuse” is a stigmatizing term, but up until now it has not been clear what was to be done. On 24 July 2022, it was decided that the article would not be moved to “substance addiction” because this article descibes risky use which is non-habitual in nature. There is also a recent yet seemingly inactive discussion about whether to merge substance abuse into substance use disorder, again misguided for the same reason ( Talk:Substance use disorder).
Available editorial guidance is clear on this issue. Since 2017, the Associated Press Stylebook has advised authors and editors to avoid stigmatizing words such as “abuse” or “problem” and to instead use “risky,” “unhealthy,” “excessive,” “heavy,” or “misuse,” depending on context ( link). Further, since 2021, the U.S. National Institute on Drug Abuse (NIDA) has advised against using the stigmatizing term “abuse.” NIDA has advised using the word “use” for non-legal drugs and “misuse” for the use of medically available drugs in a way which deviates from the prescriber’s explicit intent ( link).
As written, this article pertains to the use of both legal and non-legal drugs, it mentions that the term “drug abuse” is not preferred, and it even has a section devoted to “drug misuse” which is consistent with NIDA’s recommendations. With the above in mind, I propose this article be moved to “Substance use and misuse.” HussainHx ( talk) 01:01, 2 October 2023 (UTC)
substance abuse, also known as drug abuse, is the use of a drug in amounts or by methods that are harmful to the individual or others; this is by definition what "abuse" means. Perceived "stigmatization" is not a good reason. For "substance use", see recreational drug use or self-medication. -- WikiLinuz ( talk) 19:00, 6 October 2023 (UTC)
References
{{
cite journal}}
: CS1 maint: PMC format (
link)
"The term ‘abuse’ is sometimes used disapprovingly to refer to any use at all, particularly of illicit drugs. The term is not used in ICD-10 because of its ambiguity and to avoid including social consequences in the definition of a diagnosis. Harmful use is the closest equivalent in ICD-10. 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’. The term drug use is often preferred as it is non-judgemental." [1]
References