TYPES OF SUBSTANCE ABUSE
Many substances can be used and abused; some can be obtained legally, whereas others are illegal. This discussion includes alcohol and prescription medications as sub-stances that can be abused. Abuse of more than one sub-stance is termed polysubstance abuse.
The Diagnostic and Statistical Manual of Mental Disor-ders, 4th edition, Text Revision (DSM-IV-TR) lists 11 diag-nostic classes of substance abuse:
· Amphetamines or Similarly Acting Sympathomimetics
· Phencyclidine (PCP) or Similarly Acting Drugs
· Sedatives, Hypnotics, or Anxiolytics
It also categorizes substance-related disorders into two groups: (1) those that include disorders of abuse and dependence and (2) substance-induced disorders such as intoxication, withdrawal, delirium, dementia, psychosis, mood disorder, anxiety, sexual dysfunction, and sleep disorder.
Intoxication is use of a substance that results in mal-adaptive behavior. Withdrawal syndrome refers to the negative psychologic and physical reactions that occur when use of a substance ceases or dramatically decreases. Detoxification is the process of safely withdrawing from a substance. The treatment of other substance-induced dis-orders such as psychosis and mood disorders is discussed in depth in separate section.
Substance abuse can be defined as using a drug in a way that is inconsistent with medical or social norms and despite negative consequences. The DSM-IV-TR distin-guishes substance abuse from dependence for purposes of medical diagnosis. Substance abuse denotes problems in social, vocational, or legal areas of the person’s life, whereas substance dependence also includes problems associated with addiction such as tolerance, withdrawal, and unsuc-cessful attempts to stop using the substance. This distinc-tion between abuse and dependence frequently is viewed as unclear and unnecessary (Jaffe & Anthony, 2005) because the distinction does not affect clinical decisions once withdrawal or detoxification has been completed. Hence, the terms substance abuse and substance dependence or chemical dependence can be used interchangeably.