Historique
Article de Périodique
Defining substance use disorders: Do we really need more than heavy use? [For debate] (2013)
Auteur(s) :
J. REHM ;
S. MARMET ;
P. ANDERSON ;
A. GUAL ;
L. KRAUS ;
D. J. NUTT ;
R. ROOM ;
A. V. SAMOKHVALOV ;
E. SCAFATO ;
M. TRAPENCIERIS ;
R. W. WIERS ;
G. GMEL
Article en page(s) :
633-640
Domaine :
Plusieurs produits / Several products
Langue(s) :
Anglais
Discipline :
SAN (Santé publique / Public health)
Note générale :
* Commentaries:
- A commentary on 'Defining substance use disorders: do we really need more than heavy use?' Rice P., p. 641.
- Why not add consumption measures to current definitions of substance use disorders? Bradley K.A., Rubinsky A.D., p. 642-643.
- The concept of substance use disorders. Saunders J.B., p. 644-645.
- A radical but flawed proposal. Heather N., p. 646-647.
* EMCDDA scientific paper 2014 award winner
- A commentary on 'Defining substance use disorders: do we really need more than heavy use?' Rice P., p. 641.
- Why not add consumption measures to current definitions of substance use disorders? Bradley K.A., Rubinsky A.D., p. 642-643.
- The concept of substance use disorders. Saunders J.B., p. 644-645.
- A radical but flawed proposal. Heather N., p. 646-647.
* EMCDDA scientific paper 2014 award winner
Résumé :
Aims: The aim of the study was to explore whether the concept of heavy substance use over time can be used as definition of substance use disorder.
Methods: Narrative review.
Results: Heavy use over time clearly underlies the neurobiological changes associated with current thinking of substance use disorders. In addition, there is evidence that heavy use over time can explain the majority of social problems and of burden of disease (morbidity and mortality). A definition of substance use disorders via heavy use over time would avoid some of the problems of current conceptualizations, for instance the cultural specificity of concepts such as loss of control. Finally, stressing the continuum of use may avoid the high level of stigmatization currently associated with substance use disorders.
Conclusion: 'Heavy substance use over time' seems to be a definition of substance use disorders in line with results of basic research and epidemiology. Additionally, it reduces stigmatization. This approach should thus be further explored.
Methods: Narrative review.
Results: Heavy use over time clearly underlies the neurobiological changes associated with current thinking of substance use disorders. In addition, there is evidence that heavy use over time can explain the majority of social problems and of burden of disease (morbidity and mortality). A definition of substance use disorders via heavy use over time would avoid some of the problems of current conceptualizations, for instance the cultural specificity of concepts such as loss of control. Finally, stressing the continuum of use may avoid the high level of stigmatization currently associated with substance use disorders.
Conclusion: 'Heavy substance use over time' seems to be a definition of substance use disorders in line with results of basic research and epidemiology. Additionally, it reduces stigmatization. This approach should thus be further explored.
Affiliation :
Institute for Clinical Psychology and Psychotherapy, TU Dresden, Dresden, Germany