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Question by Stephanie: psychology question..?
okay so i have this project on substance abuse n my psychology class and i need to know who when and how substance abuse was diagnosed as a mental disease

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Answer by David Salti
The disorder is characterized by a pattern of continued pathological use of a medication, non-medically indicated drug or toxin, that results in repeated adverse social consequences related to drug use, such as failure to meet work, family, or school obligations, interpersonal conflicts, or legal problems. There are on-going debates as to the exact distinctions between substance abuse and substance dependence, but current practice standard distinguishes between the two by defining substance dependence in terms of physiological and behavioral symptoms of substance use, and substance abuse in terms of the social consequences of substance use.
Substance abuse may lead to addiction or substance dependence. Medically, physiologic dependence requires the development of tolerance leading to withdrawal symptoms. Both abuse and dependence are distinct from addiction which involves a compulsion to continue using the substance despite the negative consequences, and may or may not involve chemical dependency. Dependence almost always implies abuse, but abuse frequently occurs without dependence, particularly when an individual first begins to abuse a substance. Dependence involves physiological processes while substance abuse reflects a complex interaction between the individual, the abused substance and society.
drug abuse, drug addiction, and chemical dependency, but actually refers to the use of substances in a manner outside sociocultural conventions. All use of illicit drugs and all use of licit drugs in a manner not dictated by convention (e.g. according to physician’s orders or societal norms) is abuse according to this definition, however there is no universally accepted definition of substance abuse.

The physical harm for twenty drugs was compared in an article in the Lancet, with the results shown in the diagram. Physical harm was assigned a value from 0 to 3 for acute harm, chronic harm and intravenous harm. Shown is the mean physical harm. Not shown, but also evaluated, was the social harm.

In the early 1950s, the first edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders grouped alcohol and drug abuse under Sociopathic Personality Disturbances, which were thought to be symptoms of deeper psychological disorders or moral weakness.

The third edition,in the 1980s, was the first to recognize substance abuse (including drug abuse) and substance dependence as conditions separate from substance abuse alone, bringing in social and cultural factors. The definition of dependence emphasised tolerance to drugs, and withdrawal from them as key components to diagnosis, whereas abuse was defined as “problematic use with social or occupational impairment” but without withdrawal or tolerance.

In 1987 the DSM-IIIR category “psychoactive substance abuse”, which includes former concepts of drug 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 physically hazardous”. It is a residual category, with dependence taking precedence when applicable. It was the first definition to give equal weight to behavioural and physiological factors in diagnosis.

By 1988, the DSM-IV defines substance dependence as “a syndrome involving compulsive use, with or without tolerance and withdrawal”; whereas substance abuse is “problematic use without compulsive use, significant tolerance, or withdrawal”. Substance abuse can be harmful to your health and may even be deadly in certain scenarios

By 1994, The fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) issued by the American Psychiatric Association ,the DSM-IV-TR, defines substance dependence as “when an individual persists in use of alcohol or other drugs despite problems related to use of the substance, substance dependence may be diagnosed.” followed by criteria for the diagnose
DSM-IV-TR defines substance abuse as:

A. A maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by one (or more) of the following, occurring within a 12-month period:
Recurrent substance use resulting in a failure to fulfill 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)
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)
Recurrent substance-related legal problems (e.g., arrests for substance-related disorderly conduct)
Continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effec

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