Definitions of some terms used in this chapter

• Psychoactive Any chemical (alcohol, therapeutic agent, industrial compound or illicit drug) with important effects on the central nervous system

• Substance A psychoactive that typically is associated with a substance use disorder. The term includes alcohol, opioids, sedative-hypnotics and antianxiety agents of the barbiturate and benzodiazepine types, psychomotor stimulants, especially amphetamines and cocaine, tobacco products, and certain over-the-counter psychoactives. The terms chemical and drug in this context are synonymous with substance (e.g., 'chemical dependence', 'drug abuse')

• Drink A standard drink of beverage alcohol is equivalent to a 360-ml beer (alcohol content about 4%), a 150-ml. glass of table wine (about 1 2% alcohol), or a mixed drink containing 30-45ml of spirits (about 40% alcohol)

• Use Appropriate medical or social consumption of a psychoactive in a manner that minimizes the potential for dependence or abuse

• Heavy use Use of a substance in greater quantity than the usual norms, but without obvious negative social, behavioral or health consequences. Heavy alcohol or tobacco users may be dependent upon the substance. At-risk or risky drinkers refer to heavy consumers of alcohol, usually at rates of 3 15-21 drinks/week for men, 3 10-14 for women or binges in which 3 4-6 drinks are consumed on a single drinking occasion. Safe drinking levels for elderly persons are recommended by the U.S. National Institute on Alcohol Abuse and Alcoholism not to exceed 7 drinks/week or 2 drinks on a single drinking occasion

• Misuse Use of a prescribed drug in a manner other than directed. The term can mean overuse, underuse, improper dose sequencing, lending or borrowing another's medication, with or without harmful consequences

• Problem use Use of a substance in a manner that induces negative social, behavioral or health consequences. A 'problem' user may or may not meet criteria for substance dependence or abuse, although many do. Alcohol 'problems' or drug 'problems' are categories often have been used by epidemiologists in community prevalence surveys.

• Abuse Abuse of a substance is defined in DSM-IV as 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: (a) recurrent substance use resulting in failure to fulfill major role obligations at work or home; (b) recurrent substance use in physically hazardous situations; (c) recurrent substance-related legal problems; (d) continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of a substance. Harmful use (ICD-1 0 approximates abuse in definition. Both imply milder severity of substance involvement than in substance dependence

• Dependence Dependence upon a substance is defined by explicit diagnostic criteria, such as those listed in DSM-IV or ICD-1 0. Serious and persistent involvement in the heavy use of the substance is the rule. These approaches set aside the older distinction between physical dependence and psychological dependence, which are now viewed as differing manifestations of similar disorders. The terms alcoholism and addiction are usually used as synonyms for dependence on alcohol and other drugs, respectively

• Substance use disorder A clinical condition in which substance abuse or substance dependence can be diagnosed

• Substance abuse, chemical dependence, and addictions These terms are often used to refer to the entire professional/scientific field

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