Defining Substance Use Disorders

Edited by Dwight L. Evans, Edna B. Foa, Raquel E. Gur, Herbert Hendin, Charles P. O'Brien, Martin E.P. Seligman and B. Timothy Walsh

in Treating and Preventing Adolescent Mental Health Disorders

Published on behalf of Oxford University Press

Published in print June 2005 | ISBN: 9780195173642
Published online August 2012 | e-ISBN: 9780199951024 | DOI:

Series: Adolescent Mental Health Initiative

Defining Substance Use Disorders

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  • Psychiatry
  • Child and Adolescent Psychiatry


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An occasion of drug taking may be a passing indulgence of an adolescent, perhaps initiated in a moment of immature judgment. All too often, the drug taking can become repetitive and may lead to a syndrome of abuse or addiction, possibly in an interaction of inherited vulnerability traits with environmental conditions and processes. The development of addiction and the dependence syndrome in adolescents are emotion-laden, controversial, and often misunderstood topics. Public opinion leaders often do not appreciate the scientific evidence that tends to favor a disease concept of addiction or dependence on alcohol, tobacco, and other drugs such as cocaine or cannabis. This evidence includes a neuronal basis for many of the prominent clinical features of dependence, genetic vulnerability, and a characteristic chronic, relapsing course that resembles that of many medical illnesses. Unfortunately, these biological bases of addiction are often forgotten or misunderstood by a nonetheless opinionated American public that can view adolescent drug problems as purely behavioral and morally objectionable. Consequently, many affected adolescents end up being managed by their parents, school authorities, or the judicial system rather than being treated in specialized adolescent treatment programs. Even those seeking treatment often discover that appropriate programs do not exist in their geographic region or are difficult to access because of low capacity or managed care policies. While there would be a public uproar if treatment were not available to adolescents with head injuries, diabetes, or cancer, obvious disparities in addiction treatment have been tolerated for decades and may well reflect public skepticism about the biological bases of drug dependence and addiction. Unfortunately,we have much to learn about the onset, nature, and treatment of these conditions in adolescents. It is our contention that gaps in our knowledge should be addressed with research and clinical experience, and not cited to justify an inadequate treatment infrastructure.

Chapter.  32743 words.  Illustrated.

Subjects: Psychiatry ; Child and Adolescent Psychiatry

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