Defining Substance Use Disorders: Do We Really Need More Than Heavy Use?

被引：180

作者：

Rehm, J. ^{[1
,2
,3
,4
,5
]}

Marmet, S. ^{[6
]}

Anderson, P. ^{[7
,8
]}

Gual, A. ^{[9
]}

Kraus, L. ^{[10
,11
]}

Nutt, D. J. ^{[12
]}

Room, R. ^{[11
,13
,14
]}

Samokhvalov, A. V. ^{[2
,5
]}

Scafato, E. ^{[15
,16
]}

Trapencieris, M. ^{[17
]}

Wiers, R. W. ^{[18
]}

Gmel, G. ^{[2
,6
,19
,20
]}

机构：

[1] Tech Univ Dresden, Inst Clin Psychol & Psychotherapy, Dresden, Germany

[2] Ctr Addict & Mental Hlth CAMH, Toronto, ON, Canada

[3] Univ Toronto, Inst Med Sci, Toronto, ON, Canada

[4] Univ Toronto, Dalla Lana Sch Publ Hlth DLSPH, Toronto, ON, Canada

[5] Univ Toronto, Dept Psychiat, Toronto, ON, Canada

[6] Addict Switzerland, Lausanne, Switzerland

[7] Newcastle Univ, Inst Hlth & Soc, Newcastle Upon Tyne NE1 7RU, Tyne & Wear, England

[8] Maastricht Univ, Fac Hlth Med & Life Sci, Maastricht, Netherlands

[9] Hosp Clin Barcelona, IDIBAPS, Inst Neurosci, Addict Unit,Psychiat Dept, Barcelona, Spain

[10] IFT Inst Therapieforsch, Munich, Germany

[11] Stockholm Univ, Ctr Social Res Alcohol & Drugs, S-10691 Stockholm, Sweden

[12] Univ London Imperial Coll Sci Technol & Med, Ctr Neuropsychopharmacol, London, England

[13] Univ Melbourne, Melbourne Sch Populat & Global Hlth, Parkville, Vic 3052, Australia

[14] Turning Point Alcohol & Drug Ctr, Ctr Alcohol Policy Res, Fitzroy, Vic, Australia

[15] Ist Super Sanita, Natl Ctr Epidemiol Surveillance & Hlth Promot, Natl Observ Alcohol CNESPS, Populat Hlth Unit, I-00161 Rome, Italy

[16] Ist Super Sanita, Natl Ctr Epidemiol Surveillance & Hlth Promot, Natl Observ Alcohol CNESPS, Hlth Determinants Unit, I-00161 Rome, Italy

[17] Univ Latvia, Inst Philosophy & Sociol, Riga, Latvia

[18] Univ Amsterdam, Addict Dev & Psychopathol ADAPT Lab, Amsterdam, Netherlands

[19] Univ W England, Bristol BS16 1QY, Avon, England

[20] Univ Lausanne Hosp, Alcohol Treatment Ctr, CH-1011 Lausanne, Switzerland

来源：

ALCOHOL AND ALCOHOLISM | 2013年 / 48卷 / 06期

关键词：

ALCOHOL-USE DISORDERS; COMPARATIVE RISK-ASSESSMENT; DSM-IV; NICOTINE DEPENDENCE; GLOBAL BURDEN; DIAGNOSTIC-CRITERIA; IDENTIFICATION TEST; BRIEF INTERVENTION; MENTAL-DISORDERS; SCREENING-TEST;

D O I：

10.1093/alcalc/agt127

中图分类号：

R194 [卫生标准、卫生检查、医药管理];

学科分类号：

摘要：

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.

引用

页码：633 / 640

页数：8

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