Substance-Related Disorders: Introduction | Classification Systems | Neurobiology | Approach to the Patient | Treatment: General Principles | Alcohol | Cannabis | Stimulants | Opioids | Nicotine | Sedative-Hypnotics | Hallucinogens | Phencyclidine and Ketamine | Club Drugs | Inhalants | Anabolic–Androgenic Steroids | Polysubstance Use | Co-Occurring Substance Use Disorders and Other Psychiatric Disorders | Gender Considerations | Considerations in Adolescents | Considerations in Older Adults | Cultural/Ethnic Considerations | Key Points | Suggested Readings | References
Psychoactive substance use has been part of
people's lives for millennia (Austin 1978).
About half of the world population uses at least one psychoactive
substance, and although most do so without difficulties, for others
problems arise that are related to the substance use (United Nations Office on Drugs and Crime 2005). Worldwide, drug
and alcohol use disorders (excluding tobacco) are the sixth leading
cause of disease burden in adults, whereas tobacco use and exposure
to tobacco smoke are the leading preventable causes of death (World Health Organization 2003). Nationally (again excluding tobacco),
63% of American adults report that alcohol or drug addiction
in themselves, family, or close friends has had an impact on their
lives (Peter D. Hart Research Associates 2004). This
chapter presents an overview of substance-related disorders, primarily
focusing on those substances that are abused for their psychoactive
effects, with additional material contained in the "Suggested Readings" listed
at the end of the chapter.