12-month period:
Tolerance, defined by either: a) a need for a markedly increased amount of the substance to achieve intoxication or desired effect; b) markedly diminished effect with continued use of the same amount of the substance.
Withdrawal, manifested by either: 1) the characteristic withdrawal syndrome for the specific substance; b) the same or a closely related substance is taken to relieve or avoid withdrawal symptoms;
The substance is taken in larger amounts over a longer period than was intended.
There is a persistent desire or unsuccessful efforts to cut down/control substance use;
A great deal of time is spent in activities necessary to obtain the substance;
Important social, occupational, or recreational activities are given up or reduced because of substance use;
The substance use of continued despite knowledge of having a persistent/recurrent physical or psychological problem caused or exacerbated by the substance.
Substance abuse, as characterized by the APA (1994), is diagnosed according to criteria presented in Figure 2, below.
Figure 2: Criteria for Substance Abuse
Definition: A maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by one or more of the following, within a 12-month period:
Recurrent substance use resulting in a failure to fulfill role obligations at work, home, or school;
Recurrent substance use in situations in which it is physically hazardous;
Recurrent substance-use-related legal problems;
Continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance.
According to the APA (1994) and the CWLA (2002), substance abuse is associated with such diverse drugs as alcohol, amphetamines and their correlates, cannabis (marijuana), cocaine, hallucinogens, inhalants, opioids, phencyclidine, sedatives, hypnotics, and an...