Substance Abuse Disorders

  • Timothy J. O’Farrell


This chapter discusses serious psychological problems that can arise in relation to the use of certain substances. These substances are called psychoactive substances because they can be used to affect moods, thinking, and behavior. In most societies, use of certain substances to modify mood or behavior is regarded as normal and appropriate, and such use may be a valued part of the culture. Customary and social drinking of alcohol as a beverage with meals or to enhance interaction at social gatherings is one example. The ritual use of peyote (a drug obtained from the mescal cactus that produces a variety of vivid visual hallucinations) for religious purposes by Indians in Mexico and the Southwestern United States is another. Further, some psychoactive substances are used for medical purposes under a physician’s prescription to relieve pain or decrease anxiety, or for other appropriate medical purposes. Therefore, this chapter is concerned not with these and other normal and appropriate uses of psychoactive substances, but rather with use that is considered pathological largely due to the negative behavioral effects. Table 1 lists major classes of psychoactive substances that are commonly subject to problematic use. The criteria for determining problematic use of such substances is considered next.


Psychoactive Substance Alcohol Problem Substance Dependence Drug Problem Substance Abuse Disorder 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. American Psychiatric Association (1980). Diagnostic and statistical manual of mental disorders, 3rd Edition. Washington, DC: Author.Google Scholar
  2. American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders, 3rd Edition, Revised. Washington, DC: Author.Google Scholar
  3. American Psychiatric Association (1993). DSM-IV draft criteria. Washington, DC: Author.Google Scholar
  4. Anthony, J. C., & Heizer, J. E. (1991). Syndromes of drug abuse and dependence. In L. N. Robins & D. A. Regier (Eds.), Psychiatric disorders in America: The Epidemiologic Catchment Area study (pp. 116–154). New York: The Free Press.Google Scholar
  5. Cahalan, D. (1970). Problem drinkers: A national survey. San Francisco: Jossey-Bass.Google Scholar
  6. Cloninger, C. R. (1987). Neurogenetic adaptive mechanisms in alcoholism. Science, 236, 410–416.PubMedCrossRefGoogle Scholar
  7. Cotton, N. S. (1979). The familial incidence of alcoholism. Journal of Studies on Alcohol, 40, 89–116.PubMedGoogle Scholar
  8. Croughan, J. L. (1985). The contributions of family studies to understanding drug abuse. In L. N. Robins (Ed.), Studying drug abuse. New Brunswick, NJ: Rutgers University Press.Google Scholar
  9. Heizer, J. E., & Pryzbeck, T. R. (1988). The co-occurrence of alcoholism with other psychiatric disorders in the general population and its impact on treatment. Journal of Studies on Alcohol, 49, 219–224.Google Scholar
  10. Heizer, J. E., Burnham, A., & McEvoy, L. T. (1991). Alcohol abuse and dependence. In L.N. Robins & D. A. Regier (Eds.), Psychiatric disorders in America: The Epidemiologic Catchment Area study (pp. 81–115). New York: Free Press.Google Scholar
  11. Hesselbrock, M. N., Meyer, R. E., & Keener, J. J. (1985). Psychopathology in hospitalized alcoholics. Archives of General Psychiatry, 42, 1050–1055.PubMedCrossRefGoogle Scholar
  12. Hester, R. K., & Miller, W. R. (Eds.) (1989). Handbook of alcoholism treatment approaches: Effective alternatives. New York: Pergamon Press.Google Scholar
  13. Institute of Medicine (1990). Broadening the base of treatment for alcohol problems. Washington, DC: National Academy of Science Press.Google Scholar
  14. Jellinek, E. M. (1960). The disease concept of alcoholism. Highland Park, NJ: Hillhouse Press.Google Scholar
  15. McGue, M., Pickens, R. W., & Svikis, D. S. (1992). Sex and age effects on the inheritance of alcohol problems: A twin study. Journal of Abnormal Psychology, 101, 3–17.PubMedCrossRefGoogle Scholar
  16. National Institute on Drug Abuse (NIDA). (1989). National household survey on drug abuse: 1988 population estimates. (DHHS Publication no. ADM 89–1636). Rockville MD: Author.Google Scholar
  17. Polich, J. M., Armor, D. J., & Braiker, H. B. (1981). The course of alcoholism: Four years after treatment. New York: Wiley.Google Scholar
  18. Robins, L. N., Locke, B. A., & Regier, D. A. (1991). An overview of psychiatric disorders in America. In L. N. Robins & D. A. Regier (Eds.), Psychiatric disorders in America: The Epidemiologic Catchment Area study (pp. 328–386). New York: Free Press.Google Scholar
  19. Robins, L. N., & Regier, D. A. (Eds.). (1991). Psychiatric disorders in America: The Epidemiologic Catchment Area study. New York: Free Press.Google Scholar
  20. Russell, M. (1990). Prevalence of alcoholism among children of alcoholics. In M. Windle & J. S. Searles (Eds.), Children of alcoholics: Critical perspectives (pp. 9–38). New York: Guilford Press.Google Scholar
  21. Skinner, H. A. (1988). Executive summary: Spectrum of drinkers and intervention responses. Prepared for the Institute of Medicine Committee for the Study of Treatment and Rehabilitation Services for Alcoholism and Alcohol Abuse. Unpublished manuscript available from the author at Addiction Research Foundation, Toronto.Google Scholar
  22. Taylor, J. R., & Heizer, J. E. (1983). The natural history of alcoholism. In B. Kissin & H. Begleiter (Eds.), The biology of alcoholism (Vol. 6) (pp. 17–65). New York: Plenum Press.CrossRefGoogle Scholar
  23. US. Department of Health and Human Services. (1992). National Household Survey on Drug Abuse. ADAMHA News. January-February, 18–19.Google Scholar

Copyright information

© Plenum Press, New York 1994

Authors and Affiliations

  • Timothy J. O’Farrell
    • 1
    • 2
    • 3
  1. 1.Department of PsychiatryHarvard Medical SchoolBostonUSA
  2. 2.Veterans Affairs Medical CenterBrocktonUSA
  3. 3.Veterans Affairs Medical CenterWest RoxburyUSA

Personalised recommendations