For many people, drug abuse and addiction are emotionally charged issues. People often have deeply held personal theories about the nature and causes of these problems. But in psychiatry and addiction medicine, definitions and diagnoses of medical problems must be objective, not based on personal, social, or political theories, which often change.

For example, during the 1960s, drug abuse was popularly defined as the use of drugs that are illegal and not condoned by the general population. By this definition, the use of illegal drugs (e.g., marijuana) was considered drug abuse, whereas the use of legal drugs (e.g., alcohol) was not.

Since that time, there has been a tremendous amount of medical research regarding our understanding of drug abuse and addiction. Based on this research, current definitions of drug problems are objective and clinical and are designed to help in the identification and treatment process.

Drug abuse is defined as the use of psychoactive drugs in such a way that it seriously interferes with a person's life, including physical, psychological, occupational, legal, educational, spiritual, or social functioning. The key concept regarding drug abuse is evidence of impairment. This impairment can include a family fight, working while hung over, or spending rent money on cocaine. Drug abuse also includes behaviors that are risky or hazardous, such as driving or taking care of children, while intoxicated. In these cases, people are making poor decisions that can easily lead to disaster: they are taking drug-induced risks.

Drug abuse includes a wide range of behaviors. At the low end of the continuum, a person becomes intoxicated, experiences a hangover, dislikes it, and never uses any drug again. At the other end, an individual experiences a pattern of drug-induced impairment over many years. Thus, some people experience drug abuse patterns, whereas others have only rare drug abuse experiences. Fortunately, most people who abuse drugs "grow out of it," often in response to adverse consequences caused by the drugs. . .

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