APA defines substance abuse as a "maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by one (or more) of the following, occurring within a 12-month period:
1. Recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home (e.g., repeated absences or poor work performance related to substance use; substance-related absences, suspensions or expulsions from school; neglect of children or household);
4. Continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance (e.g., arguments with spouse about consequences of intoxication, physical fights) (DSM-IV, 2000).
Apparently, the core characteristic of substance abuse is continued use of alcohol, tobacco, non-medically prescribed medications, drug or chemicals, which commonly leads to recurring socially negative consequences. Substance abuse is believed to be the major predictor of more severe conditions, namely substance addiction or dependence (Onken & Blaine, 1990). However, one should distinguish between them: abuse and dependence differ from addiction that involves a compulsion to continue using the substance despite the negative consequences, and may or may not involve chemical dependency. ...
Dependence involves physiological processes while substance abuse reflects a complex interaction between the individual, the abused substance (Anderson, 2001). This complex interaction is perhaps the major contributor to the difficulties associated with identifying the etiology of substance abuse.
The almost epidemic situation with substance abuse and dependency has negative health consequences and impressive economic costs. Substance abuse, including tobacco use and nicotine addiction, is associated with a wide range of serious health and social problems. Recent epidemiological evidence demonstrates that 72 conditions requiring inpatient treatment are wholly or partially attributable to substance abuse. Consequently, the estimated annual cost for health care, law enforcement, motor vehicle crashes, crime, and lost productivity due to substance abuse is nearly 1 thousand dollars for every American citizen, including children (Austin, 2005). The economic costs of drug abuse is comparable to the cost of widespread chronic diseases that have traditionally been considered the major health care burden, namely diabetes with estimated annual cost of $131.7 billion (ADA, 2002) and cancer with estimated annual cost of $171.6 billion (ACS, 2003).
Drug abuse affects the society on many levels and is directly linked to America's most vital social problems such as driving under influences, domestic violence, and stress. According the recent estimates of the National Highway Traffic Safety Administration from 10 to 22 percent of traffic accidents can be attributed to drug abuse (NHTSA, 1997). Statistical data collected over several years