Diagnostic and Statistical Manual of Mental Disorders - Case Study Example

Under the manual guidelines published by WHO and the American Psychiatric Association (APA), the term ‘drug abuse’ is not official anymore; instead, they have opted for the term ‘substance abuse’ that in its nature and scope includes the term drug abuse. According to APA (1932), the term drug abuse can be applicable “to the illegal, nonmedical use of a limited number of substances, most of the drugs, which have properties of altering the mental state in ways that are considered by social norms and defined by statute to be inappropriate, undesirable, harmful, threatening, or, at minimum, culture-alien" (Glasscote, et al., 1932). However, we find that in 1973, the National Commission on Marijuana and Drug Abuse, recommended the removal of the term ‘drug abuse’ from official documents; stating that the term refers to only social disapproval, and actually has no relevant scientific meaning.

The Commission states “drug abuse may refer to any type of drug or chemical without regard to its pharmacologic actions.The Commission believes that the term drug abuse must be deleted from official pronouncements and public policy dialogue. The term has no functional utility and has become no more than an arbitrary codeword for that drug use which is presently considered wrong”.Difference between drug and chemical dependency According to Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), substance dependence can be termed as “When an individual persists in use of alcohol or other drugs despite problems related to use of the substance, substance dependence may be diagnosed.

Compulsive and repetitive use may result in tolerance to the effect of the drug and withdrawal symptoms when use is reduced or stopped” (APA, 2000). Chemical dependence is the same thing as substance dependence, and is also used to define the excessive use (often compulsive, pertaining to being addicted) of any chemicals, it may be drugs or even alcohol, and the inability of that person to stop using these chemical substances, despite being aware of their harmful effects on his/her body.

If the substance or the chemical being used excessively, is suddenly stopped, the person starts showing ‘withdrawal symptoms’ (a physical and psychological disorder) which can be sometimes extremely painful; and hence the compulsion for the user to keep on taking the chemicals. Alcohol, cocaine, and opiates, cause substance or chemical dependency (refer to fig A). Here the doses of the chemicals ‘abused’ have to be gradually increased with time, as the body’s tolerance level also increases, thus causing more harm to the body with time.

Drug dependence also refers to the excessive use of drugs, mainly by self-administration and for non-therapeutic purposes; and the user exhibits withdrawal symptoms if the drug being administered is suddenly stopped. This dependency is sometimes also noticed in cases of terminal patients (like cancer patients), who have to take certain drugs regularly, and with time, it has been seen that the body gets used to these drugs (becomes addicted) and shows withdrawal symptoms if stopped. This term, as we have already seen, is not used officially anymore, and has been replaced by ‘substance abuse’ and substance dependency’, which covers the drug abuse, within its scope and nature.

Fig A shows the various drugs in terms of their ‘use’ and ‘abuse’, and their potential effects on the human body in terms of a scale ranging from 0 to 3.Fig A: To the show the transition from scale 0, where drugs are useful and cause minimum physical damage; to scale 3 where it turns into ‘abuse’, inflicting a higher level of damage to the human body (Source: Nutt, King, Saulsbury, and Blakemore, 2007).