Substance abuse

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Substance abuse refers to the use of any legal or illegal substance when that use is causing damage to the user's physical and/or mental health and causes the person legal, social, financial or other problems including endangering their lives or the lives of others. The phrase "problematic substance use" is a newer term for "substance abuse" that is gaining acceptance.

When science began to study addictive behavior in the 1930s, substance abusers were thought to be morally flawed and lacking in willpower. Those views shaped society's responses to substance abuse, treating it as a moral failing rather than a health problem, which led to an emphasis on punitive rather than preventative and therapeutic actions.^[1]

According to the US National Institute on Drug Abuse, abuse and addiction to alcohol, nicotine, and illegal substances cost Americans upwards of half a trillion dollars a year, considering their combined medical, economic, criminal, and social impact. Every year, abuse of illicit drugs and alcohol contributes to the death of more than 100,000 Americans, while tobacco is linked to an estimated 440,000 deaths per year.^[1]

Gottheil et al (1997) examined the effects of an outreach program designed to engage substance abuse clients who failed to attend their initial appointment. An outpatient treatment facility attempted to contact by phone clients who did not show up for their first appointment. Overall, 36% of clients showed up for their initial appointment. The clinic was then able to contact and reschedule 44% of the clients who failed to show. Out of this group, 49% kept their appointment. By instituting this simple outreach program, the clinic was able to increase the percentage of patients engaged in treatment from 36% to 46%.