Abstract
Much of the controversy concerning whether or not substance use disorders constitute “diseases” centers on the failure to consider the issue in the context of the definition of a disease. By definition a disease (1) interferes with the functioning of the organism, (2) is related to genetic, pathogenic, or environmental factors, and (3) can be identified by a unique constellation of symptoms. The current study briefly reviews some of the current literature addressing the first two points and presents data from two assessment instruments that supports the contention that substance dependence meets the third criteria of a disease. Substance abuse for the present analyses is considered with the other nondependent cases. Findings from five distinct samples assessed with two different structured interviews produced striking similar differentials for dependent individuals. The samples included 390 general assistance applicants, 310 arrestees, 598 state prison inmates, 244 drug boot-camp graduates, and 1,329 women accused of child abuse or neglect. Dependent individuals produced clinical profiles well beyond the minimal DSM-IV criteria as contrasted to nondependent cases whose modal symptom count was zero. Dependence for alcohol, marijuana, and cocaine show similar distinctions from nondependent cases
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