Substance Use Overview

Principles

Definition

Substance use is a multidisciplinary research concept examining the patterns, determinants, consequences, and treatment of human consumption of psychoactive substances. This field integrates biological, psychological, sociological, and public health perspectives to inform clinical practice, policy development, and prevention strategies.

Ontological type

Interventions

Epidemiology

Health Consequences

Key developments

Key Figures

Medical-Disease Paradigm era

William R. Martin [1] emerged as a leading figure within the Medical-Disease Paradigm era, with affiliations at the University of Chicago [2] and the University of Toronto [3] during this period. His key contributions in this era centered on empirical pharmacology and animal models that clarified tolerance and dose–response, exemplified by the 1963 paper Factors regulating oral consumption of an opioid (etonitazene) by morphine-addicted rats [4], which showcased how regulated intake could illuminate the medical basis of addiction. Martin [1] helped anchor addiction in a biomedical framework by linking neuropharmacological mechanisms to clinical and public-health implications, a shift that underpinned prognosis and treatment expectations in this era. Through roles at the University of Chicago [2] and the University of Toronto [3], Martin's work reinforced the era's trajectory toward medicalization, integrating laboratory findings with clinic-based interventions and policy orientations.

Neurobehavioral Synthesis era

Carlo C. DiClemente [1], whose work in this era was associated with University of Washington [3] and University of Maryland, Baltimore [4]. A key contribution is the stages-of-change concept for addictive behaviors [7], which reframed readiness to change and informed tailored interventions. C. Robert Cloninger [2], with ties to Harvard University [5] and Johns Hopkins University [6] in this era. His work on neurogenetic adaptive mechanisms in alcoholism [8] and inheritance of alcohol abuse [9] advanced etiological models linking genetics and temperament to risk and relapse, informing targeted interventions.

Neuropublic Health Integration era

Deborah S. Hasin [1] is a leading scholar whose work in this era spans affiliations with Harvard University [3] and the University of California, San Francisco [4]. Her research on population-level epidemiology of substance use, as reflected in Prevalence, Correlates, Disability, and Comorbidity of DSM-IV Alcohol Abuse and Dependence in the United States [7], Epidemiology of<i>DSM-5</i>Alcohol Use Disorder [8], and Prevalence of Marijuana Use Disorders in the United States Between 2001-2002 and 2012-2013 [9], advanced standardized prevalence and comorbidity measures that informed prevention, monitoring, and policy responses in this era. Lloyd D. Johnston [2] is a key figure in youth-drug-use surveillance, with affiliations spanning University of Minnesota [5] and the University of Pittsburgh [6]. His contribution to the era includes the Monitoring the Future study—Monitoring the Future: National Results on Adolescent Drug Use: Overview of Key Findings [10]—which provided longitudinal, nationally representative data on adolescent drug use that informed prevention, public-health planning, and policy responses within the integrated brain-behavior framework of this era.