Substance abuse , also known as drug abuse , is a patterned use of drugs in which users consume substance in quantities or by methods harmful to themselves or others, and constitute forms of substance-related disorders. A very different definition of drug abuse is used in the context of public health, medical and criminal justice. In some cases criminal or anti-social behavior occurs when the person is under the influence of the drug, and long-term personality changes in the individual may occur as well. In addition to the possibility of physical, social, and psychological damage, the use of some drugs can also lead to criminal penalties, although this varies greatly depending on local jurisdiction.
The drugs most commonly associated with this term include: alcohol, marijuana, barbiturates, benzodiazepines, cocaine, methaqualone, opioids and some substituted amphetamines. The exact cause of substance abuse is unclear, with two main theories: whether genetic dispositions are learned from others, or habits that if addiction develop, manifests itself as a crippling chronic disease.
In 2010 about 5% of people (230 million) used prohibited substances. Of this 27 million have high-risk drug use or known as repeated drug use that causes damage to their health, psychological problems, or social problems that put them at risk. By 2015 disruption of substance use resulted in 307,400 deaths, up from 165,000 deaths in 1990. Of these, the highest number came from alcohol use disorders at 137,500, disruption of opioid use in 122,100 deaths, amphetamine dysfunction at 12,200 deaths, and cocaine use disorders at 11,100.
Video Substance abuse
Classification
Definition of public health
Public health practitioners have sought to see the use of substance from a wider perspective than individuals, emphasizing the role of society, culture, and availability. Some health professionals choose to avoid alcohol-based or substance-based "abuse" drugs that they perceive as more objective, such as "substance and alcohol problems" or "dangerous/problematic drug use". The Council of Health Officers of British Columbia - in their 2005 policy discussion paper, Public Health Approach to Drug Control in Canada] - has adopted a public health model of the use of psychoactive substances that challenge simple black-and-white antonym construction binary (or complementary) "use" vs "abuse". This model explicitly recognizes the spectrum of uses, ranging from useful usage to chronic dependency.
Medical definition
'Drug abuse' is no longer the current medical diagnosis in one of the world's most used diagnostic tools, the Diagnostic and Statistics of the American Psychiatric Association's Mental Disorder (DSM), and the International Statistical Classification of the World Health Organization (ICD)).
Substance abuse has been adopted by DSM as a blanket term to include 10 separate classes of drugs, including alcohol; caffeine; marijuana; hallucinogens; inhalants; opioid; sedative, hypnotic, and anxiolytic; stimulants; tobacco; and other substances. ICD uses the term Dangerous use to cover physical or psychological damage to users from usage.
Physical dependence, abuse, and withdrawal from drugs and other substances are described in DSM a:
When a person continues to use alcohol or other drugs despite problems related to the use of the substance, substance dependence can be diagnosed. Compulsive and repeated use may lead to tolerance to drug effects and withdrawal symptoms when use is reduced or discontinued.
However, the other definitions are different; they may require psychological or physical dependence, and may focus on treatment and prevention in terms of the social consequences of substance use.
Rating rating
Philip Jenkins points out that there are two problems with the term "drug abuse". First, what constitutes "medicine" is debatable. For example, GHB, a natural substance in the central nervous system is considered a drug, and is illegal in many countries, while nicotine is not officially considered a drug in most countries.
Second, the word "abuse" implies a recognized standard of use for any substance. Drinking a glass of wine is occasionally considered acceptable in most Western countries, while drinking a few bottles is considered an abuse. Strong temperance supporters, who may or may not have religious motivation, will see drinking just one glass as abuse. Some groups even condemn the use of caffeine in any amount. Similarly, adopting the view that any (recreational) use of marijuana or substituted amphetamines is a substance abuse implies a decision made that a substance harmful, even in minute amounts. In the US, drugs have been legally classified into five categories, schedules I, II, III, IV, or V in Controlled Substance Act. Drugs are classified based on their potential for abuse. The use of several drugs is strongly correlated. For example, consumption of seven drugs (amphetamines, cannabis, cocaine, ecstasy, legal high, LSD, and magic mushrooms) correlates and Pearson correlation coefficient r & gt; 0.4 on each pair of them. ; potash consumption strongly correlated ( r & gt; 0.5) with the use of nicotine (tobacco), heroin correlated with cocaine ( r & gt; 0.4), methadone ( r & gt; 0.45), and strongly correlated with crack ( r & gt; 0.5)
Drug abuse
Drug abuse is a term commonly used when prescription drugs with sedatives, anxiolytic, analgesic, or stimulants are used for mood swings or toxicity ignore the fact that overdose of these drugs can sometimes have serious side effects. Sometimes it involves the transfer of drugs from the individual for whom it is prescribed.
Prescription abuse has been defined differently and somewhat inconsistently based on prescription status, prescription use, intentional use to achieve intoxicating effects, route administration, joint consumption with alcohol, and presence or absence of symptoms of dependence. The use of certain substances chronically causes a change in the central nervous system known as 'tolerance' to the drug so that more substances are needed to produce the desired effect. With some substances, stopping or reducing use may cause withdrawal symptoms to occur, but this is highly dependent on the specific substance in question.
Levels of prescription drug use rapidly outstripped the use of illegal drugs in the United States. According to the National Institute of Drug Abuse, 7 million people take prescription drugs for nonmedical use in 2010. Among the 12th graders, the use of nonmedical prescription drugs is now second only to marijuana. "Almost 1 in 12 senior high school seniors report the use of nonmedical Vicodin; 1 out of 20 report the use of such OxyContin." Both of these drugs contain opioids.
Different ways of getting prescription drugs to be misused vary: sharing between family and friends, illegally buying drugs at school or workplace, and often "doctor's shopping" to find some doctors to prescribe the same medicine, without the knowledge of other prescription experts.
Increasingly, law enforcement holds physicians responsible for prescribing controlled substances without fully establishing patient controls, such as patient "contracts". Careful doctors educate themselves on how to identify drug-seeking behavior in their patients, and become familiar with "red flags" that will remind them of potential prescription drug abuse.
Maps Substance abuse
Signs and symptoms
Depending on the actual compound, drug abuse including alcohol can cause health problems, social problems, morbidity, injuries, unprotected sex, violence, death, motor vehicle accidents, murder, suicide, physical dependence or psychological addiction.
There is a high rate of suicide in alcoholics and other drug abusers. Reasons that are believed to lead to an increased risk of suicide include abuse of alcohol and other long-term drugs that cause physiological distortions of brain chemistry as well as social isolation. Another factor is the acute intoxication effect of drugs can make suicide more likely. Suicide is also very common in teenage alcohol users, with 1 in 4 suicide cases in adolescents associated with alcohol abuse. In the United States about 30% of suicides are associated with alcohol abuse. Alcohol abuse is also associated with an increased risk of committing crimes including child abuse, domestic violence, rape, robbery and assault.
Drug abuse, including alcohol and prescription drugs, can induce symptomatology that resembles mental illness. This can happen both in a drunken state and also during a withdrawal state. In some cases, psychiatric disorders caused by this substance can last long after detoxification, such as prolonged psychosis or depression after amphetamine or cocaine abuse. The prolonged withdrawal syndrome may also occur with symptoms persisting for months after discontinuation of use. Benzodiazepines are the most important drugs to induce a persistent withdrawal effect with symptoms that sometimes persist for years after cessation of use. Both alcohol, barbiturates and the withdrawal of benzodiazepines are potentially fatal. The abuse of hallucinogens can trigger delusional and other psychotic phenomena long after termination of use.
Cannabis can trigger panic attacks during poisoning and with continuous use, this can lead to a situation similar to dysthymia. Researchers have found that daily use of marijuana and high-power cannabis use are independently associated with a higher likelihood of developing schizophrenia and other psychotic disorders.
Severe anxiety and depression are commonly caused by continued alcohol abuse, which in many cases subsides with persistent abstinence. Even moderate continuous alcohol use can increase the level of anxiety and depression in some individuals. In many cases, this drug-induced psychiatric disorder fades with persistent abstinence.
Impulsivity
Impulsivity is characterized by action based on a sudden desire, desire, or inclination rather than careful thought. Individuals with substance abuse have higher impulsivity rates, and individuals who use multiple drugs tend to be more impulsive. A number of studies using Iowa gambling as a measure for impulsive behavior found that drug-using populations made riskier choices than healthy controls. There is a hypothesis that impulse control loss may be due to inhibitory control disorders resulting from drug-induced changes occurring in the frontal cortex. The developmental development of nerves and hormonal changes that occur during adolescence may modulate impulse controls that may lead to experiments with drugs and may lead to pathway addiction. Impulsivity is considered a feature of the side in the personality domain of neuroticism (excessive/negative urgency) that is prospectively associated with the development of substance abuse.
Filtering and rating
There are several different screening tools that have been validated for use with teenagers such as the CRAFFT Screening Test and the adult CAGE questionnaire.
Some recommendations for screening tools for substance abuse in pregnancy include that they take less than 10 minutes, should be used routinely, including the educational component. Suitable tools for pregnant women include i.a. 4P, T-ACE, TWEAK, TQDH (Ten-Question History Drink), and AUDIT.
Treatment
Psychological
From the literature on applied behavioral analysis, behavioral psychology, and from randomized clinical trials, several proven-based interventions have emerged: behavioral marriage therapy, motivational interviews, community strengthening approaches, exposure therapy, contingency management. They help suppress cravings and mental anxiety, improve focus on treatment and new skill learning skills, reduce withdrawal symptoms and reduce the chances of relapse.
In children and adolescents, cognitive behavioral therapy (CBT) and family therapy today have the most research evidence for the treatment of substance abuse problems. Well-established studies also include ecologically-based family treatments and CBT groups. These treatments can be given in a variety of different formats, each having different levels of research support. Research has shown that what makes the most effective CBT group is that encourages the development of social skills, emotional regulatory skills that match the development and other interpersonal skills.. Some models of integrated care, which combine parts of different types of treatments, have also been seen as established or perhaps effective. A study of alcohol and the use of maternal medicine has shown that an integrated treatment program has produced significant results, resulting in a higher negative result on the toxicology screen. In addition, short-term school-based interventions have proven to be effective in reducing alcohol use and teenage marijuana. Motivational interviews can also be effective in treating substance use disorders in adolescents.
Alcoholics Anonymous and Narcotics Anonymous is one of the best known self-help organizations in which members support each other not to use alcohol. Social skills are significantly impaired in people suffering from alcoholism because of the neurotoxic effects of alcohol on the brain, especially the area of ​​the brain's prefrontal cortex. It has been suggested that additional social skills training for inpatient care of alcohol dependence may be efficacious, including managing the social environment.
Drugs
A number of drugs have been approved for the treatment of substance abuse. These include replacement therapies such as buprenorphine and methadone as well as antagonistic drugs such as disulfiram and naltrexone in either short acting, or newer longer acting forms. Some other drugs, often those originally used in other contexts, have also been shown to be effective including bupropion and modafinil. Methadone and buprenorphine are sometimes used to treat opiate addiction. These drugs are used in lieu of other opioids and still cause withdrawal symptoms.
Antipsychotic drugs have not been found helpful. Acamprostate is a NMDA glutamatergic antagonist, which helps with alcohol withdrawal symptoms because alcohol withdrawal is associated with a hyperglutamatergic system.
Double diagnosis
It is common for individuals with impaired drug use to have other psychological problems. The term "double diagnosis" or "coexisting disorder," refers to mental health disorders and substance use at the same time. According to the British Association for Psychopharmacology (BAP), "symptoms of psychiatric disorders such as depression, anxiety and psychosis are rules rather than exceptions in patients who abuse drugs and/or alcohol."
Individuals who have comorbid psychological disorders often have a poor prognosis if one of the disorders is not treated. Historically, most individuals with multiple diagnoses received treatment only for one of their disorders or they did not receive any treatment. However, since the 1980s, there has been a push to integrate mental health care and addiction. In this method, the condition is not considered primary and both are treated simultaneously by the same provider.
Epidemiology
Initiation of drug and alcohol use is most likely to occur during adolescence, and some experiments with substances by older adolescents are common. For example, the results of the 2010 Monitoring the Future survey, a national study of substance use rates in the United States, show that 48.2% of 12th graders report having used illicit drugs at some point in their lives. In the 30 days prior to the survey, 41.2% of 12th graders consumed alcohol and 19.2% 12th graders smoked cigars. In 2009 in the United States about 21% of high school students had taken prescription drugs without prescription. And earlier in 2002, the World Health Organization estimated that around 140 million people are alcohol dependent and 400 million others with alcohol-related problems.
Research has shown that the overwhelming majority of adolescents will stop using drugs before it becomes problematic. Thus, although overall use rates are high, the percentage of adolescents who meet the criteria for substance abuse is significantly lower (close to 5%). According to the BBC, "Worldwide, the United Nations estimates there are more than 50 million regular users of diacetate morphine (heroin), cocaine and synthetic drugs."
History
WHAT, AMA, and NCDA
In 1932, the American Psychiatric Association created a definition that uses legality, social acceptance, and cultural familiarity as a qualifying factor:
... as a general rule, we reserve the term drug abuse to be applied to the illegal non-physical use of a limited number of substances, most of them medicines, which have the nature of altering mental states in a manner considered by social norms. and is defined by law to be inappropriate, undesirable, dangerous, threatening, or, at least, foreign-cultural. "
In 1966, the American Medical Association's Committee on Alcoholism and Addiction defines the abuse of stimulants (amphetamines, especially) in terms of 'medical supervision':
... 'use' refers to appropriate stimulant sites in medical practice; 'abuse' applies to the role of physician in initiating potentially hazardous therapies; and 'abuse' refers to the self-administration of these drugs without medical supervision and especially in large doses that can lead to psychological dependence, tolerance and abnormal behavior.
In 1973, the National Commission on Ganja and Drug Abuse stated:
... drug abuse may refer to any type of drug or chemical without regard to its pharmacological action. It is an eclectic concept that has only one uniform connotation: community rejection.... The Commission believes that the term drug abuse should be removed from official statements and public policy dialogue. This term has no functional usability and has become nothing more than a random code word for current illicit drug use.
DSM
The first edition of the American Diagnostic Diagnostic and Statistical Manual of the American Mental Disorder Association (published in 1952) classifies alcohol and drug abuse under the Sociopath Personality Disorder, which is considered to be a symptom of deeper psychological disorders or moral weakness. The third edition, published in 1980, was the first to recognize substance abuse (including substance abuse) and substance dependence as a condition separate from substance abuse alone, bringing social and cultural factors. The definition of dependence emphasizes tolerance to drugs, and withdrawal from them as a key component to diagnosis, whereas abuse is defined as "problematic use with social or occupational disorder" but without withdrawal or tolerance.
In 1987, the category of DSM-IIIR "psychoactive substance abuse", which includes earlier concepts of drug abuse defined as "the pattern of maladaptive usage demonstrated by... continuous use despite having knowledge of having a persistent social, occupational, psychological work or recurrent, or physical problems caused or exacerbated by the use of (or by) repeated use in situations that are physically harmful. "This is a residual category, with dependence taking precedence when applicable. That is the first definition that gives equal weight to behavioral and physiological factors in diagnosis. In 1988, DSM-IV defines substance dependence as "a syndrome involving compulsive use, with or without tolerance and withdrawal"; whereas substance abuse is "problematic use without compulsive use, significant tolerance, or withdrawal." Substance abuse can be harmful to your health and may even be deadly in certain scenarios. In 1994, the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) issued by the American Psychiatric Association, DSM-IV-TR, defines substance dependence as "when a person continues to use alcohol or other drugs despite problems related to substance use, substances can be diagnosed. "followed by criteria for diagnosis
DSM-IV-TR defines substance abuse as:
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- A. Maladaptive patterns of substance use that lead to clinically significant disturbances or distress, as manifested by one (or more) of the following, occur within a 12 month period:
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- Use of recurrent substances that result in failure to fulfill primary role obligations at work, school, or at home (eg recurrent absences or poor performance of work related to drug use, absence related to substance, suspension or expulsion from school, neglecting children or household)
- Use of recurrent substances in situations where physically harmful (eg, driving a car or operating a machine when harmed by substance use)
- Legal issues with recurring issues (e.g., capture for certain unrelated behaviors related to the material)
- Continuous use of substance despite persistent or recurrent social or interpersonal problems caused or aggravated by the effects of substance (for example, arguments with a partner about the consequences of poisoning, physical fights)
- B. The symptoms never satisfy the criteria for substance dependence for this class of substances.
The fifth edition of DSM (DSM-5), which is planned for release in 2013, will likely have this terminology reviewed again. In consideration is the transition from the terminology of abuse/dependence. Currently, abuse is seen as an early form or less harmful form of a disease characterized by dependency criteria. However, the term 'dependence' of WHAT, as mentioned above, does not mean that physiological dependence exists but rather means that there is a state of the disease that is likely to be referred to as a state of addiction. Many involved recognize that terminology often causes confusion, both in the medical community and with the general public. The American Psychiatric Association asks for input on how the terminology of this disease should be changed as it moves forward with the DSM-5 discussion.
Society and culture
Legal approach
- Related articles: Drug control law, Prohibition (drugs), Arguments for and against drug prohibition, harm reduction
Most governments have drafted legislation to criminalize certain types of drug use. These drugs are often called "illegal drugs" but generally illegally are their unlicensed production, distribution and ownership. These drugs are also called "controlled substances". Even for simple ownership, legal punishment can be very severe (including death penalty in some countries). Laws vary in different countries, and even within, and have fluctuated widely throughout history.
Attempts by government-sponsored drug control policies to prevent the supply of illegal drugs and eliminate drug abuse are largely unsuccessful. Despite the great efforts made by the United States, drug supply and drug purity have reached the highest point all the time, with most of the resources spent on bans and law enforcement, not public health. In the United States, the number of nonviolent criminals in prisons exceeds 100,000 populations imprisoned in the EU, despite the fact that the EU has 100 million more citizens.
Although drug laws (or perhaps therefore), large, organized criminal drug cartels operate around the world. Proponents of decriminalization argue that drug prohibitions make drugs deal with profitable businesses, leading to many related criminal activities.
Cost
Policy makers try to understand the relative costs of drug-related interventions. The appropriate drug policy depends on the assessment of public expenditure related to the drug based on the classification system in which the cost is correctly identified.
Drug-related expenditures are defined as planned direct expenditures that reflect the country's voluntary state involvement in the field of illegal drugs. Direct public expenditures that are explicitly labeled as drug-related can easily be traced back to in depth reviewing official accounting documents such as national budgets and year-end reports. Unlimited spending refers to unplanned and estimated expenditure through modeling techniques, based on top-down budget procedures. Starting from the overall aggregate expenditure, this procedure estimates the proportion of substance abuse (Unspecified Drug-related Expenditure = Overall Expenditure - Proportion of Attributes). For example, to estimate drug-related expenditures in a particular country, two elements will be required: the overall prison spending in that country for a certain period, and the proportion of prisoners caused by drug-related issues. Products of both will provide rough estimates that can be compared in different countries.
Europe
As part of the 2005 reporting exercise, the European surveillance center for Drug and Narcotic Addiction networks established in the 27 EU Member States, Norway and candidate countries to the EU, is required to identify public expenditure on drugs, at country level.
It was reported by 10 countries categorized according to government function, totaling EUR 2.17 billion. Overall, the highest proportion of this amount comes from government functions in the Health sector (66%) (eg medical services), and Public Safety and Order (POS) (20%) (eg police services, courts of law, prisons). By country, the average share of GDP is 0.023% for Health, and 0.013% for POS. However, these stocks vary across countries, ranging from 0.00033% in Slovakia, to 0.053% of GDP in Ireland in Health cases, and from 0.003% in Portugal, to 0.02% in the UK, in the case of POS; almost a 161-fold difference between the highest and lowest states for Health, and a 6-fold difference for POS. Why did Ireland and Britain spend so much money on Health and POS, or Slovakia and Portugal very little, in terms of GDP?
In response to this question and to make a comprehensive assessment of public drug expenditure across the country, this study compares health spending and POS and GDP in the 10 reporting countries. The findings show that GDP is a major determinant of public expenditure on drugs and POS from a country. Drug-related public expenditures show a positive relationship with GDP across the country under consideration: r = 0.81 in Health cases, and r = 0.91 for POS. The percentage change in Health expenditure and POS due to a one percent increase in GDP (demand income elasticity) is estimated at 1.78% and 1.23%, respectively.
Being a very elastic expenditure, Health, and POS can be considered a luxury; as a nation becomes richer, it openly expends more proportionally on health-related health and public order and safety interventions.
English
The UK House Office estimates that the social and economic costs of drug abuse for the UK economy in terms of crime, absenteeism and illness exceed $ 20 billion per year. However, the UK Home Office does not estimate which part of the crime is an unintended consequence of a drug ban (a crime to maintain expensive drug consumption, risky production and dangerous distribution), or how much it enforces it. These aspects are necessary for a full analysis of the economic prohibition.
United States
These figures represent the overall economic costs, which can be divided into three main components: health costs, productivity losses and non-health direct expenditures.
- Health-related costs are projected to reach $ 16 billion in 2002.
- Productivity loss is estimated at $ 128.6 billion. In contrast to other costs of drug abuse (which involve direct spending on goods and services), this value reflects a potential loss of resources: work in the labor market and in household production that has never been done, but can be expected to have been absent from the impact of abuse drugs.
- Including estimates of productivity loss due to premature death ($ 24.6 billion), illicit drug-related illness ($ 33.4 billion), detention ($ 39.0 billion), criminal career ($ 27.6 billion) and losses productivity of crime victims ($ 1.8 billion).
- Direct non-health expenditures primarily involve costs associated with the criminal justice system and the cost of crime victims, but also include a modest level of expenditure for the administration of the social welfare system. Total for 2002 is estimated at $ 36.4 billion. The largest detailed component of this charge is for state and federal correction of $ 14.2 billion, primarily for prison operations. Another $ 9.8 billion was spent on state and local police protection, followed by $ 6.2 billion for federal supply reduction initiatives.
According to a report from the Research and Quality Health Agency (AHRQ), Medicaid was billed for a higher number of hospitals for excessive use of opioid drugs than Medicare or private insurance in 1993. By 2012, the difference is reduced. At the same time, Medicare experienced the fastest growth in hospital admissions.
Custom population
Immigrants and refugees
Immigrants and refugees are often under great pressure, physical trauma and depression and anxiety because the separation of loved ones often marks the pre-migration and transit phases, followed by "cultural dissonance," language barriers, racism, discrimination, economic hardship, population density , social isolation, and loss of status and difficulty in getting a job and deportation worries are common. Refugees often experience concerns about the health and safety of loved ones left behind and uncertainty about the possibility of returning to their home country. For some people, substance abuse serves as a coping mechanism to try to cope with this stress.
Immigrants and refugees can bring patterns of use and substance abuse and behavior of their home country, or adopt attitudes, behaviors, and norms about the use and abuse of substances present in the dominant culture in which they enter.
Street children
Street children in many developing countries are high risk groups for substance abuse, especially solvent abuse. Based on research in Kenya, Cottrell-Boyce argues that "drug use among street children is essentially functional - dulling the senses of life's difficulty on the road - but it can also provide links to the support structure of the group 'street families' as a symbol of shared experience strong. "
Musician
To maintain high-quality performance, some musicians take chemicals. Some musicians consume drugs or alcohol to cope with performance stress. As a group they have higher levels of substance abuse. The most common chemistry that is abused by pop musicians is cocaine, because of its neurological effects. Stimulants such as cocaine increase alertness and cause feelings of euphoria, and therefore can make players feel as if they are in some ways 'on stage'. One way in which substance abuse is harmful to a player (especially a musician) is if the substance that is abused is aspirated. Lungs are important organs used by singers, and cigarette addiction can severely damage the quality of their performance. Smoking causes damage to the alveoli, which is responsible for absorbing oxygen.
Veteran
Substance abuse can be another factor affecting the physical and mental health of veterans. Substance abuse can also damage personal family relationships and cause financial hardship. There is evidence to suggest that substance abuse is affecting the population of homeless veterans. A 2015 Florida study compared the causes of homelessness between veterans and non-veteran populations in self-reporting questionnaires. The results of the study found that 17.8% of veteran homeless participants linked their homelessness to alcohol and drug problems compared with only 3.7% of the non-veteran homeless group.
A 2003 study found that homelessness was associated with access to support from family/friends and services. However, this relationship is incorrect when comparing homeless participants who have substance abuse at this time. The US Department of Veterans Affairs provides a summary of treatment options for veterans with substance use disorders. For treatments that do not involve drugs, they offer therapeutic options that focus on finding outside support groups and "seeing how substance use issues may be associated with other problems such as PTSD and depression".
See also
References
External links
- Substance abuse in Curlie (based on DMOZ)
- A Comprehensive Minimum Age Experience: Mental Substance Risk Factors and Mental Health. Your Robert from the US Disease Control Center explains the relationship between childhood difficulties and then pains, including substance abuse (video)
- The National Institute for Drug Abuse
Source of the article : Wikipedia
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