Overview
Harmful use of psychoactive substances refers to a pattern of substance use that leads to significant harm, including health problems (physical or mental) and impairment in social functioning 1. This encompasses a range of conditions from substance abuse to dependence 1.Diagnosis
Diagnosis is based on a pattern of use leading to clinically significant impairment or distress, manifested by 1:
* Failure to fulfill major role obligations at work, school, or home.
* Recurrent use in situations where it is physically hazardous.
* Recurrent substance-related legal problems.
* Continued use despite persistent or recurrent social or interpersonal problems.
Severity specifiers (mild, moderate, severe) can be applied based on the number of criteria met 1.Management
Treatment approaches are individualized and may include behavioral therapies, counseling, and pharmacotherapy 1.
Motivational interviewing and cognitive behavioral therapy are commonly used 1.
Pharmacological interventions are often used to manage withdrawal symptoms and cravings, or to treat co-occurring mental health conditions 1.Special Populations
Management in pregnant women requires careful consideration of risks to both mother and fetus, often involving specialized perinatal substance use treatment programs 1.
Adolescents may require tailored interventions that address developmental factors and family dynamics 1.Key Recommendations
Assessment of harmful psychoactive substance use should include evaluation for health problems and social impairment 1. (Evidence: Expert opinion)
Treatment plans should be individualized and may incorporate behavioral therapies and pharmacotherapy 1. (Evidence: Expert opinion)
Specialized care is recommended for pregnant women and adolescents with harmful substance use 1. (Evidence: Expert opinion)References
1 Provencher MT, Brand JC, Rossi MJ, Lubowitz JH. Are Orthopaedic Systematic Reviews Overly Prevalent?. Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association 2016. link