Substance use and public health

This chapter begins with a broad overview of what is meant by problem use of substances and explores distinctions between use, misuse, and abuse. By making distinctions between use and abuse the judgements that are made when attempting to understand drug related harms are revealed. The elements that underpin the addiction concept are also identified and introduced to explore how and in what way substance use problems and related harm can be understood. The utility of the addiction concept in defining or diagnosing addiction as a disease uses a case study of Mr B, a user of tobacco who prior to cutting down and eventually stopping, describes all of the hallmarks of ‘addiction’ related to his use of tobacco. Finally, interventions that are useful in reducing harms associated with problematic substance use are discussed.