Substance Use and Abuse

Elizabeth J. Thomson, MS, RN
JAMA. 1991;266(11):1512. doi:10.1001/jama.1991.03470110058026.
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To the Editor.  — I have often pondered what characteristics authors and editors use to distinguish between substance use (utilization, employment, habituation) and substance abuse (misuse, incorrect or improper use, corrupt practice). I wondered if an objective guideline had been developed beyond which substance use becomes substance abuse.After reading recent JAMA articles,1-3 one explanation seems obvious. It may not be the specific agent used or the amount of the agent employed as much as it is the race, ethnicity, socioeconomic status, gender, pregnancy status, or the profession of the abuser. I think both authors of articles and editors of professional journals ought to consider this issue and the implications of the messages they are sending.


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