Edwards G, Arif A, Hadgson R
Bull World Health Organ. 1981;59(2):225-42.
Earlier work in this field is reviewed and present concepts and terminologies are examined in detail. A revised way of dealing with ideas implicit in the terms "drug abuse" or "drug misuse" is proposed; the term "neuroadaptive state" is suggested as an alternative to "physical dependence"; a profile is given of the elements that constitute a "drug dependence syndrome"; and the need to differentiate conceptually between "dependence" and "drug related disability" is stressed. A model of dependence is outlined in which dependence is considered as a psycho-physiological-social syndrome determined and kept going by a complex system of reinforcements. The association between substance use and mental illness is discussed with emphasis on possible two-way relationships. The need for population studies and in particular for longitudinal studies is emphasized. The bearing of all the fore-going considerations on work towards the revision of relevant classification systems is considered, and, in the final section, several recommendations on nomenclature are brought together and suggestions are made for research that might lead to refinement of classification and diagnostic systems.
回顾了该领域早期的工作，并详细审视了当前的概念和术语。提出了一种处理“药物滥用”或“药物误用”隐含概念的修订方法；建议用“神经适应性状态”一词替代“身体依赖”；给出了构成“药物依赖综合征”的要素概述；强调了在概念上区分“依赖”和“药物相关残疾”的必要性。概述了一种依赖模型，其中依赖被视为一种由复杂强化系统决定并维持的心理 - 生理 - 社会综合征。讨论了物质使用与精神疾病之间的关联，重点强调了可能的双向关系。强调了进行人群研究，特别是纵向研究的必要性。考虑了上述所有因素对修订相关分类系统工作的影响，在最后一部分，汇总了关于术语的若干建议，并对可能有助于完善分类和诊断系统的研究提出了建议。
