The Tangible Common Denominator of Substance Use Disorders: A Reply to Commentaries to Rehm et al. (2013a)

J. Rehm*, P. Anderson, A. Gual, L. Kraus, S. Marmet, D. J. Nutt, R. Room, A. V. Samokhvalov, E. Scafato, K. D. Shield, M. Trapencieris, R. W. Wiers, G. Gmel

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


In response to our suggestion to define substance use disorders via 'heavy use over time', theoretical and conceptual issues, measurement problems and implications for stigma and clinical practice were raised. With respect to theoretical and conceptual issues, no other criterion has been shown, which would improve the definition. Moreover, heavy use over time is shown to be highly correlated with number of criteria in current DSM-5. Measurement of heavy use over time is simple and while there will be some underestimation or misrepresentation of actual levels in clinical practice, this is not different from the status quo and measurement of current criteria. As regards to stigma, research has shown that a truly dimensional concept can help reduce stigma. In conclusion, 'heavy use over time' as a tangible common denominator should be seriously considered as definition for substance use disorder.
Original languageEnglish
Pages (from-to)118-122
JournalAlcohol and Alcoholism
Issue number1
Publication statusPublished - 2014

Cite this