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Problem Severity Continuum

Abstinence

Experimental use: minimal use, typically associated with recreational activities; often limited to alcohol use.

Early abuse: more established use, often involving more than one drug; greater frequency; adverse consequences begin to emerge.

Abuse: regular and frequent use over an extended period; several adverse consequences emerge.

Dependence: continued regular use despite repeated severe consequences; signs of tolerance; adjustment of activities to accommodate drug seeking and drug use.

Recovery: return to abstinence.

Some youths may relapse and cycle through the stages again.

Source: Winters, KC. 2001. Assessing Adolescent Substance Use Problems and Other Areas of Functioning in Adolescents, Alcohol, and Substance Abuse: Reaching Teens Through Brief Interventions (eds. Monti, PM, Colby SM & O'Leary, TA) New York: The Guilford Press.