Substance Use and Substance Use Disorders

Substance use and substance use disorders are of great public health significance because of their high prevalence and associated mortality, morbidity, and economic cost. Moreover, substance use and substance use disorders must be studied within a developmental context, given the etiological importance of age-related neurobiological maturation of reward and control systems; age-related sensitivities to substance use effects; age-related developmental tasks, social roles, and changes in social context; and age (and stage of substance use) differences in heritability. This chapter applies a developmental psychopathology perspective to the literature on substance use and substance use disorders. We describe multiple biopsychosocial pathways of risk, including those that are broad and not specific to substance use (i.e., externalizing and internalizing pathways) and those that are specific to substance use effects. Because these risk pathways are themselves embedded in broader societal contexts, we also consider macrolevel societal influences. Finally, we consider implications of these models for prevention and treatment interventions.