"When observed within approximately 1 to 12 months after heroin onset, an estimated 23% to 38% of new heroin users have become dependent on heroin. Rank-order correlation and post hoc exploratory analyses prompt a hypothesis of recently increased odds of becoming dependent on heroin.

"Consistent with previous research, rates of AUD [Alcohol Use Disorder] were greater among men than women.1,2,5,14 Age was inversely related to 12-month AUD, a finding also observed in earlier epidemiologic studies.1-5,14 Whether this result is owing to cohort effects, differential mortality, or recall bias merits further investigation. The 12-month rate of 7.1% for severe AUD among 18- to 29-year-old respondents is especially striking.

"In 2012 through 2013, US prevalences of DSM-5 12-month and lifetime AUD [Alcohol Use Disorder] among adults 18 years and older were 13.9% and 29.1%, respectively, representing approximately 32 648 000 and 68 485 000 individuals, respectively, in the United States.

"In 2012–2013, the NESARC-III [National Epidemiologic Survey on Alcohol and Related Conditions–III], a large national survey of US adults, assessed 12-month and lifetime disorders, including DUDs, diagnosed according to the new DSM-5. The NESARC-III used rigorous survey and field methods and incorporated measures of functioning and detailed assessments of treatment use. The NESARC-III results indicate that the prevalence rates of 12-month and lifetime DSM-5 DUD were 3.9% and 9.9%, respectively, representing approximately 9,131,250 and 23,310,135 US adults, respectively.

"Drug dependence treatment—within an acute care, symptoms-focused paradigm—has fallen short of properly addressing the complex, multifactorial nature of drug dependence that often follows the course of a relapsing and remitting chronic disease. There is disillusionment with the 'admit, treat, and discharge', revolving door cycles of high dropout rates, post-treatment relapse, and readmission rates.

"Opioid analgesics are useful in managing acute and chronic pain. They are sometimes underused in patients with severe acute pain or with pain and a terminal disorder such as cancer, resulting in needless pain and suffering. Reasons for undertreatment include
"• Underestimation of the effective dose
"• Overestimation of the risk of adverse effects

"The issues of measurement and conceptualization described above in relation to efforts to screen for problematic or harmful cannabis use highlight the shortcomings of ‘one-size-fits-all’ approaches to screening.

"Illicit drug use disorder is defined as meeting DSM-IV criteria for either dependence or abuse for one or more of the following illicit drugs: marijuana, cocaine, heroin, hallucinogens, inhalants, methamphetamine, or prescription psychotherapeutic drugs that were misused (i.e., stimulants, tranquilizers or sedatives, and pain relievers).⁴⁴ There are seven possible dependence criteria for specific illicit drugs:

Is Marijuana Addictive? The best scientific data available indicate that marijuana is less potentially addictive than many other substances in common use. This should not be construed as meaning that marijuana has no potential for dependence or that it is entirely safe.

"Our results indicate a moderate relation between early teen marijuana use and young adult abuse of other illicit substances; however, this association fades from statistical significance with adjustments for stress and life-course variables. Likewise, our findings show that any causal influence of teen marijuana use on other illicit substance use is contingent upon employment status and is short-term, subsiding entirely by the age of 21. In light of these findings, we urge U.S.