These terms refer to substance use that is ‘problematic’ – which harms the person and others.
The terms are generally used and accepted. Contention has been raised by people who regard all substance use as harmful. They argue that these terms imply that there are forms of substance use that are not problematic and that this is not true – that non-problem use is impossible. They argue also that such an implication normalises substance use (see pro and anti-drugs).
This objection is difficult to sustain for several reasons. Firstly the use of substances is present throughout human history and across human geography (see abstinence). In this sense, the use of substances is normal. Secondly, it implies that all substance use is harmful when the personal experience of the vast majority of people who use substances – alcohol and other drugs – is that their use is not harmful in any overly concerning way. They are in control of their use and make a risk assessment and seek to reduce harm – just as they do when they go cycling, do sports or choose what to eat. Thirdly it undermines people who have a substance use problem and trivialises the real issues they face by implying that all people who use substances (i.e. the majority of adults) have a problem.