substance that, if consumed, will affect a person's psychological status or physiological state or behavior. We consider only substances whose use is problematic enough to represent a meaningful threat to the welfare of individual users or others and whose prevalence is high enough among the work force to have the potential to affect business productivity. The report focuses its attention on general drug class categories, includes alcohol within its scope, and briefly addresses issues surrounding tobacco.

Use, Abuse, and Dependence: Drug taking can be classified into one of three categories: (1) use, (2) abuse, and (3) dependence. Use is defined as the limited, controlled consumption of a drug (in terms of frequency and quantity) without significant toxic, adverse physical, or psychological consequences to the user (Glantz, 1992). Regular use of prescribed medications, legal drugs such as nicotine, caffeine, and alcohol, and certain illegal drugs can lead to physiological dependence. This simply means that the abrupt cessation of drug taking produces a set of symptoms called a withdrawal syndrome. The presence of physiological dependence does not necessarily imply abuse or dependence in the behavioral sense. Abuse is defined as a level of drug use that typically leads to adverse consequences (physical or psychological). Drug use at this level is not necessarily associated with any particular frequency but is associated with use in quantities sufficient to result in some toxicity to the user, and the patterns of use usually have some characteristics of psychopathological behavior. Dependence in the behavioral sense is defined as a level of drug use that has significant adverse physical and psychological consequences. This level of use is characterized by the consumption of toxic doses of the drug that impair the user's ability to function and is also characterized by a compulsive desire to use a drug repeatedly.

Work Force: Although one might confine the question of alcohol and other drug use by the work force to the use of those substances by employees while at work, the committee believes its charge requires a more encompassing definition. By work force we mean to include any active member of the labor force, including those seeking or available for employment. Work force alcohol and other drug use is the use of those substances by any work force member, whether the use occurs on or off the job, so long as the use has potential workplace effects. Consequently, issues concerning hangover or residual effects of alcohol and other drugs taken when not at work, as well as correlates of individual alcohol and other drug use and work force participation, are all relevant.



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