A padrão of uso of non-psychoactive substances that has caused clinically significant harm to a person’s physical or mental health. The padrão of uso is evident over a period of at least 12 months if uso is episodic and at least one month if uso is continuous (i.e., daily or almost daily). Harm may be caused by the direct or secondary toxic effects of the substance on body organs and systems, or a nocivo route of administration.