A Word about Words
A Word about Words: Substance Abuse Terminology
Words are important and sometimes what we call things makes a big difference in how our patients perceive their situations. In fact, in many cases a “diagnosis” is really just applying a term to a set of symptoms, thereby naming what is going on with a patient.
Some key terms in managing commonly abused prescription medications include:
- Addiction: Neurobehavioral syndrome with genetic and environmental influences that result in psychological dependence for psychic effects. Chronic, Craving, Compulsive and Continuous despite harm
- Dependence: Neuro-adaptation characterized by withdrawal syndrome if substance is stopped or lowered abruptly
- Tolerance: Physiologic state resulting from regular use of drug in which the dose must be increased to achieve the same clinical response
- Diversion: Illegal acquisition and sale of prescription medications (most often stimulants, sedatives, and opioids)
- Illegitimate use of legitimate Rx, illegitimate Rx and or stolen from pharmacy or manufacturer.
- Substance abuse
- Maladaptive use of substances (tobacco, alcohol, licit and illicit drugs) over time that does not meet criteria for addiction
- Pseudoaddiction: Behavior of a patient who is prescribed pain relieving medication but who exhibits opioid drug-seeking patterns in response to inadequate pain relief through the prescribed treatment
- Aberrancy: Refers to a range of anomalous events involving prescribed narcotic medications suggestive of patient opioid misuse and possibly a substance use disorder
|Aberrant Medication Behaviors|
|A spectrum of behaviors that may reflect misuse: aberrant drug behaviors are common, with nearly four out of five subjects reporting one or more aberrant drug behaviors. Most patients may exhibit some aberrant drug behaviors.Some warnings are RED FLAGS. If these are indicated, even once, they strongly suggest a problem and merit action. Other warnings are YELLOW FLAGS, and suggest further exploration and monitoring.
Aberrant Medication-Taking Behavior More Likely to be Suggestive of Addiction – RED FLAGS
|Aberrant Medication-Taking Behavior Less Likely to be Suggestive of Addiction – YELLOW FLAGS