Index:

Definitions in Addiction Medicine - adopted 99.10.14
Definitions in Addiction Medicine - Two - adopted 01.10.19
Definitions in Addiction Medicine - Three - adopted 03.10.17

Definitions in Addiction Medicine - adopted 99.10.14

Developed 1999 October 14 through a workshop entitled Play with a Full Deck… 52 Definitions in Addiction Medicine

1. Addiction - A primary, chronic disease, characterised by impaired control over the use of a psychoactive substance and/or behaviour. Clinically, the manifestations occur along biological, psychological, sociological and spiritual dimensions. Common features are change in mood, relief from negative emotions, provision of pleasure, pre-occupation with the use of substance(s) or ritualistic behaviour(s); and continued use of the substance(s) and/or engagement in behaviour(s) despite adverse physical, psychological and/or social consequences. Like other chronic diseases, it can be progressive, relapsing and fatal.
   
   Consider adding qualifiers such as full, partial remission, etc. based on DSM IV.
   
   
2. Agonist - a substance that acts at a neuronal receptor to produce effects similar to those of a reference psychoactive substance, e.g. methadone is an agonist at the opioid receptors.

3. Antagonist - a substance that counteracts the effects of a reference psychoactive substance by inhibiting or reversing its effects at a neuronal receptor site, e.g. naltrexone acts as an antagonist at the opioid receptor.

4. * Alcoholism - an imprecise term, which may encompass alcohol abuse or dependence.

5. * Alcoholic - an imprecise term, referring to an individual experiencing alcohol abuse or dependence.

   *These definitions, and other similar ones, will be put in a separate section for terms that may be in common use but are not recommended for continuing use
   

6. Chronic Non-Cancer Pain - a condition, as defined by Canadian Pain Society - ? pain lasting at least six months; of a duration longer than the expected time to tissue healing or resolution of the underlying disease process; or due to a condition when there is ongoing nociception.?

7. Concurrent Disorders - the presence of one or more primary, physical and/or psychiatric disorders that have an interactive effect on the course of Substance Dependence and require specific diagnosis and treatment in order to achieve stabilization and/or recovery.

8. Craving - A bio-psychological arousal and urge to return to addictive behaviour, characterized by a strong desire, pre-occupation and possible impulsivity.

9. Depressants - a category of psychoactive substances that suppress, inhibit or decrease some aspects of the function of the central nervous system (CNS), e.g. alcohol, barbiturates, benzodiazepines or other sedative/hypnotics.

10. Hallucinogens - a category of psychoactive substances that induce alterations in perception, thinking and feeling, which may resemble functional psychoses, without necessarily producing the gross impairment of memory and orientation, characteristic of the organic syndromes, e.g. cannabis, psilocybin, amphetamine derivatives (MDA, MDMA or ecstasy) and phencyclidine (PCP).

11. Harm Reduction - health promotion, prevention, assessment and intervention options that aim to decrease the health and socio-economic consequences of drug use and addictive behaviour, without necessarily requiring abstinence. Abstinence-based strategies are an integral component of comprehensive harm reduction.

12. Mutual-help program - a non-professional approach that utilizes individual and group support to aid in the process of recovery from Addiction, eg. Twelve-step groups such as Alcoholics Anonymous and Narcotics Anonymous, Rational Recovery, Secular Organization for Sobriety (SOS), Women for Sobriety (WFS) etc.

13. Stimulants - a category of psychoactive substances that activate, enhance or increase neural activity in the nervous system, e.g. amphetamines, caffeine, cocaine, nicotine etc.

14. Substance Abuse - a medical diagnosis, as specified in the Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition (DSM IV) -
    1. A maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by one (or more) of the following, occurring within a 12-month period:
       1. recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home (e.g., repeated absences or poor work performance related to substance use; substance-related absences, suspensions, or expulsions from school; neglect of children or household)
       2. recurrent substance use in situations in which it is physically hazardous (e.g., driving an automobile or operating a machine when impaired by substance use)
       3. recurrent substance-related legal problems (e.g., arrests for substance-related disorderly conduct)
       4. continued substance use despite having persistent or recurrent social or interpersonal problems caused by or exacerbated by the effects of the substance (e.g., arguments with spouse about consequences of intoxication, physical fights)

    2. The symptoms have never met the criteria for Substance Dependence for this class of substance.

15. Substance Dependence - a medical diagnosis as specified the Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition (DSM IV) -
    A maladaptive pattern of substance use , leading to clinically significant impairment or distress, as manifested by three (or more) of the following, occurring at any time in the same 12-month period:
    1. tolerance, as defined by either of the following:
       1. a need for markedly increased amounts of the substance to achieve intoxication or desired effect
       2. markedly diminished effect with continued use of the same amount of the substance
    2. withdrawal, as manifested by either of the following:
       1. the characteristic withdrawal syndrome for the substance (refer to Criteria A and B of the criteria sets for Withdrawal from the specific substances)
       2. the same (or closely related0 substance is taken to relieve or avoid withdrawal symptoms
    3. the substance is often taken in larger amounts or over a longer period of time than was intended
    4. there is persistent desire or unsuccessful efforts to cut down or control substance use
    5. a great deal of time is spent in activities necessary to obtain the substance (e.g., visiting multiple doctors or driving long distances), use the substance (e.g., chain-smoking), or recovering from its effects
    6. important social, occupational, or recreational activities are given up or reduced because of substance use
    7. the substance use is continued despite knowledge of having a persistent of recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance (e.g., current cocaine use despite recognition of cocaine-induce depression, or continued drinking despite recognition that an ulcer was made worse by alcohol consumption)
16. Tolerance - same as in criteria (1) of DSM IV definition for Substance Dependence.

17. Withdrawal - same as in criteria (2) of DSM IV definition for Substance Dependence.

Definitions in Addiction Medicine - Two - adopted 01.10.19

1. Abuse liability - the propensity of a particular psychoactive substance to result in the development of Substance Use Disorders.

2. Addict - someone who has the disease of Addiction

3. Addictionist - a physician who has specialized expertise and experience in Addiction Medicine. Sometimes also referred to as an Addictionologist.

4. Addiction Medicine - a field of Medicine that is focused on the diagnosis, treatment and prevention of Substance-Related Disorders and Addiction.

5. Blackout - a period of memory loss, resulting from the use of alcohol and/or other psychoactive substances, not associated with loss of consciousness.

6. Dependence potential - the propensity of a particular psychoactive substance to result in the development of Substance Dependence.

7. Flashbacks - a spontaneous recurrence of previously experienced physical symptoms, perceptual distortions, intense emotions and/or loss of ego boundaries.

8. Inhalants - volatile substances that vaporize at ambient temperatures and are inhaled for psychoactive effects, e.g. organic solvents, such as glue, aerosol, paints, industrial solvents, gasoline etc.; and aliphatic nitrites, such as amyl nitrite

9. Intoxication - a physiological condition that follows the administration of psychoactive substances and results in disturbances in perception, cognition, affect, level of consciousness, judgment, behaviour or other psychophysiological functions and responses. The condition varies due to individual biophysiological factors, tolerance, substances used, setting and personal expectations about the effects of psychoactive substance(s).

10. Low-risk Drinking - a level of alcohol use that is not likely to produce any acute or chronic harmful effects.

11. Maintenance Therapy - treatment of Substance Dependence by a prescription drug, to prevent withdrawal and reduce the harm associated with a particular method of administration, attendant dangers to health and/or social consequences, e.g. methadone for Opioid Dependence or nicotine replacement therapy (NRT) for tobacco.

Definitions in Addiction Medicine - Three - Adopted 2003 October 17

1. Psychoactive Substance - a substance that affects thinking (cognitive), feeling (affective) and/or perceptual processes of the brain, e.g. depressants, stimulants, hallucinogens, opioids, inhalants, etc.

2. Substance Misuse - use of substance(s) for a purpose not consistent with legal guidelines or medical recommendations for dosage intervals or amounts.

3. Substance Use Disorders - a category of two disorders, namely, Substance Abuse and Substance Dependence, as in DSM IV.