What All the Words Mean – A Glossary

Definitions approved by ASAM—
The American Society of Addiction Medicine ©1998

Abstinence. Non-use of a specific substance. In recovery, non-use of any addictive psychoactive substance. May also denote cessation of addictive behavior, such as gambling, over-eating, etc.

Abuse. Harmful use of a specific psychoactive substance. The term also applies to one category of psychoactive substance use disorder. While recognizing that "abuse" is part of present diagnostic terminology, ASAM recommends that an alternative term be found for this purpose because of the pejorative connotations of the word "abuse."

Addiction. A disease process characterized by the continued use of a specific psychoactive substance despite physical, psychological or social harm.

Addictionist. A physician who specializes in addiction medicine.

Blackout. Acute anterograde amnesia with no formation of long-term memory, resulting from the ingestion of alcohol or other drugs; i.e. a period of memory loss for which there is no recall of activities.

Chemical Dependency. A generic term relating to psychological or physical dependency, or both, on one or more psychoactive substances.

Cross-tolerance. Tolerance, induced by repeated administration of one psychoactive substance, that is manifested toward another substance to which the individual has not been recently exposed.

Decriminalization. Removal of criminal penalties for the possession and use of illicit psychoactive substances.

Dependence. Use in three different ways: (1) physical dependence, a physiological state of adaptation to a specific psychoactive substance characterized by the emergence of a withdrawal syndrome during abstinence, which may be relieved in total or in part by readministration of the substance; (2) psychological dependence, a subjective sense of need for a specific psychoactive substance, either for its positive effects or to avoid negative effects associated with its abstinence; and (3) one category of psychoactive substance use disorder.

Detoxification. A process of withdrawing a person from a specific psychoactive substance in a safe and effective manner.

Drug Intoxication. Dysfunctional changes in physiological functioning, psychological functioning, mood state, cognitive process, or all of these, as a consequence of consumption of a psychoactive substance; usually disruptive, and often stemming from central nervous system impairment.

Enabling. Any action by another person or an institution that intentionally or unintentionally has the effect of facilitating the continuation of an individual’s addictive process.

Familial Alcoholism. A pattern of alcoholism occurring in more than one generation within a family, due to either genetic or environmental factors, or both.

Family Intervention. A specific form of intervention, involving family members of an alcoholic/addict, designed to benefit the patient as well as the family constellation.

Impairment. A dysfunctional state resulting from the use of psychoactive substances.

Intervention. A planned interaction with an individual who may be dependent on one or more psychoactive substances, with the aim of making a full assessment, overcoming denial, interrupting drug-taking behavior, or inducing the individual to initiate treatment.The preferred technique is to present facts regarding psychoactive substance use in a caring, believable and understandable manner.

Legalization. Removal of legal restrictions on the cultivation, manufacture, distribution, possession and/or use of a psychoactive substance.

Loss of Control. The inability to consistently limit the self-administration of psychoactive substances.

Misuse. Any use of a prescription drug that varies from accepted medical practice.

Overdose. The inadvertent or deliberate consumption of a dose much larger than that either habitually used by the individual or ordinarily used for treatment of an illness, and likely to result in a serious toxic reaction or death.

Polydrug Dependence. Concomitant use of two or more psychoactive substances in quantities and with frequencies that cause the individual significant physiological, psychological and/or sociological distress or impairment.

Prevention. Social, economic, legal, medical and/or psychological measures aimed at minimizing the use of potentially addicting substances, lowering the dependence risk in susceptible individuals, or minimizing other adverse consequences of psychoactive substance use. Primary prevention consists of attempts to reduce the incidence of addictive diseases and related problems in a general population. Secondary prevention aims to achieve early detection, diagnosis and treatment of affected individuals. Tertiary prevention seeks to diminish the incidence of complications of addictive diseases.

Problem Drinking. An informal term describing a pattern of drinking associated with life problems prior to establishing a definitive diagnosis of alcoholism. Also, an umbrella term for any harmful use of alcohol, including alcoholism. ASAM recommends that the term not be used in the latter sense.

Recovery. A process of overcoming both physical and psychological dependence on a psychoactive substance, with a commitment to sobriety.

Rehabilitation. The restoration of an optimum state of health by medical, psychological and social means, including peer group support, for an alcoholic/addict, a family member or a significant other.

Relapse. Recurrence of psychoactive substance-dependent behavior in an individual who has previously achieved and maintained abstinence for a significant period of time beyond withdrawal.

Sobriety. A state of complete abstinence from psychoactive substances by an addicted individual, in conjunction with a satisfactory quality of life.

Tolerance. A state in which an increased dosage of a psychoactive substance is needed to produce a desired effect.

Treatment. Application of planned procedures to identify and change patterns of behavior that are maladaptive, destructive and/or injurious to health; or to restore appropriate levels of physical, psychological and/or social functioning.

Withdrawal Syndrome. The onset of a predictable constellation of signs and symptoms following the abrupt discontinuation of, or rapid decrease in dosage of a psychoactive substance.

SOME ADDITIONAL DEFINITIONS:

Pain
An unpleasant sensory and emotional experience signaling the presence of actual or threatened tissue damage, or described in terms of such.

Chronic Pain
Pain that has outlived its usefulness.

Acute Pain
An adaptive, beneficial response necessary for the preservation of tissue integrity.
The Neuroscientist, Vol. 5, No. 5, 1999

"Pain is the most powerful and tangible force in life. The threat of torture, for instance, is better than the threat of death. Execution can be faced, but pain is corrosive, like an acid eating at the personality. Pain, as anyone with a toothache knows, drives out all other emotions and sensations before it. Pain is priority. It may even be man’s best and most undeniable reality."
Tom Boswell in the Washington Post

Pseudoaddiction
The patient who seeks additional medications appropriately or inappropriately secondary to significant under treatment of the pain syndrome. When the pain is treated in the proper manner, all inappropriate behavior ceases.
Weissman DE, Haddox JD. Pain, 1989, 36:363-66