Definitions are taken from:
1. DSM IV (Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association - 1994)
2. the Lexicon of Alcohol and Drug Terms and the World Drug Report 1997 of the World Health Organisation.
3. National Library of Medicine: IGM Metathesaurus Information Screen
4. Katzung BG. Basic and Clinical Pharmacology. London: Prentice Hall International, 1999
5. National Institute of Drug Abuse (National Institute of Health USA) Website 2001
NOTA BENE: some definitions might have been only partially reported. They have been simplified to be respondent to our purpose.
The essential feature of Substance Abuse is a maladaptive pattern of substance use manifested by recurrent and significant adverse consequences related to the repeated use of substances.
The Criteria for Substance Abuse stated in DSM-IV are:
A.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 fulfil 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 expulsion 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 or exacerbated by the effects of the substance (e.g. arguments with spouse about consequences of intoxication, physical flights)
The practice of piercing specific peripheral nerves with needles to relieve the discomfort associated with painful disorders, to induce surgical anaesthesia, and for therapeutic purposes. This procedure was originally introduced and practiced in China.
Repeated use of a psychoactive substance or substances to the extent that the user is periodically or chronically intoxicated, shows a compulsion to take the preferred substance, has great difficulty in voluntarily ceasing or modifying substance use, and exhibits determination to obtain psychoactive substances by almost any means. Addiction is a term of long-standing and variable usage. In 1963 the WHO Expert Committee on Drug Dependence decided to replace the term addiction and habituation by the term dependence. Addiction is not a diagnostic term in ICD-10." According to the definition given by the Du Pont Product Monograph of Trexan R, addiction, in the simplest terms, is the conditioning of an individual to desire the effect that the addictive substance produces (in heroin addiction: euphoria) and to not desire the withdrawal symptoms (e.g. pain) that follows lack of the substance.
Drugs that act on adrenergic receptors or affect the life cycle of adrenergic transmitters. Included here are adrenergic agonists and antagonists and agents that affect the synthesis, storage, uptake, metabolism, or release of adrenergic transmitters (3).
An antiviral that is used in the prophylactic or symptomatic treatment of influenza A. It is also used as an antiparkinsonian agent, to treat extrapyramidal reactions, and for postherpetic neuralgia. The mechanisms of its effects in movement disorders are not well understood but probably reflect an increase in synthesis and release of dopamine, with perhaps some inhibition of dopamine uptake (3).
A powerful central nervous system stimulant and sympathomimetic. Amphetamine has multiple mechanisms of action including blocking uptake of adrenergics and dopamine, stimulation of release of monoamines, and inhibiting Monoamine oxidase. Amphetamine is also a drug of abuse and a psychotomimetic. The l- and the d,l-forms are included here. The l-form has less central nervous system activity but stronger cardiovascular effects. The d-form is DEXTROAMPHETAMINE
Sometimes produce an initial sense of enhanced well being (or even euphoria), which is replaced after repeated use by lack of energy, irritability, and other forms of dysphoria. Continued use of these substances may lead to more severe symptoms (e.g. depressive symptomatology) and general medical conditions (liver disease).
The antianxiety substances include the benzodiazepines, the carbamate (e.g. glutethimide, meprobamate). The non benzodiazepine antianxiety agents (e.g. buspirone, gepirone) are not included in the class.
Is a behavioural treatment based on the assumption that environmental stimuli can act as cues for drug-taking behaviour. These stimuli appear to cause anxiety in addicts who are trying to abstain from drugs and such anxiety may in turn motivate further drug use. The biofeedback procedure aims to relieve anxiety. Electromyography (EMG) biofeedback consist in a training over EMG activity in which subjects learn to control their EMG activity
Brief Intervention (BI)
A treatment strategy in which a short structured therapy is offered (between 5 minutes and 2 hours) and typically on a single occasion. Aimed at helping a person reduce or stop substance use.
D2 dopamine agonist used as a prolactin inhibitor
a narcotic analgesic with mixed agonist-antagonist opiate properties; potential efficacy in heroin withdrawal (3)
a central stimulant found in coffee and tea
Cannabinoids are substances that are derived from the cannabis plant. When the upper leaves, tops, and stems of the plant are cut, dried, and rolled into cigarettes, the product is usually called marijuana. Hashish is the dried, resinous exudate that seeps from the tops and undersides of cannabis leaves; hashish oil is a concentrate distillate of hashish. Cannabinoids are usually smoked, but may be taken orally and are sometimes mixed with tea or food.
An anticonvulsant used to control grand mal and psychomotor or focal seizures. Its mode of action is not fully understood, but some of its actions resemble those of PHENYTOIN (see some of its actions resemble those of PHENYTOIN (see below); although there is little chemical resemblance between the two compounds, their three-dimensional structure is similar
An anxiolytic benzodiazepine derivative with anticonvulsant, sedative, and amnesiac properties. It has also been used in the symptomatic treatment of alcohol withdrawal
A sedative and anticonvulsant often used in the treatment of alcohol withdrawal. Chlormethiazole has also been proposed as a neuroprotective agent. The mechanism of its therapeutic activity is not entirely clear, but it does potentiate GABA receptor response and it may also affect glycine receptors
Clinical Management Is design to "provide (1) non-specific elements of a psychotherapeutic relationship, including a supportive doctor-patient relationship, education, empathy, and the instillation of hope, without providing active ingredients specific to RP; (2) medication management, as well as an opportunity to monitor subjects' clinical status and treatment response; and (3) a convincing therapeutic rationale to foster greater retention in the protocol and compliance with medication
An alpha-2 adrenergic agonist that crosses the blood-brain barrier. Clonidine's central actions reduce sympathetic tone, resulting in a fall in diastolic and systolic blood pressure and a reduction in heart rate. It also acts peripherally, and this peripheral activity may be responsible for the transient increase in blood pressure seen during rapid intravenous administration.
The prototypical phenothiazine antipsychotic drug. Like the other drugs in this class chlorpromazine's antipsychotic actions are thought to be due to long-term adaptation by the brain to blocking dopamine receptors. Chlorpromazine has several other actions and therapeutic uses, including as an antiemetic and in the treatment of intractable hiccup
Club Drugs MDMA (Ecstasy), Rohypnol, GHB, and Ketamine are among the drugs used by teens and young adults who are part of a nightclub, bar, rave, or trance scene.
A naturally substance produced by the coca plant. It is consumed in several preparations (e.g. coca leaves, coca paste, cocaine hydrochloride, and cocaine alkaloid) that differ in potency due to varying levels of purity and speed of onset. Cocaine is the active ingredient in each preparation.
A commonly used form of cocaine is "crack", a cocaine alkaloid that is extracted from its powdered hydrochloride salt by mixing it with sodium bicarbonate and allowing it to dry into small "rocks". Crack differs from other forms of cocaine primarily because it is easily vaporised and inhaled and thus its effects have an extremely rapid onset.
Is an active, directive, time-limited system of psychotherapy that focuses on uncovering and understanding the relationship and influence of automatic thoughts and underlying assumptions on problematic feelings and behaviours. The behavioural component consists of deep muscular relaxation training with imaginal and actual approach of conflict situations; identification and practice of verbal and non verbal components of assertiveness; identification of and engagement in pleasant events; isolation and graduated rehearsal of small units of behaviour leading to goal attainment. The Cognitive component includes identification and disputation of irrational assumptions; sensitisation to aversive consequences of drug use; lowering of expectations and restructuring of goal setting strategies; development and contingent application of positive self-statements and evaluations.
A behavioural treatment based on positive/negative reinforcers.
Is a pschosocial intervention which entails the assessment of individual patient needs and the provision of services to meet these needs. The intervention does not consider intrapsychic processes.
A slavish urge to find and consume drug and more of the drug.
According to ICD-10 Classification of Mental and Behavioural Disorders it is "... a strong desire or sense of compulsion to take the drug, as manifested by drug-seeking behaviour which is difficult to control."
A benzodiazepine with anticonvulsant, anxiolytic, sedative, muscles relaxant, and amnesiac properties and a long duration of action.
Its actions are mediated by enhancement of GABA activity. It is used in the treatment of severe anxiety disorders, as a hypnotic in the short-term management of insomnia, as a sedative and premedicant, as an anticonvulsant, and in the management of alcohol withdrawal syndrome.
A carbamate derivative used as an alcohol deterrent. It is a relatively non-toxic substance when administered alone, but markedly alters the intermediary metabolism of alcohol. When alcohol is ingested after administration of disulfiram, blood acetaldehyde concentrations are increased, followed by flushing, systemic vasodilatation, respiratory difficulties, nausea, hypotension, and other symptoms (acetaldehyde syndrome). It acts by inhibiting other symptoms (acetaldehyde syndrome). It acts by inhibiting aldehyde dehydrogenates.
The term refers to all psychoactive substances, i.e., "... any substance that, when taken into a living organism, may modify its perception, mood, cognition behaviour or motor function."
Since 1992 the WHO definition is "a cluster of physiological, behavioural and cognitive phenomena of variable intensity, in which the use of a psychoactive drug (or drugs) takes on a high priority. The necessary descriptive characteristics are preoccupation with a desire to obtain and take the drug and persistent drug-seeking behaviour. Determinants and the problematic consequences of drug dependence may be biological, physiological or social, and usually interact."
The essential feature of Substance Dependence is a cluster of cognitive, behavioral, and physiological symptoms indicating that the individual continues use of the substance despite significant substance-related problems.
The Criteria for Substance Dependence stated in DSM-IV are:
A.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:
(a)a need for markedly increased amounts of the substance to achieve intoxication or desired effect.
(b)Markedly diminished effect with continued use of the same amount of the substance.
2)Withdrawal, as manifested by either of the following:
(a)the characteristics withdrawal syndrome for the substance
(b)the same (or closely related) substance is taken to relieve or avoid withdrawal symptoms.
3)The substance is often taken in larger amount or over a longer period than was intended.
4)There is a 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 recover from its effects.
MDMA is a synthetic, psychoactive drug with both stimulant (amphetamine-like) and hallucinogenic (LSD-like) properties. Street names for MDMA include Ecstasy, Adam, XTC, hug, beans, and love drug. (...)MDMA usually is taken in pill form, but some users snort it, inject it, or use it in suppository form (...).
A structured and strategic approach which places particular emphasis on developing appropiate boundaries and limits before introducing a strategic intervention. Where the patient was in a couple, the therapist worked primarly with the couple. Nevertheless other significant relationships were also included in the discussion during the sessions, and other family members were also invited to attend some sessions
A thioxanthene neuroleptic that, unlike CHLORPROMAZINE (see above), is claimed to have CNS-activating properties. It is used in the treatment of psychoses although not in excited or manic patients.
Since about 1990, GHB (gamma hydroxybutyrate) has been abused in the U.S. for euphoric, sedative, and anabolic (body building) effects. It is a central nervous system depressant that was widely available over-the-counter in health food stores during the 1980s and until 1992. It was purchased largely by body builders to aid fat reduction and muscle building. Street names include Liquid Ecstasy, Soap, Easy Lay, and Georgia Home Boy
Drugs capable of inducing illusions, hallucinations, delusions, paranoid ideations, and other alterations of mood and thinking. Despite the name, the feature that distinguishes these agents from other classes of drugs is their capacity to induce states of altered perception, thought, and feeling that are not experienced otherwise.
"... a pattern of psychoactive substance use that is causing damage to health ... physical or mental."
Hypnotics and sedative Drugs
used to induce drowsiness or sleep or to reduce psychological excitement or anxiety
Aliphatic and aromatic hydrocarbons found in substance such gasoline, glue, paint thinners, and spray paints. Less commune are halogenated hydrocarbons (found in cleaners, typewriter correction fluid, spray-can propellants) and other volatile compounds containing esters, ketones, and glycol. Most compounds that are inhaled are a mixture of several substances that can produce psychoactive effects, and is often difficult to ascertain the exact substance responsible for the disorder. These volatile substances are available in a wide variety of commercial products and may be used interchangeably, depending on availability and personal preference. Although they may be subtle differences in the psychoactive and physical effects of the different compounds, not enough is known about their differential effects to distinguish among them. All are capable of producing Dependence, Abuse and Intoxication.
Several methods are used to inhale intoxicating vapors. Most commonly, a rag soaked with the substance is applied to the mouth and nose, and the vapors are breathed in. The substance may also be placed in a paper or plastic bag and the gases in the bag inhaled.
Interpersonal Therapy Is a supportive/dynamic psychotherapeutic model (Carroll 1991a), based on the concept that psychiatric disorders, including depression and cocaine addiction, are associated with dysfunction in interpersonal relationships, which may be associated with the genesis and perpetuation of the disorder. Delivered in individual sessions
Ketamine is an anesthetic that has been approved for both human and animal use in medical settings since 1970; about 90 percent of the ketamine legally sold is intended for veterinary use. It can be injected or snorted. Ketamine is also known as "Special K" or "vitamin K". Certain doses of ketamine can cause dream-like states and hallucinations, and it has become common in club and rave scenes and has been used as a date rape drug. At high doses, ketamine can cause delirium, amnesia, impaired motor function, high blood pressure, depression, and potentially fatal respiratory problems.
Reduces narcotic withdrawal symptoms
is the brand name (with a Quaalude and Sopor) of a non-barbiturate downer Methaqualone wich effects are very similar to those of the barbiturates, although on its own it is less likely to depress the respiratory centre in overdose.
Characteristic withdrawal symptoms Substance use to relieve withdrawal. In addition, these symptoms or behaviours must persist for more than one month. Depending on the number of criteria met, drug dependence can be graded as mild, moderate or severe. A full remission means no use or use with any dependence in the past six months
Matrix Neurobehavioral Treatment
Developed by Richard Rawson and his associates, the Matrix Model is design to integrate a wide range of interventions into a comprehensive, structured approach. Elements of the treatment include individual therapy, family education and relapse prevention groups, conjoint sessions, urine testing, and 12-step involvement. The main features of this model are: (a) cognitive-behavioural therapy, which involves cognitive restructuring (identification and modification of maladaptive though patterns which facilitate cocaine use) and coping skills training (development and rehearsal of strategies for dealing with stressful situations), (b) relapse prevention techniques, which include specific risk avoidance methods, developing alternatives to cocaine use, and extinguishing conditioned responses to cocaine cues, (c) therapeutic alliance between patient and therapist, with consistent positive reinforcement to engage and maintain patients in treatment, (d) stages of recovery orientation. Patients are guided through observed neuropsychological stages of recovery from stimulant abuse, classified by the model as "withdrawal", "honeymoon", "the wall", "adjustment", and "resolution".
Hallucinogenic alkaloid isolated from the flowering heads (peyote) of Lophophora (Formerly Anhalonium) williamsii, a Mexican cactus used in Indian religious rites and as an experimental psychotomimetic. Among its cellular effects are agonist actions at some types of serotonin receptors. It has no accepted therapeutic uses although it is legal for religious use by members of the Native American Church
A synthetic opioid that is used as the hydrochloride. It is an opioid analgesic that is primarily a mu-opioid agonist. It has actions and uses similar to those of MORPHINE. It also has a depressant action on the cough centre and may be given to control intractable cough associated with terminal lung cancer. Methadone is also used as part of the treatment of dependence on opioid drugs, although prolonged use of methadone itself may result in dependence.
A quinazoline derivative with hypnotic and sedative properties. It has been withdrawn from the market in many countries because of problems with abuse.
A specific opiate antagonist that has no agonist activity. It is a competitive antagonist at mu, delta, and kappa opioid receptors.*
Derivative of noroxymorphone that is the N-cyclopropylmethyl congener of NALOXONE. It is a narcotic antagonist that is effective orally, longer lasting and more potent than naloxone, and has been proposed for the treatment of heroin addiction. The FDA has approved naltrexone for the treatment of alcohol dependence
"Laughing gas" causes rapid onset of an intoxication that is characterized by light-headedness and a floating sensation that clears in a matter of minutes after administration is stopped. There are reports of temporary but clinically relevant confusion and reversible paranoid states when nitrous oxide is used regularly. Other substances that are capable of producing mild intoxication include:
Catnip, doses is reported to result in LSD-type perceptions;
Betel nut, which is chewed in many cultures to produce a mild euphoria and floating sensation;
Kava, a substance derived from the South Pacific pepper plant, which produces sedation, incoordination, weight loss, mild forms of hepatitis, and lung abnormalities.
In addiction, individuals can develop dependence and impairment through repeated self-administration of over-the-counter and prescription drugs, including cortisol, antiparkinsonian agents that have anticholinergic properties, and antihistamines.
"Poppers" forms of amyl, butyl and isobutyl nitrite, produce an intoxication that is characterized by a feeling of fullness in the head, mild euphoria, a change in the perception of time, relaxation of smooth muscles, and a possible increase of potential impairment of immune functioning, irritation of the respiratory system, a decrease in the oxygen-carrying capacity of the blood, and a toxic reaction that can include vomiting, severe headache, hypotension, and dizziness.
The opioids include natural opioids (e.g. morphine), semisynthetics (e.g. heroin), and synthetics with morphine-like action (e.g. codeine, hydromorphone, methadone, oxycodone, meperidine, fentanyl). Medications such as pentazocine and buprenorphine that have both opiate agonist and antagonist effects are also included in this class because their agonist properties produce similar physiological and behavioural effects. Opioids are prescribed as analgesics, anaesthetics, antidiarrheal agents, or cough suppressants. Heroin is one of the most commonly abused drugs of this class and is usually taken by injection, although it can be smoked or "snorted" when very pure heroin is available. Fentanyl is injected, whereas cough suppressants and antidiarrheal agents are taken orally. The other opioids are taken both by injection and orally.
The major of two hallucinogenic components of Teonanacatl, the sacred mushroom of Mexico, the other component being psilocin. (From Merck Index, 11th ed) (3)
An anticonvulsant that is used in a wide variety of seizures. It is also an anti-arrhythmic and a muscle relaxant. The mechanism of therapeutic action is not clear, although several cellular actions have been described including effects on ion channels, active transport, and general membrane stabilization. The mechanism of its muscle relaxant effect appears to involve a reduction in the sensitivity of muscle spindles to stretch. Phenytoin has been proposed for several other therapeutic uses, but its use has been limited by its many adverse effects and interactions with other drugs.
Reinforcement-Based Therapy This cognitive-behavioral approach was modeled after CRA but tailored to the needs of inner-city heroin-dependent patients exiting brief residential detoxification program. It includes individual counseling and abstinence-contingent support for housing, food and recreational activities plus skills training for securing employment
A return to drug use or drinking after a period of abstinence, often accompanied by reinstatement of dependence symptoms. Some writers distinguish between relapse and lapse (= slip) with the latter denoting an isolated occasion of alcohol or drug use." According to De Jong, relapse is the resumption of substance use after a period of abstinence.
Adapted from the original work of Marlatt 1985 for use with cocaine users, "includes techniques intended to facilitate the identification and reduction of subjective craving for cocaine through the identification and recognition of high risk situations for cocaine use and the development of effective coping behaviours and urge control strategies. Primary interventions of this approach include (1) reducing exposure to cocaine and cocaine cues, (2) fostering resolution to stop cocaine use through exploring positive and negative consequences of continued use, (3) self-monitoring to identify high-risk situations for relapse, (4) recognition of conditioned cocaine craving and development of strategies for coping with cocaine craving, (5) identification of seemingly irrelevant decisions that could culminate in high-risk situations, (6) preparation for emergencies and coping with a relapse to cocaine use, and (7) developing alternate activities to cocaine use
Rohypnol, a trade name for flunitrazepam, has been of particular concern for the last few years because of its abuse in date rape. It belongs to a class of drugs knows as benzodiazepines.(...)
Compounds with diverse chemical and pharmacological properties that have in common the ability to allay excitement and anxiety and at higher concentrations induce sleep.
Short-term Interpersonal Psychotherapy
Is a treatment based on the concept that psychiatric disorders, including addiction, are intimately associated with disturbances in interpersonal functioning, which may be associated with the genesis and perpetuation of the disorder.
This intervention is based on a psychoanalytic theory that states that unconscious wishes and fantasies have a direct impact on overt behaviour particularly pathological behaviour. The experimental stimuli are designed to activate unconscious wishes and fantasies that have affected behaviour in ways that neutral stimuli have not.
Is an analytic oriented treatment. The supportive techniques aim to help the patient feel comfortable in discussing his or her personal experiences. The expressive techniques aim to help the patient identify and work through problematic relationship themes.
tendency of a drug, with repeated use, to become less effective (i.e., require higher dosage) or associated with user
dependence; do not use for lack of adverse reactions, as in "the subject tolerated the drug well" (3)
Other or Unknown Substance-Related Disorders
The Other or Unknown Substance-Related Disorders category is for classifying Substance-Related Disorders associated with substances not listed above. Examples of these substances, which are described in more detail below, include anabolic steroids, nitrite inhalants ("poppers") , nitrous oxide, over-the-counter and prescription medications not otherwise covered by the 11 categories (e.g. cotisol, antihistamines, benztropine), and other substances that have psychoactive effects. In addiction, this category may be used when the specific substance is unknown (e.g. intoxication after taking a bottle of unlabeled pills).
Both are described as "consequences of drug exposure, but alone are not considered sufficient for a positive diagnosis of drug dependence." Withdrawal syndrome is described as follows: "... after the repeated administration of certain dependence-producing drugs ... abstinence can increase the intensity of drug-seeking behaviour because of the need to avoid or relieve withdrawal discomfort and/or produce physiological changes of sufficient severity to require medical treatment."