I. Failure of explanatory models has been related to the inability to
define precisely the terms used in the field of addictions, resulting in
conflicting definitions.
A. American Medical Association definition
B. World Health Organization definition
II. Precise and useful definitions:
A. Abuse: The self-administration of a drug in a culturally
disapproved fashion which results in (or has great
potential to result in) adverse consequences.
B. Addiction: A behavioral pattern of drug abuse characterized by an
overwhelming preoccupation with the use of a drug
(compulsive use), the securing of its supply, and a high
tendency for relapse once the drug has been discontinued.
C. Dependence: The state of neuroadaptation caused by the repeated
administration of a drug, such that if abruptly
discontinued, a withdrawal or abstinence syndrome results.
(It is of little to no value to separate "physical" from
"psychological" dependence, since they probably have the
same biologic substrate.)
D. Tolerance: The state of neuroadaptation which exists when a given
dose of a drug, given to an individual repeatedly,
produces less or no effect as compared to the initial
experience with the drug.
E. Cross-tolerance:
(cross- The property which allows one dependence-causing drug to
dependence) replace another dependence-causing drug and, thereby,
prevent its withdrawal syndrome.
F. Withdrawal: The neurobehavioral and somatic effects of abrupt
(abstinence) discontinuation of a drug to which dependence exists.
G. Rebound: Return of symptoms, after discontinuation of a drug which
blocked those symptoms, which are of greater intensity
than before treatment with the drug began.
H. Recurrence
of symptoms: The return of symptoms, after discontinuation of a drug
which blocked those symptoms, which are of similar
intensity as before treatment with the drug.
I. Relapse: The recurrence of the active phase of an illness after a
period of quiescence or remission.