E Training Prescription Drug Abuse: Etiology, Prevention and Treatment

This training I took at work for CEUs presented lots of information on substance use and substance use treatment.  I wanted to share this glossary of terms.  One thing I learned from this is it is never good to leave old medications hanging around.  Too often kids can get that stuff and trade with friends to experiment.  I have some medicine cabinets to go through.

Addiction: A chronic, relapsing disease characterized by compulsive drug seeking and use, despite serious adverse consequences, and by long-lasting changes in the brain.

Agonist: A chemical entity that binds to a receptor and activates it, mimicking the action of the natural, or abused, substance that binds there.

Antagonist: A chemical entity that binds to a receptor and blocks its activation. Antagonists prevent the natural, or abused, substance from activating its receptor.

Barbiturate: A type of CNS depressant used in surgical procedures, as an anticonvulsant or prescribed to promote sleep.             

Benzodiazepine: A type of CNS depressant prescribed to relieve anxiety and sleep problems. Valium and Xanax are among the most widely prescribed medications overall.

Buprenorphine: A mixed opiate agonist/antagonist medication approved by the FDA in October 2002 to treat opiate addiction, such as heroin.

Central nervous system (CNS): The brain and spinal cord.

CNS depressant: A class of drugs – also called sedatives and tranquilizers – that slow CNS function, some of which are used to treat anxiety and sleep disorders; includes barbiturates and benzodiazepines.

Co-morbidity: The occurrence of two disorders or illnesses in the same person; also referred to as co-occurring conditions or dual diagnosis. Patients with co-morbid illnesses may experience a more severe illness course and require treatment for each or all conditions.

Detoxification: A process in which the body rids itself of a drug or its metabolites. During this period, withdrawal symptoms can emerge that may require medical treatment. This is often the first step in drug abuse treatment.

Didactic: A teaching method that follows a consistent scientific approach or educational style.

Dopamine: A brain chemical, classified as a neurotransmitter, found in regions that regulate movement, emotion, motivation and pleasure.

Epidemiology: The study of the distribution and patterns of health events and their characteristics, causes and influences in well-designed populations.

Hyperalgesia: Abnormal pain sensitivity.

Methadone: A long-acting synthetic opioid medication that is effective in treating opioid addiction and pain.

Narcolepsy: A disorder characterized by uncontrollable episodes of deep sleep.

Norepinephrine: A neurotransmitter present in the brain and the peripheral sympathetic nervous system, and a hormone released by the adrenal glands. Norepinephrine is involved in attention and response to stress, and it regulates smooth muscle contraction, heart rate and blood pressure.

Opioid: A compound or drug, such as morphine, heroin, hydrocodone and oxycodone, that binds to receptors in the brain involved in controlling pain and other functions.

Opioid-induced hyperalgia: A phenomenon associated with long-term use of opioids that leads to developing an increased pain sensitivity and escalating dependence. In trying to manage pain, the patient experiences more pain as a result of the opioid treatment.

Pathophysiology: The study of the changes of normal mechanical, physiological and biochemical functions caused by disease or resulting from an abnormal syndrome. It includes the biological and physical manifestations of the disease as they correlate to underlying abnormalities and physiological disturbances.

Physical dependence: An adaptive physiological state that occurs with regular drug use and results in a withdrawal syndrome when drug use is stopped; often occurs with tolerance. Physical dependence can happen with chronic, even appropriate, use of many medications, and by itself does not constitute addiction.

Polydrug abuse: The use of two or more drugs at the same time, such as a CNS depressant and alcohol.

Prescription drug abuse: The use of medication without a prescription, in a way other than prescribed, or for the experience or feeling elicited. This term is used interchangeably with “nonmedical use,” a term employed by many of the national surveys.

Psychotherapeutic drugs: Drugs that affect the brain’s function and are often used to treat psychiatric/neurologic disorders; includes opioids, CNS depressants and stimulants.

Respiratory depression: Slowing of respiration that results in the reduced availability of oxygen to vital organs.

Sedatives: Drugs that suppress anxiety and promote sleep; the NSDUH classification include benzodiazepines, barbiturates and any other type of CNS depressant.

Stimulant: A class of drugs that enhance the activity of monoamines – such as dopamine – in the brain, increasing arousal, heart rate, blood pressure and respiration, and decreasing appetite; includes some medications used to treat attention-deficit hyperactivity disorder (ADHD), methylphenidates and amphetamines, as well as cocaine and methamphetamine.

Tolerance: A condition in which higher doses of the drug are required to produce the same effect achieved during initial use and often associated with physical dependence.

Tranquilizers: Drugs prescribed to promote sleep or reduce anxiety; NSDUH classification includes benzodiazepines, barbiturates and other types of CNS depressants.

Withdrawal: Symptoms that occur after chronic use of the drug is reduced or stopped abruptly.

(Definitions from NIDA.)

·      AOD use can cause psychiatric symptoms and mimic psychiatric syndromes.

·      AOD use can initiate or exacerbate a psychiatric disorder.

·      AOD use can mask psychiatric symptoms and syndromes.

·      AOD withdrawal can cause psychiatric symptoms and mimic psychiatric syndromes.

·      Psychiatric and AOD use disorders can independently coexist.

·      Psychiatric behaviors can mimic AOD use problems.

 (NIDA, 2011)