ABPM Addiction Medicine key terms

A need for markedly increased amounts of a substance to achieve the desired effect, or markedly diminished effect with continued use of the same amount. It is a physiologic adaptation, not by itself evidence of addiction.

A substance-specific syndrome of symptoms and signs that develops when a person who has used a drug heavily reduces or stops it. It reflects physiologic dependence and can be medically dangerous, as with alcohol or benzodiazepines.

The state in which repeated drug exposure produces adaptations so that stopping the drug causes withdrawal. It can occur with appropriately prescribed medications and does not by itself equal addiction.

A DSM-5-TR diagnosis defined by a problematic pattern of substance use causing impairment or distress, met by at least two of eleven criteria within a twelve-month period, graded as mild, moderate, or severe.

An intense desire or urge to use a substance, often triggered by cues, stress, or withdrawal. It is one of the DSM-5-TR criteria for substance use disorder and a common driver of relapse.

A return to substance use after a period of abstinence or reduced use. In addiction treatment it is viewed as a common, modifiable event rather than a moral failure or the end of recovery.

A process of improved health, wellness, and quality of life through which people with substance use disorder pursue self-directed change and strive to reach their full potential. It may or may not include abstinence-based treatment.

A public health approach in which validated tools identify unhealthy substance use, a short motivational conversation follows, and people needing more care are referred to treatment. It targets risky use before dependence develops.

A three-item alcohol screen asking about frequency of drinking, typical number of drinks, and occasions of heavy drinking. A higher score suggests hazardous drinking and prompts further assessment.

A unit used to quantify alcohol intake, defined in the United States as about 14 grams of pure alcohol, equivalent to a 12-ounce beer, 5 ounces of wine, or 1.5 ounces of distilled spirits.

A pattern of drinking that brings blood alcohol concentration to roughly 0.08 g/dL or higher, typically four or more drinks for women and five or more for men on a single occasion.

A syndrome beginning hours after heavy alcohol use stops, with tremor, anxiety, insomnia, nausea, and possibly seizures or delirium tremens. It is a medical emergency requiring benzodiazepines and thiamine.

Severe alcohol withdrawal marked by agitation, confusion, hallucinations, fever, and autonomic instability, typically starting 48 to 96 hours after the last drink. Untreated it carries substantial mortality and needs intensive medical management.

An acute neurologic emergency caused by thiamine deficiency, classically with confusion, ataxia, and eye movement abnormalities. It is most often seen in heavy alcohol use and can progress to Korsakoff syndrome if untreated.

Administration of vitamin B1, given before or with glucose in patients at risk for deficiency, to prevent or treat Wernicke encephalopathy. It is standard practice in alcohol withdrawal and malnourished patients.

A problematic pattern of opioid use causing impairment or distress, meeting DSM-5-TR criteria. It includes misuse of prescription opioids and use of heroin or illicitly manufactured fentanyl and is treatable with medication.

Treatment of opioid use disorder with buprenorphine, methadone, or naltrexone, combined with counseling. These medications reduce craving and withdrawal, lower overdose death, and are first-line therapy.

A partial opioid agonist used to treat opioid use disorder, often combined with naloxone to deter injection misuse. It has a ceiling effect on respiratory depression, making overdose risk lower than with full agonists.

A long-acting full opioid agonist used for opioid use disorder, dispensed through federally regulated opioid treatment programs. Steady dosing prevents withdrawal and craving without producing euphoria.

An opioid antagonist available in oral and long-acting injectable forms, used for opioid use disorder and alcohol use disorder. It requires prior opioid detoxification because it can precipitate withdrawal.

A short-acting opioid antagonist that rapidly reverses opioid overdose, given intranasally or by injection. It has no effect on non-opioid overdoses and may precipitate withdrawal in dependent persons.

A medication for alcohol use disorder that reduces craving and supports abstinence, typically dosed three times daily. It is generally well tolerated and requires normal kidney function.

An aversive medication for alcohol use disorder that blocks aldehyde dehydrogenase, causing flushing, nausea, and tachycardia if alcohol is consumed. It works best with supervised adherence and a motivated patient.

A collaborative, person-centered counseling style that strengthens a person's own motivation and commitment to change by exploring and resolving ambivalence. It is a core skill across screening and treatment settings.

A model describing readiness to change as precontemplation, contemplation, preparation, action, and maintenance, with possible relapse. Interventions are matched to the person's current stage rather than assumed readiness.

A behavioral treatment that provides tangible, often monetary or voucher-based, rewards for verified abstinence or other target behaviors. It has strong evidence for stimulant use disorder.

A structured psychotherapy that helps people identify and change thoughts and behaviors that maintain substance use, and build coping skills for high-risk situations. It is effective across several substance use disorders.

The activation of craving and physiologic responses by stimuli previously paired with substance use, such as people, places, or paraphernalia. It helps explain relapse after prolonged abstinence.

A withdrawal syndrome in newborns exposed to opioids in utero, with irritability, tremors, feeding difficulty, and autonomic signs. It is assessed with standardized scoring tools and managed supportively or with medication.

A range of lifelong physical, behavioral, and cognitive effects caused by prenatal alcohol exposure. They are preventable by avoiding alcohol during pregnancy and are not curable once established.

A problematic pattern of alcohol use causing impairment or distress, meeting DSM-5-TR criteria, ranging from mild to severe. It is distinct from risky drinking that has not yet caused harm.

A problematic pattern of tobacco or nicotine use causing impairment or distress, with features such as craving, tolerance, and unsuccessful attempts to quit. Nicotine dependence drives continued use despite known harms.

Use of nicotine delivered by patch, gum, lozenge, inhaler, or nasal spray to relieve withdrawal and craving during a quit attempt. Combining a long-acting patch with a short-acting form improves success.

A partial nicotinic agonist used for smoking cessation that reduces craving and the rewarding effect of cigarettes. It is among the most effective single agents and requires monitoring for mood changes.

Policies and practices that reduce the negative consequences of substance use without requiring abstinence, such as naloxone distribution, sterile syringes, and fentanyl test strips. It meets people where they are and complements treatment.

A program providing sterile injection equipment, safe disposal, and referrals to health and treatment services. It reduces transmission of HIV and hepatitis C and does not increase illicit drug use.

A peer-led recovery group such as Alcoholics Anonymous or SMART Recovery that offers social support and a structured program for abstinence or behavior change. It is often used alongside clinical treatment.

A pattern in which family members organize their lives around another person's substance use, often enabling it while neglecting their own needs. The concept guides family-focused education and support.

Behavior by family or friends that unintentionally shields a person from the consequences of substance use, such as covering debts or excuses. It can sustain use and is a focus of family counseling.

Services that help relatives of people with substance use disorder cope, communicate, and set boundaries, such as family therapy, support groups, and education. Involving family improves engagement and outcomes.