COMMONLY USED TERMS

Clara Hidalgo-Fuderanan, MD
Fellow, Philippine College of Addiction Medicine
Fellow, Philippine College of Psychopharmacology
Fellow, Philippine Society of Medical Specialists,
Inc.
These lecture notes can be shared with other learners but please give the authors the
credit they deserve.

"Training Program for Physicians on the Assessment and Management of Drug Dependence", November 16-
27, 2015, Citystate Tower Hotel, Mabini, Ermita, Manila
 DRUGS
 Substances given to humans or animals
 For Treatment, Prevention or
 For Diagnosis of illness
 To relieve pain and other suffering
 To improve and control abnormal conditions of
the mind and body
 Can either be Medicinal (cure for ailments)
 Or Illicit (illegally sold in the market)

"Training Program for Physicians on the Assessment and Management of Drug Dependence",
November 16-27, 2015, Citystate Tower Hotel, Mabini, Ermita, Manila
 SUBSTANCE
SUBSTANCE is gen. preferable to the
word DRUG because DRUG implies a
manufactured chemical whereas
Many substances associated with abuse
patterns occur naturally (e.g. OPIUM) or
not meant for human consumption (e.g.
glue)
For this module, the term SUBSTANCE will
be used in referring to Drugs, whether legal
or illegal.
"Training Program for Physicians on the Assessment and Management of Drug Dependence",
November 16-27, 2015, Citystate Tower Hotel, Mabini, Ermita, Manila
 SUBSTANCE USE

The use of a substance (not Maladaptive

use) to relieve pain or other suffering and to
improve abnormal condition of the mind and
body.
Also refers to intake of substances that are
brain altering.
SUBSTANCE USE: no maladaptive use while
SUBSTANCE ABUSE: with maladaptive use
of a substance

"Training Program for Physicians on the Assessment and Management of Drug Dependence",
November 16-27, 2015, Citystate Tower Hotel, Mabini, Ermita, Manila
 SUBSTANCE ABUSE
 Maladaptive pattern of substance use leading to
clinically significant impairment or distress, occur
recurrently in 12-month period
 failure to fulfill major obligations at work, school or
home
 recurrent use of substance in situations physically
hazardous
 recurrent substance related problems
 continued use despite persistent social/interpersonal
problems
 Do not include Tolerance ,Withdrawal or pattern of
compulsive use
"Training Program for Physicians on the Assessment and Management of Drug Dependence",
November 16-27, 2015, Citystate Tower Hotel, Mabini, Ermita, Manila
 ADDICTION
 Is a chronic, progressive, relapsing condition
that involves compulsion, loss of control and
continued use despite adverse consequences
 For the purpose of this module, SUBSTANCE
ADDICTION will be synonymous to
SUBSTANCE DEPENDENCE.
 The terms ADDICTION and DEPENDENCE
may be used interchangeably in this module

"Training Program for Physicians on the Assessment and Management of Drug Dependence",
November 16-27, 2015, Citystate Tower Hotel, Mabini, Ermita, Manila
 SUBSTANCE DEPENDENCE
Maladaptive pattern of use leading to clinically
significant impairment or distress manifested by 3
0r more within 12-month period:
 TOLERANCE as defined by the ff:
• A. Need for markedly increased amount of the
substance to achieve desired effect or intoxication
• B. Markedly diminished effect with continued use
of the same amount of substance
-e.g. A man needed to consume 3 more bottles of
beer than the usual to get drunk

"Training Program for Physicians on the Assessment and Management of Drug Dependence",
November 16-27, 2015, Citystate Tower Hotel, Mabini, Ermita, Manila
Substance dependence…
 SUBSTANCE WITHDRAWAL defined as;
• -The development of a substance-specific syndrome
due to cessation of or reduction in substance use that
has been heavy or prolonged
• The substance specific syndrome causes clinically
significant distress or impairment in social,
occupational, or other important areas of functioning
 -characteristic withdrawal syndrome for the substance
is met
 (Criteria for Withdrawal for Specific Substance)
-ex. An alcoholic who suddenly stopped taking alcohol
began to have jitteriness, seizures and psychotic
symptoms

"Training Program for Physicians on the Assessment and Management of Drug Dependence",
November 16-27, 2015, Citystate Tower Hotel, Mabini, Ermita, Manila
Substance dependence…
 The substance is often taken in larger
amounts over a longer period than it was
intended.

 Persistent desire to or unsuccessful efforts

to cut down or control substance use

 Great deal of time is spent in activities

necessary to obtain substance
"Training Program for Physicians on the Assessment and Management of Drug Dependence",
November 16-27, 2015, Citystate Tower Hotel, Mabini, Ermita, Manila
Substance dependence…
 Important social, occupational or
recreational activities are reduced or given
up because of substance use

 Substance is continued despite knowledge

of having a persistent or recurrent physical
or psychological problem that is likely to
have been caused or exacerbated by the
substance.
"Training Program for Physicians on the Assessment and Management of Drug Dependence",
November 16-27, 2015, Citystate Tower Hotel, Mabini, Ermita, Manila
 CO-DEPENDENCE
 Used to designate behavioral patterns of family
members who have been significantly affected by
another family member’s substance use
 A reactive, submissive response to the
dominance of another person
 ENABLING – characteristic of codependence
which often resists modification
 Families may feel they have no control over the
enabling acts- social pressure to protect and
support family members

"Training Program for Physicians on the Assessment and Management of Drug Dependence",
November 16-27, 2015, Citystate Tower Hotel, Mabini, Ermita, Manila
 INTOXICATION
 A. Development of reversible substance-specific syndrome
due to recent ingestion or exposure to a substance.
 B. Clinically significant maladaptive behavioral or
psychological changes due to effects of substance on CNS
 having unwanted physiological or psychological effects
after taking a substance.
 Ex. Excessive sleepiness following use of antihistamine or
Clumsiness or being noisy and talkative after
consuming excessive amounts of alcohol
Belligerence, impaired judgment, cognitive
impairment
 Symptoms are not due to a general medical condition
"Training Program for Physicians on the Assessment and Management of Drug Dependence",
November 16-27, 2015, Citystate Tower Hotel, Mabini, Ermita, Manila
 DETOXIFICATION

 Is defined as the period of medical

treatment, usually including
counseling, during which time an
individual is helped to overcome
physical and psychological
dependence on alcohol or drugs

"Training Program for Physicians on the Assessment and Management of Drug Dependence",
November 16-27, 2015, Citystate Tower Hotel, Mabini, Ermita, Manila
 DRUG REHABILITATION
 Dynamic process including aftercare and follow-up
treatment directed towards physical, emotional,
psychological, vocational, social and spiritual change
on a drug dependent to enable him/her to live life
without dangerous drugs, enjoy fullest life compatible
with his capabilities and potentials and render him/her
to become a law abiding and productive member of
the community (DDB 2002).
 Refers to the restoration of any optimum state of
health by medical, psychological, social and spiritual
means, including peer group support, a family
member or significant other
"Training Program for Physicians on the Assessment and Management of Drug Dependence",
November 16-27, 2015, Citystate Tower Hotel, Mabini, Ermita, Manila
"Training Program for Physicians on the Assessment and Management of Drug Dependence",
November 16-27, 2015, Citystate Tower Hotel, Mabini, Ermita, Manila