Substance-Related and Addictive Disorders – Vocabulary Review

A comprehensive set of 65 vocabulary flashcards covering key terminology, mechanisms, risk factors, diagnostics, pharmacology, and treatment concepts related to substance-related and addictive disorders as presented in the lecture notes.

Addiction

A chronic, relapsing condition in which moderation is ineffective and the disorder is ultimately fatal without intervention.

Substance Use Disorder (DSM-5)

Single diagnostic category that replaces abuse and dependence; classified as mild, moderate, or severe.

Appropriate Use

Use of a substance without any negative consequences.

Misuse

Using a substance in a manner likely to cause significant consequences across life areas.

Abuse (older nomenclature)

Substance use producing life consequences; may still be self-moderated or represent an early problem stage.

Addiction Risk Factors

Genetics, trauma, and early-life substance exposure.

Intoxication (DSM-5 coding rule)

If present with a use disorder, code the intoxication diagnosis with a specifier indicating the co-existing use disorder.

Tolerance

Reduced response to a drug with repeated use, requiring higher doses for the same effect.

Behavioral Tolerance

Learned ability to perform tasks while under the influence of alcohol.

Pharmacokinetic Tolerance

Adaptation of metabolic systems to clear alcohol more rapidly.

Pharmacodynamic (Cellular) Tolerance

Neuronal adaptation that resists alcohol’s effects despite high blood levels.

Cross-Tolerance

Tolerance to one depressant confers tolerance to others in the same class.

Standard Drink

Contains ~10–12 g ethanol: 12 oz beer, 5 oz wine, or 1.5 oz 80-proof liquor.

Alcohol Blackout

Anterograde amnesia for events that occurred during heavy drinking while still awake.

Alcohol-Related Sleep Impairment

Suppression of REM, inhibition of stage 4 sleep, and fragmented sleep with vivid dreams as BAC falls.

Wernicke’s Syndrome

Acute neuropsychiatric disorder (often with 6th-nerve palsy) caused by thiamine deficiency in alcohol use.

Korsakoff’s Syndrome

Severe, persistent anterograde amnesia out of proportion to confusion, linked to thiamine deficiency.

Thiamine (Vitamin B1)

Nutrient whose deficiency underlies Wernicke-Korsakoff spectrum in alcohol use.

ALDH2*2 Polymorphism

Mitochondrial ALDH2 gene variant causing disulfiram-like reaction and near-zero AUD risk.

Congeners

Non-ethanol chemicals in alcoholic beverages (e.g., methanol, aldehydes) that influence taste and toxicity.

Type 2 / Type B Alcoholism

Early-onset, severe AUD associated with criminality and polysubstance problems.

Blood Alcohol 20–30 mg/dL

Level associated with slowed motor performance and decreased thinking ability.

γ-Glutamyltransferase (GGT)

35 U/L suggests heavy alcohol use; a state marker for AUD screening.

Carbohydrate-Deficient Transferrin (CDT)

3 % is a laboratory marker indicating heavy drinking.

Mean Corpuscular Volume (MCV)

91 µm³ may reflect chronic heavy alcohol intake.

Natural Plant Stimulants

Erythroxylon coca, Ephedra sinica, and Catha edulis.

Bath Salts

Synthetic cathinone powders marketed as legal highs; routes include oral, intranasal, smoking, IV.

Caffeine

World’s most widely used mood-altering drug; peak plasma 45–60 min; half-life 4–6 h.

Cytochrome P450 1A2

Primary hepatic enzyme metabolizing caffeine.

ADORA2A Gene

Encodes adenosine A2A receptor; variants influence caffeine effects and consumption.

Caffeine Half-Life

Averages 4–6 hours; shortened by smoking, prolonged by oral contraceptives and late pregnancy.

Caffeine Reduction Schedule

Decrease intake ~25 % weekly to minimize withdrawal, aiming for ≤50 mg/day.

Cannabis sativa

Plant source of marijuana; female flowers richest in cannabinoids.

Delta-9-Tetrahydrocannabinol (THC)

Primary psychoactive cannabinoid in cannabis.

CB1 Receptor

Brain cannabinoid receptor mediating THC’s psychological and behavioral effects.

CB2 Receptor

Cannabinoid receptor linked to immune modulation and inflammation.

Anandamide

Endogenous ligand for cannabinoid receptors produced in the brain.

Hash Oil

Concentrated cannabis extract containing 15–20 % THC.

Bhang

Tea made in India from cannabis leaves and stems.

Classic Hallucinogens

5-HT2A agonists such as LSD, psilocybin, mescaline producing visual illusions and mystical experiences.

Phencyclidine (PCP)

NMDA-antagonist dissociative hallucinogen causing depersonalization and cognitive impairment.

MDMA

Serotonin-releasing agent producing feelings of love, acceptance, and closeness.

Ibogaine

Long-acting hallucinogen from Iboga alkaloids; can cause intense complete break with reality.

Salvinorin A

Kappa-opioid agonist hallucinogen from Salvia divinorum; very brief but intense experiences.

Anticholinergic Deliriants

Muscarinic antagonists (e.g., Datura, diphenhydramine) producing true hallucinations and delirium.

Inhalants

Volatile hydrocarbons (e.g., toluene, xylene, gasoline) abused by breathing concentrated vapors.

Toluene

Commonly abused solvent; rapidly absorbed, lipophilic, alters dopamine and NMDA/GABA systems.

Hippuric Acid

Urinary metabolite of toluene; hippurate/creatinine ratio >1 may indicate inhalant abuse.

Toluene NMDA Inhibition

Non-competitive blockade of NMDA receptors at abuse-level concentrations.

Toluene GABA_A Activation

Enhances GABA_A receptor function acutely, contributing to CNS-depressant effects.

Nicotine Replacement Therapy (NRT)

FDA-approved nicotine patch, gum, lozenge, inhaler, or nasal spray to aid smoking cessation.

Varenicline

Partial α4β2 nicotinic agonist used as non-nicotine pharmacotherapy for tobacco use disorder.

Bupropion

Dopamine-norepinephrine reuptake inhibitor approved for tobacco cessation.

Benzodiazepine Discontinuation Syndrome

Cluster of rebound, recurrence, and true withdrawal symptoms after BZD cessation.

Discontinuation Risk Factors

Higher dose, longer duration, rapid taper, and underlying psychopathology increase withdrawal severity.

Methadone Dose Conversion Ratio

Guideline converting total daily oral morphine equivalents to methadone using ratios 4:1 to 20:1 based on prior dose.

Pre-Synaptic Opioid Action

Inhibition of neurotransmitter release via reduced calcium influx.

Post-Synaptic Opioid Action

Hyperpolarization of neurons by increasing potassium efflux.

Anabolic-Androgenic Steroids (AAS)

Synthetic derivatives of testosterone used for anabolic and androgenic effects with addiction potential.

Muscle Dysmorphia

Body-image disorder characterized by pathological pursuit of increased muscle size; linked to AAS use.

HPG Axis Suppression

Reduction of hypothalamic-pituitary-gonadal function leading to hypogonadism after AAS use.

Naltrexone for AAS

Opioid antagonist investigated for treating classical addiction pathway effects of steroid use.

Clomiphene

Selective estrogen receptor modulator used to stimulate endogenous testosterone after AAS cessation.

Human Chorionic Gonadotropin (hCG)

Hormone therapy to restore testicular function in hypogonadism related to AAS withdrawal.

Fentanyl

Potent synthetic opioid (50-100 µg IV≈10 mg IM morphine) with 7-12 h half-life and rapid onset.