Substance Use and Addictive Disorders – Key Vocabulary

A comprehensive set of vocabulary flashcards covering core diagnostic terms, clinical features, neurobiology, comorbidities, and treatment concepts related to substance use and addictive disorders, with emphasis on alcohol and cannabis.

Substance Use Disorder

A DSM-5 diagnosis describing a maladaptive pattern of repeated substance use leading to clinically significant impairment or distress.

Substance Intoxication

A reversible, substance-specific syndrome caused by recent ingestion or exposure, producing maladaptive behavioral or psychological changes.

Substance Withdrawal

A substance-specific syndrome that follows abrupt cessation or reduction of heavy, prolonged use, causing distress or impairment.

Substance-Induced Mental Disorder

Clinically significant psychiatric symptoms produced directly by substance use, distinguished from primary mental illnesses.

Behavioral Dependence

Compulsive substance-seeking and pathologic use patterns that continue despite harm.

Physical Dependence

Physiologic adaptation to a drug, evidenced by tolerance and a withdrawal syndrome on cessation.

Psychological Dependence

Craving or drug-seeking motivated by the desire to avoid dysphoria or produce pleasure.

Tolerance

Need for markedly increased amounts of a substance to achieve intoxication or diminished effect with continued use of the same amount.

Craving

Intense desire or urge to use a substance, often triggered by cues or stress.

DSM-5

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition; provides criteria for substance-related and other psychiatric disorders.

ICD-10

International Classification of Diseases, 10th Revision; alternative coding system that labels substance disorders as ‘mental and behavioral disorders due to…’ a substance.

Gambling Disorder

A DSM-5 non-substance addictive disorder characterized by persistent, recurrent problematic gambling behavior.

Pharmacologic Symptoms (SUD)

Tolerance and withdrawal criteria within substance use disorder diagnosis.

Impaired Use Symptoms

Using more than intended, unsuccessful efforts to cut down, and significant time spent related to substance.

Social Impairment (SUD)

Failure to fulfill obligations, continued use despite problems, or giving up activities.

Risky Use (SUD)

Recurrent use in hazardous situations or continued use despite physical/psychological harm.

Controlled Environment (Specifier)

A setting where access to the substance is restricted (e.g., jail, hospital); used to qualify remission status.

Maintenance Therapy (Specifier)

Remission qualifier when the patient is taking prescribed agonist medication such as methadone or nicotine replacement.

Early Remission

No SUD criteria (except craving) met for at least 3 but less than 12 months.

Sustained Remission

No SUD criteria (except craving) met for 12 months or longer.

Severity Specifier

DSM-5 designation of mild, moderate, or severe SUD based on symptom count.

Harmful Use (ICD)

ICD-10 term for a pattern causing physical or mental damage without necessarily meeting dependence criteria.

Comorbidity

Co-occurrence of two or more psychiatric disorders in the same individual.

Antisocial Personality Disorder

Personality disorder frequently comorbid with substance abuse, marked by disregard for others and impulsivity.

Major Depressive Disorder (Substance Context)

Mood disorder often seen in substance users; must distinguish substance-induced versus independent depression.

Suicide Risk in Substance Use

Substance abusers are ~20 times more likely to die by suicide; alcohol accounts for ~15% of suicides.

Disulfiram

Alcohol-sensitizing agent that inhibits aldehyde dehydrogenase, causing unpleasant reactions if alcohol is consumed.

Naltrexone

Oral opioid antagonist (50 mg/day) that reduces alcohol craving and heavy-drinking days.

Acamprosate

Glutamatergic modulator (≈2 g/day) that lessens protracted withdrawal symptoms and supports abstinence from alcohol.

Methadone

Long-acting full opioid agonist used in maintenance treatment of opioid use disorder.

Buprenorphine

Partial opioid agonist employed for maintenance or detoxification in opioid dependence.

Nicotine Replacement Therapy

Use of nicotine patches, gum, lozenges, etc., to treat tobacco dependence by reducing withdrawal.

Varenicline

α4β2 nicotinic receptor partial agonist that diminishes craving and reward from smoking.

Bupropion

Antidepressant with dopaminergic activity used to aid smoking cessation.

Stages of Change

Behavioral model with pre-contemplation, contemplation, preparation, action, and maintenance phases guiding intervention matching.

Motivational Interviewing

Client-centered counseling style enhancing intrinsic motivation to change substance-using behavior.

Detoxification

Medically supervised management of acute withdrawal and stabilization before rehabilitation.

Rehabilitation

Long-term treatment phase focusing on motivation, lifestyle change, and relapse prevention.

Relapse Prevention

Cognitive-behavioral strategies identifying high-risk situations and coping skills to maintain abstinence.

Pharmacologic Intervention

Use of medications (e.g., methadone, naltrexone) as part of comprehensive substance treatment.

Alcohol Use Disorder

Problematic pattern of alcohol use leading to impairment/distress, meeting DSM-5 criteria.

Alcohol Intoxication

Recent ethanol ingestion producing maladaptive behavioral changes plus physical signs like nystagmus or ataxia.

Blood Alcohol Concentration (BAC)

Grams of ethanol per deciliter of blood; U.S. legal intoxication typically ≥0.08 g/dL.

Alcohol Withdrawal

Autonomic hyperactivity, tremor, insomnia, seizures, or delirium following cessation of heavy drinking.

Tremulousness

Fine hand tremor—classic, early sign of alcohol withdrawal (‘the shakes’).

Withdrawal Seizures

Generalized tonic-clonic seizures occurring 6–48 h after stopping heavy alcohol use.

Delirium Tremens (DTs)

Severe alcohol withdrawal delirium with confusion, hallucinations, autonomic instability, high mortality.

Wernicke Encephalopathy

Acute thiamine-deficiency triad of confusion, ataxia, and ocular motor dysfunction; reversible with thiamine.

Korsakoff Syndrome

Chronic amnestic disorder with anterograde memory loss and confabulation following untreated Wernicke’s.

Wernicke-Korsakoff Syndrome

Combined acute (Wernicke) and chronic (Korsakoff) neuropsychiatric sequelae of thiamine deficiency from alcoholism.

Blackout

Anterograde amnesia for events during intoxication despite preserved consciousness and behavior.

Alcohol-Induced Psychotic Disorder

Auditory hallucinations or delusions occurring during heavy use or withdrawal, resolving with abstinence.

Alcohol-Induced Mood Disorder

Depressive episode brought on by heavy drinking that typically remits within weeks of sobriety.

Alcohol-Induced Anxiety Disorder

Panic or anxiety states occurring during intoxication or withdrawal, subsiding with abstinence.

Fetal Alcohol Syndrome

Congenital disorder with growth retardation, facial anomalies, and neurodevelopmental deficits from in-utero alcohol exposure.

Gamma-Glutamyltransferase (GGT)

Liver enzyme; levels >35 U/L often indicate heavy alcohol use.

Carbohydrate-Deficient Transferrin (CDT)

Serum biomarker (>3%) reflecting heavy drinking over preceding weeks.

Cannabis Use Disorder

Problematic cannabis pattern leading to impairment or distress, per DSM-5 criteria.

Cannabis Intoxication

Recent cannabis use causing euphoria, perceptual change, conjunctival injection, increased appetite, and impaired coordination.

Cannabis Withdrawal

Irritability, sleep problems, decreased appetite, and physical discomfort occurring after cessation in heavy users.

Cannabis-Induced Psychotic Disorder

Rare psychosis with hallucinations or delusions triggered by cannabis, more likely with high-potency use.

Amotivational Syndrome

Apathy, reduced goal-directed activity, and lethargy associated with long-term heavy cannabis use.

Delta-9-Tetrahydrocannabinol (Δ9-THC)

Primary psychoactive cannabinoid in Cannabis sativa responsible for intoxication.

Cannabinoid Receptor

Gi-coupled brain receptor (CB1) abundant in hippocampus, basal ganglia, cerebellum; mediates THC effects.

Hemp Insanity

Colloquial term for florid psychosis seen with chronic high-dose cannabis use in some regions.

Dronabinol

Synthetic Δ9-THC approved for chemotherapy-related nausea and HIV-associated anorexia.

Nabilone

Synthetic cannabinoid analog approved for refractory chemotherapy-induced nausea and vomiting.

Nabiximols

Oromucosal spray containing THC/CBD mixture under study for cancer pain and spasticity.

Sensitization

Progressive amplification of a drug’s effects (or drug-cue salience) after repeated exposures.

Brain Reward Circuitry

Neural pathways (e.g., VTA-to-nucleus accumbens dopamine tract) mediating reinforcement of addictive behaviors.

Ventral Tegmental Area (VTA)

Midbrain dopaminergic nucleus critical to reward, targeted by most addictive drugs.

Alcohol Dehydrogenase (ADH)

Hepatic enzyme converting ethanol to toxic acetaldehyde; rate-limiting in alcohol metabolism.

Aldehyde Dehydrogenase

Enzyme oxidizing acetaldehyde to acetate; inhibited by disulfiram, causing aversive reactions with alcohol.

Disulfiram Reaction

Flushing, tachycardia, nausea, and hypotension produced when alcohol is ingested after disulfiram.

Mellanby Effect

Greater behavioral impairment at a given BAC when levels are rising than when falling.

Cross-Tolerance

Reduced responsiveness to one drug because of tolerance developed to another (e.g., alcohol and benzodiazepines).

Protracted Withdrawal

Persistent subacute symptoms (anxiety, insomnia) lasting weeks-months after acute alcohol withdrawal.

Social Model Detoxification

Non-pharmacologic withdrawal management emphasizing peer support and milieu over medications.

Alexithymia

Difficulty identifying and describing emotions; prevalent among some substance-dependent individuals.

Neuroadaptation

Brain changes (receptor, neurotransmitter, circuit) that maintain homeostasis during chronic substance exposure and drive dependence.