Addictions and Recovery

Neuroadaptation

The process, once called “tolerance,” by which the nervous system adapts to the constant presence of a foreign compound. This usually involves modification of the receptor sites on the neurons affected by that compound. This term is usually applied to the brain’s adjustments to the constant presence of a prescribed chemical, while the term “tolerance” is applied to the same process when it involves an illicit compound.

Tolerance

Tolerance to a drug is said to develop when the individual must use more of a compound to achieve the effects once achieved at a lower dose.

Withdrawal Syndrome

Withdrawal Syndrome is a phenomenon experienced when the individual either stops or significantly reduces their intake of a specific compound. The withdrawal syndrome is usually the opposite of the compound’s effects on the body. For example, alcohol acts as a chemical “brake” on the neurons of the brain. The neurons struggle to compensate, increasing the number of neurotransmitter receptor sites for excitatory neurotransmitters to overcome the inhibitory effects of persistent alcohol use. When an individual with a severe AUD stops drinking, this “brake” is removed, and neurons in the brain may become overactive. This is experienced by the individual as anxiety, withdrawal tremors, and in extreme cases, delirium tremens (DTs).

Delirium Tremens (DTs)

A psychotic condition typical of withdrawal in chronic alcoholics, involving tremors, hallucinations, anxiety, and disorientation.

Social Use

A point of confusion is that the use of a substance is equated with a substance use disorder, especially when a person is using illicit drugs. However, “being a substance user does not mean invariably that one has a substance use disorder” (Gonzalez et al., 2009, p. 456). The individual’s culture defines the frequency with and conditions under which an individual might use a substance(s). Depending on where you are as you read this chapter, alcohol, tobacco, cannabis, and possibly other substances may be legal or illegal.

Substance Abuse

Is the term that has been used when an individual uses a compound when there is no legitimate medical need to do so or when the compound is used in excess of social standards (Schuckit, 2006a, 2006b). There is no physical dependence on the chemical(s) at this time, and it does not automatically progress to a physical addiction to the compound (Swift, 2005). However, given the frequent confusion that arises from the use of the term “substance abuse,” including confusion resulting from its previous inclusion as a diagnostic category, the term substance misuse will be used instead of substance abuse in this text. This change is consistent with the move by the Office of National Drug Control Policy (2006) to reduce stigma, which also includes the push to use what is called person-first language, that is, referring to the person first, such as an individual with a substance use disorder, or an individual who misuses substances, rather than an alcoholic, substance abuser, or addict.

Lifetime Prevalence

Period prevalence is the proportion of a population that has the characteristic at any point during a given time period of interest. “Past 12 months” is a commonly used period. Lifetime prevalence is the proportion of a population who, at some point in life has ever had the characteristic.

Period Prevalence

Period prevalence is the proportion of a population that has the characteristic at any point during a given time period of interest. “Past 12 months” is a commonly used period. Lifetime prevalence is the proportion of a population who, at some point in life has ever had the characteristic.

Hypnotic

A compound that can induce sleep or a sleep-like state.

Distillation

Boiling wine, then collecting and cooling the steam to form a liquid with a higher alcohol concentration that the original wine.

Avitaminosis

is a condition that occurs when there is a deficiency in one or more essential vitamins in the body

blood alcohol concentration (BAC)

refers to the amount of alcohol in a person's bloodstream, expressed as a percentage. It is measured in grams of alcohol per 100 milliliters (mL) of blood. 

TIQ hypothesis

Another theory that attempted to explain the effects of alcohol. Trachtenberg and Blum (1987) suggested that alcohol use significantly reduced the brain’s production of natural opioid-like molecules known as enkephalins and dynorphins. Further, during the process of alcohol biotransformation, an alcohol metabolite and naturally occurring neurotransmitters combined to form the toxic compound tetrahydroisoquinoline (TIQ) (Blum, 1988). TIQ was thought to bind to the opioid receptor sites within the brain’s reward system, causing euphoria and a sense of well-being (Blum & Payne, 1991; Blum & Trachtenberg, 1988). However, TIQ’s effects are short-lived, a characteristic that would force the individual to continue to drink to maintain the initial feeling of well-being achieved through alcohol use, according to the authors. Over time, heavy habitual alcohol use was thought to cause the brain to reduce its production of natural opioid-like molecules as the ever-present TIQ was substituted for these natural neurotransmitters (Blum & Payne, 1991; Blum & Trachtenberg, 1988). The individual’s cessation of drinking would result in a lack of stimulation in the reward system, which the individual would experience as “craving” for further alcohol use. While the TIQ theory had many proponents in the latter part of the 20th century and still is occasionally suggested as accounting for alcohol-induced feelings of euphoria experienced by individuals who drink alcohol, a number of studies have failed to find evidence supporting the TIQ hypothesis, and it has been found that changes in diet can also induce the same changes in TIQ as observed following alcohol ingestion (Woodward, 2009).

Mellanby effect

A phenomenon in which the individual’s subjective sense of intoxication appears to be stronger while the BAL is still rising.

disinhibition effect

Effect after one or two drinks, caused when alcohol interferes with the normal function of the cortex region responsible for inhibitions and abstract thinking and speech.