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Research Report Series - Prescription Drugs: Abuse and Addiction



Glossary


Addiction: A chronic, relapsing disease characterized by compulsive drug seeking and use, despite harmful consequences, and by neurochemical and molecular changes in the brain.

Barbiturate: A type of CNS depressant often prescribed to promote sleep. Benzodiazepine: A type of CNS depressant often prescribed to relieve anxiety. Valium and Librium are among the most widely prescribed medications.

Buprenorphine: Medication approved by the FDA in October 2002 for treatment of opioid addiction.

Central nervous system (CNS): The brain and spinal cord.

CNS depressants: A class of drugs that slow CNS function (also called sedatives and tranquilizers), some of which are used to treat anxiety and sleep disorders; includes barbiturates and benzodiazepines.

Detoxification: A process that enables the body to rid itself of a drug, while at the same time managing the individual's symptoms of withdrawal; often the first step in a drug treatment program.

Dopamine: A neurotransmitter present in regions of the brain that regulate movement, emotion, motivation, and feelings of pleasure.

Methadone: A long-acting synthetic medication that is effective in treating opioid addiction.

Narcolepsy: A disorder characterized by uncontrollable episodes of deep sleep.

Norepinephrine: A neurotransmitter present in some areas of the brain and the adrenal glands; decreases smooth muscle contraction and increases heart rate; often released in response to low blood pressure or stress.

Opioids: Controlled drugs or narcotics most often prescribed for the management of pain; natural or synthetic chemicals based on opium's active componentÑmorphineÑthat work by mimicking the actions of pain-relieving chemicals produced in the body.

Opiophobia: A healthcare provider's fear that patients will become addicted to opioids even when using them appropriately; can lead to the underprescribing of opioids for pain management.

Physical dependence: An adaptive physiological state that can occur with regular drug use and results in withdrawal when drug use is discontinued. (Physical dependence alone is not the same as addiction, which involves compulsive drug seeking and use, despite its harmful consequences.)

Polydrug abuse: The abuse of two or more drugs at the same time, such as CNS depressants and alcohol.

Prescription drug abuse: The intentional misuse of a medication outside of the normally accepted standards of its use.

Prescription drug misuse: Taking a medication in a manner other than that prescribed or for a different condition than that for which the medication is prescribed.

Psychotherapeutics: Drugs that have an effect on the function of the brain and that often are used to treat psychiatric disorders; can include opioids, CNS depressants, and stimulants.

Respiratory depression: Depression of respiration (breathing) that results in the reduced availability of oxygen to vital organs.

Sedatives: Drugs that suppress anxiety and relax muscles; the National Survey on Drug Use and Health classification includes benzodiazepines, barbiturates, and other types of CNS depressants.

Stimulants: Drugs that increase or enhance the activity of monamines (such as dopamine and norepinephrine) in the brain, which leads to increased heart rate, blood pressure, and respiration; used to treat only a few disorders, such as narcolepsy and ADHD.

Tolerance: A condition in which higher doses of a drug are required to produce the same effects as experienced initially.

Tranquilizers: Drugs prescribed to promote sleep or reduce anxiety; this National Survey on Drug Use and Health classification includes benzodiazepines, barbiturates, and other types of CNS depressants.

Withdrawal: A variety of symptoms that occur after chronic use of some drugs is reduced or stopped.


References


American Chronic Pain Association. Press Release: Survey Shows Myths, Misunderstanding about Pain Common Among Americans, 2000.

Baillargeon, L.; et al. Discontinuation of benzodiazepines among older insomniac adults treated with cognitive-behavioural therapy combined with gradual tapering: a randomized trial. CMAJ 169:1015-1020, 2003.

Baum, C.; Kennedy, D.L.; Knapp, D.E.; Juergens, J.P.; and Faich, G.A. Prescription drug use in 1984 and changes over time. Med Care 26(2):105-114, 1988.

Boyer, E.W. Dextromethorphan abuse. Pediatr Emerg Care 20(12):858-863, 2004.

Cowan, D.R.; Wilson-Barnett, J.; Griffiths, P.; and Allan, L.G. A survey of chronic noncancer pain patients prescribed opioid analgesics. Pain Medicine 4(4):340-351, 2003.

CSAT. Substance Abuse Among Older Adults (TIP #26). DHHS Pub. No. BKD250. SAMHSA, 1997.

Fishbain, D.A.; Rosomoff, H.L.; and Rosomoff, R.S. Drug abuse, dependence and addiction in chronic pain patients. Clin J Pain 8:77-85, 1992.

Helling, D.K.; Lemke, J.H.; Semla, T.P.; Wallace, R.B.; Lipson, D.P.; and Cornoni-Huntley, J. Medication use characteristics in the elderly: the Iowa 65+ Rural Health Study J Am Geriatr Soc 35(1):4-12, 1987.

Johnston, L.D.; O'Malley, P.M.; and Bachman, J.G. Monitoring the Future: National Survey Results on Drug Use, Overview of Key Findings 2004. Bethesda, MD, NIDA, NIH, DHHS (2005). Available at: www.monitoringthefuture.org.

Joransson, D.E.; Ryan, K.M.; Gilson, A.M.; and Dahl, J.L. Trends in medical use and abuse of opioid analgesics. JAMA 283(13):1710-1714, 2000.

Michna, E.; Ross, E.L.; Hynes, W.L.; Nedeljkovic, S.S.; Soumekh, S.; Janfaza, D.; Palombi, D.; and Jamison, R.N. Predicting aberrant drug behavior in patients treated for chronic pain: importance of abuse history. J Pain Symptom Manage 28(3):250-258, 2004.

NIDA. Buprenorphine Approval Expands Options for Addiction Treatment. NIDA NOTES 17(4), 2002.

NIDA. Research Eases Concerns About Use of Opioids to Relieve Pain. NIDA NOTES 15(1), 2000.

Office of Applied Studies (OAS). Emergency Department Trends from the Drug Abuse Warning Network, Final Estimates 1995- 2002. DHHS Pub. No. (SMA) 03-3780. SAMHSA, 2003.

OAS. Results from the 2001 National Household Survey on Drug Abuse: Volume I. Summary of National Findings. DHHS Pub. No. (SMA) 02-3758. SAMHSA, 2002.

OAS. Results from the 2003 National Survey on Drug Use and Health: National Findings. DHHS Pub. No. (SMA) 04-3964. SAMHSA, 2004.

Paterniti, S.; Dufouil, C.; and Alperovitch, A. Long-term benzodiazepine use and cognitive decline in the elderly: The Epidemiology of Vascular Aging Study. J Clin Psychopharmacol 22(3):285-293, 2002.

Shorr, R.I.; Bauwens, S.F.; and Landefeld, C.S. Failure to limit quantities of benzodiazepine hypnotic drugs for outpatients: placing the elderly at risk. Am J Med 89(6):725-732, 1990.

Simoni-Wastila, L.; Ritter, G.; and Strickler, G. Gender and other factors associated with the nonmedical use of abusable prescription drugs. Subst Use Misuse 39(1):1-23, 2004.

Simoni-Wastila, L. The use of abusable prescription drugs: The role of gender. J Women's Health and Gender-based Medicine 9(3):289-297, 2000.

Turnheim K. When drug therapy gets old: pharmacokinetics and pharmacodynamics in the elderly. Exp Gerontol 38(8):843-853, 2003.


Index

Letter from the Director

What are some of the commonly abused prescription drugs?

Opioids



CNS depressants



Stimulants



Trends in prescription drug abuse



Preventing and detecting prescription drug abuse



Treating prescription drug addiction



Some Commonly Prescribed Medications: Use and Consequences

Glossary and References

 

Prescription Drugs: Abuse and Addiction Research Report Cover



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