Prescription drug abuse terms

A common vocabulary has not been established in the field of prescription drug abuse. Because much of the survey data collected in this area refer to nonmedical use of prescription drugs, this definition of abuse, rather than that of the Diagnostic and Statistical Manual of Mental Disorders (DSM), is used. Also, because physical dependence to prescription medications can develop during medically supervised appropriate use, the term addiction is used to reflect dependence as defined by the DSM. 

Abuse. We have all heard the terms substance abuse, drug abuse, alcohol abuse, cocaine abuse, and so on. In one sense, any illicit use of a substance is abuse. For example, from the legal point of view, whenever someone smokes crack (even if it is the only time), (s)he has broken the law and abused cocaine. Likewise, if you borrow a prescription sedative or pain reliever from a friend, then you have similarly abused that medication. That is an appropriate use of the term in many cases, but this is not customarily the way that mental health specialists use the term. From our perspective, substance abuse involves a pattern of repeated use over time that results in problems in one or more areas. These include compromised physical health and well-being, legal proceedings, job status, and relationships as well as overall day-to-day functioning. 

Although statistics on alcoholism are extensive, no one knows how many persons are dependent on prescription sedatives. However, physiologic dependence has been relatively rare and usually occurs following long-term treatment with doses of 40 mg/d or more of diazepam or its equivalent. These abusers often are codependent on other drugs such as opioids, alcohol, or stimulants. "Therapeutic dose dependence" at doses of 15-30 mg/d of diazepam may be characterized by weight loss, changes in perception, paresthesias, and headache. 

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