Words matter. And when it comes to speaking about – or documenting – sensitive information, they matter even more. As patient advocates and providers of unbiased care, it’s important that we use the correct terminology related to substance use and addiction. Here’s a glossary of terms to know; it’s important that we use them correctly and encourage others to do the same. Note that in the American Psychological Association's Diagnostic and Statistical Manual of Mental Disorders, 5th Edition,
there was a change in the language used to describe addiction, using “substance use disorder” instead of “abuse” and “dependence.”
Addiction is a disease that affects the complex interactions between biological and environmental factors. Recent evidence suggests that addiction is less identified by physical dependence and withdrawal, and more as a compulsive repetition of an activity despite life-damaging consequences. The behavior reinforces the pleasurable feeling derived from the substance and causes a loss of control in limiting its use (Murphy, 2018). Addiction may also be referred to as substance use disorder.
Alcohol use disorder
In alcohol use disorder (AUD), the impact of alcohol consumption on various neurotransmitters can cause changes to emotions, motivation, and cognitive processing. Repeated exposure to alcohol impacts the effectiveness of the neurotransmitters, causing a need for increased amounts of alcohol to produce similar effects (Walters, 2021).
The term misuse often refers to prescription drugs. It means taking a medication in a manner or dose other than prescribed; taking someone else’s prescription, even if for a legitimate medical complaint; or taking a medication to feel euphoria (National Institute on Drug Abuse, 2020).
Opioid use disorder
Opioid use disorder is defined as chronic use of opioids to the extent that it causes clinically significant distress or impairment (Dydyk et al, 2021).
As mentioned above, it is preferable to use the phrase “substance use disorder” as the word "abuse" implies that the person has choice and control over their behavior (Burda, 2020).
Substance use disorder
Substance use disorder (SUD) is a brain disorder that alters the circuitry of the basal ganglia, extended amygdala, and prefrontal cortex. These changes impact the processes of reward gratification, self-control, and stress (Walters, 2021).