Abstinence results in regression of the histological abnormalities. Under usual conditions, beverages produced by fermentation have an alcohol concentration of no more than 14%. In international drug control, drug-related problems are taken into account in setting a level of control for a controlled substance through a WHO assessment of the drug's dependence potential and abuse liability. The term marijuana is of Mexican origin. The term is often used to refer to psychoactive drugs and precursors covered by international drug conventions {the 1961 Single Convention on Narcotic Drugs, amended by a 1972 Protocol; the 1971 Convention on Psychotropic Substances: the 1988 Convention Against Illicit Traffic in Narcotic Drugs and Psychotropic Substances). from petroleum, but this has rarely been used for alcoholic beverages. amfetamine psychosis A disorder characterized by paranoid delusions, frequently accompanied by auditory or tactile hallucinations, hyperactivity, and lability of mood, which develops during or shorly after repeated use of moderate or high doses of amfetamines. In other countries, it appears mainly in habitual heavy drinkers (alcoholic pellagra). The most active constituent is ?9-tetrahydrocannabinol (THC), and TH C and its metabolites can be detected in urine for several weeks after usage of cannabis (usually by smoking). The disease is often progressive and fatal. An alcohol-induced withdrawal syndrome with delirium is known as delirium tremens. However, the term "minor tranquillizer" has been incorrectly assumed to indicate an absence of significant harmful effects. Alcoholic gastritis is commonly accompanied by oesophagatis. Examples of alcohol-sensitizing drugs include disulfiram (Antabuse) and calcium carbamide. gamma alcoholism—characterized by increasing tolerance, loss of control, and precipitation of a withdrawal syndrome on cessation of alcohol intake; also called " Anglo-Saxon" alcoholism. With respect to substance use and other behavioural disorders, the term refers principally to lists of questions oriented to diagnosis, including structured interview schedules that can be administered by trained lay interviewers. Increased doses of alcohol or other drugs are required to achieve the effects originally produced by lower doses. Although adverse reactions of this type are usually associated with the use of hallucinogens, they may also be caused by the use of amfetamines and other psychomotor stimulants, anticholinergics, antihistamines, and sedatives/hypnotics. See also: Jellinek's typology (delta alcoholism). reinstatement Reversion to a pre-existing level of substance use and dependence in an individual who has resumed use following a period of abstinence. compulsion When applied to psychoactive substance use, the term refers to a powerful urge-attributed to internal feelings rather than external influences- to take the substance (or substances} in question. Thirteenth report of the WHO Expert Committee. Psychological or psychic dependence refers to the experience of impaired control over drinking or drug use (see craving, compulsion), while physiological or physical dependence refers to tolerance and withdrawal symptoms (see also neuroadaptation). There are now some hundreds of organizations of twelve-step groups, each focused on one of a wide range of behavioural, personality, and relationship problems. over-the-counter (OTC) See pharmaceutical drug. Heavy use can result in dependence and medical problems. In 1964 a WHO Expert Committee introduced "dependence" to replace addiction and habituation*. Under international drug control treaties (see conventions, international drug) WHO is responsible for determining the abuse liability and dependence potential, as distinct from therapeutic usefulness, of controlled substances. alcoholic beverage Liquid that contains alcohol (ethanol) and is intended for drinking. The terms "street person" and "street people'' often imply use of alcohol or other drugs in public. "Self-help group" is a more common term, but "mutual-help group" more exactly expresses the emphasis on mutual aid and support. cognition or affect. In the nicotine user who has become physically dependent, a withdrawal syndrome develops within a few hours of the last dose: craving for a smoke, irritability, anxiety, anger, impaired concentration, increased appetite, decreased heart rate, and sometimes headaches and sleep disturbances. Most such drugs are sympathomimetic amines, whose efficacy is limited by associated insomnia, dependence phenomena, and other adverse effects Amfetamines were formerly in medical use for their appetite suppressant effects. Brief intervention is often linked to systematic screening testing for hazardous and harmful substance use, particularly of alcohol and tobacco. Together with inebriate (a person displaying inebriety), inebriety was standard terminology in the late 19th century for habitual intoxication, and remained in use until the 1940s. In DSM-IIIR*, "psychoactive substance abuse" is defined as "a maladaptive pattern of use indicated by ...continued use despite knowledge of having a persistent or recurrent social, occupational, psychological or physical problem that is caused or exacerbated by the use [or by] recurrent use in situations in which it is physical1y hazardous". The `crash` may be viewed as a withdrawal syndrome in which elation gives way to apprehension, profound depression, sleepiness, and inertia. Although both the assumption that P, K, and R are constants and the conceptual basis of the formula attracted increasingly heavy criticism, and, by 1959, Jellinek himself recommended abandoning it, for lack of alternatives, the formula remained in wide use into the 1970s. Included are the amfetamines, cocaine, caffeine and other xanthines, nicotine, and synthetic appetite suppressants such as phenmetrazine or methylphenidate. Withdrawal reactions can be severe and may occur after no more than several weeks of moderate use of a sedative/hypnotic or anxiolytic drug. In ICD-I0, mental and behavioural disorders due to use of stimulants are subdivided into those due to the use of cocaine (F14) and those due to the use of other stimulants, including caffeine (F15). Temperance A term of varying usage concerning alcohol and other drugs; originally meaning a commitment to moderation in personal drinking habits (e.g. poisoning, alcohol or drug (T40, Ts1, X61, X61, X6s, X66) A state of major disturbance of consciousness level, vital functions, and behaviour following the administration in excessive dosage (deliberately or accidentally) of a psychoactive substance. In contact with saliva, the mixture releases arecoline, an anticholinergic CNS stimulant, somewhat similar to nicotine. The term is preferred by some to abuse in the belief that it is less judgemental. A controversial entity primarily used in a forensic context. diacetylmorphine, diamorphine Alternative generic names for heroin. In medicine, it refers to any substance with the potential to prevent or cure disease or enhance physical or mental welfare, and in pharmacology to any chemical agent that alters the biochemical physiological processes of tissues or organisms. It is used medically to relieve the pain of angina pectoris and biliary colic. Synonym: alcoholic heart muscle disease. Hazardous drinking is a rough equivalent in current use. caffeine A xanthine, which is a mild central nervous system stimulant, vasodilator, and diuretic. In ICD-I0, mental and behavioural disorders due to use of stimulants are subdivided into those due to the use of cocaine (F14) and those due to the use of other stimulants, including caffeine (F15). It impairs driving and the performance of other complex, skilled activities; it impairs immediate recall, attention span, reaction time, learning ability, motor co-ordination, depth perception, peripheral vision, time sense (the individual typically has a sensation of slowed time), and signal detection. Synonymous with drug policy (definition 2) in the context of WHO's Action Programme on Essential Drugs; termed "medicines policy" in Scandinavian countries. psychotic disorder, alcohol- or drug-induced (F1x.5) A cluster of psychotic phenomena that occur during or following substance abuse but not as a result of acute intoxication alone and not as part of a withdrawal syndrome. Methanol is highly toxic; depending on the amount consumed, it may produce blurring of vision, blindness, coma, and death. Tolerance is one of the criteria for the dependence syndrome. Such an individual is sometimes known as a mentally ill chemical abuser (MICA). Skid Row (Skid Road) A district of a town, particularly in North America, with inexpensive lodgings, often including single-room-occupancy hotels, and a clustering of charity and welfare services, bars, and liquor stores, inhabited in part by destitute chronic heavy drinkers (hence the term "skid-row a1coholic" for such drinkers), and now also other drug users. Report of a WHO Expert Committee. See also: addiction medicine; alcohology; narcologist. alcohol flush reaction Flushing of the face, neck, and shoulders after the ingestion of alcohol, often accompanied by nausea, dizziness, and palpitations. Habitual intoxication (habitual drunkenness), applied primarily to alcohol, refers to a regular or recurrent pattern drinking to intoxication. Some people are more severely affected than others. Beer and ale are produced from fermented grain (malted barley. Synonym: harm minimization, harmful use (F1x..l) A pattern of psychoactive substance use that is causing damage to health. prohibition Policy under which the cultivation, manufacture, and/or sale (and sometimes the use) of a psychoactive drug are forbidden (although pharmaceutical sales are usually permitted). Over time, morphine and its analogues induce tolerance and neuroadaptive changes that are responsible for rebound hyperexcitability when the drug is withdrawn. Many, but not all, state markers for alcohol are in fact tests of hepatic damage (such as elevated plasma ?- glutamylfransferase). Policy on psychoactive drugs is normally an important component, reflecting the large proportion of all prescriptions which are for such drugs. The rationale for brief intervention is that, even if the percentage of individuals who alter their substance use after a single intervention is small, the public health impact of large numbers of primary health care workers providing these interventions systematically is considerable. controlled drinking see drinking, controlled. tobacco Any preparation of the leaves of Nicotiana tabacum, an American plant of the nightshade family. passive smoking The involuntary inhalation of smoke, usually tobacco smoke, from another person's smoking. Alcohol abuse now categorised as a disease and disorder under the Diagnostic and Statistical Manual of Mental Disorders (DSM). One manifestation is Wernicke encephalopathy (E51.2); another is peripheral neuropathy, and the two may occur together . non-medical use Use of a prescription drug, whether obtained by prescription or otherwise, other than in the manner or for the time period prescribed, or by a person for whom the drug was not prescribed. appetite suppressant An agent used to reduce hunger and diminish food intake in the treatment of obesity. Cannabis contains at least 60 cannabinoids, several of which are biologically active. withdrawal, conditioned A syndrome of withdrawal-like signs and symptoms sometimes experience by abstinent alcohol- or opiate-dependent individuals who are exposed to stimuli previously associated with alcohol or drug use. A third Indian term, bhang. mutual-help group A group in which participants support each other in recovering or maintaining recovery from alcohol or other drug dependence or problems, or from the effects of another' s dependence, without professional therapy or guidance. Sedative withdrawal syndromes have many features in common with alcohol withdrawal, but may also include muscle aches and twitches, perceptual distortions, and distortions of body image. The first stage consists of a systematic procedure for early detection. *This five-character category is not included in ICD-I0 but may be found in: Hallucinogens have been used for insight therapy in psychotherapy but this has been restricted or even banned by legislation. Major classes of sedatives/hypnotics include the benzodiazepines and the barbiturates. rice, millet. codependent  A relative, dose friend, or colleague of an alcohol- or drug-dependent person, whose actions are defined by the term as tending to perpetuate that person's dependence and thereby retard the process of recovery. Examples include lysergide (lysergic acid diethylamide, LSD). hepatitis, alcoholic See alcoholic hepatitis. For example, narcotics control legislation in Canada, USA, and certain other countries includes cocaine and cannabis as well as opioids (see also conventions, international drug). They are used as antiepileptics, anaesthetics, sedatives, hypnotics, and less commonly-as anxiolytics or anti-anxiety drugs (see sedative/hypnotic). nicotine An alkaloid, which is the major psychoactive substance in tobacco. dimethyltryptamine (DMT). Convulsions due to idiopathic epilepsy or structural brain damage following trauma or infection in individuals with psychoactive substance use disorders are excluded from this definition. alcoholic cardiomyopathy (I42.6) A diffuse disorder of heart muscle seen in individuals with a history of hazardous consumption of alcohol, usually of at least 10 years' duration. A variety of colloquial and legal terms exists for those who are destitute, marginalized, and publicly drinking, using other drugs, or intoxicated, e.g. buspirone A non-benzodiazepine anxiolytic. A full-blown delusional psychosis may occur. problem, drug-related See drug-related problem. anticonvulsant drug See anti-epileptic drug. withdrawal syndrome (Flx.3) A group of symptoms of variable clustering and degree of severity which occur on cessation or reduction of use of a psychoactive substance that has been taken repeatedly, usually for a prolonged period and/ or in high doses. Official screening tests for doping substances have been carried out at the Olympic Games since 1968 and are now a regular practice in a range of professional and amateur sports in many countries. See also: controlled substances; illicit drug; temperance, protracted withdrawal See withdrawal, protracted. Geneva, World Health Organization , 1957 (WHO Technical Report Series, NO.116). For example, surgical patients given opiate substances to relieve pain may sometimes experience withdrawal symptoms but may not recognize them as such or have any desire to continue taking drugs. Although the actions of pethidine are similar to those of other opioids, use of the drug is further characterized by a high incidence of dysphoria and irritability, and sometimes myoclonic twitches, seizures, and delirium following prolonged use.Synonym: meperidine, peyote Hallucinogenic buttons from several types of cactus (Lophophora williamsii, Anhalonium lewinii. It has a long half-life, and can be given orally once daily with supervision. unsanctioned use Use of a substance that is not approved by a society or by a group within that society. See also: addiction; alcoholism; dependence; substance use disorders, depressant Any agent that suppresses, inhibits, or decreases some aspects of central nervous system (CNS) activity. Used also in parts of the Eastern Mediterranean and North Africa, khat is a stimulant with effects similar to those of amfetamine. pharmaceutical policy The system of regulations intended to affect the availability of and demand for pharmaceutical drugs. See also: decriminalization. Its most common cause in industrialized countries is thiamine deficiency associated with alcoholism. As applied to alcohol and other drugs, the term implies a need for repeated doses of the drug to feel good or to avoid feeling bad. A caffeine-bearing extract is widely used in mass-marketed carbonated cola drinks, some of which also contain an extract of coca leaves with the cocaine removed. (revised).Washington, DC, American Psychiatric Association,1987. “A common misperception is that addiction is a choice or moral problem, and all you have to do is stop. Esser MB, Hedden SL, Kanny D, Brewer RD, Gfroerer JC, Naimi TS. Antabuse reaction See disulfiram; alcohol flush reaction. The term can be used generally with reference to the whole range of psychoactive drugs (drug dependence, chemical dependence, substance use dependence), or with specific reference to a particular drug or class of drugs (e.g. or "white lightning" in the USA, "poteen" in Ireland, "samogon" in countries of the former Soviet Union) and may be contaminated with poisons (e.g. see also: psychotropic, psychoactive substance use disorders A shortened version of the term used in ICD-10—Mental and behavioural disorders associated with psychoactive substance use. The term "problematic drinking" has been used by some to cover the related concept of drinking that has the potential to cause problems (roughly equivalent to hazardous use of alcohol), while "the drink problem" is a term that dates from the temperance era and—like "the liquor question"-referred to alcohol policy as a whole. The term is applied especially when there is a reason to question the ability to drink in a controlled fashion at all times, as in the case of individuals who have exhibited signs of alcohol dependence or harmful drinking. Others use the term to refer to substances with a high abuse liability because of their effects on mood, consciousness, or both—stimulants, hallucinogens, opioids, sedatives/hypnotics (including alcohol), etc. See also: withdrawal, conditioned. Replacement therapy with niacin is effective in reversing most symptoms, although severe mental changes of long duration may not respond completely. psychoactive drug or substance A substance that, when ingested, affects mental processes, e.g. "Diversion" is also used more broadly for any pattern of referral from the court at any stage of processing, including as a sentence or condition of probation. Delusional elabaration of the hallucinations may occur, but delusions do not dominate the clinical picture.See also: psychotic disorder, alcohol- or drug-induced. dependence (F1x.2.) See also: compulsion; control, impaired; dependence syndrome; withdrawal, conditioned. For families of alcoholics or addicts, there are Al-Anon, Alateen, and CoDependents Anonymous. Hangover usually lasts no more than 36 hours after all traces of alcohol have left the system. (3) In general public health usage concerning risk factors may refer to prevention and treatment policies concerning alcohol in general (although alcohol policy is less ambiguous in this context). They are diagnostic tests of alterations in liver status secondary to chronic drinking, and not valid indicators of alcohol dependence. Use of the term can relate either to an individual drinker or to society, and was endorsed by a 1979 WHO Expert Committee* A 1977 WHO report had used alcohol-related disability as an equivalent term at the individual level**Alcohol problem is often used as an equivalent term (as distinct from "the alcohol problem", which implies that an individual's drinking pattern is in itself a problem). Compare dysfunctional use and misuse, drug or alcohol. When this occurs in the course of chronic alcohol ingestion, it is sometimes referred to as the 'alcoholic palimpsest" . 40-80 mg of diazepam taken shortly before or immediately after a daily maintenance dose of methadone. A wide variety of prescription drugs, proprietary (over-the-counter) drugs, and herbal and folk remedies may be involved. Pharmacologically related drugs include methylphenidate, phenmetrazine, and amfepramone (diethylpropion). The withdrawal syndrome includes craving, anxiety , dysphoria, yawning, sweating, piloerection (waves of gooseflesh), lacrimation, rhinorrhoea, insomnia, nausea or vomiting, diarrhoea, cramps, muscle aches, and fever. Professional formulations (e.g. control, impaired Diminished ability of an individual to control his or her use of a psychoactive substance in terms of onset, level, or termination. drinking-driving The generally favoured term for the criminal action of driving a vehicle with a blood alcohol level over a specified limit. Prominent groups in the alcohol and other drug field include Alcoholics Anonymous, Narcotics Anonymous, and Al-Anon (for members of alcoholics' families), which are among a wide range of twelve-step groups based on a non-denominational, spiritual approach. It is sometimes distinguished from tapering-off therapy (see detoxificatjon). Alcoholic cirrhosis is sometimes termed "portal cirrhosis" or "Laënnec cirrhosis'', although neither of these terms necessarily implies an alcohol causation. According to classical conditioning theory, environmental stimuli temporarily linked to unconditioned withdrawal reactions become conditioned stimuli capable of eliciting the same withdrawal-like symptoms. Other general terms for intoxication or intoxicated include: drunkenness, high, under the influence, inebriation. alcohol dependence, opioid dependence). See also: IDU; IVDU. See also: alcoholic brain syndrome. These compounds are related to male sex hormones; they increase muscle mass and, in women, cause masculinization. Ethanol (C2H5OH, ethyl alcohol) is one of this class of compounds, and is the main psychoactive ingredient in alcoholic beverages. Overdose appears to be more frequent with crack than with other forms of cocaine. In most cases there is no clouding of consciousness, but an acute delirium is occasionally seen after the ingestion of very high doses. People with addiction use substances or engage in behaviors that become compulsive and often continue despite harmful consequences. Geneva, World Health Organization,1977 (WHO Offset publication, No.32). After the 1850s it often implied a commitment to local, national, or global alcohol control, usually with the aim of eventual prohibition of the sale of alcoholic beverages (hence prohibitionist). Spanish pdf, 1.86Mb; absolute alcohol Ethanol containing not more than 1% by mass of water.See also: alcohol.. abstinence Refraining from drug use or (particularly) from drinking alcoholic beverages, whether as a matter of principle or for other reasons. Maintenance therapy Treatment of drug dependence by prescription of a substitute drug for which cross-dependence and cross-tolerance exist. problem, alcohol-related See alcohol-related problem. See also: inebriate. Excessive alcohol use can also cause an irregular heart rate, heart attacks and congestive heart failure (difficulty pumping blood). Drug-seeking behaviour is prominent and continues after the physical symptoms have abated. Other general terms for intoxication or intoxicated include: drunkenness, high, under the influence, inebriation. 1992 (WHO Technical Report Series. pellagra (E52) A nutritional deficiency syndrome caused by lack of niacin (vitamin B 6, nicotine acid) or the essential amino acid tryptophan (which can be converted to niacin) and characterized by confusion, depression, a symmetrical dermatitis affecting light-exposed parts of the body, and gastrointestinal symptoms, especially diarrhoea. convulsion, alcohol- or drug-related A seizure-like event occurring during withdrawal from or intoxication by alcohol or another drug. Barbiturates have a narrow therapeutic-to-toxic dosage ratio and are often lethal in overdose. Alcoholism, or alcohol dependence, used to be considered the most severe form of alcohol abuse. screening test An evaluative instrument or procedure, either biological or psychological, whose main purpose is to discover, within a given population, as many individuals as possible who currently have a condition or disorder or who are at risk of developing one at same point in the future. Delirium usually appears within one week after cessation or significant reduction in dosage. narcotic A chemical agent that induces stupor, coma, or insensibility to pain. It is also commonly referred to as alcohol use disorder. beriberi See thiamine deficiency syndrome.