The following are hard, medical definitions of terms that are frequently used, but infrequently defined.

This infographic will make sense once these terms are figured out:

Image result for drug use reinforcement

  1. Reinforcement
    1. An action that leads to pleasure, which causes the action to be repeated
      1. For example…
        1. We drink coffee, and find ourselves in pleasant stimulation
        2. We exercise regularly because we know that we’ll feel much better afterward
        3. We do good deeds after realizing how happy we feel doing them
  2. Habit
    1. A cue in one’s environment continually creating a reinforced response
      1. For example…
        1. Feeling the need to have a cigarette when starting the car, after eating, upon waking, and before going to bed
        2. A tense day at work drives one to have a few drinks at night
        3. As a peer specialist, seeing someone alone and downcast in the psycho-social club I volunteer at leads me to try to console them
  3. Dependence
    1. The brain has become physically reliant on a substance in order for the body as a whole to function normally
    2. This doesn’t just include recreational or illegal drug use, but is common if one has taken a psychiatric drug for a long time
      1. Reducing use too fast reveals dependence
    3. If one takes psychiatric drugs, dependence is usually expected
      1. Though it doesn’t flat out mean dependence for life
    4. Image result for reinforcement dependence definition
  4. Tolerance
    1. A behavior that produced a desired effect is no longer sufficient to create that effect
      1. People may respond to “chase the high”
        1. Increase frequency and level of dosing to relive the original feeling
        2. This can go on until one stops, forced or otherwise
  5. Recreation
    1. Using drugs for fun, or, enhancement of an activity that is already enjoyable
      1. The drug isn’t used to self-medicate
      2. This is not to escape reality or run from one’s problems
      3. If one is mentally healthy, this may perhaps be having a beer or two with friends on Friday night
  6. Abuse
    1. A pattern of drug use with irrational involvement with acquiring and using a drug, and great tendency for relapse after stopping use
      1.  The drug is hampering one’s life in some manner, or, is on course to hamper one’s life
      2. One has use of the drug as a high priority
      3. Technically, all illegal drug use is abuse
      4. Going to far out of one’s way to find and use drugs
  7. Addiction
    1. Similar to a combination of dependence and abuse, being unable to control one’s ever-escalating drug use to get high and avoid withdrawal, despite one’s life falling to pieces
    2. At this point, the drug has hijacked the brain
    3. One feels, in a deep and fundamental level, that they need the drug to survive
    4. Stimulants generally cause one to become addicted and cause negative side effects the most quick
    5. Though alcoholics can be formed over decades, they can also be formed over a few months
    6. Commercial smoking tobacco may be the most addictive substance in existence
    7. Image result for drug addiction ranking
  8. Withdrawal
    1. The experience of significant discomfort after drug abuse has stopped
    2. This, at some level, affects one’s mind, body, and spirit
    3. This can be fatal, depending on the drug, and pre-existing conditions
      1. GABAergic drugs such as alcohol and benzodiazepines
    4. Generally, things get better after two weeks clean
    5. Post-acute withdrawal syndrome (PAWS)
      1. A particularly long-lasting type of withdrawal, during which one becomes very slowly used to not having drugs in its system
      2. This can last for years
      3. Hard drugs such as alcohol, opioids, tobacco, and methamphetamine usually have PAWS in withdrawal
      4. It’s not the severity of withdrawal so much as the length that makes it so painful
      5. The post-acute withdrawal syndrome is oftentimes behind relapse, not the initial withdrawal symptoms of ~2-4 weeks
      6. Image result for drug terms use abuse withdrawal
  9. Impulsivity
    1. Acting instinctively without careful regard for the future, or, without foresight
    2. Apart from drug use, muscle memory is impulsive
    3. A small immediate reward in the present over a larger reward in the future
    4. Being unable to stop an action, to change one’s course
    5. At this point, addiction is likely
  10. Compulsivity
    1. A persistent activity that doesn’t necessarily offer reward
      1. Looking for fallen pieces of crack on one’s floor and smoking anything found that looks vaguely like crack
      2. A lot of people are addicted to using a needle, regardless if a drug is being administered
      3. People high on stimulants cleaning a living space, then continuing to do so, despite it being clean
    2. Persevering in a pattern of maladaptation
    3. Using, even though it’s hurting
  11. Abstinence
    1. This definition is a bit more vague than the others
    2. Not using recreational drugs, or, not using a specific drug that one has had problems with in the past
    3. Former addicts are told that, when they get clean, they shouldn’t do other things that can cause addiction, as one addiction can be fairly easily swapped for another
      1. This is called substitute addiction
    4. Ironically enough, at most AA meetings, there are ample amounts of cigarettes, coffee, doughnuts, and religion
      1. Is this abstinence, or substitute addiction?
      2. Four addictions in place of one greater addiction?
  12. Kindling Effect
    1. Withdrawals become more severe as they accrue
    2. The first time one withdraws from drug addiction, it might not be so bad
      1. The kindling effect holds that successive withdrawals will become more severe
      2. The third withdrawal from one’s substance of choice is notably more harsh
    3. Image result for drug tolerance
  13. Rebound, or, Relapse
    1. An original illness coming back (initially) stronger than before, after stopping a treatment
    2. This oftentimes happens after stopping the use of psychiatric medication
  14. Cross-tolerance
    1. Using a second addictive behavior to cover up the adverse consequences of stopping a first addictive behavior
    2. So, an alcoholic stops drinking, only to start using opioids
      1. The fundamental addiction hasn’t been broken

Sources: Dr. Kevin Davis, Dr. Theodore Papperman, Stahl’s Essential Psychopharmacology, Ben Komor,,,,,,,,,,,