Table 6.

Common and unique elements in definitions of prescription medication MARE terminology

Term	Common element (included in ≥ 2 definitions)	Unique elements (included in 1 definition)
Misuse
	Use that contradicts medical advice or that is not as prescribed*
	Restricted to prescription or over-the-counter medications
	Restricted to use for a medical purpose
Abuse
	Use for nontherapeutic, recreational purposes	Harm to the user or others#
	Use to obtain psychotropic or euphoric effects§	Illegal use of a substance
	Use that contradicts medical advice or that is not as prescribed*	Use for dependence or suicide attempt
Addiction
	Compulsive use†
	Use despite harm or negative consequences#
	Chronic disease
	Impaired control†
	Craving†
	Neurobiologic dysfunction
Physical dependence
	Associated with withdrawal symptoms or a withdrawal syndrome
	Adaptive physiologic process
	Occurs when drug is rapidly withdrawn
	Tolerance to substance effects
Psychological dependence
	Compulsive use and impaired control†	Unpleasant emotional and motivational effects
	Craving†	Non-physiological attachment to availability of a drug
	Characterized by drug use to obtain psychotropic or euphoric effects§
	Avoidance of negative effects and symptoms associated with drug absence
Diversion
	Removal of a medication from legal distribution
Intoxication
	Disrupts psychophysiological functions	Associated with excessive use
Nonmedical or nontherapeutic use
	Use of prescription drug without a prescription	Prescription drug use to obtain psychotropic or euphoric effects§
		Prescription drug use that is not as prescribed*

^§Element occurs in definitions of abuse, psychological dependence, and nonmedical or nontherapeutic use

^*Element occurs in definitions of misuse, abuse, and nonmedical or nontherapeutic use

^#Element occurs in definitions of abuse and addiction

^†Element occurs in definitions of addiction and psychological dependence