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editorial
. 2017 May 4;1(1):2–7. doi: 10.1080/24740527.2017.1319733

Table 2.

Definitions of substance use terms.

Term Definition Source
Addiction A primary, chronic, neurobiological disease with genetic, psychosocial and environmental factors influencing its development and manifestations. It is characterized by one or more of impaired control, compulsive use, continued use despite harm and craving Liaison Committee on Pain and Addiction8
Opioid Use Disorder A minimum of 2–3 criteria is required for a mild substance use disorder diagnosis, while 4–5 is moderate, and 6– is severe. Opioid Use Disorder is specified instead of Substance Use Disorder, if opioids are the drug of abuse. Note: A printable checklist version is linked below:

  1. Taking the opioid in larger amounts and for longer than intended

  2. Wanting to cut down or quit but not being able to do it

  3. Spending a lot of time obtaining the opioid

  4. Craving or a strong desire to use opioids

  5. Repeatedly unable to carry out major obligations at work, school, or home due to opioid use

  6. Continued use despite persistent or recurring social or interpersonal problems caused or made worse by opioid use

  7. Stopping or reducing important social, occupational, or recreational activities due to opioid use

  8. Recurrent use of opioids in physically hazardous situations

  9. Consistent use of opioids despite acknowledgment of persistent or recurrent physical or psychological difficulties from using opioids

  10. *Tolerance as defined by either a need for markedly increased amounts to achieve intoxication or desired effect or markedly diminished effect with continued use of the same amount. (Does not apply for diminished effect when used appropriately under medical supervision)

  11. *Withdrawal manifesting as either characteristic syndrome or the substance is used to avoid withdrawal (Does not apply when used appropriately under medical supervision)


*This criterion is not considered to be met for those individuals taking opioids solely under appropriate medical supervision.		 DSM-59
Opioid misuse NSDUH Use in any way not directed by a doctor, including … use in greater amounts, more often, or longer than told to take a drug *NSDUH18
Opioid use to get high CTADS Use of an opioid in order to get high **CTADS19
Physical dependence A state of adaptation manifested by a drug class-specific withdrawal syndrome that can be produced by abrupt cessation, rapid dose reduction, decreasing blood level of the drug and/or administration of an antagonist Liaison Committee on Pain and Addiction8
Tolerance A state of adaptation in which exposure to the drug results in changes that result in diminution of one or more of the drugs effects over time Liaison Committee on Pain and Addiction8
Opioid use Use of an opioid as opposed to a disorder (see definition above)  

*NSDUH = US National Survey on Drug Use and Health.

**CTADS = Canadian tobacco, alcohol and drug use monitoring survey.