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, 5^th Edition, there was a change in the language used to describe addiction, using “substance use disorder” instead of “abuse” and “dependence.”

Addiction

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).

Misuse

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).

Substance abuse

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).

More Resources

• Substance Abuse and Mental Health Services Administration (SAMHSA)
• American Psychiatric Association: Addiction and Substance Use Disorders
• Journal of Addictions Nursing

References:
Burda, C. (2020). Substance use disorders: Semantics and stigma. The Nurse Practitioner, 45(1), 14-17. https://doi.org/10.1097/01.NPR.0000586060.78573.ab

Dydyk A.M., Jain N.K., & Gupta M. Opioid Use Disorder. [Updated 2021 Jul 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. https://www.ncbi.nlm.nih.gov/books/NBK553166/

Murphy, K. (2018). The Science of Addiction. Nursing Made Incredibly Easy!, 16(3), 38-45. https://www.doi.org/10.1097/01.NME.0000531870.46498.da

National Institute on Drug Abuse. (2020, June.) Misuse of Prescription Drugs Research Report. https://www.drugabuse.gov/publications/research-reports/misuse-prescription-drugs/overview

Walters, M. (2021). Using SBIRT for substance use relapse. Nursing2021, 51(3), 63-66. https://www.doi.org/10.1097/01.NURSE.0000724424.00301.19

More Resources
Collection	Guideline Summary	Collection
Nursing and the Opioid Epidemic	Alcohol Withdrawal	Self-Care for Nurses