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Université Bordeaux 2 CHU de Bordeaux INSERM
Département Hospitalo-Universitaire de Pharmacologie de Bordeaux
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Pharmacodependence lexicon

 

Abuse
Excessive voluntary use on a regular or intermittent basis of one or several substances having detrimental effects on physical or mental health.
Consommation
Occasional, periodic or chronic use, independent of potential consequences, be they medical, social, etc.
Dependance/pharmacodependence
A collection of behavioural, cognitive and psychological phenomena of varying intensity where the use of one or several substances becomes of high priority, the characteristics of which are essentially an obsessional desire to obtain and take the substance(s) in question or a permanent quest for their obtention. The state of dependence can lead to an auto-administration of substances that produce physical or behavioural changes that are public health problems.
Maintenance treatment
Medicine used as a substitute for an illicit substance for minimizing risks (medical, social, etc.).
In the case of opioid dependence, a maintenance treatment should ideally correspond to the following criteria:
1) to have the same pharmacodynamic properties as the substance to be substituted
2) to have a long duration of action (24 hours minimum) to avoid fluctuations in its effect and in particular signs and symptoms of withdrawal.
3) generate little euphoria and to have little reinforcing effect for the substance to be substituted and other drugs
4) to be administered sub-lingualy and not to lend itself to other routes of administration, particularly intravenous
5) to be approved for this indication, established from clinical and non-clinical data on both its efficacy (comparative clinical trials) and safety.
6) to be compatible with a satisfactory quality of life.
Problematic use
Occasional, periodic or chronic use that has medical and/or social consequences.
Recreational use
Use of a substance at group events usually associated with music.
Serious case of dependence or abuse
(Pharmaco)dependence or abuse leading to death, a life-threatening condition, incapacity, hospitalisation or a prolongation of hospitalisation
Substance
Product containing one or more active ingredients with or without known psycho-active properties that can be the object of an abusive, festive, problematic consumption or for the purpose of doping or involved in criminal activities.
Substitution treatment
With respect to pharmacodépendance, this is a treatment used by a subject dependent on a substance for the reduction of risks (reduction of the risk of viral infection in the case of intravenous injection, death by overdose, delinquency or prostitution, etc. in the case of opiate dependency; reduction of the carcinogenic risk, cardiac risk, etc. in the case of tobacco dependency).
The substitution treatment should associate a medicine with a holistic treatment approach. This treatment should allow the prevention of relapse. A longer term secondary objective can be complet withdrawal.
Withdrawal
Discontinuation of an exposure to a substance. This can lead to a "rebound effect" (an exacerbation of pre-existing symptoms). A withdrawal syndrome (that includes clinical signs not present before) can occur, that may indicate physical dependence. The withdrawal can be spontaneous or provoked (by the administration of an antagonist).