The Lexicon of Drug Abuse

Abstract

We review the historical changes that occurred as a result of the formation of the Expert Committee on Drug Dependence from its 1949 inception at the World Health Organization of the United Nations. Philosophical, scientific, and vernacular changes occurred over the years in response to the growing scientific literature base appearing in peer-reviewed journals. Drug dependencies of all known and popular drugs-of-abuse became the focus of many of the international drug control policy meetings from the early 1960s to today. However, despite the growing body of literature and cumulative knowledge base, there is still no general consensus on the language we use to discuss our science. Journal of Drug Abuse 2471-853X 2This article is available in: http://drugabuse.imedpub.com/archive.php dependence" and the Committee once again renamed itself the "WHO Expert Committee on Drug Dependence". In an attempt to form a consensus on the general terminology regarding drug abuse, the 16 th meeting of the group [4] defined "dependence" as:A state, psychic and sometimes also physical, resulting from the interaction between a living organism and a drug, characterized by behavioral and other responses that always include a compulsion to take the drug on a continuous or periodic basis in order to experience its psychic effects, and sometimes to avoid the discomfort of its absence. Tolerance may or may not be present. A person may be dependent on more than one drug.By its 20 th meeting [5], the international drug supply, distribution, and abuse scenes world-wide had changed dramatically, and the focus of intervention started to be directed on aspects of the individual abuser, the environment, social setting, as well as the pharmacology of the drug substance. The Committee reaffirmed the definition of dependence and redirected its main concern to identifying ways of reducing or eliminating the actual or potential harm to health and social functioning resulting in the repeated use of psychoactive drugs. At the 28 th meeting, the Committee also noted that:1. Dependence on psychoactive drugs may also arise where use is not for subjective pleasure or to relieve distress;2. The distinction between physical and psychic dependence was difficult in the clinical setting. And, 3. This view was no longer consistent with the scientific literature supporting the notion that all drugs effects on the individual are potentially understandable in biological terms (i.e., there was no use for the term "psychic") [6].Based on the evolution of understanding the scientific underpinnings of drug dependence the 28 th meeting of the Committee also redefined the term "dependence" to be:A cluster of physiological, behavioral and cognitive phenomena of variable intensity in which the use of a psychoactive drug (or drugs) takes on high priority. The necessary descriptive characteristics are preoccupation with a desire to obtain and take the drug and persistent drug-seeking behavior. Determinants and the problematic consequences of drug dependence may be...