In this Chapter:
(1) "Abuse" or "substance abuse"--the essential feature
of substance abuse is a maladaptive pattern of substance use manifested
by recurrent and significant adverse consequences related to the repeated
use of substances.
(2) "Acute pain"--the normal, predicted, physiological
response to a stimulus such as trauma, disease, and operative procedures.
Acute pain is time limited.
(3) "Addiction"--a primary, chronic, neurobiological
disease characterized by craving and compulsive use of drugs. Addiction
is often characterized by impaired control over drug use, including
taking more drugs more often than prescribed by a physician. It may
also be characterized by continued use despite harm to oneself or
others. Genetic, psychosocial, and environmental factors may influence
the development and manifestation of addiction. Physical dependence
and tolerance are normal physiological consequences of extended drug
therapy for pain and, alone, do not indicate addiction.
(4) "Chronic pain"--a state in which pain persists
beyond the usual course of an acute disease or healing of an injury.
Chronic pain may be associated with a chronic pathological. process
that causes continuous or intermittent pain over months or years.
(5) "Dangerous drugs"--medications defined by the Texas
Dangerous Drug Act, Chapter 483, Texas Health and Safety Code. Dangerous
drugs require a prescription, but are not included in the list of
scheduled drugs. A dangerous drug bears the legend "Caution: federal
law prohibits dispensing without a prescription" or "Prescription
(6) "Diversion"--the use of drugs by anyone other than
the person for whom the drug was prescribed.
(7) "Escalation"--increasing the dosage and/or frequency
of the use of drugs.
(8) "Pain"--An unpleasant sensory and emotional experience
associated with actual or potential tissue damage or described in
terms of such damage.
(9) "Physical dependence"--A state of adaptation that
is manifested by drug class-specific signs and symptoms that can be
produced by abrupt cessation, rapid dose reduction, decreasing blood
level of the drug, and/or administration of an antagonist. Physical
dependence, alone, does not indicate addiction.
(10) "Pseudoaddiction"--the iatrogenic syndrome resulting
from the misinterpretation of relief seeking behaviors as though they
are drug-seeking behaviors that are commonly seen with addiction.
The relief seeking behaviors resolve upon institution of effective
(11) "Scheduled drugs" (sometimes referred to as "Controlled
Substances")--medications defined by the Texas Controlled Substances
Act, Chapter 481, Texas Health and Safety Code. This Act establishes
five categories, or schedules of drugs, based on risk of abuse and
addiction. (Schedule I includes drugs that carry an extremely high
risk of abuse and addiction and have no legitimate medical use. Schedule
V includes drugs that have the lowest abuse/addiction risk).
(12) "Tolerance" (tachyphylaxis)--a physiological state
resulting from regular use of a drug in which an increased dosage
is needed to produce a specific effect, or a reduced effect is observed
with a constant dose over time. Tolerance does not necessarily occur
during opioid treatment and does not, alone, indicate addiction.
(13) "Withdrawal"--the physiological and mental readjustment
that accompanies discontinuation of a drug for which a person has
established a physical dependence.