What Types of Misuse Is Occurring?

SAMHSA³ has noted that distinctions should be made between nonmedical uses of substances, substance misuse, abuse, physiological dependence, psychological dependence (also known as “addiction”), and pseudo-addiction.

• Nonmedical Use: Use of prescription drugs that were not prescribed by a medical professional (i.e., obtained illicitly) or use for the experience or feeling a drug causes.
• Misuse: Incorrect use of a medication by patients, who may use a drug for a purpose other than that for which it was prescribed, take too little or too much of a drug, take it too often, or take it for too long (misuse does not apply to off‐label prescribing [prescribing a medication for a condition other than the conditions for which the Food and Drug Administration approved the medication] when such use is supported by common medical practice, research, or rational pharmacology).
• Abuse: A maladaptive pattern of substance use leading to clinically significant impairment or distress as manifested by one or more behaviorally based criteria.
• Physiological Dependence: Increasing tolerance for a drug, withdrawal signs and symptoms when a drug is discontinued, or the continued use of a substance to avoid withdrawal.
• Psychological Dependence (addiction): A set of psychological symptoms that demonstrate overall loss of control or obsessive compulsive drug‐seeking and continued use of a substance in spite of clearly adverse consequences. Symptoms may include specific physiological signs of dependence, such as increasing tolerance, or withdrawal signs and symptoms when the drug is discontinued.
• Pseudo-addiction: Drug‐seeking and other behavior that is consistent with addiction but actually results from inadequate pain relief. Once the pain is adequately treated, the person no longer abuses the medication.