PS3.1 | Addiction Psychiatry — Glossary

Evidence-based brief tobacco cessation framework for primary care: Ask about tobacco use, Advise all users to quit, Assess willingness, Assist with counselling and pharmacotherapy, Arrange follow-up.

Alcohol Use Disorders Identification Test: a 10-item WHO-validated questionnaire screening for hazardous, harmful, and probable-dependent alcohol use; scores ≥8 indicate problematic use.

A partial agonist at mu-opioid receptors used for opioid agonist therapy (OAT); its ceiling effect on respiratory depression makes it safer than full agonists in overdose; often combined with naloxone to deter injection.

A 4-item screening questionnaire for alcohol use disorders (Cut down, Annoyed, Guilty, Eye-opener); two or more positive responses indicate probable harmful use or dependence.

A long-acting benzodiazepine preferred for alcohol withdrawal management in India; its long half-life and active metabolites produce a self-tapering effect, reducing seizure risk.

Clinical Institute Withdrawal Assessment for Alcohol (Revised): a validated 10-item scale that quantifies alcohol withdrawal severity and guides benzodiazepine dosing decisions.

The most severe form of alcohol withdrawal, typically occurring 48–72 hours after the last drink, characterised by delirium (fluctuating consciousness), autonomic hyperactivity (fever, tachycardia), and vivid hallucinations; medical emergency.

ICD-11 category for a pattern of psychoactive substance use that has caused actual documented harm — physical or psychological — to the user or others, without necessarily meeting criteria for dependence.

A chronic amnesic disorder that follows untreated Wernicke encephalopathy, characterised by severe anterograde amnesia (inability to form new memories) and confabulation; results from permanent mammillary body and thalamic damage.

The 'reward circuit' running from the ventral tegmental area (VTA) to the nucleus accumbens; subverted by virtually all addictive substances to produce exaggerated dopamine surges that drive conditioning, craving, and relapse.

A competitive mu-opioid receptor antagonist used to reverse opioid intoxication (overdose); short duration of action requires repeat dosing and monitoring.

Pharmacological approach to tobacco cessation delivering controlled nicotine (patch, gum, lozenge) without tobacco carcinogens; reduces withdrawal symptoms and doubles quit rates compared to placebo.

Key structure in the mesolimbic reward pathway receiving dopaminergic input from the VTA; central to pleasure, motivation, and addiction; its dysregulation underlies compulsive substance use.

Long-term maintenance treatment for opioid use disorder using supervised opioid agonists (buprenorphine, methadone) to eliminate withdrawal and craving, enabling social functioning and reducing mortality.

Excessive, purposeless motor activity accompanying severe alcohol withdrawal, delirium tremens, and stimulant intoxication; a key clinical marker of severity requiring urgent intervention.

ICD-11 disorder characterised by impaired control over use, increasing priority of the substance over other activities, and physiological features (tolerance and/or withdrawal); requires an established pattern of use.

An essential water-soluble vitamin acting as cofactor for pyruvate dehydrogenase and transketolase; deficiency in malnourished or alcohol-dependent patients precipitates Wernicke encephalopathy when glucose is administered without replacement.

A state of neuroadaptation in which repeated exposure to a substance produces diminishing effect at a given dose, such that higher doses are required to achieve the same response.

A partial agonist at nicotinic α4β2 acetylcholine receptors; reduces nicotine craving (agonist component) and blocks smoking reward (partial antagonism); the most effective single pharmacotherapy for tobacco cessation.

An acute neuropsychiatric emergency caused by thiamine deficiency, characterised by the classic triad of confusion, ophthalmoplegia (especially lateral gaze palsy), and ataxia; precipitated by glucose loading without thiamine replacement in at-risk patients.