Pain that usually starts suddenly and has a known cause, like an injury or surgery. It normally gets better as your body heals and generally lasts less than three months.

Addiction is a disease characterized by the repeated use of a substance (medication or alcohol) despite the negative impacts caused by that use.

Pain relieving medications including over-the-counter medications like acetaminophen (Tylenol®) or ibuprofen (Advil®) and prescription medicines like opioids.

Drugs that are similar in chemical structure or pharmacologic effect to another drug but are not identical.

Sometimes called “benzos,” these are sedatives often used to treat anxiety, insomnia, and other conditions. Combining benzodiazepines with opioids increases a person’s risk of overdose and death.

A problematic pattern of cannabis use that causes significant impairment or distress. A diagnosis is based on specific criteria such as unsuccessful efforts to cut down or control use, or use resulting in social problems and a failure to fulfill obligations at work, school, or home, among other criteria.

Cannabis refers to all compounds derived from the plant Cannabis sativa. Marijuana refers to the parts of the plant (Cannabis sativa) that contain tetrahydrocannabinol (THC) and cannabidiol (CBD). THC is the substance that makes you high. CBD does not appear to have mind-altering effects. The cannabis plant has over 500 chemicals (cannabinoids). We know that the body has cannabinoid receptors in the brain, gut, and immune system, but the exact process of how these chemicals affect the body remains unclear. The federal government considers cannabis an illegal drug, however, most states have legalized cannabis for medical and/or recreational use.

Pain that lasts 3 months or more and can be caused by a disease or condition, injury, medical treatment, inflammation, or an unknown reason.

CBT is a type of talk therapy that teaches patients coping skills to recognize and change unhelpful thinking patterns and behaviors. For example, CBT may help patients learn strategies to cope with pain and face one’s fears instead of avoiding them. CBT has been shown to help individuals with a number of problems including chronic pain, depression, anxiety, and substance use disorders. It is one of the most studied interventions and has been demonstrated to lead to improvement in functioning and quality of life. It is considered the “gold standard” of pain interventions.

Drug dependency occurs when a person stops using a drug and their body experiences withdrawal. A person who is dependent on a medication is not necessarily addicted to that medication.

Depressed mood is a normal emotional response to loss, disappointment, or failure. Depressive disorders are common mental disorders that occur in people of all ages and ethnicities. Major Depression is an episodic treatable illness associated with changes in mood (sadness, irritability, anxiety, apathy), self worth, and physical functioning (sleep, energy, concentration, pain). It is common in individuals with chronic pain. Major Depression is usually best treated with a combination of medication and talk therapy.

The preferred term is substance use disorder. When referring to opioids, see the Opioid Use Disorder (OUD) definition below and text box discussing the difference between “tolerance,” “dependence,” and “addiction.”

The use of prescription drugs or illegal drugs in a manner other than as directed by a doctor. This could include taking drugs in greater amounts than prescribed, taking them more often, or for a longer period of time. Using someone else’s prescription drugs is also a form of drug misuse. 

Slower-acting medication with a longer duration of pain-relieving action.

Pharmaceutical fentanyl is a synthetic opioid, approved for treating severe pain, typically advanced cancer pain. It is 50 to 100 times more potent than morphine. However, illegally made fentanyl is sold through illicit drug markets for its heroin-like effect, and it is often mixed with heroin or other drugs, such as cocaine, or pressed into counterfeit prescription pills.

An illegal, highly addictive opioid drug processed from morphine and extracted from certain poppy plants.

The nonmedical use of a variety of drugs that are prohibited by law. These drugs can include: amphetamine- type stimulants, marijuana/cannabis, cocaine, heroin, other opioids, and synthetic drugs, such as illicitly manufactured fentanyl (IMF) and ecstasy (MDMA).

Faster-acting medication with a shorter duration of pain-relieving action.

Treatment for opioid use disorder (OUD) may include methadone, buprenorphine, or naltrexone. Treatment is often combined with counseling and behavioral therapies.

A highly addictive central nervous system stimulant that is also categorized as a psychostimulant. Methamphetamine use has been linked to mental disorders, problems with physical health, violent behavior, and overdose deaths. Methamphetamine is commonly referred to as meth, ice, speed, and crystal, among many other terms.

Mindfulness is the ability to be fully present and aware of where we are and what our bodies are doing. It is a tool to avoid judgment while identifying and accepting emotions and thoughts in everyday life. Meditation is a part of mindfulness interventions, but interventions involve other practices such as focusing on breathing, awareness, and acceptance. Mindfulness-based stress reduction (MBSR) was designed in the 1970s for the treatment of chronic pain. A number of studies show mindfulness improves quality of life and self-compassion and reduces depression, anxiety, stress, and pain.

The amount of milligrams of morphine an opioid dose is equal to when prescribed. Calculating MME accounts for differences in opioid drug type and strength.

A drug that can reverse the effects of opioid overdose and can be life-saving if administered in time. The drug is sold under the brand name Narcan or Evzio.

Originally referred to any substance that dulled the senses and relieved pain. Some people use the term to refer to all illegal drugs but technically, it refers only to opioids. Opioid is now the preferred term to avoid confusion.

Naltrexone is medication approved for the treatment of opioid use disorder and alcohol use disorder because it blocks the opioid receptor, which blocks euphoria and reduces or stops cravings for opioids and alcohol. It should be used as a component of treatment that includes counseling and behavioral therapies. It is available as a daily pill or a monthly injection. It is not an opioid, is not addictive, and does not cause withdrawal if stopped. Patients should wait at least 7 days after last use of short-acting opioids before starting naltrexone.

Taking prescribed or diverted prescription drugs (drugs not prescribed to the person using them) not in the way, for the reasons, in the amount, or during the time-period prescribed.

Methods of managing pain that does not involve opioids. These methods can include, but are not limited to, acetaminophen (Tylenol®) or ibuprofen (Advil®), cognitive behavioral therapy, physical therapy, acupuncture, meditation, exercise, medications for depression or for seizures, or interventional therapies (injections).

Treatments that do not involve medications, including physical treatments (e.g., exercise therapy, weight loss) and behavioral treatments (e.g., cognitive behavioral therapy).

Although these terms are often used interchangeably they are different. Opiates refer to natural opioids such as heroin, morphine and codeine. Opioids refer to all natural, semisynthetic (oxycodone, hydrocodone, hydromorphone and oxymorphone) and synthetic (methadone, tramadol and fentanyl) opioids.

Opioids are chemicals that interact with opioid receptors on nerve cells in the body and brain, and reduce the intensity of pain signals and feelings of pain. Prescription opioids are generally safe when taken for a short time and as directed by a doctor, but because they produce euphoria in addition to pain relief, they can be misused and have addiction potential.

A problematic pattern of opioid use that causes significant impairment or distress. A diagnosis is based on specific criteria such as unsuccessful efforts to cut down or control use, or use resulting in social problems and a failure to fulfill obligations at work, school, or home, among other criteria. Opioid use disorder is preferred over other terms with similar definitions, “opioid abuse or dependence” or “opioid addiction.”

Injury to the body (poisoning) that happens when a drug is taken in excessive amounts. An overdose can be fatal or nonfatal.

Adaptation to a drug that produces symptoms of withdrawal when the drug is stopped.

State or territorial-run electronic databases that track controlled substance prescriptions. PDMPs help providers identify patients at risk of opioid misuse, opioid use disorder, and/or overdose due to overlapping prescriptions, high dosages, or co-prescribing of opioids with benzodiazepines.

Psychiatry is the branch of medicine focused on mental, emotional, and behavioral health. A psychiatrist is a medical doctor who can recognize, diagnose, and treat mental health conditions with medications and other treatments. Psychiatrists think about the patient as a whole person and can help patients understand the relationship between the body, the mind, and life stressors. Psychiatric conditions (depression, insomnia) and chronic pain often go hand in hand and can worsen each other if left untreated. This is why treatment of both the body and mind is important. A psychiatrist will use a number of different treatments including medications, talk therapy, and psychosocial interventions to treat your pain and other mental health conditions.

Psychology is the study of the mind and behavior including how the brain, social interactions, and the environment affect how individuals think, feel, and act. A psychologist receives an advanced degree to help patients learn to cope with stressful situations, manage chronic illness such as pain, and improve quality of life. Psychologists use evidence-based talk therapies such as cognitive behavioral therapy, interpersonal therapy, mindfulness and acceptance and commitment therapy, especially for pain management.

Tolerance occurs when the body’s response to a substance (medication, drug or alcohol) lessens over time and higher doses or amounts of the substance are needed to reach the same effect as when they were first used.

A urine toxicology test (also called drug test or tox screen) checks for legal and illegal drugs in your urine. Providers may order urine toxicology to help detect appropriate use or misuse of drugs or to rule out medical conditions, especially if you have recent changes in your thinking or behavior.