"Notice: this publication appears on the PPSG website with the express permission of the copyright holder, who should be consulted for further permission to reproduce."
[Contents]

 

Annex 1

Use of terms in this Document

WHO Analgesic Method (also called the "Three-Step Analgesic Ladder") was developed to promote the sequential use of drugs to achieve effective pain relief. The first step is a non-opioid medication (such as aspirin, paracetamol, or ibuprofen). If this does not relieve the pain, an opioid for mild to moderate pain (such as codeine) should be added. When an opioid for mild to moderate pain in combination with a non-opioid medication does not provide effective analgesia, then an opioid for moderate to severe pain (such as morphine or one in the therapeutic group of morphine) should be substituted. Adjuvant drugs should be given at any point during drug treatment to relieve adverse effects of analgesics, to enhance pain relief, and to treat concomitant psychological disturbances such as insomnia, anxiety, and depression.

Consumption statistics are reported by governments to the INCB annually and represent the amounts of narcotic drugs that are distributed in a country to the retail level, i.e. to hospitals, pharmacies and practitioners.

DDD or "defined daily dose" is the assumed average maintenance dose per day for a drug used on its main indication in adults. Drug consumption figures are presented as numbers of DDDs per population per day for comparative purposes in drug utilization studies. In the INCB technical publications, DDD figures were calculated as the annual average daily dose of drug consumed, computed over five years, per million inhabitants in a given country.

Diversion refers to the movement of controlled drugs from licit to illicit channels of distribution or use.

Drug dependence is a cluster of physiological, behavioural and cognitive phenomena of variable intensity, in which the use of a psychoactive drug (or drugs) takes on a high priority. The necessary descriptive characteristics are preoccupation with a desire to obtain and take the drug and persistent drug-seeking behaviour.

Law refers to rules of conduct having binding legal force adopted by a sovereign authority, legislative or other governmental body at the national, state or local level.

Narcotic drug is a legal term that refers to all those substances covered by the Single Convention on Narcotic Drugs, 1961 and the 1972 Protocol amending that Convention, including opiates, opioids, as well as cocaine and marihuana.

National policy should be interpreted broadly. There are different levels of "national policy," including law (sometimes referred to as codes or statutes), regulations (issued by governmental agencies to interpret or implement laws), and other policy (governmental directives, budgets or policy documents). For example, some provisions and administrative practices should be in law, while others are a more appropriate function of administrative activities of governments. In some cases, the authoritative sources specify the level. There are also different types of national policies that may be relevant to the subject of these Guidelines. For example, some of the relevant provisions and administrative practices may be found in governmental policies on public health, drugs, drug abuse and cancer control. "National policy" also refers to the government policies of states, provinces, territories, and other governmental subdivisions especially where this level of government is deemed to have responsibilities relevant to the subject of the guidelines. For example, some states adopt policies that are relevant to narcotics control.

Opiate refers to substances that are produced from the poppy plant, such as codeine and morphine.

Opioid is a scientific term that refers to both natural and synthetic drugs whose effects are mediated by specific receptors in the central and peripheral nervous systems, including codeine, morphine, oxycodone and fentanyl.

Regulation is an official ruling by government having the force of law and issued for the purpose of implementing or interpreting laws.

The 1961 Convention refers to the Single Convention on Narcotic Drugs, 1961, as amended by the 1972 Protocol Amending the Single Convention on Narcotic Drugs, 1961.

Tolerance refers to a reduction in the sensitivity to a drug following repeated administration, in which increased doses are required to produce the same magnitude of effect previously produced by a smaller dose.

Withdrawal syndrome refers to the consequences of repeated administration of certain drugs, whose abstinence can increase the intensity of drug-seeking behaviour because of the need to avoid or relieve withdrawal discomfort and/or produce physiological changes of sufficient severity to require medical treatment.