Terminology

This page contains terms that are seen in this website which have meanings that are specific to benzodiazepines or Z-drugs or where the terms are used differently for benzodiazepines or Z-drugs than they are used in other contexts. The equal sign (=) is used to indicate which terms have identical or nearly identical meaning. These definitions reflect how the terms are used in this website. Note that other internet sites and the literature may define these terms differently. Some of variations of meaning are discussed below to limit confusion for the reader reviewing other sources of information.

Abuse
Refers to inappropriate use of a substance. Although it is a term frequently used, it is not recommended for a couple reasons. It is pejorative as it tends to imply moral failing which is not the cause of inappropriate use of an agent. It implies an understanding of the motivational dynamics of an individual which is not necessarily the case. It has now become a confusing term because in the older diagnostic structure – DSM-4 – it was a separate diagnosis and now in DSM-5 the features described for “abuse” previously are now the features that characterize mild Substance Use Disorder. “Misuse” and “non-medical use” are the terms that are recommended to replace what has been meant by the term “abuse”.

Addiction = Substance Use Disorder
A disease of the reward system of the brain that results in compulsion, loss of control, and continuation despite negative consequences. Sometimes the term “non-medical use” is used to mean the same thing, but there are reasons other than addiction why someone might use a substance non-medically.

Adverse Events = Adverse Reactions = Side Effects

Agonist
A chemical that binds to and activates a receptor to result in a biological response.

Amnestic
Causing memory loss

Antagonist = Blocker
A chemical that binds to and does not activates a receptor. It does not allow an agonist to attach to that receptor and therefore reduces any biological response that might have been produced by an agonist.

Anterograde amnesia = Blackout
Loss of the ability to create new memories after the event that caused amnesia, leading to a partial or complete inability to recall the recent past, while long-term memories from before the event remain intact. Can occur as a result of use of alcohol or benzodiazepines.

Anticonvulsant
Causing reduction in seizures

Anxiogenic / Anxiogenesis
Causing increase in anxiety

Anxiolytic / Anxiolysis
Causing reduction in anxiety

Benzo = Benzodiazepine = BZD = BZ

Benzo brain
A colloquialism designating any of several forms of dyscognition which result from the use or withdrawal of benzodiazepines or Z-drugs.

Benzodiazepine = Benzo = BZD = BZ
A chemical in the class of psychoactive substances that have a core chemical structure in which a benzene ring is fused with a diazepine ring.

Benzodiazepine-induced neurological dysfunction = BIND
A constellation of functionally limiting neurologic symptoms (both physical and psychological) that are the consequence of neuroadaptation to benzodiazepine exposure. These symptoms may begin while taking benzodiazepines, and can persist for weeks, months, or even years after discontinuation.

Benzodiazepine receptor agonist = BZRA
A member of that class of drugs which act as agonists on benzodiazepine receptor sites.  This class of drugs includes benzodiazepines, non-benzodiazepines (Z-drugs), and other drugs.

Benzodiazepine Use Disorder = Benzodiazepine Addiction
A disease of the reward system of the brain that results in compulsion, loss of control, and continuation despite negative consequences specifically to benzodiazepines. This is actually rare and is used inaccurately to refer to persons who struggle with benzodiazepine-related problems when they do not have the true addiction to benzodiazepines.

Benzowise = Benzo-wise
A colloquial adjective used to describe a medical professional who understands benzodiazepine physiologic dependency and its accompanying withdrawal syndrome.

Dependence
The general use of this term means “reliant upon”, for example, I’m dependent on oxygen to stay alive. When used in relation to medications that affect the nervous system, it refers to the result of neuroadaptation which results in a) tolerance and b) withdrawal symptoms.

Effectiveness
A measure of the degree of beneficial effect under “real world” clinical settings.

Efficacy
A measure of whether an intervention produces the expected result under ideal circumstances.

Endogenous
Processes and chemicals that originate within a living organism

Exogenous
Processes and chemicals that originate outside of a living organism

Full agonist
A chemical that binds to and fully activates a receptor to result in a full biological response

Gamma aminobutyric acid = GABA
A molecule normally present in the central nervous system which acts at a receptor. It does not cross into the brain (across the blood-brain barrier) from oral administration, though GABA can reach a few areas of the brain that do not have a blood-brain barrier.

Half-life
A measure of how long after application it takes until half of a drug becomes inactivated.

Hypnotic
Sleep-producing

Kindling
A neuropharmacologic phenomenon that involves sensitization of the nervous system related to repeated exposure to a substance, such as alcohol or benzodiazepines. Clinically, this may present as increased severity of withdrawals on successive use and then discontinuation of those agents. For a detailed discussion, see the Dependence page .

Long-term use
For benzodiazepines, long-term use is defined in this website as daily (or more frequent) use for more than 4 weeks.  There is no generally agreed-upon timeframe for this, and in the literature many other timeframes are used.

Misuse
Use of a substance in a way other than prescribed for example, taking a benzodiazepine for anxiety but double-dosing when it was not prescribed to be taken that way. See also Non-medical use.

Non-benzodiazepines = Z-drugs

Non-Medical Use = NMU
Use of a substance for a reason other than for which it is prescribed. This includes but is not limited to the disease of addiction. For example, if a benzodiazepine is prescribed for anxiety but is used for pain or to boost the effect of alcohol – this is non-medical use. See also misuse.

Off-label use
Any use that is not listed in the drug’s label or Prescriber Information.  This is at the discretion of the prescriber, but also without the approval of the FDA.

Onset of action
Refers to the amount of time it takes until the first effect of a substance taken is noticed by someone.

Paradoxical Reaction
Reaction opposite of what is expected typically. Agitation and irritability are paradoxical reactions to benzodiazepine use as relaxation and calming are the expected and more common responses.

Psychomotor
Refers to the relationship between perception or cognition and physical motion. Psychomotor problems reflect the ability for someone to translate an intention into volitionally-directed physical action. It can include such skills as eye-hand skills, coordination, speech, balance, walking, reaction time, and driving ability. Psychomotor deficits, in turn, can factor into accidents, injuries, and falls.

Receptor
A protein molecule in a cell membrane that can receive chemical signals outside of the cell and in turn transmit signals into the cell.

Receptor affinity
This describes the extent to which a chemical binds to a receptor: weak, intermediate, or strong.

Recovery
Can refer to any process that is intended to assist someone in returning to a previous, healthier condition. In common use it refers to the process of regaining health and a meaningful life for persons with Substance Use Disorder (addiction). Since it is rare that persons with benzodiazepine-related problems are addicted to those agents, the use of recovery in that context may be confusing.

Short Term
This seems self-evident but it is necessary to determine what is meant since it may be used to refer to anywhere from a few days to a few months.

Short-term use
For benzodiazepines, this is defined as daily (or more frequent) use for less than 4 weeks.

Side Effects = Adverse Reactions = Adverse Events

Substance Use Disorder = Addiction

Tolerance
The process of neuroadaptation in which use of a substance over time results in the need to increase the dose of that substance in order to get the same effect as that seen when the substance is first started.

Wave
A colloquial term use to describe the increase of symptoms of withdrawal from benzodiazepines.

Window
A colloquial term use to describe the lessening of the symptoms of withdrawal from benzodiazepines, as in a window to the patient’s condition prior to exposure.

Withdrawal
The process of discontinuing a substance.

Withdrawal Symptoms
The process of neuroadaptation in which use of a substance over time results in a characteristic group of symptoms that occur when that substance is withdrawn.

Z-drugs = non-benzodiazepines
A class of drugs which, like benzodiazepines, are benzodiazepine receptor agonists, but do not have the specific chemical structure of benzodiazepines.