What does the term "formication" refer to?

The term "formication" specifically refers to the sensation of insects or bugs crawling on or under the skin. This phenomenon is often associated with substance use, particularly stimulants like cocaine and methamphetamine, as well as with certain medical conditions. Individuals experiencing formication may feel extreme discomfort or distress due to the belief that something is on or under their skin. Understanding this symptom is crucial for counselors working with clients who may be experiencing the effects of substance use or other related issues.

The other options, while related to different topics, do not encapsulate the definition of formication. The creation of freebase cocaine pertains to drug chemistry, sexual relations among unmarried individuals relate to behavioral concerns, and extrapyramidal symptoms involve side effects from certain medications, such as antipsychotics, rather than a sensory experience. Thus, the correct answer aligns with the definition and context of formication as a sensory experience rather than a behavioral or chemical process.