ABSTINENCE

The absence of substance use. However, there are many different types of abstinence. Abstinence is typically interpreted as complete abstinence, defined below:

• Continuous abstinence:not consuming the drug of choice during a specified period of time
• Essentially abstinent:not consuming more than a specified amount of the drug over a period of time
• Minimal abstinence:achieving a minimal period of recovery during a period of time
• Point-in-time abstinence:not consuming the drug of choice at a single point in time (e.g., the past 30 days)
• Complete abstinence:continuous abstinence from all alcohol and other drugs
• Involuntary abstinence:enforced abstinence due to hospitalization or incarceration

ACUTE CARE

Immediate, short-term medically managed or monitored care, lasting up to 31 days in length. Most addiction treatment programs (e.g., “rehab”) follow an acute care model. Understanding substance use disorder to be a chronic illness, recovery may require ongoing continuing care beyond acute treatment episodes.

ADDICT

(Stigma Alert) A person who exhibits impaired control over engaging in substance use (or other reward-seeking behavior, such as gambling) despite suffering severe harms caused by such activity. While this language is commonly used, in order to help decrease stigma associated with these conditions, it has been recommended to use “person first” language: instead of describing someone as an “addict,” describe them as “a person with, or suffering from, addiction or substance use disorder.”

ADDICTION

According to the American Society of Addiction Medicine (ASAM),addiction is a primary, chronic, neurobiologic disease with genetic, psychosocial, and environmental factors influencing its development and manifestation. Addiction is characterized by behaviors that include:

• Impaired control over drug use
• Compulsive use
• Continued use despite harm
• Cravings

ADDICTION COUNSELOR

Type of non-medically credentialed addiction treatment provider. Counselors vary across jurisdictions in their titles, their required level of education, and required level of training. Addiction counselors encompass “substance abuse counselors” (SACs), “certified alcohol and substance abuse counselors” (CASACs), and “certified alcohol and drug counselors” (CADCs).

ADDICTION MEDICINE PHYSICIAN

A board-certified physician in some specialty (e.g., family medicine, pediatrics, neurology) who has undergone specialized training in addiction diagnosis, treatment, and management, but who does not typically provide addiction-specific psychotherapy, although often provides brief counseling.

ADDICTION PSYCHIATRIST

A physician who is board-certified as a psychiatrist with specialized training in addiction diagnosis, treatment, and management. Addiction psychiatrists can provide therapy, although most emphasize and prescribe medications and work in collaboration with social workers, psychologists, or counselors who provide psychotherapy.

AL-ANON

A mutual-help organization or peer support group for people who have been affected by a loved one’s alcohol use disorder. Groups are based on the 12-step principles of Alcoholics Anonymous (AA), and have attendees share stories and build supportive networks to help one another cope with the difficulties of having a loved one experience an alcohol use disorder. The focus is placed more on changing oneself and one’s patterns of interacting with the addicted loved one, rather than on trying to change the alcohol-addicted person’s behavior directly.

ALCOHOL

A liquid that is or contains ethanol or ethyl alcohol produced by the fermentation of sugars. Alcohol acts as a depressant to the central nervous system, producing feelings of relaxation and pleasure, reduced inhibitions, motor impairment, memory loss, slurred speech, and additionally at high doses can cause breathing problems, coma, or death. Alcohol consumption is also connected to increased risk of accidents (e.g., car crashes), risky sexual behavior, violent behavior, suicide, and homicide. Also known as juice, the hard stuff, sauce, suds, or most often by variety or brand name.

Long-term health consequences include: neurological impairment, liver disease, pancreatic disease, cancer (mouth, esophagus, throat, liver, breast), high blood pressure, stroke, heart problems, and weakened immune system. 

ALCOHOLIC

(Stigma Alert) A person who exhibits impaired control over engaging in alcohol use despite suffering severe harms caused by such activity.

While this language is commonly used, in order to help decrease stigma associated with these conditions, it has been recommended to use “person first” language: instead of describing someone as an “addict,” describe them as “a person with, or suffering from, addiction or substance use disorder.”

ALCOHOLICS ANONYMOUS (AA)

International fellowship for individuals with problematic drinking. Founded in 1935, AA is a nonprofessional, financially self-supporting, multiracial, apolitical organization that is open to all ages, and as the largest mutual-help organization, offers meetings in most locations in North America and most countries around the world.

ALCOHOL USE DISORDER

A problematic pattern of alcohol consumption, characterized by compulsive use of alcohol, impaired control over alcohol intake, and a negative emotional state when not using. According to the 5^th Edition of the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association, an alcohol use disorder is present if two or more of the following situations occur within a 12-month period:

• Drinking more or for a longer period than intended
• On more than one occasion feeling the need or attempting to cut down or stop drinking
• Spending a lot of time drinking or recovering from the aftereffects of alcohol
• Craving or thinking about wanting a drink, or having the urge to use alcohol
• Failing to fulfill major work, school, or home responsibilities due to drinking
• Continuing to drink even though it is causing relationship troubles with your family or friends
• Prioritizing drinking by giving up or cutting back on activities that were important to you or gave you pleasure
• Drinking before or during situations that are physically dangerous—while driving a car, operating machinery, swimming, or having unsafe sex
• Continuing to drink even though drinking is making you feel depressed or anxious, is linked to another health problem, or results in having memory blackouts
• Developing a tolerance for drinking—needing much more than you once did to get the desired effect from alcohol, or not experiencing the same effect when drinking the same amount of alcohol
• Withdrawal as characterized by having withdrawal symptoms (trouble sleeping, shakiness, restlessness, nausea, sweating, a racing heart, a seizure, or sensing things that are not there [hallucinations])

ASSESSMENT

An ongoing process used to determine the medical, psychological, and social needs of individuals with substance-related conditions and problems. It can take the form of biological assays (e.g., blood or urine samples), as well as clinical diagnostic interviewing and the completion of self-report measures to determine the presence of a substance use disorder or other psychiatric condition, and other symptoms and challenges with the ultimate goal of developing a fully informed and helpful treatment and recovery plan.