DEATHS OF DESPAIR
Deaths by drug, alcohol, and/or suicide.

DEDUCTIBLE
A dollar amount a patient must pay before their health insurer will contribute benefit payments.

DELIRIUM TREMENS
A severe form of alcohol withdrawal involving sudden & severe mental or nervous system changes resulting in varying degrees of severe mental confusion and hallucinations. Onset typically occurs 24 hours or longer following cessation of alcohol. It is often preceded by physiological tremulousness and sweating following acute cessation in severely alcohol addicted individuals.

DENIAL
Denial describes individuals who deny substance use problems. It is the tendency of addicted individuals to either disavow or distort variables associated with their drinking or drug use in spite of evidence to the contrary. It’s a common misconception that all addicted individuals with substance use disorder are “in denial.” In fact, individuals have various levels of awareness of their substance use problems and readiness to change behavior. Individuals may accurately recognize certain facts concerning their use, such as number of arrests or how often they drink, while at the same time, misperceive the impact that their use has on the individuals around them, their relationships, how they feel about themselves, or the implications of their substance use history.

DEPENDENCE
The state in which metabolic status and functioning is maintained through the sustained presence of a drug; manifested as a mental or physical disturbance or withdrawal upon removal of the substance.

DEPRESSANT
Psychoactive substance that decreases levels of physiological or nervous system activity in the body decreasing alertness, attention, and energy through decreased heart rate, blood pressure, and respiration rates. Informally referred to as “downers” (e.g., alcohol; benzodiazepines, barbiturate).

DETOX
Short for “detoxification,” it is the medical process focused on treating the physical effects of withdrawal from substance use and comfortably achieving metabolic stabilization; a prelude to longer-term treatment and recovery.

DISEASE MODEL OF ADDICTION
Classifies addiction as a disease. There are several “disease models,” but addiction is widely considered a complex disease with biological, neurobiological, genetic, and environmental influences among clinical scientists.

DOPE SICK
(stigma alert) A slang term used to reference withdrawal symptoms from opioids, such as heroin. It is preferable to use more accurate terminology such as suffering from withdrawal.

DRUG
(stigma alert) Drug can mean either a “medication” or a “non-medically used psychoactive substance.” The term drug has a stigma alert due to the ambiguity of the term. This ambiguity may create a barrier to accessing prescription (psychoactive) medications in cases where their use IS medically appropriate. Many advocate instead to use “medication” or “non-medically used psychoactive substances” to decrease stigma and communicate with greater specificity.

DRUG ABUSE
(stigma alert) A term sometimes used to describe an array of problems resulting from intensive use of psychoactive substances. It has also been used as a diagnostic label. According to the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), “substance abuse” is defined as a maladaptive pattern of substance use leading to clinically significant impairment or distress as manifested by one (or more) of the following, occurring within a 12-month period:

1. Recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home (such as repeated absences or poor work performance related to substance use; substance-related absences, suspensions, or expulsions from school; or neglect of children or household).
2. Recurrent substance use in situations in which it is physically hazardous (such as driving an automobile or operating a machine when impaired by substance use)
3. Recurrent substance-related legal problems (such as arrests for substance related disorderly conduct)
4. Continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance (for example, arguments with spouse about consequences of intoxication and physical fights).

DRUG CLASSES
Substances can belong to one or more drug categories or classes. A drug class is a group of substances that while not identical, share certain similarities such as chemical structure, elicited effects, or intended usage.
Three common classes of commonly medications and non-medically used psychoactive substance include:

1. opioids (e.g. oxycodone, hydrocodone, fentanyl, morphine, heroin)
2. depressants (diazepam, clonazepam, alcohol)
3. stimulants (dextroamphetamine, methylphenidate, cocaine)

DRUG COURTS
Drug courts are problem-solving courts that operate under a specialized model in which the judiciary, prosecution, defense bar, probation, law enforcement, mental health, social service, and treatment communities work together to help non-violent offenders find restoration in recovery and become productive citizens. With an emphasis on rehabilitation and treatment, drug courts serve only a fraction of the estimated 1.2 million individuals suffering from Substance Use Disorder in the United States criminal justice system.