Glossary of Terms
A
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 5th 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.
B
BARBITURATE
A type of medication and class of compounds that are central nervous system depressants causing sedation and sleep. These medications have been replaced largely by benzodiazepines because they are less toxic and benzodiazepines have lower potential for overdose risk. Barbiturates are still sometimes used medically, however, as anticonvulsants (e.g., phenobarbital).
BEHAVIORAL HEALTH
The field of health care concerned with substance use and other mental health disorders.
BENZODIAZEPINES
A class of psychoactive drugs that act as minor tranquilizers producing sedation and muscle relaxation, and sleep; commonly used in the treatment of anxiety, convulsions, and alcohol withdrawal.
BINGE DRINKING
Excessive alcohol consumption within a short time period.
According to NIAAA, binge drinking is any alcohol consumption that results in a blood alcohol concentration (BAC) level of 0.08 or higher (usually achieved after 4 drinks for women and 5 drinks for men within a 2-hour period).
According to SAMHSA binge drinking is 4 or more alcoholic drinks for women and 5 or more alcoholic drinks for men within a short amount of time.
BUPRENORPHINE
A semisynthetic opioid to control moderate to severe pain and to treat opioid use disorder. Buprenorphine is administered by injection to control pain, is used in the form of a transdermal skin patch to control pain or treat opioid use disorder and is used alone or in combination with naloxone in the form of a dissolvable tablet placed under the tongue or film placed inside the cheek to treat opioid use disorder. Brand names include: Bunavail, Buprenex, Butrans, Subutex, Suboxone, and Zubsolv.
C
CASE MANAGEMENT
The collaborative process of assessment, planning, care coordination, evaluation, and advocacy for options and services to facilitate disease management (e.g. connecting individuals to mutual help organizations, peer & family support services and counseling, employment, housing, basic healthcare, childcare, etc.).
CLEAN
(stigma alert) A reference to a state of a person being abstinent from drugs of misuse. It may also be used in describing urine test results that are not positive for substance use. The term has been viewed as potentially stigmatizing because of its pejorative connotation, with the opposite being “dirty.” Instead, many in the field advocate for use of proper medical terminology such as describing someone as an individual in remission or recovery and describing urine toxicology test results as either negative or positive.
COCAINE
A stimulant drug derived from the leaves of the coca plant, that activates the reward centers of the brain to produce sensations of extreme happiness and energy, increased mental alertness, hypersensitivity to sight, sound, and touch, irritability or anxiety, constricted blood vessels, dilated pupils, nausea, tremors and muscle twitches, rapid and/or irregular heartbeat, and increased blood pressure and body temperature. Also known as blow, coke, crack, rock, snow.
Long-term health consequences include: loss of sense of smell, extreme bowel decay, increased risk of HIV and Hepatitis.
Cocaine can be: inhaled (e.g. smoked, or vapors inhaled), snorted, or injected.
CODEINE
An analgesic opioid synthetically produced for the treatment of mild to moderate pain that works by activating the reward centers of the brain to provide pain relief. Side effects include headache, skin rash, constipation, changes in heart rate, hallucinations, loss of coordination, decreased sexual desire or irregular menstruation, and trouble breathing. Approved by the Food and Drug Administration in 1950, Codeine is frequently combined with Tylenol or aspirin as a prescription pain medication.
- Long-term health consequences include: dependency, addiction, insomnia, nightmares, liver damage, and seizures.
- Codeine can be: ingested orally, injected, snorted
COGNITIVE BEHAVIORAL THERAPY (CBT)
A prevalent type of talk therapy (psychotherapy) that involves working with a professional to increase awareness of inaccurate or negative thinking and behavior and to learn to implement new coping strategies.
COLD TURKEY
Slang term for the abrupt and complete cessation in intake of an addictive substance. It stems from the appearance of goosebumps on the skin often observable in addicted individuals when physiologically withdrawing from a substance.
COMMUNITY REINFORCEMENT APPROACH (CRA/CRAFT)
The Community Reinforcement Approach (CRA) is a psychosocial cognitive-behavioral intervention for individuals with alcohol and other drug use disorders that has been adapted for several populations, including adolescents (the Adolescent-Community Reinforcement Approach; A-CRA) and family members of individuals resistant or reluctant to enter treatment (Community Reinforcement and Family Training; CRAFT).
CONTINUING CARE
Ongoing care of patients suffering from chronic incapacitating illness or disease. Understanding substance use disorder to be a chronic illness, it requires continuing care and ongoing recovery management rather than acute care or treatment delivered in isolated episodes.
CO-PAYMENT
A dollar amount that an insured patient is expected to pay at the time of service.
COPING STRATEGIES
The specific efforts, both behavioral & psychological, utilized to master, tolerate, reduce, or minimize the effects of stressful events.
Two general coping strategies have been distinguished as:
- problem solving strategies (active efforts to alleviate stressful circumstances)
- emotion focused strategies to regulate the emotional consequences of stressful or potentially stressful events.
The specific efforts, both behavioral & psychological, utilized to master, tolerate, reduce, or minimize the effects of stressful events.
CRAVING
A powerful & strong psychological desire to consume a substance or engage in an activity; a symptom of the abnormal brain adaptions (neuroadaptations) that result from addiction. The brain becomes accustomed to the presence of a substance, which when absent, produces a manifest psychological desire to obtain and consume it.
D
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:
- 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).
- 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)
- Recurrent substance-related legal problems (such as arrests for substance related disorderly conduct)
- 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:
- opioids (e.g. oxycodone, hydrocodone, fentanyl, morphine, heroin)
- depressants (diazepam, clonazepam, alcohol)
- 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.
E
EARLY RECOVERY
The first year of remission from a substance use disorder.
ECSTASY
A synthetic substance with stimulant and hallucinogenic effects, that produces feelings of increased energy, euphoria, and distorted sensory and time perception. Side effects include nausea, muscle cramping, involuntary teeth clenching, blurred vision, chills, and sweating. Also known as Molly, E, M&M, MDMA, XTC, Adam, and essence.
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- Long-term health consequences include: damage to serotonin neurons
- Ecstasy can be: ingested orally, snorted
EVIDENCE-BASED PRACTICE (EBP)
Patient care informed through the integration of clinical expertise and best available clinical evidence from systematic research.
F
FENTANYLA potent opioid synthetically produced in laboratories, that activates the reward centers of the brain to produce sensations of euphoria and provide pain relief. Side effects have included alterations in consciousness, sensations of heaviness, decreases in mental function, constipation, anxiety, changes in mood and appetite, nausea, dry mouth, intense itching, constricted pupils, and increased body temperature. Fentanyl is 50 to 100 times more potent than morphine, and is available in legal prescription form, and increasingly, in illegal illicit forms. Also known as Apache, China Girl, or Jackpot.
Long-term health consequences (most often through injection use) include: insomnia, infection of the heart lining and valves, collapsed veins, loss of sense of smell, abscesses, constipation, liver or kidney disease, pneumonia, sexual dysfunction (men), irregular menstrual cycles (women), increased risk of HIV and Hepatitis, coma or death.
Fentanyl can be:
- In prescription form: injected, worn as a transdermal patch, or ingested through lozenges
- In non-prescription illicit form: ingested (eaten), snorted, injected
An irreversible syndrome inherited by children exposed to alcohol consumption by the mother during pregnancy. This syndrome is characterized by physical and mental birth defects. This is currently more commonly referred to as fetal alcohol spectrum disorder. FULL SUSTAINED REMISSION
1 year without substance use disorder symptoms (except craving).
G
GATEWAY HYPOTHESIS
The gateway hypothesis postulates that use of a certain drug increases the risk for the subsequent use of more potent and addictive or harmful drugs. For instance, marijuana is sometimes referred to as a “gateway drug” because its use has been shown to increase the risk for the use of other drugs. This does not mean that the use of marijuana will inevitably lead to the use of other drugs; only that it is associated with an increased risk.
The exact mechanism by which this risk is conferred is not clear; it could be direct (i.e., through changes in the brain) or indirect through exposure to marijuana-using friends who are also using other drugs and who may introduce the person to these other drugs, or both.
GUILT
A cognitive-affective state that emerges in humans when one perceives a personal wrong-doing; it can be adaptive and helpful in increasing the likelihood that behavior remains consistent with one’s values.
H
HALLUCINOGEN
A substance that induces hallucinations (i.e. visions, sounds, smells, tastes, or sensations) that do not actually exist. Common examples include LSD (“acid”) and psilocybin (“magic mushrooms”). Cannabis/marijuana in high doses also can act as a hallucinogen.
HARM REDUCTION
Policies, programs and practices that aim to reduce the harms associated with the use of alcohol or other drugs.
The defining features include a focus on the prevention of harm, rather than on the prevention of substance use itself, with attention and focus on the individual’s active substance use (e.g., a clean needle exchange program can reduce rates of transmission of hepatitis C, HIV, or other infectious disease for individuals suffering from heroin use disorder).
HEROIN
A drug made from the opium poppy plant, that activates the reward centers of the brain to produce sensations of euphoria. Heroin can also produce alterations in consciousness, sensations of heaviness, decreases in mental function, nausea, dry mouth, intense itching, increased body temperature, coma or death. Also known as smack, hell dust, H.
Long-term health consequences (most often related to injection use) include: insomnia, infection of the heart lining and valves, collapsed veins, loss of sense of smell, abscesses, constipation, liver or kidney disease, pneumonia, sexual dysfunction (men), irregular menstrual cycles (women), increased risk of HIV and Hepatitis.
Heroin can be: inhaled (e.g. smoked), snorted, or injected.
HYDROCODONE
An analgesic opioid semi-synthetically produced for the treatment of moderate to severe pain, that activates the reward centers of the brain to provide pain relief. Side effects include constipation, nausea, vomiting, upset stomach, sleepiness, drowsiness, dizziness, blurred vision, itching, headache, dry mouth, sweating, changes in heart rate, and trouble breathing. Hydrocodone is more likely to cause constipation and stomach pain than Oxycodone. Also known as Vicodin or dihydrocodeinone.
- Long-term health consequences include: dependency, addiction
- Hydrocodone can be: ingested orally (often in syrup form), injected, snorted
I
INHALANT
Substances that produce chemical vapors that are inhaled to induce a psychoactive or mind-altering effect. There are four general categories of inhalants – volatile solvents, aerosols, gases, and nitrites.
IN-PATIENT TREATMENT
Admission to a hospital or facility for treatment that requires at least one overnight stay and typically requires medical management. (see residential treatment)
INTEGRATED HEALTH CARE
An approach characterized by a high degree of collaboration and communication among health professionals, with sharing of information among team members related to patient care and the establishment of a comprehensive treatment plan to address the physical, psychological and social needs of the patient.
The inter-professional health care team can include a diverse group of members (e.g., physicians, nurses, psychologists, social workers, and other health professionals), depending on patient needs.
INTEGRATED TREATMENT PROGRAMS
Treatment programs that work to treat substance use disorder alongside other co-occurring mental, physical, emotional or social considerations, recognizing how the presence of each can be a risk factor for relapse to either. The term is most often used to indicate the combination of addiction treatment services with mental health treatment services, or on-site pregnancy, parenting, or child-related services.
INTENSIVE OUTPATIENT TREATMENT
A time limited, intensive, non-residential clinical treatment that often involves participation in several hours of clinical services several days per week. It is a step below partial hospitalization in intensity.
INTERVENTION
- A procedure of varying duration typically conducted by a clinician and implemented to stimulate, facilitate, and induce changes in signs, symptoms, or behavior.
- A meeting of an individual with an identifiable substance-related problem with family or other significant others held to directly address the problems being caused by the individuals’ substance use and typically involves expression of care, concern, and explicit demands for behavioral change or the receipt of addiction treatment. Typically conducted when other attempts to influence change have failed. Also known as the Johnson Intervention.
L
LAPSE
(stigma alert) A non-technical term, also referred to as a “slip”. It implies a short-term resumption of substance use or heavy/hazardous use (e.g., for a night or a day) that is followed by a return to the original goal of moderate use or abstinence.
This term has a stigma alert due to the term’s potentially moral meanings rooted in morality and religion (e.g. lapse in grace), and implied “accidental” manifestation (e.g. lapse in judgement). Many advocate instead to use the terms “resumed,” or “experienced a recurrence” of substance use or substance use disorder symptoms.
LEVELS OF CARE
Various levels of treatment intensity ranging from weekly outpatient therapy to more intensive medically monitored or medically managed hospitalization. The American Society of Addiction Medicine (ASAM) have constructed a detailed assessment process based on specific criteria that can provide clinicians with a holistic approach to individualized assessment and placement to the most appropriate level of care along with outcome-driven treatment plans that focus on individualized needs.
LONG TERM RECOVERY
5 years of continued remission; the point at which the risk of meeting criteria for a substance use disorder in the following year is no greater than that of the general population.
M
MANDATED TREATMENT
Treatment required through a drug court or as a condition of pretrial release, probation, or parole.
MARIJUANA
The leaves, flowers, stems and seeds of the hemp plant Cannabis sativa, containing the active ingredient of delta-9 tetrahydrocannabinol (THC) that can produce altered senses and perceptions of time, changes in mood and appetite, pain relief, impaired body movement, impaired problem-solving and memory, and at high doses, hallucinations, delusions, and psychosis. Also known as weed, pot, hashish, hash, ganga, herb, grass, 420, Mary Jane.
Marijuana can be: inhaled (e.g. smoked, vaporized), ingested (e.g. edibles)
MEDICAL MODEL
An addiction theory that considers addiction a medical, rather than social issue.
MEDICATION ASSISTED DETOX
Detoxification in a medical setting, often with use of medications to support initial withdrawal and stabilization following cessation of alcohol or other drugs.
MEDICATION ASSISTED TREATMENT
(stigma alert) Medication-assisted treatment (MAT), including opioid treatment programs (OTPs), combines behavioral therapy and medications to treat substance use disorders (see agonist; antagonist).
This term has been issued a Stigma Alert, as the term may not fully appreciate research that has shown that with or without psychosocial support, medications are effective treatments for addiction – hence, the term “assisted” may undervalue the role of the medication. In addition, this term may create a double standard for substance use disorder treatment, as no other medications used to treat other health conditions are referred to as ‘assisted’ treatment. Many advocate instead to simple state “medications for addiction treatment.”
METHADONE
A synthetic opioid medication used to reduce withdrawal and post-acute withdrawal symptoms and is often used as a mid- to long-term opioid use disorder medication for helping stabilize and facilitate recovery among those suffering from opioid use disorders.
METHAMPHETAMINES
A stimulant drug synthetically produced, that activates the reward centers of the brain to produce sensations of euphoria, increased wakefulness and physical activity, decreased appetite, faster breathing, rapid and/or irregular heartbeat, and increased blood pressure and body temperature. Also known as meth, ice, crystal meth, speed, crank.
Long-term health consequences include: Extreme weight loss, severe dental problems (e.g. meth mouth, skin sores from intense itching, anxiety, confusion, sleeping problems, paranoia, hallucinations, increased risk of HIV and Hepatitis.
Methamphetamines can be: inhaled (e.g. smoked), swallowed as a pill, snorted, or injected.
MINDFULNESS-BASED RELAPSE PREVENTION
Training of techniques in mindfulness meditation, or the ability to be present in the here and now, in order to target depression, stress, negative emotions, and cravings in the prevention of relapse for individuals with addiction. It is often combined with cognitive-behavioral therapy.
MORPHINE
An analgesic opioid derived from the opium poppy, that activates the centers of the brain to provide pain relief. Side effects have included nausea, vomiting, constipation, lightheadedness, dizziness, drowsiness, increased sweating, or dry mouth. Also known as Kadian or Avinza.
- Long-term health consequences include:dependency, addiction
- Morphine can be:ingested orally, injected
MUTUAL HELP ORGANIZATIONS
Also known as self-help groups, peer support groups, and mutual aid, mutual help organizations are for the most part peer run volunteer organizations that focus on socially supportive communication and exchange of addiction and recovery experiences and skills.
Mutual help organizations include such organizations as:
- Alcoholics Anonymous (AA)
- Narcotics Anonymous (NA)
- Marijuana Anonymous (MA)
- Cocaine Anonymous (CA)
- Smart Recovery
- All Recovery Groups
- Celebrate Recovery
- LifeRing
- Women For Sobriety
- Other online forums.
For family members and friends mutual help organizations include:
- Al-Anon
- Nar-Anon
- Learn2Cope
- Other online forums.
N
NALOXONE
An opioid antagonist, similar to Naltrexone, that works by blocking opioid receptors in the brain, thereby blocking the effects of opioid agonists (e.g., heroin, morphine). Naloxone has poor bio-availability when taken sublingually. Naloxone has a high affinity to the mu opioid receptor, yet not as high of an affinity as buprenorphine at the mu receptor. Brand name: Narcan.
NAR-ANON
Nar-Anon is a mutual help organization or peer support group for people who have been affected by a loved one’s drug use disorder. Groups are based on 12-step principles and practices and have attendees share stories and build supportive networks to help cope with the difficulties of having a loved one with a drug use disorder.
NARCOTIC
Originally, narcotic referred to psychoactive compounds with sleep inducing properties (typically opioids such as heroin). In moderate doses, narcotics will dull the senses, relieve pain, and induce sleep. In large doses, narcotics will cause stupor, coma, and death.
Today however, narcotic is often used in a legal context, where narcotic is used generally to refer to illegal or illicit substances.
NARCOTICS ANONYMOUS
Born out of the principles, practices, and structure of Alcoholics Anonymous (AA), Narcotics Anonymous is an international fellowship for individuals with problematic drug use. NA is a nonprofessional, self-supporting, multiracial, apolitical organization that is open to all ages, offering meetings in over 100 countries. NA is a 12-step program that revolves around its main text, known as the Basic Text.
NEONATAL ABSTINENCE SYNDROME (NAS)
A post-natal withdrawal syndrome inherited by children exposed to substances, most often opioids, during pregnancy. Babies born with Neonatal Abstinence Syndrome are more likely to suffer from low birthweight, breathing problems, feeding problems, seizures, or birth defects.
NETWORK (IN-NETWORK, OUT-OF-NETWORK)
- In Network: The group of physicians, hospitals and other medical care professionals that a managed care plan has contracted with to deliver medical and/or behavioral health services to its members.
- Out-of-Network: Physicians, hospitals, facilities and other health care providers that are not contracted with the plan or insurer to provide health care services at discounted rates. Depending on an individual’s plan, expenses incurred by services provided by out-of-plan health care professionals may not be covered or may be only partially covered.
NICOTINE
A toxic colorless or yellowish oily liquid that is the chief active constituent of tobacco. It acts as a stimulant in small doses, but in larger amounts blocks the action of autonomic nerve and skeletal muscle cells acting as a depressant.
O
OPIATE
A drug derived directly from the natural opium poppy plant.
OPIOID
A family of drugs used therapeutically to treat pain, that also produce a sensation of euphoria (a “high”) and are naturally derived from the opium poppy plant (e.g., morphine and opium) or synthetically or semi-synthetically produced in a lab to act like an opiate (e.g., methadone and oxycodone). Chronic repeated use of opioids can lead to tolerance, physical dependence and addiction.
OPIOID REPLACEMENT THERAPY (ORT)
(stigma alert) An outdated term for use of medications to treat opioid use disorder symptoms and craving, also referred to as “opioid substitution therapy”, “opioid maintenance therapy”, or “mediation assisted therapy”.
When used, this term could imply that one is simply swapping one addiction for another, replacing an illegal opioid, such as heroin, with a longer acting but less euphoric opioid. Research has shown that with or without psychosocial support, opioid agonist and antagonist medications are effective treatments for opioid use disorder. In addition, this term may create a double standard for substance use disorder treatment, as no other medications used to treat other health conditions are referred to as “replacements.” Many advocate instead to use the term “medications for addiction treatment.”
OUTPATIENT TREATMENT
A professionally delivered substance use disorder treatment modality that requires daily to weekly attendance at a clinic or facility, allowing the patient to return home or to other living arrangements during non-treatment hours.
OVER-THE-COUNTER MEDICATIONS (OTC)
Medications directly obtainable in a pharmacy by a consumer without a prescription from a healthcare provider.
OXYCODONE
An analgesic opioid semi-synthetically produced for the treatment of moderate to severe pain, that activates the reward centers of the brain to provide pain relief. Side effects include constipation, nausea, vomiting, upset stomach, sleepiness, drowsiness, dizziness, lightheadedness, itching, headache, blurred vision, dry mouth, sweating, changes in heart rate, and trouble breathing. Oxycodone is more likely to cause side effects of dizziness and drowsiness, as well as fatigue, headaches, and feelings of euphoria than Hydrocodone. Also known as OxyCotin or Percocet.
- Long-term health consequences include: dependency, addiction
- Oxycodone can be: oral (immediate and controlled release formulations), injected, snorted
P
PARTIAL HOSPITALIZATION
A time-limited, intensive, clinical service that is often medically monitored but is a step in intensity below inpatient hospitalization. A patient may participate in clinical services all day long for days to weeks but resides at home. Definitions of levels of care may vary by state.
PEER SUPPORT GROUP
Also known as mutual help organizations, peer support groups are structured non-clinical relationships, in which individuals participate in activities that engage, educate, and support patients recovering from substance use disorder. Peer to peer groups include such organizations as: AA, NA, Smart Recovery, All Recovery groups, LIfeRing, Women for Sobriety, and online forums.
As part of a larger treatment plan, peer providers offer valuable guidance and connection to individuals in recovery through the process of sharing their own experiences in recovery from substance use disorder.
Peer support groups include such organizations as:
- Alcoholics Anonymous (AA)
- Narcotics Anonymous (NA)
- Marijuana Anonymous (MA)
- Cocaine Anonymous (CA)
- Smart Recovery
- All Recovery Groups
- Celebrate Recovery
- LifeRing
- Women For Sobriety
- Other online forums.
For family members and friends peer support groups include:
- Al-Anon
- Nar-Anon
- Learn2Cope
- Other online forums.
PERSON-FIRST LANGUAGE
A linguistic prescription structuring sentences to name the person first and the condition or disease from which they suffer, second. It is recommended to use “person first” language: instead of describing someone as an “addict”, for instance, to describe them as a person with, or suffering from, addiction or a substance use disorder. Person-first language articulates that the disease is a secondary attribute and not the primary characteristic of the individual’s identity.
POTENCY
The degree of concentration of the psychoactive ingredient of a substance.
PRE-AUTHORIZATION
Confirmation of coverage by the insurance company for a service or product before receiving the service or product from the medical provider. This is also known as prior authorization.
PRESCRIPTION DRUG MISUSE
(stigma alert) The use of a medication without a prescription or usage of a drug in a way other than as prescribed; or for the experience or euphoric feeling elicited. This term is used interchangeably with “non-medically used psychoactive substance” or “prescription drug abuse”. This term has a stigma alert as the word “misuse” is thought by some people as an expression of negative judgement. Instead, use non-stigmatizing terminology such as “non-medical use of a psychoactive substance.”
PRESCRIPTION MEDICATIONS
Medications available to consumers only with a specific written authorization from a healthcare provider.
PRIOR AUTHORIZATION
A medical insurance term that requires patients and clinicians to seek approval from insurance providers before implementing a treatment service.
PUBLIC HEALTH APPROACH
An approach to drug policy that is a coordinated, comprehensive effort that balances public health & safety in order to create safer, healthier communities, measuring success by the impact of both drug use & drug policies on the public’s health.
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RECOVERY
The process of improved physical, psychological, and social well-being and health after having suffered from a substance use disorder.
RECOVERY COACH
Typically a non-clinical peer support specialist or “peer mentor” operating within a community organization (e.g., a Recovery Community Center) or a clinical organization (e.g., treatment program or hospital) and can therefore be a paid or volunteer position. Recovery coaches are most often in recovery themselves and therefore offer the lived experience of active addiction and successful recovery. They focus on helping individuals to set & achieve goals important to recovery. They do not offer primary treatment for addiction, do not diagnose, & generally, are not associated with any specific method or pathway to recovery, supporting instead an array of recovery pathways.
RECOVERY COMMUNITY CENTER
A center or hub that organizes recovery networks regionally and nationally to facilitate supportive relationships between individuals in recovery as well as family and friends of people in recovery. Centers may provide advocacy training, peer support organization meetings, social activities, job linkage, and other community based services.
RECOVERY COMMUNITY ORGANIZATIONS (RCO’s)
An independent, non-profit organization led and governed by representatives of local communities of individuals in recovery from a substance use disorder.
RECOVERY RESIDENCES
An alcohol- and drug-free living facility for individuals recovering from alcohol or other drug use disorders that often serves as an interim living environment between detoxification experiences or residential treatment and mainstream society. Also known as Sober Houses, Sober Living Houses (SLHs), Sober Living Homes, or Sober Living Environments.
REFERRAL
A clinical linkage strategy designed to enhance engagement with another clinical service, provider, or recovery support service (see also: assertive linkage).
RELAPSE
(stigma alert) Relapse often indicates a recurrence of substance use. More technically, it would indicate the recurrence and reinstatement of a substance use disorder and would require an individual to be in remission prior to the occurrence of a relapse.
The highest risk for recurrence of substance use disorder symptoms occurs during the first 90 days following the initial intervention. The risk for recurrence of symptoms decreases after 90 days. This indicates that individuals attempting to recover from substance use disorder need the most intensive support during this first 3-month period, as individuals are experiencing substantial physiological, psychological, and social changes during this early recovery phase. There is typically a greater sensitivity to stress and lowered sensitivity to reward that makes continued recovery challenging.
This term has a stigma alert, as it can imply a moral failing for some people. Instead it may be preferable to use morally neutral terms such as “resumed,” or experienced a “recurrence” of symptoms.
RELAPSE PREVENTION (RP)
Relapse Prevention is a skills-based, cognitive-behavioral treatment approach that requires patients and their clinicians to identify situations that place the person at greater risk for relapse – both internal experiences (e.g., positive thoughts related to substance use or negative thoughts related to sobriety that arise without effort, called “automatic thoughts”) and external cues (e.g., exposure to people that the person associates with prior substance use).
RESIDENTIAL TREATMENT
A model of care for substance use disorder that houses affected individuals with others suffering from the same conditions to provide longer-term rehabilitative therapy in a therapeutic socially supportive milieu. Also known sometimes as in-patient treatment, although more technically, is medically managed or monitored whereas residential treatment does not have to be.
RISK FACTORS
Attributes (e.g., genetics), characteristics (e.g., impulsivity) or exposures (e.g., to prescription opioids) that increases the likelihood of developing a disease or injury.
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SCREENING, BRIEF INTERVENTION, AND REFERRAL TO TREATMENT (SBIRT)
An evidence-based method used to detect, reduce, and prevent problematic substance use and substance use disorder.
- SCREENING –An assessment – usually brief such as a paper and pencil self-report measures or a biological assay (e.g., urine/blood) – to help detect risky or harmful substance use. This is often conducted by healthcare professionals using standardized screening tools in a specific clinic or other setting.
- BRIEF INTERVENTION –A short conversation or counseling session in which healthcare providers typically offer feedback and advice in order to motivate individuals identified as at-risk for substance-related harm to become more aware of the risk and to reduce or eliminate substance use or to seek treatment.
- REFERRAL TO TREATMENT –The 3rd and final stage in the SBIRT model, when a healthcare provider formally refers a patient identified as having or is at-risk for substance use disorder to additional services such as brief therapy or longer-term treatment.
SEMI-SYNTHETIC OPIOIDS
Opioids derived from a combination of the opium poppy and synthetically man-made analogues.
SHAME
A painful, negative emotion, which can be caused or exacerbated by conduct that violates personal values. Can also stem from deeply held beliefs that one is somehow flawed and unworthy of love, support, and connection, leading to increased odds of isolation.
SOBER
A state in which one is not intoxicated or affected by the use of alcohol or drugs.
SOBRIETY
The quality or state of being sober.
SOCIAL DETOX
Detoxification in an organized residential setting to deliver non-medical support to achieve initial recovery from the effects of alcohol or another drug. Staff provide safe, twenty-four-hour monitoring, observation, and support in a supervised environment for patients.
Social detoxification is characterized by an emphasis on peer and social support for patients whose intoxication or withdrawal signs and symptoms require twenty-four-hour structure and support but do not require medically managed inpatient detoxification.
SPONSOR
A volunteer who is currently practicing the 12-step program of recovery espoused by Alcoholics Anonymous (AA) or other 12-step mutual-help organizations (e.g., Narcotics Anonymous, Marijuana Anonymous) and who helps newer AA members by providing support, encouragement, & guidance to promote sustained long-term recovery.
STIGMA
An attribute, behavior, or condition that is socially discrediting. Known to decrease treatment seeking behaviors in individuals with substance use disorders.
STIMULANT
A psychoactive substance that increases or arouses physiologic or nervous system activity in the body. A stimulant will typically increase alertness, attention, and energy through a corresponding increase in heart rate, blood pressure, and respiration rates. Informally referred to as “uppers” (e.g., cocaine, amphetamine/methamphetamine).
SUBSTANCE 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 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:
- 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).
- 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)
- Recurrent substance-related legal problems (such as arrests for substance related disorderly conduct)
- 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).
SUBSTANCE DEPENDENCE
A term used synonymously with “addiction” but sometimes also used to distinguish physiological dependence from the syndrome of addiction/substance use disorder. It was used in prior iterations of the DSM to signify the latter.
According to the Diagnostic and Statistical Manual of Mental Disorders, substance dependence is defined as a maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by three (or more) of the following, occurring any time in the same 12-month period:
- Tolerance, as defined by either of the following:
- A need for markedly increased amounts of the substance to achieve intoxication or the desired effect or
- Markedly diminished effect with continued use of the same amount of the substance.
- Withdrawal, as manifested by either of the following:
- The characteristic withdrawal syndrome for the substance or
- The same (or closely related) substance is taken to relieve or avoid withdrawal symptoms.
- The substance is often taken in larger amounts or over a longer period than intended.
- There is a persistent desire or unsuccessful efforts to cut down or control substance use.
- A great deal of time is spent in activities necessary to obtain the substance, use the substance, or recover from its effects.
- Important social, occupational, or recreational activities are given up or reduced because of substance use.
- The substance use is continued despite knowledge of having a persistent physical or psychological problem that is likely to have been caused or exacerbated by the substance (for example, current cocaine use despite recognition of cocaine-induced depression or continued drinking despite recognition that an ulcer was made worse by alcohol consumption).
SUBSTANCE MISUSE
(stigma alert) The use of a substance for unintended or intended purposes in improper amounts or doses. Term has a stigma alert, as some people believe it implies negative judgement and blame. Instead, many recommend using the terms “substance use” or “non-medical use.”
SUBSTANCE USE DISORDER
The clinical term describing a syndrome consisting of a coherent set of signs and symptoms that cause significant distress and or impairment during the same 12-month period.
SYNDROME
A group of signs and symptoms that appear together and characterize a disease or medical condition.
SYNTHETIC
Made synthetically or entirely from chemicals, and not made as a derivative of the original substance or plant (e.g. the opium poppy, marijuana plant, etc.) Examples of synthetic drugs include: carfentanil/carfentanyl, sufentanil, and fentanyl.
SYNTHETIC MARIJUANA
Synthetic compounds produced in laboratories to mimic the effects of the active ingredient in marijuana, delta-9 tetrahydrocannabinol (THC). While the intention of these compounds are to mimic the effects of marijuana, this is not always achieved. As one strain of synthetic marijuana is banned and made illegal, new compound combinations are created to avoid regulation. The result is the ongoing creation of compounds that are structurally more and more different from the natural THC found in marijuana, increasing the potential risks associated. Side effects have included vomiting, sweating, seizures, body spasms, rapid and/or irregular heartbeat, increased blood pressure, severe paranoia and hallucinations. Also known as K2, spice.
Long-term health consequences are unknown.
K2 can be: inhaled (e.g. smoked, vaporized), ingested (e.g. edibles)
T
TAPER
A practice in pharmacotherapy of lowering the dose of medication incrementally over time to help prevent or reduce any adverse experiences as the patients’ body makes adjustments and adapts to lower and lower doses.
TOLERANCE
A normal neurobiological adaptation process characterized by the brain’s attempt to accommodate abnormally high exposure to a drug. Tolerance results in a need to increase the dosage of a drug overtime to obtain the same original effect obtained at a lower dose. A state in which a substance produces a diminishing biological or behavioral response (e.g. an increasingly higher dosage is needed to produce the same euphoric effect experienced initially).
TREATMENT
The management and care of a patient to combat a disease or disorder. Can take the form of medicines, procedures, or counseling and psychotherapy. .
TREATMENT LIMITATIONS
- Quantitative Treatment Limitation (QTL) Limits based on frequency of treatment, number of visits, days of coverage or days in a waiting period. A limitation that is expressed numerically, such as an annual limit of 50 outpatient visits.
- Non-Quantitative Treatment Limitation (NQTL) Any non-financial treatment limitation imposed by a health plan that limits the scope or duration of treatment (i.e. pre-authorization, medical necessity, utilization review, exclusions, etc.).
TRIGGER
A specific stimulus that sets off a memory or flashback, transporting the individual back to a feeling, experience, or event which may increase susceptibility to psychological or physical symptom recurrence and reinstatement of substance use disorder.
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WITHDRAWALPhysical, cognitive, and affective symptoms that occur after chronic use of a drug is reduced abruptly or stopped among individuals who have developed tolerance to a drug.
Addiction Help Resources for Spokane Washington and Surrounding Areas
Our goal is to simplify the path to recovery from addiction by providing a comprehensive, easy-to-navigate website. We highlight addiction help resources in Spokane and surrounding areas, focusing on prevention, treatment, recovery, and support. Designed for all community members impacted by addiction, our platform serves as a centralized hub of information for individuals, loved ones, and healthcare professionals alike.