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:

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).

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:

1. 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.
2. 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.
3. The substance is often taken in larger amounts or over a longer period than intended.
4. There is a persistent desire or unsuccessful efforts to cut down or control substance use.
5. A great deal of time is spent in activities necessary to obtain the substance, use the substance, or recover from its effects.
6. Important social, occupational, or recreational activities are given up or reduced because of substance use.
7. 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)