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Opioid Addiction: A Glossary of Common Terms 

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This abridged Addictionary™ was adapted and used with permission from the Research Recovery Institute of Massachusetts General Hospital, an affiliate of Harvard Medical School. The nonprofit research group is dedicated to the advancement of addiction treatment and recovery.

A

Abstinence

The absence of substance use. Although there are many different types of abstinence, the term typically suggests long-term avoidance of alcohol and other drugs.

(W.L. White, 2012)

Abuser

A person who exhibits impaired control when engaging in substance use despite suffering harm from it.

Stigma Alert The word “abuser” has been found to increase stigma, which can affect quality of care and act as a barrier for those seeking treatment. Instead, some advocates recommend the use of “person-first” language and medical terminology. Rather than describing someone as a “drug abuser,” he or she is “a person with, or suffering from, addiction or substance-use disorder.”

Read the research: The Real Stigma of Substance Use Disorders

(Kelly, Saitz, Wakeman, 2016; Kelly and Westerhoff, 2010; Kelly et al, 2010)

Acute Care

Immediate, short-term medically managed or monitored care that lasts up to 31 days. Most addiction treatment programs, including “rehab,” follow this model. Recovery from substance-use disorder, which can be a chronic illness, may require ongoing continuing care beyond acute treatment episodes.

Addict

A person who exhibits impaired control when engaging in substance use — or other reward-seeking behavior, such as gambling — despite suffering harm from it.

Stigma Alert Instead of describing an individual as an “addict,” some advocates recommend the use of “person-first” language: “a person with, or suffering from, addiction or substance-use disorder.”

(Kelly, Saitz, Wakeman, 2016; Kelly and Westerhoff, 2010; Kelly et al, 2010; Sholten et al, 2017)

Addiction

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

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

(Ries, 2009)

Addiction Counselor

Addiction treatment provider with no medical credentials. Counselors vary across jurisdictions in their titles and required levels of education and training. Addiction counselors may be “substance-abuse counselors” (SACs), “certified alcohol- and substance-abuse counselors” (CASACs) or “certified alcohol and drug counselors” (CADCs).

Addiction Medicine Physician

A board-certified physician who has undergone specialized training in addiction diagnosis, treatment and management but who does not typically provide addiction-specific psychotherapy beyond brief counseling sessions.

Agonist

A substance that activates a receptor to produce a biological response. Unlike an antagonist, which blocks an action, the agonist precipitates one. For example, heroin and oxycodone are agonists that activate opioid receptors in the brain, producing effects such as euphoria, sedation and, ultimately, dependence.

Al-Anon

A mutual help organization/peer support group based on the 12-step principles of Alcoholics Anonymous for people who have been affected by a loved one’s alcohol-use disorder. The focus is placed more on changing oneself and patterns of interacting with the alcohol-addicted person than on trying to directly change his or her behavior.

Alcoholics Anonymous (AA)

The world’s largest mutual help organization offers fellowship for individuals with alcohol-use disorder. Founded in 1935, AA is a 12-step program that revolves around its main text, known as the Big Book. Attendees share stories and build supportive networks to cope with the challenges of problem drinking.

Antagonist

A substance that interferes with or inhibits the physiological action of another, such as blocking the effects of illicit substances. For example, the opioid-overdose-reversal drug naloxone is an antagonist that stops activation of opioid receptors.

B

Barbiturate

A type of medication and a class of compounds that depress the central nervous system, causing sedation and sleep. These medications have been replaced largely by benzodiazepines, which are less toxic with lower potential for overdose. Barbiturates are still sometimes used medically, however, as anticonvulsants (e.g., phenobarbital).

Behavioral Addiction

A form of addiction that involves a compulsion to engage in a rewarding, non-drug-related behavior — such as sex, gambling, food, shopping, internet use — despite its potentially harmful effect.

Behavioral Health

The health care field concerned with substance-use and other mental health disorders.

Behavioral Medicine

An interdisciplinary field that integrates knowledge across disciplines to study the behavioral and social aspects of medical conditions and illness.

Benzodiazepines

A class of psychoactive drugs that act as minor tranquilizers commonly used in the treatment of anxiety, convulsions and alcohol withdrawal.

Biological Model of Addiction

A conceptual understanding of addiction that focuses on the genetic or other biological pre-determinants or risks for developing a substance-use disorder.

Buprenorphine

A semisynthetic opioid used to treat opioid-use disorder — alone or in combination with naloxone — in the form of a dissolvable tablet placed under the tongue or film placed inside the cheek. Buprenorphine may also be administered by injection or via transdermal skin patch to control moderate to severe pain. 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. Includes employment, housing and childcare.

Clean

The state of being abstinent. The term may also be used to describe a urine toxicology test that is free of misused drugs.

Stigma Alert To avoid the pejorative connotation of “dirty,” some advocates recommend proper medical terminology to describe an individual in remission or recovery. Test results should be simply “negative” or “positive.”

(Kelly, Saitz, Wakeman, 2015)

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; and hypersensitivity to sight, sound and touch. Also known as blow, coke, crack, rock, snow.

Long-term health consequences include loss of sense of smell, extreme bowel decay, and increased risk of HIV and hepatitis. Cocaine can be 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. Approved by the U.S. Food & Drug Administration in 1950, it is frequently combined with acetaminophen or aspirin.

Side effects include headache, skin rash, constipation, changes in heart rate, hallucinations, loss of coordination, decreased sexual desire or irregular menstruation.

Long-term health consequences include dependency, addiction, insomnia, nightmares, liver damage and seizures. Codeine can be ingested orally, injected or snorted.

Codependency

Emotional or psychological over-reliance on a partner, especially in relation to an illness or disease such as substance-use disorder.

Stigma Alert Some view this term as stigmatizing, as it risks pathologizing concern and care for a loved one.

Coercion

The practice of compelling a victim to act against his or her will by using psychological pressure, physical force or threats, or by withholding drugs.

Cold Turkey

Slang term for the abrupt and complete cessation of addictive substance use. It stems from the goosebumps often observable on the skin of individuals in physiological withdrawal.

Comorbidity

The presence of two disorders or illnesses in the same person, also referred to as “co-occurring conditions” or “dual diagnosis.”

Compulsive Behaviors

Performing an act persistently and repetitively even in the absence of reward or pleasure. This may be to avoid or reduce the experience of negative emotion or physical symptoms such as anxiety or withdrawal from a substance.

Continuing Care

Ongoing care of patients suffering from chronic incapacitating illness or disease, including substance-abuse disorder, as opposed to acute care or treatment delivered in isolated episodes.

Co-Occurring Disorders

This term is used to describe an individual with both mental illness and substance-use disorder. Also known as “comorbidity” or “dual diagnosis.”

Craving

A powerful and strong psychological desire to consume a substance or engage in an activity — a symptom of the abnormal neuroadaptations that result from addiction. The brain becomes accustomed to the presence of a substance, which, when absent, produces a manifest psychological desire to get more.

Cross-Dependence

The ability of one drug to prevent withdrawal symptoms from physical dependence on another.

Cross-Tolerance

An individual’s tolerance for one drug results in a lessened response to another, typically within the same class of substances, such as alcohol and benzodiazepines. It can happen with different classes of substances, as well.

D

Deaths of Despair

Deaths by drug, alcohol and/or suicide.

Denial

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 and its removal results in a mental or physical disturbance or withdrawal.

Depressant

A psychoactive substance that lowers levels of physiological or nervous system activity in the body, minimizing alertness, attention and energy through decreased heart rate, blood pressure and respiration rates. Informally referred to as “downers,” they include alcohol, benzodiazepines and barbiturates.

Designer Drugs

A synthetic analog of an illegal drug, devised to circumvent drug laws through changes to chemical compounds.

Deterrence

The use of punishment as a threat to deter people from committing offenses. Often contrasted with retributivism, which holds that punishment is a necessary consequence of a crime and should be calculated based on the gravity of the wrong done — a foundational concept of the U.S. “War on Drugs.”

Detox

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

Dirty

A reference to a urine test that indicates substance use or, more broadly, a person using addictive drugs.

Stigma Alert This term is viewed as stigmatizing because of its pejorative connotation.

Disease Model of Addiction

Classifies addiction as a complex disease with biological, neurobiological, genetic and environmental influences.

Dope Sick

A slang term used to reference withdrawal symptoms from opioids, such as heroin. Some prefer the medical term “suffering from withdrawal.”

Drug

The term “drug” can refer either to a medication or a nonmedically used psychoactive substance.

Stigma Alert To reduce stigma and confusion, some recommend the terms “medication” and “nonmedically used psychoactive substances.”

Drug Abuse

A term interchangeable with “substance abuse” that describes 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, “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).

Stigma Alert Some advocates recommend using the terms “substance use” or “nonmedical use” instead.

(Kelly, Saitz, Wakeman, 2016; Kelly and Westerhoff, 2010; Kelly et al, 2010)

Drug 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 are:

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

Drug Classifications

In the United States, drugs are classified into five groups known as “schedules.” These five schedules determine the medical and legal status of a substance.

Learn more about: drug classifications

Drug Courts

Drug courts are problem-solving tribunals in which the judiciary, prosecution, defense bar, probation, law enforcement, mental health, social service and treatment communities work together to help nonviolent 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.

Drug Policy

Government guidelines on the control and regulation of alcohol and other drugs considered dangerous, particularly those with addictive qualities. This includes hazard ratings of different drugs (“scheduling”) and criminal penalties for illegal sale, distribution and use.

Dual Diagnosis

This term is used to describe an individual with both mental illness and substance-use disorder. Also known as “comorbidity” or “co-occurring disorders.”

Learn more about: co-occurring disorders

Dysynergy

The tendency of one addiction to predispose an individual to another type or form of addiction.

E

Early Recovery

The first year of remission from a substance-use disorder.

Enabling

Actions that remove or diminish negative consequences of substance use, increasing the likelihood that it will continue.

Evidence-Based Practice

Patient care that integrates the best available clinical evidence from systematic research.

F

Fentanyl

A potent opioid that is 50 to 100 times stronger than morphine. Fentanyl activates the reward centers of the brain to produce sensations of euphoria and provide pain relief. Synthetically produced in laboratories, prescription fentanyl can be injected, worn as a transdermal patch or ingested through lozenges. In increasingly common nonprescription illicit forms, it can be ingested, snorted or injected. Also known as Apache, China Girl or Jackpot.

Long-term health consequences 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, irregular menstrual cycles, increased risk of HIV and hepatitis, coma, or death.

Full Sustained Remission

One year without substance-use disorder symptoms — except craving.

H

Harm Reduction

Policies, programs and practices that aim to reduce the negative outcomes associated with the use of drugs. The defining features include a focus on the prevention of harm, rather than on the prevention of substance use itself. For example, a clean needle exchange program can reduce transmission rates of hepatitis C, HIV or other infectious diseases.

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 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, irregular menstrual cycles, and increased risk of HIV and hepatitis. Heroin can be smoked, snorted or injected.

Higher Power

A supreme deity or being, a malleable conception of God or a “power greater than ourselves,” popularized by the recovery mutual help organization Alcoholics Anonymous.

Hydrocodone

An analgesic opioid semisynthetically produced for the treatment of moderate to severe pain that activates the reward centers of the brain to provide relief. Side effects include nausea, vomiting, upset stomach, sleepiness, drowsiness, dizziness, blurred vision, itching, headache, dry mouth, sweating, changes in heart rate and breathing problems. Hydrocodone is more likely than oxycodone to cause constipation and stomach pain. Also known as Vicodin or dihydrocodeinone, it can be injected, snorted or ingested orally — often in syrup form.

I

Ibogaine

A naturally occurring psychoactive substance found in the Apocynaceae family of flowering plants. Known to have psychedelic or dissociative properties, ibogaine is not approved for treatment of substance-use disorder in the United States due to lack of proper testing related to toxicology, safety and effectiveness.

Inpatient Treatment

Admission to a hospital or facility for treatment that requires at least one overnight stay and medical management.

Integrated Treatment Programs

Treatment programs that work to treat substance-use disorder alongside other co-occurring mental, physical, emotional or social considerations, in recognition that the presence of each can be a risk factor for relapse. The term is most often used to indicate the combination of addiction and mental health treatment, or on-site pregnancy, parenting or child-related services.

Intensive Outpatient Treatment (IOP)

A time-limited, intensive, nonresidential treatment that often involves participation in clinical services several days per week.

Intervention

  1. A procedure of varying duration typically conducted by a clinician and implemented to stimulate, facilitate and induce changes in signs, symptoms or behavior.
  2. A meeting with family or other significant others to directly address the problems being caused by an individual’s substance use; expression of care, concern and explicit demands for behavioral change or the receipt of addiction treatment are common. Typically conducted when other attempts to influence change have failed.

L

Lapse

A nontechnical term, also referred to as a “slip.” It implies a short-term resumption of substance use, usually for a night or a day, that is followed by a return to the original goal of moderate use or abstinence.

Stigma Alert Advocates prefer to say an individual “experienced a recurrence” of substance use or substance-use disorder symptoms.

(White, 2010)

Long-Term Recovery

Five 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

Maintenance Dose

The amount of a medication administered to preserve its desired level in the bloodstream.

Mandated Treatment

Treatment required through a drug court or as a condition of pretrial release, probation or parole.

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.

Medication-Assisted Treatment (MAT)

Combines behavioral therapy and regularly administered medications — usually methadone, naltrexone or buprenorphine — to treat substance-use disorders.

Stigma Alert 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 for “medications for addiction treatment.”

Methadone

A synthetic opioid used to reduce withdrawal symptoms and as a mid- to long-term medicine to stabilize and facilitate recovery among those suffering from opioid-use disorders.

Methamphetamines

A synthetically produced stimulant that activates the reward centers of the brain to produce sensations of euphoria. It results in increased wakefulness and physical activity, decreased appetite, faster breathing, 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, and increased risk of HIV and hepatitis. Methamphetamines can be smoked, swallowed as a pill, snorted or injected.

Morphine

An analgesic opioid derived from the opium poppy that activates opioid receptors in the brain to provide pain relief. Side effects may include nausea, vomiting, constipation, light-headedness, dizziness, drowsiness, increased sweating or dry mouth. Also known as Kadian or Avinza.

Long-term health consequences include dependency and addiction. Morphine can be ingested orally or injected.

Mutual Help Organizations

Also known as “peer support groups,” mutual help organizations are structured nonclinical relationships in which individuals participate in activities that engage, educate and support patients recovering from substance-use disorder.

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

For family members and friends, peer support groups include:

  • Al-Anon
  • Nar-Anon

N

Naloxone

Also known by the brand name Narcan, this opioid “antagonist” reverses overdoses by blocking receptors in the brain. It’s administered nasally, intravenously or by injection.

Naltrexone

Sold under the brand names ReVia and Vivitrol, naltrexone is a medication primarily used to manage alcohol or opioid dependence.

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.

Narcotic

The term “narcotic” has come to suggest an illegal or illicit substance. But it once simply connoted psychoactive compounds with sleep-inducing properties — typically opioids such as heroin. In moderate doses, narcotics dull the senses, relieve pain and induce sleep. In large doses, they can cause stupor, coma and death.

Narcotics Anonymous (NA)

Born out of the principles, practices and structure of Alcoholics Anonymous (AA), Narcotics Anonymous is an international fellowship for individuals with problematic drug use. The 12-step program, open to all ages, offers meetings in more than 100 countries.

Natural Recovery

A recovery approach in which remission from substance-use disorder is achieved without the support or services of professional or nonprofessional intervention. Also known as self-managed recovery.

Neonatal Abstinence Syndrome

A postnatal 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 birth weight, breathing problems, feeding problems, seizures or birth defects.

Neurotransmitter

Brain chemicals (e.g., dopamine, serotonin, norepinephrine, epinephrine, GABA) that communicate information throughout the body by transmitting signals from one neuron to the next across synapses. Imbalances in key neurotransmitters and neurotransmission can create cravings and mood instability.

NIMBY ("Not In My Backyard")

A characterization of opposition by residents to a proposed development within their local area, such as for addiction treatment centers or harm-reduction programs. It often correlates with strong fears of increased crime, poverty, drug use or community degradation. The term tends to carry the connotation that residents would tolerate or even support the new development if it were not proposed in such close proximity to themselves.

O

Opiate

A drug derived directly from the natural opium poppy plant. Used therapeutically to treat pain, it can also produce a euphoric “high.” All opiates are opioids, but not all opioids are opiates.

Opioid

A family of drugs naturally derived from the opium poppy plant or synthetically or semisynthetically produced in a lab to act like an opiate, such as methadone and oxycodone. Administered therapeutically to treat pain, opioids can also produce a euphoric “high.” Chronic repeated use can lead to tolerance, physical dependence and addiction. All opiates are opioids, but not all opioids are opiates.

Outpatient Treatment

A professionally delivered substance-use disorder treatment that requires daily to weekly attendance at a clinic or other facility. During nontreatment hours, the patient can be home.

Oxycodone

An analgesic opioid semisynthetically produced for the treatment of moderate to severe pain that activates the reward centers of the brain to provide relief. Side effects include constipation, nausea, vomiting, upset stomach, sleepiness, drowsiness, dizziness, light-headedness, itching, headache, blurred vision, dry mouth, sweating, changes in heart rate and breathing problems. Oxycodone is more likely than hydrocodone to cause side effects of dizziness and drowsiness, as well as fatigue, headaches and feelings of euphoria. Also known as OxyContin or Percocet.

Long-term health consequences include dependency and addiction. Oxycodone can be injected, snorted or taken orally. The pills come in immediate and controlled-release formulations.

P

Partial Hospitalization

A time-limited, intensive clinical service that is often medically monitored but less involved than inpatient hospitalization. A patient may participate in clinical services all day long — for weeks — while residing at home.

Passive Referral

An attempt by a clinician or service worker to connect a patient with substance-use disorder to another service. Research has shown passive referral to be less effective than “assertive linkages,” which actively connect a patient through personal contact as way to improve engagement in continuing care and recovery support services.

Peer Support Groups

Also known as mutual help organizations, peer support groups are structured nonclinical relationships in which individuals participate in activities that engage, educate and support patients recovering from substance-use disorder.

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

For family members and friends, peer support groups include:

  • Al-Anon
  • Nar-Anon

Person-First Language

A method of structuring sentences to prioritize the person over the condition or disease from which they suffer. Instead of describing someone as an “addict,” for instance, advocates recommend “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.

Pharmacotherapy

Medical treatment by means of pharmaceuticals, as opposed to radiation or surgery.

Physical Dependence

Unlike addiction, physical dependence can be managed and resolved by slowly lowering the dose, or “tapering.” A person who is physically dependent on prescribed opioid medications, such as Vicodin or OxyContin, but is not addicted, will not experience a loss of control; strong cravings; compulsive drug use; a failure to meet work, social, or family obligations; or other negative symptoms that characterize addiction.

Stigma Alert The term may be stigmatizing when used to describe tolerance and withdrawal, as dependence is not just physical. To meet the World Health Organization International Classification of Diseases diagnostic criteria, dependence must include at least one psychological component.

Potency

The concentration of psychoactive content in a given substance.

Prescription Drug Abuse/Misuse

The use of a medication without a prescription or usage of a drug in a way other than as prescribed; or for the euphoric feeling elicited.

Stigma Alert Some argue the words “abuse” and “misuse” express negative judgement. To offset that, advocates recommend clear, unambiguous, non-stigmatizing terminology such as “nonmedical use of a psychoactive substance.”

(Kelly, Saitz, Wakeman, 2016; Kelly and Westerhoff, 2010; Kelly et al, 2010 etc.)

Prescription Medications

Medications available to consumers only with a specific written authorization from a health care provider.

Public Health Approach

A coordinated, comprehensive approach to drug policy that balances public health and safety.

R

Recovery

The process of improved physical, psychological and social well-being and health after having suffered from a substance-use disorder.

Recovery Capital

The social, physical, human and cultural resources necessary to begin and maintain recovery from a substance-use disorder.

(Best & Laudet, 2010; Cloud & Granfield, 2008)

Recovery Coach

Typically a nonclinical 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). Professional or volunteer, they have often experienced active addiction and are in recovery themselves. Recovery coaches do not offer primary treatment for addiction, do not diagnose and generally are not associated with any specific method or pathway to recovery.

Recovery Rates

The percentage of addicted persons undergoing treatment who achieve abstinence or remission within some stated time period. Sometimes referred to as “success rate.”

Recovery Residences

A substance-free living facility for individuals recovering from alcohol or other drug-use disorders. These venues often provide housing between detoxification experiences or residential treatment and mainstream society. Also known as sober houses, sober living houses, sober living homes and sober living environments.

Receptor

Various specific protein molecules located in the surface membranes of cells and organelles to which complementary molecules may become bound (e.g., hormones, neurotransmitters, antigens or antibodies).

Relapse

Relapse often indicates a recurrence of substance use. Specifically, 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 relapse 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 three-month period, as individuals are experiencing substantial physiological, psychological and social changes in early recovery. There is typically a greater sensitivity to stress and lowered sensitivity to reward that makes continued recovery challenging.

Stigma Alert Some people read judgment in the term and recommend morally neutral terms such as “resumed” or experienced a “recurrence” of symptoms.

(Hubbard et al., 1997; Hunt et al., 1971; White, 2010)

Remission

The complete absence of symptoms. An individual is also considered to be “in remission” if he or she once met criteria for a substance-use disorder but has not surpassed the threshold number of criteria for a year or longer.

A person with substance-use disorder is in “long-term recovery” after five years, at which time the likelihood of meeting criteria for substance-use disorder in the following year is no greater than that of the general population.

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. Although it is sometimes referred to as “inpatient treatment,” it is not always medically monitored. In other words, inpatient treatment is residential treatment, but residential treatment is not necessarily inpatient treatment.

Risk Factors

Attributes (e.g., genetics), characteristics (e.g., impulsivity) or exposures (e.g., to prescription opioids) that increase the likelihood of developing a disease or injury.

S

Semisynthetic Opioids

Opioids derived from a combination of the opium poppy and lab-made chemical compounds.

Sober

A state in which one is not intoxicated or affected by the use of alcohol or drugs.

Sober Coach

(See recovery coach)

Sobriety

The quality or state of being sober.

A volunteer currently practicing the 12-step program of recovery espoused by a mutual help organizations such as Alcoholics Anonymous or Narcotics Anonymous. These individuals help newer members by providing support, encouragement and 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.

(Kelly, Saitz, Wakeman, 2016; Kelly and Westerhoff, 2010; Kelly et al, 2010)

Stimulant

A psychoactive substance that increases or arouses physiologic or nervous system activity in the body. Users feel more alert, attentive and energetic, and there’s a corresponding elevation in pulse, blood pressure and respiration rates. Informally referred to as “uppers,” stimulants include cocaine and methamphetamine, aka “meth.”

Suboxone

Approved by the U.S. Food & Drug Administration in 2002 as a medication treatment for opioid dependence, Suboxone contains the active ingredients of buprenorphine hydrochloride and naloxone. The mixture of agonist and antagonist is intended to reduce craving while preventing misuse of the medication.

Substance Abuse

A term interchangeable with “drug abuse” that describes 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, “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).

Stigma Alert Some advocates recommend using the terms “substance use” or “nonmedical use” instead.

(Kelly, Saitz, Wakeman, 2016; Kelly and Westerhoff, 2010; Kelly et al, 2010)

Substance-Use Disorder

The clinical term for substance abuse sustained over a 12-month period, evidenced by a coherent set of signs and symptoms that cause significant distress and/or impairment.

Sustained Remission

Someone who once met diagnostic criteria for an alcohol- or other drug-use disorder, and then no longer meets the threshold for the disorder for at least one year.

Synthetic

Made from man-made chemicals, as opposed to derivatives of a natural source such as the opium poppy or marijuana plant. Examples of synthetic drugs include carfentanil/carfentanyl, sufentanil, fentanyl, spice, bath salts and herbal incense.

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 patient’s body adapts to the change.

Titration

The progressive or gradual increase in drug dosage to reach an optimal therapeutic outcome.

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 over time to obtain the original effect obtained at a lower dose.

Treatment

The management and care of a patient to combat a disease or disorder. It can take the form of medicines, procedures, or counseling and psychotherapy.

Trigger

A specific stimulus that sets off a memory or flashback, transporting the individual back to a feeling, experience or event that may increase susceptibility to substance-use disorder.

W

Withdrawal

Physical, 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.


Need Help?

If you or someone you love is suffering from opioid use disorder and need treatment and support resources, here's how to get connected:


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"Hooked: Stories and Solutions From Vermont's Opioid Epidemic" is made possible in part by funding from the Vermont Community Foundation, the University of Vermont Health Network and Pomerleau Real Estate. The series is reported and edited by Seven Days news staff; underwriters have no influence on the content.


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About The Author

Kate O'Neill

Kate O'Neill

Bio:
In “Hooked: Stories and Solutions from Vermont’s Opioid Crisis,” writer Kate O’Neill explores the state’s opioid epidemic and efforts to address it using traditional journalism, narrative storytelling and her own experiences. Her sister, Madelyn Linsenmeir, died in October 2018 after years battling opioid addiction... more

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  • Evolution of an Epidemic: A Timeline of the Vermont Opioid Crisis
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    Hundreds of Vermonters have died from opioid overdoses in the past quarter century. Eight thousand are currently in treatment for opioid-use disorder. Countless more live every day with the despair of this disease. How did we get here? No single event sparked Vermont’s current emergency, but its momentum was building for more than a decade before then-governor Peter Shumlin named it a “full-blown heroin crisis" in his State of the State address. From the invention of OxyContin to a single night last month when the University of Vermont Medical Center treated seven overdosing patients, our timeline tracks the epidemic in Vermont.
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    • Feb 20, 2019
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