Addictionary Terms

Recovery Research Institute www.recoveryanswers.org/addiction-ary/

The following selection of terms are associated with the substance use disorder (including alcohol) field. More terms may be found on the Recovery Research Institute’s webpage listed above. Note that some terms are listed as “Stigma Alert” to identify terms that may be considered offensive and counterproductive to addiction treatment.

ABUSER – (Stigma Alert) A person who exhibits impaired control over engaging in substance use despite suffering severe harm caused by such activity. Try saying “person struggling with substance use disorder.”

ACUTE CARE – Immediate short-term medically managed or monitored care, lasting up to 31 days in length.

ADDICT – (Stigma Alert) See ABUSER

ADDICTION – A primary, chronic, neurobiologic disease with genetic, psychological, and environmental factors influencing its development and manifestation.

ADDICTION TOURISM – The practice of sending individuals with substance use disorder to treatment centers or rehabilitation facilities outside of their states of permanent residence.

AL-ANON – A mutual-help organization or peer support group for people who have been affected by a loved one’s alcohol use disorder.

ALCOHOLIC – (Stigma Alert) A person who exhibits impaired control over engaging in alcohol use despite suffering severe harms caused by such activity. Instead of using this term, say “person who suffers from substance or alcohol use disorder.”

ALCOHOLICS ANONYMOUS (AA) – International fellowship for individuals with problematic drinking.

BEHAVIORAL HEALTH – The field of health care concerned with substance use and other mental health disorders.

BIG BOOK – The nickname for the basic foundational text of the mutual-help organization AA.

CASE MANAGEMENT – The collaborative process of assessment, planning, care coordination, evaluation and advocacy for options and services to facilitate disease management.

CLEAN – (Stigma Alert) A reference to a state of a person being abstinent from drugs of misuse. (For an individual, use terms like “in remission” or “in recovery” and for urine toxicology use clinical terms like “negative” or “positive” results.)

CLOSED MEETINGS – 12 Step meetings that are only available to individuals who identify with having a substance use disorder or think that they may have a substance use disorder and want to stop substance use.

CO-DEPENDENCY – (Stigma Alert) Immoderate emotional or psychological reliance on a partner. Avoid using this term or any similar reference as it tends to pathologize family members’ concern and care for their loved one and may increase feelings of shame.

COERCION – The intimidation of a victim to compel the induvial to act against his or her will by the use of psychological pressure, physical force or threats.

COMORBIDITY – The occurrence of two disorders or illnesses in the same person, also referred to as co-occurring conditions or sometimes dual diagnosis.

CROSS-DEPENDENCE – The ability of one drug to prevent the withdrawal symptoms of one’s physical dependence on another.

CROSS-TOLERANCE – An individual’s tolerance for one drug results in their lessened response to another, typically in the same class of substance, but may be observed across different classes of substances as well.

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

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.

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.

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

DETOX – Short for “detoxification”; 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.

DIRTY – (Stigma Alert) A reference to a urine test that is positive for substance use. Consider using medical terminology such as “having a positive or negative test result” or “currently to exhibit symptoms of substance use disorder.”

DOPE SICK – (Stigma Alert) A slang term used to reference withdrawal symptoms from opiods. Use more appropriate medical terms such as “suffering from withdrawal.”

DRUG – Drug can mean either a “medication” or a “non-medically used psychoactive substance.” The term has a stigma due to the ambiguity of the term. Be more specific by saying “medication” or “non-medically used psychoactive substances.”

DRUG ABUSE – (Stigma Alert) A term sometimes used to describe an array of problems resulting from intensive use of psychoactive substances. Instead say substance use disorder.

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.

DRUG DREAM – Reoccurring dreams that occur during the recovery process from substance use disorder that concern depictions of substance use, often vivid in nature, and frequently involving a relapse scenario.

DRY DRUNK – (Stigma Alert) The presence of actions and attitudes that characterize the individual with the alcohol use disorder prior to recovery. This term identifies individuals who no longer utilize alcohol, but continue to behave dysfunctionally or regress in personal growth or within their recovery program. Do not use this term.

DUAL DIAGNOSIS – See comorbidity.

ENABLING – (Stigma Alert) Actions that typically involve removing or diminishing the naturally occurring negative consequences resulting from substance use, increasing the likelihood of disease progression. This term infers judgement and blame typically on the loved one. Avoid using this term.

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. It is important to note that this hypothesis is based on increased risk of advancing to more potent drugs and not inevitability!

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. 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 AA.

IN-PATIENT TREATMENT – Admission to a hospital or facility for treatment that requires at least one overnight stay and typically requires medical management.

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. (May be referred to as Intensive Outpatient Program, or IOP)

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 that is followed by a return to the original goal of moderate use or abstinence. Refrain from using this term, but instead focus on the “return to recovery”.

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.

MEDICATION ASSISTED TREATMENT – (Stigma Alert) A treatment approach that combines behavioral therapy and medications to treat substance use disorders. The stigma alert stems from a undervaluing the role of medications in treating addictions. Instead state “medications for addiction treatment.”

MINDFULNESS-BASED RELASPSE 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.

MUTUAL HELP ORGANIZATIONS – Also known as self-help groups, peer support groups and mutual aid; peer run volunteer organizations that focus on socially supportive communications and exchange of addiction and recovery experiences and skills.

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. Promotes the fear and stereotype that crime, poverty, drug use, etc. will increase with the development of the facility/residential treatment.

OPEN MEETINGS – 12 Step meetings that can be attended by anyone, both those who identify as having a substance use disorder and those who do not. Intended to educate the public and concerned significant others/family about the nature of the 12-step meetings.

OUTPATIENT TREATMENT – A professionally delivered substance use disorder treatment modality that requires daily to weekly attendance at a clinic of facility, allowing the patient to return home or to other living arrangements during non-treatment hours. PASSIVE REFERRAL – An attempt by a clinician or service worker to connect a patient with substance use disorder to another service. (Less effective than “assertive linkages” which actively link a patient to services through personal contact with the service provider and increase the patient’s engagement.)

PATIENT ACTIVATION – How well patients are equipped to take an active role in their addiction related care and to use the primary care services available to them.

PEER SUPPORT GROUP – Also known as mutual help organizations; structured non-clinical relationships in which individuals participate in activities that engage, educate and support patients recovering from substance use disorder.

PERSON-FIRST LANGUAGE – A linguistic prescription structuring sentences to name the person first and the condition or disease from which they suffer second. (i.e.- a person with substance use disorder, or suffering from substance use disorder, etc.)

PHYSICAL DEPENDENCE – (Stigma Alert) Term used to describe physical symptoms related to tolerance and withdrawal from substance use disorder. However, this term does not the WHO or CDC definitions of “true dependence” which would include at least one psychological component.

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. Using the term “misuse” implies negative judgement. Instead use clear language such as “non-medical use of a psychoactive substance.”

RAPID DETOX – Anesthesia assisted detoxification; injection of high doses of an opiate antagonist.

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

RECOVERY CAPITAL – The resources which are necessary to begin and maintain recovery from substance use disorder. (Can be social, physical, human and cultural)

RECOVERY RESIDENCES – Also known as sober living houses; an alcohol and drug-free living facility for individuals recovering from alcohol or other substance use disorders that often serves as an interim living environment between detoxification experiences or residential treatment and mainstream society.

RELAPSE – (Stigma Alert) A recurrence and reinstatement of substance use disorder that occurs after a patient has been in remission. Use of this term can imply a “moral failing” of the patient. Try using neutral terms such as “resumed” or “experienced a recurrence of symptoms.”

REMISSION – The complete absence of symptoms or the presence of symptoms, but below a specified threshold. SLIP – (Stigma Alert) See lapse above

SUBSTANCE ABUSE – (Stigma Alert) A term sometimes used to describe an array of problems resulting from intensive use of psychoactive substances. Try using the phrase “suffering from substance use disorder” instead.

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 recurrence and reinstatement of substance use disorder.

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.