The number of terms and resources you may encounter when searching for information about substance abuse or addiction or treatment or help for families can feel overwhelming. We have defined a number of the key terms (presented in alphabetical order) and identified some of the key resources and links that can help you. But before you move through the list, you may wish to look at this two-sided summary piece that provides an overview of the New Research on Alcohol and the Brain and Secondhand Drinking (SHD)_6-12.
Key Terms A – D
Addiction – whether it’s an addiction to alcohol or illegal or prescription drugs, collectively referred to as “drugs,” “addiction is a chronic, often relapsing brain disease that causes compulsive drug seeking and use despite harmful consequences to the individual who is addicted and to those around them.” NIDA InfoFacts: Understanding Drug Abuse and Addiction.
After Care, aka Extended Care or Continuing Care – the phase of treatment that follows rehabilitation (which follows detox/stabilization). Like other chronic diseases, addiction is not “cured” in 28 days or even three months. It is a brain disease, and as such, it takes time to heal the brain when substance use is stopped. According to the American Society of Addiction Medicine (ASAM), effective addiction treatment should follow a disease management approach and include: 1) detox/stabilization, 2) rehabilitation (rehab), and 3) continuing care. Often, people engage in a combination of treatment options during rehab, but it is important they continue these in order to “re-wire” / heal their brain. This is referred to as “being in recovery.” Some recovery options include: cognitive behavioral therapy (CBT), medications to curb cravings, a 12-step program, mindfulness programs (for example, yoga), spiritual and/or religious programs or activities, healthy nutrition, exercise, group meetings, counseling, intensive outpatient (the person does not live at the treatment center but attends treatment programs at the center during the day and/or evening), and residential treatment (the person lives at the treatment center). And, please know, that if there is a dual diagnosis, treatment must also include treatment of the mental illness. To better understand the importance of continuing care, read “28-Day Residential Treatment – What More Could You Want?” To help with continuing care, some families are electing to engage the services of an expert to develop what is known as a Continuing Care Plan. For more information, check out BreakingTheCycles.com’s Continuing Care Plan services.
Alcoholic – identifies a person who has the chronic, often relapsing brain disease of alcoholism (one of the brain diseases of addiction); a person addicted to alcohol.
Alcohol Abuse – (in terms of “At-Risk drinking patterns) is 1) repeated binge drinking, defined as 5 or more standard drinks on occasion for men and 4 or more for women, or 2) heavy social drinking, defined as drinking more than an average of 1 standard drink/day for women or 2 standard drinks/day for men. [See Moderate Drinking.] Alcohol abuse (“At-Risk” drinking) causes behavioral changes. See Drinking Behaviors.
Alcoholism - watch short 10-minute video: Alcoholism is a Disease and It’s Not Alcohol Abuse
“At-Risk” Drinking – see Alcohol Abuse – watch short, 10-minute video: How Much Is Too Much? “At-Risk” Drinking Patterns Explained
Boot Camp, aka Wilderness Camp – a term use to described a “camp” to which troubled and/or addicted teens are sent to change the teen’s behavior. It is important the camp is run by counselors/addictions specialists that thoroughly understand brain development ages 12-25, the brain disease of addiction and the five key risk factors contributing to the development of an addiction. It’s so important to remember we are “not trying to get them to stop drinking or using drugs,” as much as we are trying to “help them heal their brain disease” for which one of the treatments is to stop drinking or using their drug of choice. Additionally, with bootcamps (or any treatment program, for that matter), it is important there be comprehensive family programs as well. Sending a teen to bootcamp and then back home to a family dynamic that evolved around the untreated, undiagnosed, unhealthily discussed addiction when there is no family understanding of the disease nor help for the family members specifically can undermine what a teen learns in bootcamp.
Codependent – a term often assigned to the family member or friend of an alcoholic or drug addict. It is a complicated concept to explain without first having an understanding of the disease of addiction. So for now, it just helps to know the term. See “Secondhand Drinking/Drugging (SHDD)” for additional explanation and check out “Understanding the Secondhand Drinking/Drugging – Codependency Connection .”
Continuing Care – see “After Care”
Co-Occurring Disorder – see “Dual Diagnosis”
Detox/Stabilization – the first phase of treatment when alcohol and drugs are safely removed from the addict/alcoholic’s system in order to physiologically stabilize him/her.
Drinking Behaviors – when a person drinks more than their brain and body can process, they change the way their brain works. These changes causes the person to engage in drinking behaviors, such as: getting into fights with loved ones about the drinking, driving while impaired (DUI), having work or school problems related to drinking too much and recovering therefrom, verbally or physically or emotionally abusing a loved one – typically a child, spouse, boyfriend or girlfriend, having unprotected or unwanted sex — basically doing things you would not do if it weren’t for having had too much to drink.
Drug Addict – the common term used to identify a person who as the chronic, often relapsing brain disease of drug addiction (one of the brain diseases of addiction); a person addicted to an illegal and/or prescription drug. The term is often shortened to “addict.”
Dual Diagnosis – to be diagnosed with both a mental illness and an addiction (whether it is to drugs or alcohol) is to be diagnosed with two separate brain diseases and is commonly known as a “dual diagnosis” or having “co-occurring disorders.” If your loved one suffers from a mental illness and an addiction, it will be important that both be treated at the same time, preferably by the same treatment team (when care is being provided at a treatment facility).
Key Terms E – R
Extended Care – see “Continuing Care”
Interventionist – a person who is trained to work with family members and friends to help them better understand the disease of addiction; to explain the various types of treatment options available and the best options/facilities to address a particular addict/alcoholic’s specific needs; to identify additional experts for consultations (e.g., mental health professional); and to facilitate a meeting of family members and friends with the addict/alcoholic at which all of this and more (if necessary) is discussed in a loving, non-threatening manner. The objective is for the addict/alcoholic to agree to seek / enter treatment.
IOP (Intensive Outpatient) – a treatment plan whereby the person does not live at the treatment center but attends treatment programs at the center during the day and/or evening.
Methadone Maintenance – a long-term, outpatient treatment option for treating drug addicts addicted to opioids (e.g., prescription pain killers, heroin, oxycodone, oxycontin, hydro-codone, fentanyl). See “Methadone Treatment: Isn’t It Just an Alternative Addiction?”
Moderate Drinking – aka “Low-Risk Drinking” is defined as seven standard drinks per week for women, with no more than three of the seven in any one day and as fourteen standard drinks per week for men, with no more than four of the fourteen in any one day. A standard drink is defined as: 5 ounces of table wine, 12 ounces of regular beer or 1.5 ounces of 80 proof spirits (e.g., vodka). To anonymously assess your or a loved one’s drinking patterns, visit NIAAA “Rethinking Drinking.”
Naltrexone – a medication that the blocks the effects of both opioids and alcohol used in treating opioid addictions and alcoholism.
National Alliance of Mental Health (NAMI) – the number of addicts and alcoholics with a co-occurring mental illness is significant. NAMI is a free program to help both the person with the mental illness and the family member of that person. There are NAMI chapters throughout the United States, http://www.nami.org/.
Rehab (Rehabilitation) – Rehabilitation (a.k.a. Rehab) is the phase of treatment (following detox) where individuals start the process of changing their brains – repairing, developing new and rewiring old neural networks – while at the same time, restoring their body’s physical health. Generally rehab starts with an intense, almost immersion-like period, during which time the addict/alcoholic focuses on abstinence, education and behavioral changes. As neural networks change/repair/develop and physical health returns, rehabilitation efforts are generally changed and/or modified. Rehab is often what we think of when we think of a typical 28-day residential treatment program. See “After Care” and “Treatment” for additional information.
Recovery – treatment for addiction is far more than just stopping the drug or alcohol use or the behavior. Effective treatment is about recovery, which is defined as abstinence and enjoying one’s life — it’s more than just not drinking or using.
Recovery Coach – this is a relatively new concept/function. It is the idea of having an individual who understands addiction to help the addict/alcoholic stay on their recovery path and/or implement their continuing care plan (defined above). Additional terms for this person include: Sober Companion, Sober Expert.
Recovery Residence — is basically a “home” where no alcohol, drugs or paraphernalia are allowed. Often family members and friends are not ready to have the addict/alcoholic move home, or the addict/alcoholic is not ready to move home because of too many triggers or an unhealthy recovery environment. In these instances, a sober living environment home is suggested. You can find these homes in the yellow pages or bycontacting a treatment center near you.
Residential Treatment – a treatment option whereby the addict/alcohol lives in residence at a treatment center while engaging in treatment.
Risk Factors – there are five key risk factors that contribute to a person who abuses a substance (uses/drinks more than their brain and body can process) becoming an addict/alcoholic. These include: genetics (if it runs in the family, genetic predisposition); social environment (where heavy drinking is viewed as “normal” and encouraged); childhood trauma(verbal, physical, emotional abuse – which “wires” unhealthy coping skills and brain changes); early use (see above),mental illness (e.g., depression, anxiety, ADHD, PTSD, bipolar – which also cause brain changes and a potential to “self medicate” with alcohol). Of further note, all alcoholics go through a period of alcohol abuse, but not all alcohol abusers become alcoholics. A person does not have to “hit bottom” to get and/or be encouraged to seek help. When family members and friends get help and understanding, they can be more effective in talking about the situation (moving away from blaming, shaming, for example).
Key Terms S – Z
Secondhand drinking/drugging (SHDD) – describes the impacts of a person’s substance abuse or addiction behaviors on others – especially on family members and friends, but also on co-workers, fellow students and communities-at-large.
When a person drinks too much alcohol or abuses drugs, they change the way their brain works; they interrupt the normal functioning of neural networks. Because the brain controls everything we think, feel, say and do, these brain changes get in the way of that person’s ability to act normally and make good decisions. It can cause that person to do things like: starting fights with friends, yelling at or hitting family members, missing work, carrying on rambling arguments, accusing family members or friends of doing things they haven’t done, driving while under the influence, being super nice, or continuing to use/drink after promising not to. We call these “things” substance misuse (or drinking or drugging) behaviors. When a friend or family member is on the receiving end of someone’s substance misuse behaviors and/or on the receiving end of someone’s reactions to those behaviors (i.e., a non-drinking spouse trying to control a husband/wife’s drinking or drug abuse behaviors), that person experiences SHDD (like the idea of secondhand smoke). If chronically exposed to SHDD, a person can suffer physical and/or emotional-related brain changes, such as anxiety and depression disorders, fatigue, headaches, and pain. The terms, secondhand drinking or secondhand drugging, are meant to cause impressions similar to those a person has when they hear the words, “secondhand smoke,” a term that immediately brings to mind the impacts of a person’s smoking on others.
Understanding that substance misuse (whether is abuse or addiction) causes the drinking or drug abusing behaviors; that it is not a behavioral choice once the brain changes have occurred, helps all concerned better appreciate that: 1) the alcohol or drug misuse needs to stop in order to stop the drinking/drugging behaviors, and 2) the non-drinker/drug abuser has no control over the drinking/drugging misuse behaviors caused by a person’s substance misuse-related brain changes.
To learn more, consider reading: “Secondhand Drinking/Drugging (SHDD).”
SLE (Sober Living Environment) – see “Recovery Residence”
Sober Companion – an individual who provides support to a newly recovering drug addict or alcohol in potentially stressful living, working and/or social environment.
Sober Escort – an individual who accompanies a drug addict or alcoholic from one location to another to insure they arrive safely.
Sober Home – see “Recovery Residence”
Substance Abuse – the term used to describe drinking or using more of a drug or alcohol than the brain or body can process and as a result, engaging in substance misuse behaviors. Common variations of this term include alcohol abuse and drug abuse. Repeated substance abuse causes chemical and structural changes in the brain. These brain changes contribute to a person developing the disease of addiction. Substance abuse also causes secondhand drinking/drugging impacts, as does addiction.
Suboxone or Subutex (aka Buprenorphine) – a narcotic medication used for the treatment of opioids addiction administered under a doctor’s care; reduces the cravings and blocks the effects of opiates in ways similar to methadone.
Substance Misuse – includes both substance abuse and addiction because both cause a person to engage in substance misuse behaviors. It is the substance misuse behaviors, regardless of the label, that cause the problems for the substance abuser, addict/alcoholic, family, friends and communities-at-large. (See Alcohol Abuse.)
Substance Misuse Behaviors – describes the behaviors a person engages in when they drink or use more drugs than their body and brain can process. These include arguments about the drinking, getting into fights, driving while under the influence (DUI), doing poorly in school or at work because of the substance misuse or having to recover from the misuse, having unwanted or unprotected or unplanned sex, binge drinking (defined as four or more standard drinks on a single occasion for women and five or more standard drinks on a single occasion for men) or blacking out.
Treatment – There are many treatment options because no one person’s recovery will follow a path identical to another’s. In other words, there is NO “one size fits all” when it comes to addiction treatment. Additionally, what may work in the beginning is not as effective several months along – this is because a person is being treated for a brain disease. As the brain heals/ repairs the chemical and structural changes caused by substance abuse, the brain changes the way it “works.” Thus it may be necessary to add or subtract or expand some of the many options that are available and described in the next paragraph.
According to the American Society of Addiction Medicine (ASAM), regardless of the options used, effective addiction treatment should follow a disease management approach and include: 1) detox/stabilization, 2) rehabilitation (rehab), and 3) continuing care. Often, people engage in a combination of treatment options, which may include cognitive behavioral therapy (CBT), medications to curb cravings, a 12-step program, mindfulness programs (for example, yoga), spiritual and/or religious programs or activities, healthy nutrition, exercise, group meetings, counseling, intensive outpatient (the person does not live at the treatment center but attends treatment programs at the center during the day and/or evening), residential treatment (the person lives at the treatment center) and/or a continuing care plan (a plan for what to do after rehab [rehabilitation]). And, please know, that if there is a dual diagnosis, treatment must also include treatment of the mental illness. To better understand the importance of continuing care, read “28-Day Residential Treatment – What More Could You Want?”
12-step program – term that refers to several programs, all based on the 12-steps of Alcoholics Anonymous (AA). Two are NA (Narcotics Anonymous), www.na.org, and AA (Alcoholics Anonymous), www.aa.org, which are for persons addicted to illegal or prescription drugs (NA) or alcohol (AA). Another is Dual Recovery Anonymous (DRA), a 12 step for persons with a dual diagnosis.
Three additional 12-step programs referenced in addiction recovery circles are for the families and friends of an addict/alcoholic. They are Nar-Anon (drugs), www.nar-anon.org, Al-Anon (alcohol – adults) and Alateen (alcohol – young people, 13 and up), www.al-anon.alateen.org/. There are others, as well. Each has a website where you can find meeting times and locations.
RESOURCES
The Addiction Project is produced by HBO in partnership with The Robert Wood Johnson Foundation, the NIDA and the NIAAA, and provides a wealth of information about addiction, www.hbo.com/addiction.
Chooper’s Guide, the Internet’s most comprehensive substance abuse treatment, prevention, and intervention resource directory. Find treatment providers, research and articles, addiction events and conferences, addiction professionals, help for family members and friends, vendors, and more at www.choopersguide.com.
“Drugs, Brains, and Behavior: The Science of Addiction” - National Institute on Drug Abuse (NIDA). A website and PDF resource at www.nida.nih.gov/scienceofaddiction.
National Alliance on Mental Illness (NAMI) provides information, resources and individual support for those suffering a mental illness and/or their families through its various chapters, http://www.nami.org/
NIAAA Rethinking Drinking is a website where you can anonymously assess your or a loved one’s drinking patterns to determine if there is a problem and suggestions for cutting down, http://rethinkingdrinking.niaaa.nih.gov/
National Institute on Drug Abuse – Understanding Drug Abuse and Addiction – InfoFacts, http://drugabuse.gov/infofacts/understand.html
Science of Drug Abuse and Addiction – National Institute on Drug Abuse (NIDA) is a website that explains specifics about each of the drugs (alcohol, club drugs, cocaine, heroin…) as well as a host of general resources for parents, students, teachers, medical & health professionals, researchers and more, http://www.nida.nih.gov/nidahome.html
Substance Abuse Problems – Medline Plus, a service of the U.S. National Library of Medicine, NIH National Institutes of Health, http://www.nlm.nih.gov/medlineplus/substanceabuseproblems.html
U.S. Surgeon General’s 2007 Call to Action to Prevent and Reduce Underage Drinking Available at this site, http://www.surgeongeneral.gov/topics/underagedrinking/
Working Document for Developing a Draft Global Strategy to Reduce Harmful Use of Alcohol, prepared by the World Health Organization, Department of Mental Health and Substance Abuse, www.who.int/substance_abuse/activities/globalstrategy/en/index.html
AGENCIES
The American Academy of Addiction Psychiatry (AAAP) AAAP is an international professional membership organization founded in 1985 with approximately 1,000 members. Membership consists of psychiatrists working with addiction, faculty at various academic institutions, medical students, residents and fellows, and related health professionals making a contribution to the field of addiction psychiatry.www.aaap.org
American Society of Addiction Medicine (ASAM) ASAM’s mission is to increase access to and improve the quality of addiction treatment; to educate physicians (including medical and osteopathic students), other health care providers and the public; to support research and prevention; to promote the appropriate role of the physician in the care of patients with addiction; and to establish addiction medicine as a specialty recognized by professional organizations, governments, physicians, purchasers and consumers of health care services, and the general public. www.asam.org/
National Center on Substance Abuse and Child Welfare (NCSACW), an initiative of the Department of Health and Human Services and jointly funded by the Substance Abuse and Mental Health Services Administration’s (SAMHSA) Center for Substance Abuse Treatment (CSAT) and the Administration on Children, Youth and Families (ACYF), Children’s Bureau’s Office on Child Abuse and Neglect (OCAN) to improve systems and practice for families with substance use disorders who are involved in the child welfare and family judicial systems by assisting local, State and tribal agencies. http://www.ncsacw.samhsa.gov/default.aspx
National Institute on Alcohol Abuse and Alcoholism (NIAAA) NIAAA provides leadership in the national effort to reduce alcohol-related problems by conducting and supporting research in a wide range of scientific areas, including genetics, neuroscience, epidemiology, health risks and benefits of alcohol consumption, prevention, and treatment; coordinating and collaborating with other research institutes and Federal programs on alcohol-related issues; collaborating with international, national, State, and local institutions, organizations, agencies, and programs engaged in alcohol-related work; and translating and disseminating research findings to health care providers, researchers, policymakers, and the public. www.niaaa.nih.gov
National Institute on Drug Abuse (NIDA) NIDA’s mission is to lead the Nation in bringing the power of science to bear on drug abuse and addiction. This charge has two critical components. The first is the strategic support and conduct of research across a broad range of disciplines. The second is ensuring the rapid and effective dissemination and use of the results of that research to significantly improve prevention, treatment and policy as it relates to drug abuse and addiction. www.nida.nih.gov
National Institute of Mental Health (NIMH) The mission of NIMH is to transform the understanding and treatment of mental illnesses through basic and clinical research, paving the way for prevention, recovery, and cure. In support of this mission, NIMH generates research and promotes research training to fulfill the following four objectives: promote discovery in the brain and behavioral sciences to fuel research on the causes of mental disorders; chart mental illness trajectories to determine when, where, and how to intervene; develop new and better interventions that incorporate the diverse needs and circumstances of people with mental illnesses; and strengthen the public health impact of NIMH supported research. www.nimh.nih.gov
Substance Abuse Treatment Facility Locator (SAMHSA) The Substance Abuse and Mental Health Services Agency (SAMHSA) provides an online resource for locating drug and alcohol abuse treatment programs. http://www.samhsa.gov/treatment/
©2010-12 Lisa Frederiksen, BreakingTheCycles.com 2011. All Rights Reserved.
