GLOSSARY
12-Step Program: A group providing mutual support and fellowship for people recovering from addictive behaviors. The first 12-step program was Alcoholics Anonymous (AA), founded in 1935; an array of 12-step groups following a similar model have since emerged and are the most widely used mutual aid groups and steps for maintaining recovery from alcohol and drug use disorders. It is not a form of treatment, and it is not to be confused with the treatment modality called Twelve-Step Facilitation.
Abstinence: Not using alcohol or drugs.
Addiction: The most severe form of substance use disorder, associated with compulsive or uncontrolled use of one or more substances. Addiction is a chronic brain disease that can cause recurrence (relapse) and recovery.
Agonist: A chemical substance that binds to and activates certain receptors in cells, causing a biological response. Fentanyl and methadone are examples of opioid receptor agonists.
Antagonist: A chemical substance that binds to and blocks the activation of certain receptors on cells, preventing a biological response. Naloxone is an example of an opioid receptor antagonist.
Binge Drinking: For men, drinking 5 or more standard alcoholic drinks, and for women, 4 or more standard alcoholic drinks on the same occasion on at least 1 day in the past 30 days.
Case Management: A coordinated approach to delivering health care, substance use disorder treatment, mental health care, and social services. This approach links clients with appropriate services to address specific needs and goals.
Clinical Decision Support: A system that provides health care professionals, staff, patients, or other individuals with knowledge and person-specific information, intelligently filtered or presented at appropriate times, to enhance health and health care.
Clinical Trial: Any research study that prospectively assigns human participants or groups of participants to one or more health-related interventions to evaluate the effects on health outcomes.
Compulsivity: Repetitive behaviors in the face of adverse consequences, as well as repetitive behaviors that are inappropriate to a particular situation. People suffering from compulsions often recognize that the behaviors are harmful, but they nonetheless feel emotionally compelled to perform them. Doing so reduces tension, stress, or anxiety.
Continuum of Care: An integrated system of care that guides and tracks a person over time through a comprehensive array of health services appropriate to the individual's need. A continuum of care may include prevention, early intervention, treatment, continuing care, and recovery support.
Cost-Benefit Study: A study that determines the economic worth of an intervention by quantifying its costs in monetary terms and comparing them with the benefits, also expressed in monetary terms. Total benefits divided by total costs is called a cost-benefit ratio. If the ratio is greater than 1, the benefits outweigh the costs.
Cost-Effectiveness Study: A comparative analysis of two or more interventions against their health and economic outcomes. These outcomes could be lives saved, illnesses prevented, or years of life gained.
Dependence: A state in which an organism only functions normally in the presence of a substance, experiencing physical disturbance when the substance is removed. A person can be dependent on a substance without being addicted, but dependence sometimes leads to addiction
Dissemination: The active distribution of evidence-based interventions (EBIs) to specific audiences, with the goal of increasing their adoption.
Drug Diversion: A medical and legal concept involving the transfer of any legally prescribed controlled substance from the person for whom it was prescribed to another person for any illicit use.
Fidelity: The extent to which an intervention is delivered as it was designed and intended to be delivered.
Gender: The social, cultural, or community designations of masculinity or femininity.
Health Care System: The World Health Organization defines a health care system as (1) all the activities whose primary purpose is to promote, restore, and/or maintain health, and (2) the people, institutions, and resources, arranged together in accordance with established policies, to improve the health of the population they serve. The health care system is made up of diverse health care organizations ranging from primary care, specialty substance use disorder treatment (including residential and outpatient settings), mental health care, infectious disease clinics, school clinics, community health centers, hospitals, emergency departments, and others.
Health Disparities: Preventable differences in the burden of disease or opportunities to achieve optimal health that are experienced by socially disadvantaged populations, defined by factors such as race or ethnicity, gender, education or income, disability, geographic location (e.g., rural or urban), or sexual orientation.
Heavy Drinking: Defined by the Centers for Disease Control and Prevention (CDC) as consuming 8 or more drinks per week for women, and 15 or more drinks per week for men, and by the Substance Abuse and Mental Health Services Administration (SAMHSA), for research purposes, as binge drinking on 5 or more days in the past 30 days.
Implementation: A specified set of activities designed to put policies and programs into practice.
Impulsivity: Inability to resist urges, deficits in delaying gratification, and unreflective decision-making. Impulsivity is a tendency to act without foresight or regard for consequences and to prioritize immediate rewards over long-term goals.
Inpatient Treatment: Intensive, 24-hour-a-day services delivered in a hospital setting.
Integration: The systematic coordination of general and behavioral health care. Integrating services for primary care, mental health, and substance use-related problems together produces the best outcomes and provides the most effective approach for supporting whole-person health and wellness.
Intervention: A professionally delivered program, service, or policy designed to prevent substance misuse (prevention intervention) or treat a substance use disorder (treatment intervention).
Meaningful Use: Using certified EHR technology to improve quality, safety, efficiency, and reduce health disparities; engage patients and family; improve care coordination and population and public health; and maintain privacy and security of patient health information.
Medication-assisted treatment (MAT): The use of medications in combination with counseling and behavioral therapies, which is effective in the treatment of opioid use disorders (OUD) and can help some people to sustain recovery.
Negative Reinforcement: The process by which removal of a stimulus such as negative feelings or emotions increases the probability of a response like drug taking.
Neurobiology: The study of the anatomy, function, and diseases of the brain and nervous system.
Opioid Treatment Program (OTP): SAMHSA-certified program, usually comprising a facility, staff, administration, patients, and services, that engages in supervised assessment and treatment, using methadone, buprenorphine, or naltrexone, of individuals who have opioid use disorders. An OTP can exist in several settings, including intensive outpatient (IOP), residential (RTP), and hospital settings. Services may include medically supervised withdrawal and/or maintenance treatment, along with various levels of medical, psychiatric, psychosocial, and other types of supportive care.
Intensive Outpatient Program (IOP): A primary substance use treatment program recommended in some circumstances by a clinical and medical assessment. IOP may be recommended for those who do not need medically supervised detox.
Pharmacokinetics: What the body does to a drug after it has been taken, including how rapidly the drug is absorbed, broken down, and processed by the body.
Positive Reinforcement: The process by which presentation of a stimulus such as a drug increases the probability of a response like drug taking.
Prescription Drug Misuse: Use of a drug in any way a doctor did not direct an individual to use it.
Prevalence: The proportion of a population who have (or had) a specific characteristic—for example, an illness, condition, behavior, or risk factor— in a given time period.
Protective Factors: Factors that directly decrease the likelihood of substance use and behavioral health problems or reduce the impact of risk factors on behavioral health problems.
Public Health System: Defined as “all public, private, and voluntary entities that contribute to the delivery of essential public health services within a jurisdiction” and includes state and local public health agencies, public safety agencies, health care providers, human service and charity organizations, recreation and arts-related organizations, economic and philanthropic organizations, education and youth development organizations, and education and youth development organizations.
Quality-Adjusted Life Year (QALY): A measure of the burden of disease used in economic evaluations of the value of health care interventions that accounts for both the years of life lived and the quality of life experienced during those years, relative to quality associated with perfect health.
Recovery: A process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential. Even individuals with severe and chronic substance use disorders can, with help, overcome their substance use disorder and regain health and social function. This is called remission. When those positive changes and values become part of a voluntarily adopted lifestyle, that is called “being in recovery”. Although abstinence from all substance misuse is a cardinal feature of a recovery lifestyle, it is not the only healthy, pro-social feature.
Relapse: The return to alcohol or drug use after a significant period of abstinence.
Remission: A medical term meaning that major disease symptoms are eliminated or diminished below a pre-determined, harmful level.
Residential Treatment: Intensive, 24-hour a day services delivered in settings other than a hospital.
Risk Factors: Factors that increase the likelihood of beginning substance use, of regular and harmful use, and of other behavioral health problems associated with use.
Sex: The biological and physiological characteristics that define human beings as female or male.
Standard Drink: Based on the 2015-2020 Dietary Guidelines for Americans, a standard drink is defined as 12 fl. oz. of regular beer, 8-9 fl. oz. of malt liquor, 5 fl. oz. of table wine, or 1.5 fl. oz. of 80-proof distilled spirits. All these drinks contain 14 grams (0.6 ounces) of pure alcohol.
Substance: A psychoactive compound with the potential to cause health and social problems, including substance use disorders (and their most severe manifestation, addiction).
Substance Misuse: The use of any substance in a manner, situation, amount or frequency that can cause harm to users or to those around them. For some substances or individuals, any use would constitute misuse (e.g., under-age drinking, injection drug use).
Substance Misuse Problems or Consequences: Any health or social problem that results from substance misuse. Substance misuse problems or consequences may affect the substance user or those around them, and they may be acute (e.g., an argument or fight, a motor vehicle crash, an overdose) or chronic (e.g., a long-term substance-related medical, family, or employment problem, or chronic medical condition, such as various cancers, heart disease, and liver disease). These problems may occur at any age and are more likely to occur with greater frequency of substance misuse.
Substance Use: The use—even one time—of any substance.
Substance Use Disorders: A medical illness caused by repeated misuse of a substance or substances. According to the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), substance use disorders are characterized by clinically significant impairments in health, social function, and impaired control over substance use and are diagnosed through assessing cognitive, behavioral, and psychological symptoms. Substance use disorders range from mild to severe and from temporary to chronic. They typically develop gradually over time with repeated misuse, leading to changes in brain circuits governing incentive salience (the ability of substance-associated cues to trigger substance seeking), reward, stress, and executive functions like decision making and self-control. Note: Severe substance use disorders are commonly called addictions.
Substance Use Disorder Treatment: A service or set of services that may include medication, counseling, and other supportive services designed to enable an individual to reduce or eliminate alcohol and/or other drug use, address associated physical or mental health problems, and restore the patient to maximum functional ability.
Telehealth: The use of digital technologies such as electronic health records, mobile applications, telemedicine, and web-based tools to support the delivery of health care, health-related education, or other health-related services and functions.
Telemedicine: Two-way, real-time interactive communication between a patient and a physician or other health care professional at a distant site. Telemedicine is a subcategory of telehealth.
Tolerance: Alteration of the body's responsiveness to alcohol or a drug such that higher doses are required to produce the same effect achieved during initial use.
Treatment/MOUD - Medications for opioid use disorder (MOUD) is an approach to opioid use treatment that uses FDA-approved medications as the treatment for people diagnosed with opioid use disorder.
Withdrawal: A set of symptoms that are experienced when discontinuing use of a substance to which a person has become dependent or addicted, which can include negative emotions such as stress, anxiety, or depression, as well as physical effects such as nausea, vomiting, muscle aches, and cramping, among others. Withdrawal symptoms often lead a person to use the substance again.
Wrap-Around Services: Wrap -around services are non-clinical services that facilitate patient engagement and retention in treatment as well as their ongoing recovery. This can include services to address patient needs related to transportation, employment, childcare, housing, legal and financial problems, among others.