Addiction and Dependence Terms
- What is addiction?
Addiction is a disorder that is characterized by compulsive use of a drug despite the unwanted, sometimes destructive consequences of such use. Left unmanaged, the disorder often follows a chronic, progressive, and relapsing course; its development is thought to be accompanied by long-term changes in the brain.1
- What is a substance use disorder (SUD)?
An SUD is a mental disorder that is diagnosed using a set of criteria that assess to what degree a person’s drug or alcohol use is causing problems in areas such as their physical health, mental health, or social functioning. An SUD can range in severity.2 A substance use disorder is very often referred to simply as an addiction.
- What is substance tolerance?
Tolerance reflects a growing need for more of a drug to produce the wanted effect(s).1
- What is dependence?
Distinct from but a common element of many addictions, dependence is the body’s adaption to a drug such that it goes through withdrawal when the use of the drug slows or stops.1
- What is drug withdrawal?
Substance withdrawal involves a set of symptoms that arise once a drug- or alcohol-dependent person significantly reduces their dose or quits using the drug altogether. Depending on the drug or drugs, symptoms may range from mildly uncomfortable to life-threatening.1,3
- What does recovery mean?
Recovery is the long-term process of change wherein people learn to improve their health and take back control of their lives from addiction.1 People in recovery from a substance use disorder commonly experience one or more relapses back to drug use and may benefit from multiple attempts at treatment.4
- What is individualized treatment?
This means that your individual treatment plan is created with your history and your needs in mind. Many treatment centers will closely monitor your progress and adjust your plan as needed to best promote recovery.
- What is specialized treatment?
This is treatment tailored specifically to individual patient interests or a specific type of patient. At Greenhouse, we offer several specialized programs including those for:
- What does evidence-based treatment mean?
Evidence-based treatment simply refers to the judicious use of best practices when treating the patient. Evidence-based therapies are those that are backed by research supporting their treatment efficacy.5
- What is medical detox?
Detoxification is the process wherein drugs and/or alcohol leave the body. During detox, withdrawal symptoms may arise, some of which will be more severe than others. Medical detoxification is a form of treatment where medical supervision and sometimes medications are utilized during withdrawal to keep the patient safe and as comfortable as possible.
Certain drugs, such as alcohol, benzodiazepines, and opioids are associated with more severe withdrawal syndromes than others. Those detoxing from them are often advised to seek medical detox for appropriate withdrawal management.
- What is inpatient rehab?
Inpatient rehab is one of the more intensive forms of substance rehabilitation; it refers to live-in substance abuse treatment where there may be close supervision and care from doctors or nurses for medical and/or psychiatric issues.
- What is residential rehab?
This is very similar to inpatient rehab. (The terms are often used interchangeably). However, some residential programs may not have the medical focus that inpatient or intensive, hospital-based rehabs do.
Days are usually structured around group or individual therapy, drug education classes, skills training, and personal reflection time.
The time a person spends in a residential rehab will vary, but many programs range from 30-90 days.
- What is a partial hospitalization program (PHP)? Is it outpatient?
PHPs are outpatient programs, but they do involve an intensive amount of weekly treatment (3-7 days per week of treatment in 6-8-hour blocks).
- What is an intensive outpatient program (IOP)?
Intensive outpatient programs involve relatively less time-demanding treatment scheduling (compared with PHPs) but still provide a good deal of support (3-7 days of treatment per week in 3-hour blocks).
- What is standard outpatient therapy?
This form of treatment involves weekly therapy visits and often serves as a step-down treatment for those who’ve completed a more intensive level of care.
- What is psychoeducation?
Psychoeducation helps provide patients a better framework of understanding for both their substance use disorder and recovery. It prescribes methods of coping with various recovery challenges such as cravings and social pressures for continued use. It also helps people evaluate the impact of their SUD on friends and loved ones, so that they may better navigate their newly-sober relationship within that network moving forward.6
- What are common types of therapy for drug addiction?
The following evidence-based therapies are commonly used in the realm of addiction treatment:
- Cognitive-behavioral therapy (CBT): This common form of psychotherapy focuses on the connection between how we feel, think, and behave. Working to adjust negative thoughts and behaviors can bring about positive change.7
- Dialectical-behavioral therapy (DBT): This form of therapy is similar to CBT but focuses on the patient achieving two opposing goals: acceptance and change.8
- Motivational interviewing: In this approach, a therapist helps the patient enhance their motivation to change. Essentially, the therapist helps them resolve any feelings of ambivalence toward treatment and “talk themselves into changing.”9
- Contingency management: This therapeutic approach uses small incentives/rewards to reinforce positive change.1
- Rational emotive behavior therapy (REBT): Here, the therapist uses a variety of tools and problem-solving techniques, such as “disputing,” to help change a patient’s harmful and/or irrational thoughts or emotions and to create more positive behaviors.10
- What are common trauma therapy techniques?
Eye movement desensitization and reprocessing (EMDR): This type of therapy is used to help patients process distressing emotions and thoughts related to trauma.11
Seeking Safety: This therapy type was designed for those dealing with trauma and substance abuse and treats safety as the main goal. A focus of this approach is integrated substance abuse and trauma treatment.12
- What is family therapy?
Family therapy was designed with the understanding that a family is an ecosystem; when one person suffers from an addiction, everyone else in the family unit is impacted. Family therapy helps bring about healing and restore the balance in the family ecosystem by helping all family members make positive changes as the recovering person does the same.13
- What is group therapy?
Group therapy takes several forms, and the goals are different based on the type of group. There may be process groups, where individuals process past events in the context of the group. There may be cognitive-behavioral therapy groups where clients learn to rearrange thoughts and behaviors in a group setting. There are also skills groups and education classes.14
Inpatient and residential rehabilitation programs often use more than one of these group types to help patients achieve lasting change and also garner the support of others and offer their support back.
Groups are often especially helpful for those who have been living in addiction because they help to resolve isolation, depression, and shame.14
- What are holistic therapies?
Holistic treatment means treatment of the whole person. Holistic treatment often combines Western medicine with complementary treatments such as:
- Mindfulness and meditation.
- Massage therapy.
- Art therapy.
- Music therapy.
- Biofeedback therapy.
- What is biofeedback therapy?
Biofeedback helps you learn to control some physical processes, like your heart rate. By making subtle changes in your body, you may be able to improve your physical or mental health.15
- What is medication-assisted treatment (MAT)?
MAT uses a combination of behavioral therapy with certain medications to treat substance use disorders.16
Medications for opioid use disorder include:16
Medications for alcohol use disorder include:16
- What is pharmacotherapy?
Treatment approaches that utilize medications.1
- What is pharmacogenetics?
The study of the way that a person’s genes influence how they respond to certain drugs.17
- What is 12-Step facilitation therapy?
12-Step facilitation is a therapeutic approach that works toward promoting a patient’s engagement with 12-Step programs.18
- What are 12-Step programs?
12-Step programs are those that are based in the 12 steps that are believed to support long-term abstinence from drugs and alcohol.19 The 12 steps have been adapted for other addiction as well, including gambling and sex.
In 12-Step programs, members are encouraged to find another member to be a sponsor who can support them and provide guidance in times of crisis.19
While Alcoholics Anonymous (AA) is the most well-known 12-Step program, there are numerous other programs based in the 12-Step philosophy. They include:
- Narcotics Anonymous (NA).
- Codependents Anonymous (CODA).
- Sex and Love Addicts Anonymous (SLAA).
- Gamblers Anonymous (GA).
The 12-Step programs incorporate the concept of a higher power, which is up to the individual member’s interpretation.19
- What is SMART Recovery?
Self-Management and Recovery Training (SMART) is a secular, science-based alternative to 12-Step programs. SMART focuses on teaching coping methods that can help members achieve and sustain sobriety.20
SMART Recovery is based around 4 points:20
- Building and keeping the motivation to change.
- Coping with the urge to use drugs or alcohol.
- Managing feelings, thoughts and behaviors without drugs or alcohol.
- Living a healthy, balanced, and positive life.
- What are virtual support meetings?
There are meetings that take place online. American Addiction Centers offers multiple weekly virtual meetings.
- What is aftercare?
Aftercare, or continuing care, is the stage of ongoing recovery efforts that follow the completion of a more intensive or structured treatment program. For example, aftercare may mean outpatient therapy or sober living after the completion of inpatient rehab. A good aftercare plan can help to prevent relapse.
- What is a relapse?
A relapse is a return to drug or alcohol use after a period of sobriety. Because addiction is known to be a chronic and relapsing disorder, relapse is common in recovery.21
- What does sober living mean?
Sober living refers to residences for recovering individuals that are drug- and alcohol-free. Sober living homes offer a safe place for those coming out of treatment who are not yet comfortable returning to their home environment and who need extra support in recovery.
- What are programs for alumni in recovery?
Alumni programs are the programs aimed at supporting patient alumni after they’ve completed treatment. At Greenhouse Treatment Center, the alumni program includes weekly meetings around the area.
- National Institute on Drug Abuse. (2018). Glossary.
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
- Center for Substance Abuse Treatment. Detoxification and Substance Abuse Treatment. Treatment Improvement Protocol (TIP) Series, No. 45. HHS Publication No. (SMA) 15-4131. Rockville, MD: Center for Substance Abuse Treatment, 2006.
- National Institute on Drug Abuse. (2018). Treatment and Recovery.
- Cook, S. C., Schwartz, A. C., & Kaslow, N. J. (2017). Evidence-Based Psychotherapy: Advantages and Challenges. Neurotherapeutics: the journal of the American Society for Experimental NeuroTherapeutics, 14(3), 537–545.
- Miller, S. C., Fiellin, D. A., Rosenthal, R. N., & Saitz, R. (2019). The ASAM Principles of Addiction Medicine, Sixth Edition. Philadelphia: Wolters Kluwer.
- org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Cognitive behavioral therapy. 2013 Aug 7 [Updated 2016 Sep 8].
- Dimeff, L. A., & Linehan, M. M. (2008). Dialectical behavior therapy for substance abusers. Addiction science & clinical practice, 4(2), 39–47.
- Substance Abuse and Mental Health Services Administration (SAMHSA) (2010). Spotlight on PATH practices and programs: Motivational Interviewing. Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration.
- Albert Ellis Institute. (n.d.). Frequently asked questions.
- S. Department of Veterans Affairs. (n.d.). Eye Movement Desensitization and Reprocessing (EMDR) for PTSD.
- University of Washington Alcohol & Drug Abuse Institute. (n.d.). Seeking Safety: A Psychotherapy for Trauma/PTSD and Substance Abuse.
- Substance Abuse and Mental Health Services Administration. (2013). Family Therapy Can Help.
- Center for Substance Abuse Treatment. Substance Abuse Treatment: Group Therapy. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2005. (Treatment Improvement Protocol (TIP) Series, No. 41.) 1 Groups and Substance Abuse Treatment.
- Harvard Health Publishing. (2018).
- Substance Abuse and Mental Health Services Administration. (2020). Medication and Counseling Treatment.
- S. National Library of Medicine. (n.d.). What is pharmacogenomics?
- National Institute on Drug Abuse. (2018). 12-Step Facilitation Therapy (Alcohol, Stimulants, Opiates).
- Center for Substance Abuse Treatment. Treatment of Adolescents with Substance Use Disorders. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 1999. (Treatment Improvement Protocol (TIP) Series, No. 32.) Chapter 4—Twelve-Step-Based Programs.
- SMART Recovery. (n.d.). About SMART Recovery.
- National Institute on Drug Abuse. (n.d.). What is a relapse?