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Definitions for substance use and mental health

Definitions for substance use and mental health

From abstinence to zoopsia, the definitions page is here to help you.  Keeping track of all of the vocabulary, slang and acronyms related to mental health and substance use can be overwhelming.

This page has been created to help you understand and keep up to date with what you want to know. 

Words with a red asterisk* will indicate that a word or concept is controversial or has a stigma associated with it.

Think something is missing that should be included?  Feel free to let me know.





Refraining from drug or alcohol use, whether as a matter of principle or for other reasons. The term "current abstainer", often used in population surveys, is usually defined as a person who has not drunk an alcoholic beverage in the past 12 months.   


In harm reduction therapy, abstinence is considered one of many possible goals a person might have regarding their alcohol and/or drug intake.    


A person who exhibits impaired control over managing their substance use, or behavioral addiction such as gambling.  The term is common but has a derogatory connotation.  Recommended language might state, “person struggling with addiction” or a “person with a substance use disorder”.

The word addict is not a professional diagnosis and is not found in the DSM-5.


According to the American Society of Addiction Medicine, “addiction is a treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual’s life experiences. People with addiction use substances or engage in behaviors that become compulsive and often continue despite harmful consequences. Prevention efforts and treatment approaches for addiction are generally as successful as those for other chronic diseases.”

Adopted by the ASAM Board of Directors September 15, 2019


A drug that activates certain receptors in the brain.  Full agonist opioids activate the opioid receptors resulting in the full opioid effect.  Examples include methadone, heroin, and morphine.

Partial agonist opioids activate the opioid receptors too, but to a lesser degree.  An example is buprenorphine.  (See antagonist).


Ethanol (EtOH) is the only form of alcohol that is meant for human consumption.  Alcohol is a central nervous system depressant, producing feelings of relaxation and pleasure, disinhibition, motor impairment, memory loss, and slurred speech.  At high doses alcohol can cause breathing problems, coma, or death.

Alcohol consumption is also connected to increased risk of accidents such as violence, car accidents and risky sexual behavior.  Alcohol is frequently involved when suicides or homicides occur.


Alcohol overdose (or poisoning) occurs when there is so much alcohol in the bloodstream that areas of the brain controlling basic life-support functions shut down. This includes our breathing, heart rate and temperature control.


A person who exhibits impaired control over engaging in alcohol use despite suffering severe harms caused by such activity.  This word has a negative connotation.  Recommended language might state, “person struggling with addiction” or a “person with an alcohol use disorder.”


A term of long-standing use and variable meaning, generally taken to refer to chronic continual drinking or periodic consumption of alcohol which is characterized by impaired control over drinking, frequent episodes of intoxication, and preoccupation with alcohol and the use of alcohol despite adverse consequences.

The DSM-5 does not use the word, alcoholism.  The proper terminology used by the medical community is alcohol use disorder.


A problematic pattern of alcohol consumption, characterized by compulsive use of alcohol, impaired control over alcohol intake, and a negative emotional state when not using. According to the 5th Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) published by the American Psychiatric Association, an alcohol use disorder is present if two or more of the 11 criteria are met within a 12-month period.


A state of psychological tension in which one is pulled in two different directions: to stay the same or to make changes.

Harm reduction understands and embraces ambivalence.  Rather than viewing it as a lack motivation, it is viewed as normal, healthy and indicates one is capable of seeing and understanding the “gray areas” of life.


Anger that is felt too frequently or too intensely can become problematic.  It can affect relationships, work and general wellbeing.  Anger management assists individuals in reducing both  emotional feelings and the physiological arousal that anger causes.  Anger management incorporates CBT, and involves relaxation training, cognitive re-structuring, enhanced communication skills, development of anger control plans, conflict resolution skills, assertiveness training, and humor. 


(See cognitive behavioral therapy (CBT).)


Antagonists are drugs that block opioids by attaching to the opioid receptors without activating them.  No opioid effect is caused and they block full agonist opioids.  Examples include naltrexone and naloxone.  (See agonist).


Anxiety is the anticipation of a future concern.  Although it is a normal feeling, anxiety that is felt too frequently and too intensely can get in the way of general wellbeing. An individual dealing with excess anxiety is likely to find it difficult to manage their worry, and may have symptoms such as restlessness, fatigue, problems concentrating, irritability, and disturbed sleep.

People with anxiety are more likely to use alcohol and drugs.


Assertiveness is a communication skill that anyone can learn. Assertiveness is about mutual respect; it is communicating needs, wants and boundaries in a neutral, but firm way that is respectful to others and to yourself. If you are being assertive, you are standing up for yourself, but you are also not bullying or hurting others.


The sex assigned at birth based on the child’s visible sex organs.


The gender assumed about an individual, based on their assigned sex as well as apparent societal gender markers and expectations, such as physical attributes and expressed characteristics. 


Plant-based hallucinogen that users drink.  Initially, there is nausea and vomiting, followed by anxiety and/or fear.  This is usually followed by an intense hallucinatory and dissociative experience and a sense of profound insight.  The experience lasts several hours.

Ayahuasca is almost never used recreationally, but rather as a pharmacologic aid to personal insight.  There are many proponents of using ayahuasca to treat substance use disorder and PTSD, specifically combat PTSD.  Many people who have undergone the experience report significant improvements, but there are insufficient studies to indicate overall effectiveness. 

Barriers to further studies include double blind difficulty, legality, and lack of financial incentives, among many others.

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Acronym for Black, Indigenous, and People of Color. It acknowledges the specific histories of Black, Latinx, Asian Pacific Islanders (API), and Native people within the United States without collapsing them into a homogenous category of people of color. 


A person who has the potential to be attracted to people of more than one gender.


The term to describe the total inability to recall events that occurred while the person was drunk.  During a blackout a person may appear to be in a normal state of mind and there is no lapse of consciousness during a blackout. 


BAC refers to the percent of alcohol (ethyl alcohol or ethanol) in a person's blood stream. A BAC of .10% means that an individual's blood supply contains one-part alcohol for every 1000 parts blood.


In Texas (and many other states), a person is legally intoxicated if they have a BAC of .08% or higher.


A central nervous system depressant that causes sedation and sleep. These medications have been replaced largely by benzodiazepines because they are less toxic, and benzodiazepines have lower potential for overdose risk.


Individuals who use these drugs over long periods can become dependent, even though the prescribed dose is never exceeded. Barbiturates are still sometimes used medically, however, as anticonvulsants, for example phenobarbital.


A form of addiction that involves a compulsion to engage in a rewarding non-drug-related behavior, despite experiencing negative harmful consequences due to the compulsive behavior.  Examples might include gambling, sex, food, porn, shopping, etc.

Note: only gambling is included in the DSM-5 and it is referred to as gambling disorder.


The field of health care concerned with substance use and other mental health disorders.  Sometimes used interchangeably with mental health.


A class of psychoactive drugs that act as minor tranquilizers producing sedation, muscle relaxation, and sleep; commonly used in the treatment of anxiety, convulsions, and alcohol withdrawal.

Even when benzodiazepines are taken in therapeutic doses, their abrupt discontinuation can induce a withdrawal syndrome. Symptoms are more intense with shorter-acting preparations; with the long-acting benzodiazepines, withdrawal symptoms appear one or two weeks after discontinuation and last longer but are less intense.  As with other sedatives, a schedule of slow detoxification is necessary to avoid serious complications such as withdrawal seizures.

Fatal overdose is rare with any benzodiazepine unless it is taken concurrently with alcohol or other central nervous system depressants.

Commonly referred to as benzos.  Examples, include Valium, Xanax and Klonopin.


Excessive alcohol consumption within a short time period.

The CDC defines binge drinking as: Men consuming 5 or more drinks or women consuming 4 or more drinks in about 2 hours.


A blackout (acute anterograde amnesia) is a period of amnesia or memory loss, typically caused by chronic, high-dose substance use. The person later cannot remember the blackout period. Blackouts are most often caused by sedative-hypnotics such as alcohol and benzodiazepines.  A black out is not associated with loss of consciousness


When a person initially consumes alcohol, the body first experiences an energizing or positive effect; this is followed, with continued drinking, by a depressant or negative effect of alcohol. Therefore, there is a point of diminishing returns (a blood alcohol level between .05-.06%) at which ceasing alcohol consumption will minimize negative consequences.

This effect counters cultural myths and often personal beliefs that increasing alcohol consumption will continue to lead to increasing euphoria and energy.


Boundaries are a barrier between us and other people.  Boundaries may be physical, emotional, financial or involve things like our time.  Ideally boundaries are individualized and consider context.  Strong boundaries often lead to improved mental/emotional health, better relationships, and a stronger sense of self.


A semisynthetic opioid to control moderate to severe pain and to treat opioid use disorder. Buprenorphine can be administered by injection (for pain), a transdermal skin patch (to control pain or treat opioid use disorder) and is used alone or in combination with naloxone in the form of a dissolvable tablet placed under the tongue (sublingual) or film placed inside the cheek (buccal) to treat opioid use disorder.

Common brand names include: Subutex and Suboxone.


Burnout is a state of emotional, physical, and mental exhaustion.  It is caused by excessive and prolonged stress. It occurs when you feel overwhelmed, emotionally drained, and unable to meet constant demands.  Burnout tends to happen slowly, over time.  It reduces both productivity and motivation, often creating feelings of helplessness, hopelessness, and cynicism.

Burnout can also cause health problems that make individuals more susceptible to certain illnesses.  For some, drugs and alcohol are used to cope with the feelings of burnout.

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A xanthine, which is a mild central nervous system stimulant, vasodilator, and diuretic. Caffeine is found in coffee, chocolate, cola and some other soft drinks, and tea, in some cases with other xanthines such as theophylline or theobromine.

Acute or chronic overuse (a daily intake of 500 mg or more) with resultant toxicity is termed caffeinism. Symptoms include restlessness, insomnia, flushed face, muscle twitching, tachycardia, gastrointestinal disturbances including abdominal pain, pressured or rambling thought and speech, and sometimes exacerbation of pre-existing anxiety or panic states, depression, or schizophrenia.

The DSM-5 includes caffeine related disorders (intoxication and withdrawal) and caffeine use disorders.


An incredibly versatile plant with uses ranging from industrial, to medicinal to social.   There are three main types of cannabisCannabis sativaCannabis indica, and hemp.  Cannabis is the general botanical name of the plant that produces marijuana. The cannabis plant contains more than 400 chemical and several of them of are psychoactive.  (see THC). 

Marijuana is generally considered to be safest of all recreational drugs.  Psychological and medical benefits of marijuana include, feelings of relaxation, happiness, reduced stress and aggression, increases in appetite and decrease in nausea (helpful for those with AIDS and chemotherapy patients), reduced eye pressure from glaucoma and helpful for those suffering from seizures, migraines and chronic pain.  There is no risk of overdose.

Some people do experience less desirable effects, some of which include, dry mouth, delayed reaction time, paranoia, loss of motivation, respiratory problems (when smoked), and dizziness.  Due to the increase in heart rate and decrease in blood pressure older people and those with heart problems may be at risk of a heart attack.  

Marijuana use by adolescents is generally not advised.  Regular use before age 18 has been associated with problems with learning, cognitive function, visual scanning, problems with memory formation and mental flexibility.  The reason adults are not affected in the same way seems to be related to the hippocampus while it is still developing.

The DSM-5 includes cannabis related disorders (intoxication and withdrawal) and cannabis use disorders.


Early theories tended to blame family members for the addiction issues within the family system, but later theories acknowledged the stress created by being in a close relationship with someone suffering from an alcohol or substance use disorder.

Despite agreement that family members are seriously affected by the substance use, and general acknowledgement that they are not only concerned about their loved one but also deal with the negative effects of the use, they have had limited options for help or treatment involvement. This is unfortunate, because research suggests that they not only can benefit from receiving help, but they also can positively influence the individual suffering from alcohol and/or drug use.


The part of the nervous system which consists of the brain and spinal cord, to which sensory impulses are transmitted and from which motor impulses pass out, and which supervises and coordinates the activity of the entire nervous system.

The three most vital functions that the CNS controls are the reflex system, the circulatory system, and the respiratory system. 

Some drugs are CNS stimulants, such as meth or cocaine.  Some are CNS depressants like alcohol or opioids.


A term used to refer to an individual whose gender identity aligns with the one associated with the sex assigned to them at birth. 


A reference to a state of a person being abstinent from drugs of misuse. It may also be used in describing urine test results that are not positive for substance use. The term has been viewed as potentially stigmatizing because of its negative connotation, with the opposite being “dirty.”

It is preferred to use proper, neutral medical terminology, i.e. remission, recovery, or urine drug screens as positive or negative.


A stimulant drug derived from the leaves of the coca plant.  It activates the reward centers of the brain to produce sensations of extreme happiness and energy, increased mental alertness, hypersensitivity to sight, sound, and touch, irritability or anxiety, constricted blood vessels, dilated pupils, nausea, tremors and muscle twitches, rapid and/or irregular heartbeat, and increased blood pressure and body temperature.

Also known as blow or coke.  Cocaine can be inhaled (e.g. smoked, or vapors inhaled), snorted, or injected.  (See crack, stimulant).


An analgesic opioid 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 Food and Drug Administration in 1950, codeine is frequently combined with acetaminophen (Tylenol) or aspirin as a prescription pain medication.  Codeine is often found in cough medicine; it is a narcotic cough suppressant. It affects the signals in the brain that trigger cough reflex.  (See opioid).


Immoderate emotional or psychological reliance on a partner. Often used with regards to a partner requiring support due to an illness or disease, such as a substance use disorder.

The term has been viewed as stigmatizing as it tends to pathologize family members’ concern and care for their loved one and may increase their shame.

Codependency does not have a standardized definition and is not a recognized diagnosis in the DSM-5.


A therapeutic approach that seeks to modify negative or self-defeating thoughts and behavior. CBT is aimed at both thought and behavior change.  Essentially, coping by thinking differently and coping by acting differently.


Slang term for tactile hallucinations (formication) that feel like bugs crawling on or under the skin. Chronic and high-dose stimulant abuse can cause these hallucinations.


Slang term for the abrupt and complete cessation in intake of an addictive substance. The term stems from the appearance of goosebumps on the skin often observable in individuals when physiologically withdrawing from a substance.


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


When applied to psychoactive substance use, the term refers to a powerful urge attributed to internal feelings rather than external influences; to take the substance(s) in question. The substance user may recognize the urge as detrimental to well-being and may have a conscious intent to refrain.


Substance use occurs on a continuum.  It ranges from no use (abstinence) to harmless use to out of control use or having an alcohol or substance use disorder.  Essentially, individuals differ in their levels of use or their patterns for using.


Psychoactive substances whose distribution is forbidden by law or limited to medical and pharmaceutical channels. The term is often used to refer to psychoactive drugs and precursors covered by international drug conventions (the 1961 Single Convention on Narcotic Drugs, amended by a 1972 Protocol; the 1971 Convention on Psychotropic Substances: the 1988 Convention Against Illicit Traffic in Narcotic Drugs and Psychotropic Substances).

At both international and national levels (as in the 1970 United States Controlled Substances Act), controlled drugs are commonly classified according to a hierarchy of schedules, reflecting different degrees of restriction of availability. (See controlled substance schedule).


According to the DEA: Drugs and other substances that are considered controlled substances under the Controlled Substances Act (CSA) are divided into five schedules.

An updated and complete list of the schedules is published annually in Title 21 Code of Federal Regulations (C.F.R.) §§1308.11 through 1308.15. Substances are placed in their respective schedules based on whether they have a currently accepted medical use in treatment in the United States, their relative abuse potential, and likelihood of causing dependence when abused.


Most often used to describe both a mental health diagnosis and a substance use disorder. Personality disorder may also co-exist with psychiatric illness and/or substance use disorders. Also known as comorbidity or dual diagnosis.


The specific efforts, both behavioral & psychological, utilized to master, tolerate, reduce, or minimize the effects of stressful events.  Examples might include, exercise, hobbies, or breath work.

Harm reduction respects and understands that the origin of substance use is often a coping mechanism or strategy.


Crack is alkaloidal (free base) cocaine (cocaine hydrochloride), an amorphous compound that may contain crystals of sodium chloride. It is “modified cocaine”. "Crack" refers to the crackling sound made when the compound is heated.

An intense "high" occurs 4-6 seconds after crack is inhaled; an early feeling of elation or the disappearance of anxiety is experienced, together with exaggerated feelings of confidence and self-esteem. There is also impairment of judgement, and the user is thus likely to undertake irresponsible, illegal, or dangerous activities without regard for the consequences. Speech is pressured and may become disjointed and incoherent. Pleasurable effects last only 5-7 minutes, after which the mood rapidly descends into dysphoria, and the user is compelled to repeat the process in order to regain the exhilaration and euphoria of the "high".

Overdose appears to be more frequent with crack than with other forms of cocaine.


Intense desire for a psychoactive substance or for the intoxicating effects of that substance. Craving is a term in popular use for the mechanism presumed to underlie impaired control: it is thought by some to develop, at least partly, because of conditioned associations that evoke conditioned withdrawal responses. Craving may also be induced by the provocation of any physiological arousal state resembling an alcohol or drug withdrawal syndrome.


Occurs when tolerance develops to multiple (or all) drugs in the same class. (See drug class). 


The capacity of a service provider (or organization) to understand and work effectively in accordance with the cultural beliefs and practices of persons from a given ethnic/cultural group. Also includes an ability to examine and understand nuances and exercise full cultural empathy.


The capacity and willingness of a clinician or other service provider to be open to working with issues of culture and diversity.


Biopsychosocial or other treatment that is adapted to suit the special cultural beliefs, practices, and needs of a client.

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Deaths caused by drug and alcohol use and/or suicide.


A severe form of alcohol withdrawal involving sudden and severe mental or nervous system changes resulting in varying degrees of mental confusion and hallucinations. Onset typically occurs 24-48 hours following cessation of alcohol. It is often preceded by physiological tremulousness and sweating following acute cessation in individuals with severe alcohol use disorder.

Commonly referred to as DT’s.


Usually refers to physiological dependence and is characterized only by tolerance and withdrawal.  It may have nothing to do with psychological dependence, which people generally refer to as addiction.  (See tolerance; withdrawal).


An injection of a medication that is intended to gradually disperse its therapeutic contents into the human body over a number of weeks. In the case of substance use disorders (opioid or alcohol use disorder), this can reduce problems with medication adherence as medications are more typically taken on a daily schedule and orally. Common depot injection for substance use is Vivitrol.


Any agent that suppresses, inhibits, or decreases some aspects of central nervous system (CNS) activity. The main classes of CNS depressants are the sedatives/hypnotics, opioids, and neuroleptics.


Examples of depressant drugs are alcohol, barbiturates, benzodiazepines, and heroin

Downer is slang for depressant.


Feelings of depression are common, but can become serious.  Depression negatively affects how you feel, the way you think and act.   Depression causes feelings of sadness and/or a loss of interest in activities once enjoyed. It can lead to a variety of emotional and physical problems and can decrease a person’s ability to function at work and at home.  Depression symptoms are on a range from mild to severe.


A novel chemical substance with psychoactive properties, synthesized specifically for sale on the illicit market and to circumvent regulations on controlled substances. In response, these regulations now commonly cover novel and possible analogues of existing psychoactive substances. The term was coined in the 1980's.

Examples of designer drugs include bath salts, spice and K2.


The medical process focused on treating the physical effects of withdrawal from substance use and comfortably achieving metabolic stabilization.  For some, this is the first step toward longer term treatment.

Detoxification may or may not involve the administration of medication. When it does, the medication given is usually a drug that shows cross-tolerance and cross-dependence to the substance(s) taken by the patient. The dose is calculated to relieve the withdrawal syndrome without inducing intoxication and is gradually tapered off as the patient recovers.


The 2013 update to the American Psychiatric Association’s (APA) classification and diagnostic tool. In the United States, the DSM-5 serves as a universal authority for psychiatric diagnosis.


DMT is a serotonin-related hallucinogen.  DMT comes from Central and South America.  Unlike LSD and psilocybin mushrooms, DMT is short-acting hallucinogen.  Typical trips last around an hour and often produces more anxiety in part because of its brevity.

Also, called businessman’s lunch.  (See hallucinogen, trip).


A reference to a urine test that is positive for substance use, or a person still using substances. This term is viewed as stigmatizing because of its negative connotation. Instead, it is recommended to use proper medical terminology such as an individual having positive test results or is actively using.


Slang referencing opioid withdrawal symptoms.  It is preferable to use medically accepted terminology such as withdrawal.

Symptoms of opioid withdrawal may include anxiety, nausea, diarrhea, vomiting, body aches, watery eyes, runny nose and abdominal pain. Though the symptoms are often severe, for most people they are not life-threatening.


A term of varied usage. In medicine, it refers to any substance with the potential to prevent or cure disease or enhance physical or mental welfare, and in pharmacology to any chemical agent that alters the biochemical physiological processes of tissues or organisms.


A term sometimes used to describe an array of problems resulting from intensive use of psychoactive substances.


Substances can belong to one or more drug categories or 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.

5 common psychoactive drug classes include: stimulants (cocaine, coffee), depressants (barbiturates, benzodiazepines), narcotics (opioids like morphine and heroin), hallucinogens (LSD, psilocybin), and marijuana (cannabis).


Reoccurring dreams during the recovery process from substance use disorder that concern depictions of substance use, often vivid in nature, and frequently involving a relapse scenario. These dreams decrease in frequency with time in recovery from substance use disorder.  


Commonly used by the Alcoholics Anonymous and peer support communities, this term identifies individuals who no longer utilize alcohol, but continue to behave in ways believed to be dysfunctional or show regression in personal growth or within their recovery program.

The term carries stigma and may not accurately represent complex issues and feelings a person in recovery may be going through. 


Describes patients with both a mental health diagnosis and substance use disorder. Personality disorder may also co-exist with psychiatric illness and/or substance use disorders. (See comorbid, co-occurring)

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Slang term for methylenedioxymethamphetamine (MDMA), a member of the amphetamine family. A synthetic substance with stimulant and hallucinogenic effects, that produces feelings of increased energy, euphoria, and distorted sensory and time perception. Side effects include nausea, muscle cramping, involuntary teeth clenching, blurred vision, chills, and sweating.

Also known as Molly, E, XTC, Adam.  Slang for being high on ecstasy is “rolling”.


Actions that typically involve removing or diminishing the naturally occurring negative consequences resulting from substance use, increasing the likelihood of disease progression. The term has a stigma associated with it, due to the inference of judgement and blame typically of a concerned loved-one.

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A potent synthetic opioid that activates the reward centers of the brain to produce sensations of euphoria and provide pain relief. Side effects have included alterations in consciousness, sensations of heaviness, decreases in mental function, constipation, anxiety, changes in mood and appetite, nausea, dry mouth, intense itching, constricted pupils, and increased body temperature.

Fentanyl is 50 to 100 times more potent than morphine, and is available in legal prescription form, and increasingly, in illegal illicit forms. Many overdoses have occurred due to fentanyl being added to heroin, cocaine and other drugs. 

Fentanyl is generally only prescribed to patients in extreme pain, such as those with cancer.  Fentanyl comes in various forms (lozenge on a handle, sublingual, tablet, film and a buccal tablet).  The various forms have unique brand names associated with them.

Also known as Apache, Fenty, or Jackpot.


Fentanyl analogs are similar in chemical structure to fentanyl.  Examples include acetylfentanyl, furanylfentanyl, and carfentanil. Estimates of the potency of fentanyl analogues vary from less potent than fentanyl to much more potent than fentanyl. Carfentanil, the most potent fentanyl analog detected in the U.S., is estimated to be 10,000 times more potent than morphine. 


An irreversible syndrome inherited by children exposed to alcohol consumption by the mother in utero. This syndrome is characterized by physical and mental birth defects. This is currently more commonly referred to as fetal alcohol spectrum disorder.  Most babies born with this diagnosis will have an intellectual and/or developmental disability (IDD).


Post-hallucinogen perception disorder, a spontaneous recurrence of the visual distortions, physical symptoms, loss of ego boundaries, or intense emotions that occurred when the individual ingested hallucinogens in the past.

Flashbacks are episodic, of short duration (seconds to hours), and may duplicate exactly the symptoms of previous hallucinogen episodes. They may be precipitated by fatigue, alcohol intake, or marijuana intoxication. Post- hallucinogenic flashbacks are relatively common.

Flashbacks may also refer to symptoms associated with post-traumatic stress disorder.  Flashbacks of this nature have their origins in the experience of trauma, rather than hallucinogen use.


1 year without substance use disorder symptoms, except for cravings.

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Risking something of value in the hopes of obtaining something of greater value.


The clinical term describing the diagnosis for gambling related issues in the DSM-5.  Experiencing four or more of the signs and symptoms in a 12- month period may indicate the presence of a gambling disorder. 

A gambling disorder can be diagnosed as mild, moderate, or severe depending upon the number of signs/symptoms experienced.  Although frequently referred to as 'gambling addiction', this is not the proper diagnostic label.


According to the Cleveland Clinic, gaslighting happens when someone manipulates you into thinking your version of events didn’t happen the way you say they happened. Gaslighting is a form of emotional abuse. Being gaslit causes people to question their own feelings, instincts, memories, and sanity. This gives the person doing the gaslighting an enormous amount of power and control.


Gateway drugs have been described as drugs you use earlier in life that put you at risk for using “harder” drugs later.  Marijuana has most frequently been the “poster child” for the gateway drug theory.  However, the vast majority of people who have used marijuana have never moved on to harder drugs.

According to the National Academy of Sciences, “there is no conclusive evidence that the drug effects of marijuana are causally linked to the subsequent use of other drugs”.


Research has proven alcohol and tobacco to be true gateway drugs.


Term used to describe people who are emotionally, romantically, and/or physically attracted to people of the same gender. Lesbian is often a preferred term for women, though many women use the term gay to describe themselves.  The term should not be used as an umbrella term for LGBTQ+ people.



Gender is a set of socially constructed roles, behaviors, activities, and attributes that a given society considers appropriate.


A person’s sense of self in relation to gender. Gender identity does not always correspond to biological sex. People become aware of their gender identity at many different stages of life, from as early as 18 months and into adulthood. Gender identity is a separate concept from sexuality. 


Texas is one of the very few states that does not provide basic legal protection from low-level drug offenses to 911 callers requesting emergency assistance for a suspected overdose.  During the 86th Texas Legislature, two Good Samaritan bills, SB 305 and HB 2432 were refiled. Despite thousands of opioid deaths in Texas since their initial filling, Governor Abbott essentially blocked the bills from consideration.


Grief is the natural reaction to loss. It can be an overwhelming emotion to experience. Grief is both a universal and a personal experience. Individual experiences of grief vary and are influenced by the nature of the loss.  Grief may occur following a death, a job loss, a relationship ending, the death of pet or any kind of loss that feels significant to someone.


The use of strategies that soothe and distract someone who is experiencing intense pain or other strong emotions, helping anchor them in the present. Most grounding exercises involve either sensory awareness or cognitive awareness.

Grounding techniques can be helpful in managing stress/anxiety, panic, and PTSD symptoms such as flashbacks.

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A substance that induces hallucinations.  Most often these drugs intensify or alter perceptions of reality rather than create ones that are not there.  However, this is variable by drug and by dose.

There are 3 primary types of hallucinogens.  Serotonin-related (LSD, psilocybin), Catecholamine-related (mescaline) and acetylcholine-related (ibogaine).  


According to the Harm Reduction Coalition: Harm reduction is a set of practical strategies and ideas aimed at reducing negative consequences associated with drug use. Harm Reduction is also a movement for social justice built on a belief in, and respect for, the rights of people who use drugs.


Per the founders of Harm Reduction Therapy, Patt Denning and Jeannie Little, “Harm Reduction Therapy is a revolutionary client-therapist collaboration that combines substance misuse treatment with psychotherapy, so clients can address both their substance use and the issues that are behind it.”


Hashish is a potent form of cannabis (marijuana) produced by collecting and compressing trichomes, the most potent material from cannabis plants.  Trichomes are the fine growths on cannabis plants that produce a sticky resin.

(See cannabis, THC).


Heroin (diacetylmorphine) is a drug made from the opium poppy plant.  It is a central nervous system depressant 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 and H.

Heroin can be: inhaled (smoked), snorted, or injected.  (See opiates).


A term to describe gay, lesbian, or queer people which may be offensive depending on the speaker. Originally used as a scientific or clinical term to describe LGBTQ+ people, the word has been reclaimed by the LGBTQ+ community and may be colloquially used by an LGBTQ+ person to reference themselves or another member of the community.


Non-LGBTQ+ people should avoid using the term.


An analgesic opioid semi-synthetically produced for the treatment of moderate to severe pain, that activates the reward centers of the brain to provide pain relief. It also contains the non-narcotic pain reliever acetaminophen.

Side effects are similar to those found with other opioids. (See opioids.) However, since it contains acetaminophen, liver damage may occur, especially when in taken in large doses or consumed by people with existing liver problems.

Also known as Vicodin.

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A naturally occurring psychoactive substance found in Amanita mascaria mushrooms and the iboga plant. Known to have psychedelic (acetylcholine-related) or dissociative properties, Ibogaine is not approved for treatment of substance use disorder in the United States due to lack of proper testing with regard to toxicology, and both the safety and effectiveness of the substance are largely unknown. 


Substances that produce chemical vapors that are inhaled to induce a psychoactive or mind-altering effect.  Examples include nitrites (poppers), solvents (paint thinner), glues, spray paints, lighter fluids, and fuels.

These are the most destructive of all psychoactive substances.  They routinely cause brain, lung, and liver damage. 


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


A time limited, intensive, non-residential clinical treatment that often involves participation in several hours of clinical services several days per week.  Also referred to as an intensive outpatient program, or IOP.  Some versions of this treatment are voluntary, while sometimes this treatment is court-ordered.


Intersex is the current term used to refer to people who are biologically between the medically expected definitions of male and female. This can be through variations in hormones, chromosomes, internal or external genitalia, or any combination of any or all primary and/or secondary sex characteristics. While many intersex people are noticed as intersex at birth, many are not.


As intersex is about biological sex, it is distinct from gender identity and sexual orientation. An intersex person can be of any gender identity and can also be of any sexual orientation and any romantic orientation. The Intersex Society of North America opposes the practice of genital mutilation on infants and children who are intersex, as does PFLAG National.


Formerly, the medical terms hermaphrodite and pseudohermaphrodite were used; these terms are now considered neither acceptable nor scientifically accurate.


A condition that follows the administration of a psychoactive substance and results in disturbances in the level of consciousness, cognition, perception, judgement, affect, or behavior, or other psychophysiological functions and responses.

The term is most frequently used regarding alcohol use, also referred to as being drunk.

Intoxication is highly dependent on the type and dose of drug and is influenced by an individual's level of tolerance and other factors. Frequently, a drug is taken in order to achieve a desired degree of intoxication.  How intoxication is expressed is highly individualized, but is influenced by experience with the drug, cultural beliefs and expectations and personal expectations about the effects of the drug.


An injection technique used to deliver a medication deep into the muscles. This allows the medication to be absorbed into the bloodstream quickly.  Sometimes referred to as IM.

This method is used for both licit and illicit substances.

Some of injection related health effects include, contraction of disease, track marks, skin infections and endocarditis.


Intravenous means into the vein.  The drug is sent directly into your vein using a needle or tube. Also referred to as IV. 

This method is used for both licit and illicit substances.

Some of injection related health effects include, contraction of disease, collapsed veins, track marks, skin infections and endocarditis.

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Jellinek created a classification of alcoholism, as outlined in The Disease Concept of Alcoholism (1960).  The significance of his work was that he conceived varieties of alcohol problems as opposed to the conceptualization of alcoholism as one 'giant' disorder.

Although the Jellinek curve is relatively well known, it was created by G. Maxwell Glatt and not Jellinek himself.  The Jellinek curve presents the 5 types as a progression (a U-shaped depiction), which really misses the main point of Jellinek’s findings.  The Jellinek curve only depicts the Gamma alcoholism type.

  1. Alpha alcoholism –characterized by psychological dependence, with no progression to physiological dependence; also called problem drinking, escape drinking.

  2. Beta alcoholism—characterized by physical complications involving one or more organ systems, with a general undermining of health and shortened life span.

  3. Gamma alcoholism—characterized by increasing tolerance, loss of control, and precipitation of a withdrawal syndrome on cessation of alcohol intake

  4. Delta alcoholism-characterized by increasing tolerance, withdrawal symptoms, and inability to abstain, but not loss of control of the amount of intake on any occasion.

  5. Epsilon alcoholism--periodic drinking, binge drinking.


Jellinek’s writing from 1960 is often considered more forward thinking and relevant than many of the writings from the past few decades.

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A mild stimulant from a leafy plant in East Africa and Southern Saudi Arabia.  Cathinone is the active ingredient and methcathinone is a synthetic form of khat.  It is a stimulant with effects similar to amphetamines. Heavy use can result in dependence and physical and mental problems resembling those produced by other stimulants.


The leaves of the kratom tree in Thailand have been traditionally used for the treatment of pain, diarrhea, and coughing.  In recent years it has gained popularity as a treatment for opioid dependence.  Kratom is classified as an opioid.  Its safety and use for opioid dependence are still being debated.


A chronic memory disorder associated with amnesia, caused by a severe deficiency of thiamine (vitamin B-1).  It is mostly associated with severe alcohol use disorder. (See Wernicke-Korsakoff Syndrome)

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Refers to a woman who is emotionally, romantically, and/or physically attracted to other women.  Attraction and self-identification determines orientation, not the gender or sexual orientation of one’s partner.


An acronym that collectively refers to individuals who are lesbian, gay, bisexual, transgender, or queer, sometimes stated as LGBT (lesbian, gay, bisexual, and transgender). The addition of the Q for queer is a more recently preferred version of the acronym as cultural opinions of the term queer focus increasingly on its positive, reclaimed definition.


The Q can also stand for questioning, referring to those who are still exploring their own sexuality and/or gender.


The “+” represents those who are part of the community, but for whom LGBTQ does not accurately capture or reflect their identity. 


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.


It is a serotonin-related hallucinogen.  LSD is considered the best known and most widely used hallucinogen.  It can cause changes in perception, including hallucinations.  Other reported feelings include anxiety and fear, a positive expansion of the mind and feelings of wellbeing.  Nausea is common as is numbness, muscle weakness and pupil dilation. Synesthesia may occur.

Typical doses are between 50-150 micrograms.  It is generally dissolved in liquid and then absorbed onto blotter paper.  There are no other drugs that are potent enough to be used in this form. 

LSD does not cause psychotic episodes but can trigger psychosis in vulnerable people.

LSD is commonly referred to as acid. The experience of being on LSD is referred to as tripping. (See hallucinogen, microdosing).

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(See cannabis, THC)


Detoxification in a medical setting, often with use of medications to support initial withdrawal and stabilization following cessation of alcohol or other drugs.  (See detoxification)


Medication-assisted treatment (MAT) is considered a form of harm reduction.  MAT programs administer drugs to assist people in stopping illegal and/or harmful drugs.  Many people find that MAT programs cost less (than drugs), see improved health, provide support and stability, and typically combine therapy and/or case management.

Many have a negative view of MAT programs, seeing them as simply replacing one drug for another.  Like any treatment, MAT has some drawbacks, but remains an important treatment option for many people.

Currently, MAT is only available for opioids (methadone, buprenorphine, naltrexone) and alcohol (naltrexone).

(See methadone, buprenorphine, naltrexone, and Sinclair method.)


A synthetic opioid used in maintenance therapy for those dependent on opioids.  It has a long half-life and can be taken orally once daily. It generally comes in liquid or diskette form, which is dissolved into water or juice.

It is used to reduce withdrawal and post-acute withdrawal symptoms and is often used as a mid- to long-term opioid use disorder medication for helping stabilize and facilitate recovery among those suffering from opioid use disorders.

When taking an appropriate, stable dose, individuals will not feel the effects of opioids if they take them in conjunction with the methadone, nor does the methadone produce a high.  It provides some pain relief, and is sometimes prescribed to chronic pain patients.  There are very few health risks associated with methadone (if taken as prescribed) and it is safe for pregnant women and those breast feeding.

Methadone is legal and is prescribed under the care of a doctor.



Meth as it is commonly known is a synthetically produced stimulant that activates the reward centers of the brain to produce sensations of euphoria, increased wakefulness and physical activity, decreased appetite, faster breathing, rapid and/or irregular heartbeat, and increased blood pressure and body temperature.

Since meth restricts blood flow to capillaries, dental problems and gum deterioration can be problematic. Stimulants can also cause psychotic symptoms during prolonged use or in vulnerable people due to the dopamine release. Repetitive movements, which are often self-destructive (such as skin picking), often accompany frequent use.

There is risk of overamping and overdose.


In recent years, microdosing of Psilocybin mushrooms, LSD and DMT has been gaining in popularity. Although there is no definitive amount for microdosing, most people follow the 1/10 or 1/20 of the standard dose guideline—though this is dependent on the drug and the user experience with it.

It is believed that microdosing allows some benefit of the psychedelic, but without the accompanying impairment of a full dose. Proponents of microdosing claim improvements in well-being and the enhancement of cognitive or emotional processes.  Some studies have produced findings of improved convergent and divergent thinking.

Even with a microdose, users are not guaranteed a positive experience and some have reported increases in anxiety and discomfort.

Microdosing is considered a developing area, and likely more research will be available in the coming years on both the short-term and long-term benefits and risks.


Moderate or low-risk drinking is a drinking pattern in which negative outcomes, or the development of an alcohol use disorder are severely diminished.

Exact amounts vary by site and source.  However, the following should provide a reasonable range for most adults.  (Note: this is a generality and does not take into consideration other factors such as medical problems, medications being taken, etc.)

  1. For women, moderate drinking is 1-3 alcoholic drinks per day, with no more than 7 per week.  

  2. For men, moderate drinking is 1-4 alcoholic drinks per day, with no more than 14 per week.



A general term that usually implies your emotional state or mood is distorted or inconsistent with your circumstances.  A mood disorder will often interfere with your ability to function.  You may feel empty, irritable, extremely sad, or even excessively happy.

Although there are many specific diagnoses that fall under the umbrella of mood disorders, the most common are depression and bipolar disorder.

Anxiety disorders can also affect your mood and often occur along with depression. Mood disorders may increase risk of suicide.



Developed by William Miller, it is a clinical approach that helps people with mental health, substance use disorders and other chronic conditions such as diabetes or cardiovascular conditions, make positive behavioral changes to support better health by helping them to explore and resolve ambivalence about changes.  Motivational interviewing takes a collaborative, rather than confrontational approach.

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An opioid receptor blocker that antagonizes the actions of opioid drugs. It reverses the features of opioid intoxication and is prescribed for the treatment of overdose with this group of drugs.  It is considered a form of harm reduction

Naloxone is safe and easy to administer.  It comes in injection and nasal spray form.  It has saved countless lives.  It only works for the reversal of opioid overdoses (heroin, OxyContin, fentanyl, etc.).  It is not harmful to an individual if they have not taken opiates.

Naloxone is often sold under the brand name, Narcan and is easy to obtain in most states.  Many outreach programs provide it for free, and often it is covered by insurance.


An opioid antagonist, it works by blocking opioid receptors in the brain, without activating them, therefore blocking the effects of opioids. Essentially when used for opioids the pleasurable sensations are diminished and subsequently so is the desire to use.

There are similar results when used for people with an alcohol use disorder. Naltrexone also suppresses the euphoria associated with alcohol, and people no longer receive a “reward” for drinking.

Naltrexone is usually given in pill form.  A long-lasting injectable has come to market, Vivitrol; it is administered monthly.  (See depot injection, medication assisted treatment, Sinclair Method).


A chemical agent that induces stupor, coma, and decreases sensitivity to pain. The term usually refers to opiates or opioids (morphine, heroin, hydrocodone), which are called narcotic analgesics.

In everyday language and legal usage, ‘narcotic’ is often used imprecisely to mean illicit drugs, irrespective of their pharmacology. For example, narcotics control legislation in Canada, USA, and certain other countries includes cocaine and cannabis as well as opioids, i.e. narcotics officer.


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


Brain chemicals that communicate information throughout the body by transmitting signals from one neuron to the next across synapses. Most drugs either stimulate or suppress the activity of neurotransmitters.  Drugs will mimic, expand, lessen, or bind to these neurotransmitters.

There are over 100 different neurotransmitters, but only about 8 that are affected by drugs.  They are: dopamine, norepinephrine (noradrenaline), GABA, glutamate, serotonin, endorphins, Anandamide and 2AG and acetylcholine.


Nicotine belongs to its own drug class though it has stimulant properties.  In high concentrations, it is toxic.  Nicotine is an alkaloid and is the major psychoactive substance in tobacco.  60 mg is enough to kill an adult, but cigarettes only contain 0.5-2 mg, only about 20% of which is ingested while smoking.  (Slightly more is ingested while chewing or snuffing).

When smoked, nicotine goes from the lungs, to the blood, then the brain.  In the brain it stimulates nicotinic receptors (acetylcholine neurotransmitters).  These release dopamine and increase activity in areas of the brain associated with memory and movement.  This rapid combination makes nicotine very reinforcing. Considerable tolerance and dependence develop to nicotine.

Because of its rapid metabolism, brain levels of nicotine fall rapidly and the smoker experiences craving for another cigarette 30-40 minutes after finishing the last one.

In the nicotine user who has become physically dependent, a withdrawal syndrome develops within a few hours of the last dose: craving for a smoke, irritability, anxiety, anger, impaired concentration, increased appetite, decreased heart rate, and sometimes headaches and sleep disturbances. Craving peaks at 24 hours and then declines over a period of several weeks, although it may be evoked by stimuli associated with previous smoking habits.

Tobacco is the leading cause of preventable death, in the US and the world.


Nodding out is a slang term for the early stages of depressant-induced sleep. Opioids (heroin, OxyContin) and sedative-hypnotics (benzodiazepines) induce depression of the central nervous system, causing mental and behavioral activity to become sluggish. As the nervous system becomes profoundly depressed, symptoms may range from sleepiness to coma and death. Typically, “nodding out” refers to fading in and out of a sleepy state.

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One of a group of alkaloids derived from the opium poppy, with the ability to reduce pain, induce euphoria, and, in higher doses may cause stupor, coma, and respiratory depression. Examples include heroin and morphine. The term opiate excludes synthetic opioids.


A family of drugs used therapeutically to treat pain, that also produce a sensation of euphoria and are naturally derived from the opium poppy plant (see opiate) or synthetically or semi-synthetically produced in a lab to act like an opiate, such as oxycodone.

Over time, opioids induce tolerance and neuroadaptive changes that are responsible for rebound hyperexcitability when the drug is withdrawn. The withdrawal syndrome includes craving, anxiety, dysphoria, yawning, sweating, goosebumps, insomnia, nausea or vomiting, diarrhea, cramps, muscle aches, and fever.

With short-acting drugs such as morphine or heroin, withdrawal symptoms may appear within 8-12 hours of the last dose of the drug, reach a peak at 48-72 hours, and clear after 7-10 days. With longer-acting drugs such as methadone, onset of withdrawal symptoms may not occur until 1-3 days after the last dose; symptoms peak between 3-8 days and may persist for several weeks, but are generally milder than those that follow morphine or heroin withdrawal after equivalent doses.

Opioid overdose is reversible with the use of naloxone.


The preparation of the opium poppy, Papaver somniferum.  Opium farmers cut the seedpod from the poppy and collect the sticky fluid that seeps from the cut.  The sap may be dried into a ball (gum opium) or dried and pounded into a powder (powder opium). 

Opium poppies provide the starting material for heroin.  Most opium poppy farms are located Southeast Asia, Mexico, Colombia, and Afghanistan. 


The use of any drug in such an amount that acute adverse physical or mental effects are produced. Deliberate overdose is a common means of suicide and attempted suicide.

In absolute numbers, overdoses of licit drugs are usually more common than those of illicit drugs. Overdose may produce transient or lasting effects, or death; the lethal dose of a drug varies with the person and their individual circumstances.

Commonly referred to as OD.


An analgesic opioid semi-synthetically produced for the treatment of moderate to severe pain, that activates the reward centers of the brain to provide pain relief.   It is synthesized from thebaine, a chemical in opium.  It ranks between morphine and codeine in its effectiveness against pain.

Side effects include constipation, nausea, vomiting, upset stomach, sleepiness, drowsiness, dizziness, lightheadedness, itching, headache, blurred vision, dry mouth, sweating, changes in heart rate, and trouble breathing.

Also known as OxyContin or Percocet.  The aggressive marketing of OxyContin helped lead to the opioid crisis.

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A type of delusion, or false idea, that is unchanged by reasoned argument or proof to the contrary. Clinical paranoia involves the delusion that people or events are in some way specially related to oneself. People who are paranoid may believe that others are talking about them, plotting devious plans about them, or planning to hurt them.

Paranoia often occurs during episodes of high-dose chronic stimulant use (methamphetamines) and may occur during withdrawal from sedative-hypnotics such as alcohol.


A linguistic prescription structuring sentences to name the person first and the condition or disease from which they suffer, second. It is recommended to use “person first” language; instead of describing someone as an “addict”.

Person-first language articulates that the disease is a secondary attribute and not the primary characteristic of the individual’s identity.  For example, rather than saying alcoholic, we might say, a person with alcohol use disorder.

Note: this applies to issues other than substance use.  A person with diabetes, instead of a diabetic.  Someone has schizophrenia, rather than being schizophrenic.


Medical treatment by means of medications.


A term used to describe people who have the desire for multiple consenting intimate relationships at the same time.  Consent and transparency are key components of polyamorous relationships.


The essential feature of posttraumatic stress disorder is the development of characteristic symptoms following exposure to one or more traumatic events.  Some examples may include, abuse, physical attack, sexual attack, natural or man-made disasters, severe motor vehicle accidents, or being witness to serious injury, attack, death, or abuse.

The clinical presentation varies from person to person.  Some common features include re-experiencing (of the event), dysphoric mood, hyperarousal, or dissociative symptoms. 

PTSD is classified under trauma and stressor related disorders in the DSM-5.


The terms used to describe the surgery status of a transgender person. Pre-Op means that a person has not had gender-affirming surgery and may or may not plan to.


Post-Op means that an individual has had gender-affirming surgery.


Non-Op means that a person does not plan to have gender-affirming surgery. The choice to have gender-affirming surgery is highly personal and does not affect the validity of a person’s gender identity. Refrain from discussing a trans person’s surgical history or future unless they bring up the topic.


A presciption medication those at higher risk for HIV take to prevent getting HIV from sex or injection drug use. Though PrEP is highly effective in preventing HIV, it should not be taken in place of other HIV prevention measures, such practicing safe sex and not sharing drug-related injection equipment.


Policy under which the cultivation, manufacture, and/or sale (and sometimes the use) of a psychoactive drug are forbidden (although pharmaceutical sales are usually permitted).

The term applies particularly to alcohol, notably in relation to the period of national interdiction of alcohol sales in the US, from 1919-1933.


The words used to refer to a person other than their name. Common pronouns are they/them, he/him, and she/her.


A hallucinogenic mushroom, similar to LSD in the experience, but milder.  The second most frequently used hallucinogen in the US, after LSD.  A typical dose is 4-10 mg, though much less when used for microdosing. 

At low doses, it may cause feelings of relaxation, physical heaviness or lightness, and perceptual distortions.  Higher doses induce more physical sensations such as, numbness, nausea, and anxiety. 

Also commonly referred to as magic mushrooms or shrooms. (See hallucinogen, microdosing, tripping).


(See hallucinogen)


A drug that crosses the blood-brain barrier to cause alterations in mood, perception or brain function.  Examples include prescribed medications, alcohol, and illicit drugs.

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Methaqualone (brand name Quaalude) is a central nervous system depressant that acts as a sedative and hypnotic.  Its effects include drowsiness, and reduced heart rate and respiration. An overdose of the drug, which is highly addictive, can cause coma and death.

In the 1960s, the drug was prescribed as a sedative mostly in Britain and later caught on as a sleep aid in the United States in the 1970s.  Quaaludes became popular for recreational use in the late 1960s and 1970s. They were frequently called ludes or lemons.

Congress banned domestic production of the drug and its sales as a prescription, and President Ronald Reagan signed the legislation into law in 1984.

Although they have not been available in the US for almost 30 years, they retain pop culture relevance.


A term used by some LGBTQ+ people to describe themselves and/or their community. Reclaimed from its earlier negative use, the term is also considered by some to be inclusive of the entire community, and by others who find it to be an appropriate term to describe their more fluid identities.


Since queer has been historically used in a negative way, this word should only be used when self-identifying or quoting another person who self-identifies as queer.  For example, my boss identifies as queer.


Describes those who are in a process of discovery and exploration about their sexual orientation, gender identity, gender expression, or a combination thereof. Questioning people can be of any age, so for many reasons, this may happen later in life. Questioning is a profoundly important process, and one that does not imply that someone is choosing to be LGBTQ+.

(See LGBTQ+)

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


Use of a drug, usually an illicit drug, in sociable or relaxing circumstances, by implication without dependence or other problems. The term is disfavored by those seeking to define all illicit drug use as a problem.  However, in terms of alcohol, this is usually described as “social drinking.”


A return to drinking or other drug use after a period, of abstinence (remission), often accompanied by reinstatement of dependence symptoms. Some writers distinguish between relapse and lapse ("slip"), with the latter denoting an isolated occasion of alcohol or drug use


The highest risk for recurrence of substance use disorder symptoms occurs during the first 90 days after ceasing use. Individuals attempting to recover from substance use disorder need the most intensive support during this first 3-month period, as individuals are experiencing substantial physiological, psychological, and social changes during this early recovery phase. There is typically a greater sensitivity to stress and lowered sensitivity to reward that makes continued recovery challenging.


This term has a stigma associated with it, as it can imply a moral failing for some people. Instead it may be preferable to use morally neutral terms such as “resumed,” or experienced a “recurrence” of symptoms.


A set of therapeutic procedures employed in the case of alcohol or other drug problems to help individuals avoid or cope with recurrences of substance use. The procedures may be used with treatment based on either moderation or abstinence, and in conjunction with other therapeutic approaches.


Individuals are taught coping strategies that can be used to avoid situations considered dangerous precipitants of relapse, and shown, through mental rehearsal and other techniques, how to curtail continued use once there has been a recurrence.


Attributes (genetics), characteristics (impulsivity) or exposures (prescription opioids) that increases the likelihood of developing a substance use disorder.  Risk factors are also used for disease or injury.


Route of administration refers to the various ways that drugs are taken.  They include, oral, smoking, intravenous (IV) injection, subcutaneous injection, intramuscular (IM), injection, mucous membranes and topical/transdermal.

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A group of central nervous system depressants with the capacity of relieving anxiety and inducing calmness and sleep. Some of these drugs also induce amnesia and muscle relaxation and/or have anticonvulsant properties. Major classes include the benzodiazepines and barbiturates.

All sedatives/hypnotics may impair concentration, memory, and coordination; other frequent effects are hangover, slurred speech, unsteady gait, drowsiness, dry mouth, decreased gastrointestinal motility, and lability of mood. A paradoxical reaction of excitement or rage may be produced occasionally.

Individuals treated over a long period can become psychologically and physically dependent on the drug even if they never exceed the prescribed dose. Withdrawal reactions can be severe and may occur after no more than several weeks of moderate use of a sedative/hypnotic or anxiolytic drug.

Symptoms of withdrawal include anxiety, irritability, insomnia (often with nightmares), nausea or vomiting, tachycardia, sweating, hallucinatory misperceptions, muscle cramps, tremors and myoclonic twitches, hyperreflexia, and seizures.


Self-compassion is a positive attitude toward yourself.  It also means being able to relate to yourself in capacities that are accepting, forgiving, and loving when situations might be less than ideal.


Emotional, romantic, or sexual feelings toward other people or no people. While sexual activity involves the choices one makes regarding behavior, one’s sexual activity does not define one’s sexual orientation. Sexual orientation is part of the human condition, and all people have one. Typically, it is attraction that helps determine orientation.


A person who engages in sexual activity for payment. Often considered a more respectful term than prostitute or hooker.


A painful, negative emotion, which can be caused or exacerbated by conduct that violates personal values. Can also stem from deeply held beliefs that one is somehow flawed and unworthy of love, support, and connection, leading to increased odds of isolation.

Shame is often a barrier to seeking support and/or treatment for substance use disorders


The Sinclair Method for alcohol use disorders is an evidence-based treatment for problematic drinking developed by Dr. John D. Sinclair. Unlike traditional treatments that require complete abstinence from alcohol, the Sinclair Method allows you to continue drinking alcohol at the beginning of treatment.

Treatment success depends on the continued consumption of alcohol in combination with the prescription medication naltrexone.  When you take naltrexone prior to drinking, it blocks endorphins, the naturally occurring opiates in the brain, from being released when alcohol is consumed.

When the endorphins are blocked, there is no “buzz” or rewarding experience, and the alcohol doesn’t make you feel the pleasure that drives you to drink excessively.  Over time, your brain learns not to associate alcohol with pleasure, resulting in reduced cravings and improved control over alcohol use.  


Naltrexone must be taken at least one hour before your first drink.  (See naltrexone).


Sleep hygiene refers to maintaining practices that are conducive to getting a good night’s sleep, as well as reducing sleep latency (the amount of time it takes to fall asleep).



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


The quality or state of being sober. 


An attribute, behavior, or condition that is socially discrediting. Known to decrease treatment seeking behaviors in individuals with substance use disorders.  A stigma can be a source of shame or embarrassment.


A psychoactive substance that increases or arouses physiologic or nervous system activity in the body. A stimulant will typically increase alertness, attention, and energy through a corresponding increase in heart rate, blood pressure, and respiration rates.  They may also cause unusual behavior such as, fighting, grandiosity, hypervigilance, agitation, and impaired judgement.  The effects vary based on type of stimulant taken, the amount, and individual characteristics.

Cessation of intake after prolonged or heavy use may produce a withdrawal syndrome, with depressed mood, fatigue, sleep disturbance, and increased dreaming.

Examples of stimulants include amphetamines, cocaine, caffeine, and nicotine.  Also called uppers.


Approved by the FDA 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.

Suboxone is a sublingual (under the tongue) film.  (See buprenorphine, medication assisted treatment).


A term sometimes used to describe an array of problems resulting from intensive use of psychoactive substances.  The term was a diagnostic label in previous editions of the DSM.


The use of a substance for unintended or intended purposes in improper amounts or doses.  Some people believe it implies negative judgement and blame, while others prefer it because it is more neutral than “abuse” and less stigmatizing than “disorder”.


The act of using substances. 


The clinical term describing the diagnosis for drug and alcohol related issues in the DSM-5.   Experiencing two or more of the signs and symptoms in a 12- month period may indicate the presence of a substance use disorder

A substance use disorder can be diagnosed as mild, moderate, or severe depending upon the number of signs/symptoms experienced.


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 1 year.


An effect caused by the interaction of two or more substances that magnifies the effect to be greater than the sum of each substance’s individual effects.

For example, the combination of opioids and benzodiazepines have a synergistic effect, making the combination dangerous.


Made synthetically or entirely from chemicals, and not made as a derivative of the original substance or plant (opium poppy, marijuana plant, etc.)

Examples of synthetic drugs include: fentanyl, K2 and bath salts.

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A practice in pharmacotherapy of lowering the dose of medication incrementally over time to help prevent or reduce any adverse experiences as the patients’ body makes adjustments and adapts to lower and lower doses.


Delta-9-tetrahydrocannabinol (THC) is the most potent of the 400 active ingredients in the cannabis plant.  THC receptors are found mostly in the hippocampus, which controls new memory formation, in the cerebellum and basal ganglia, which coordinate fine motor movements and the nucleus accumbens which contains dopamine.

The psychoactive effects can last a few hours.  When smoked, it moves from lungs to heart to brain a few seconds and peaks within 10-20 minutes.  When eaten, it goes through the liver first, so it can take an hour to feel the effect. 

Psychoactive potency can vary drastically in the THC content.  Low-grade marijuana is made from the leaves of both sexes of the plant; the result is very little THC.  Medium-grade marijuana is made from the dried flowering tops of female plants and fertilized by male plants.  High-grade marijuana is made from the flowering tops (cola) of female plants and raised in isolation from male plants.  The resulting marijuana is called sinsemilla (without seeds).

The potency, the circumstances and the individual characteristics of the user all influence the “type” of high and the effect on a person.

(See cannabis).


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 overtime to obtain the same original effect obtained at a lower dose. A state in which a substance produces a diminishing biological or behavioral response.

Tolerance is one of the criteria for both a substance use disorder and alcohol use disorder.


A controversial approach to promotion of behavioral change through love or affectionate concern expressed in a stern, unsentimental and/or punitive manner.

First used in 1976, the term “tough love” was not applied to the addiction model until the 1980's, when David and Phyllis York wrote Toughlove. In the book, the authors outline a view of rehabilitation techniques parents should use with their addicted children that relies on consequences ranging from mild to severe such as: taking legal custody of the children of the individual with substance use disorder, refusal to provide financial assistance, asking the individual to leave the home, or refusing to provide bail money or legal assistance.

Tough love is often a reaction of anger and frustration.  It is also more punishment than strategy and does not tend to work well.  The primary reason that it is often ineffective is that the point is to control another person’s behavior.

Limits and boundaries are important when dealing with a loved one with a substance use disorder.  However, limits and boundaries work best when they are about what you need/want, rather than what you think will make someone change.

Professional support can be helpful in finding the balance. 


A term describing a person’s gender identity that does not necessarily match their assigned sex at birth. Transgender people may or may not decide to alter their bodies hormonally and/or surgically to match their gender identity. This word is also used as an umbrella term to describe groups of people who transcend conventional expectations of gender identity or expression. 

Frequently shorted to 'trans'.


A term used to refer to the process (social, legal, and/or medical) one goes through to affirm one’s gender identity. This may, but does not always, include taking hormones; having surgeries; and changing names, pronouns, identification documents, and more. Many individuals choose not to or are unable to transition for a wide range of reasons both within and beyond their control. The validity of an individual’s gender identity does not depend on any social, legal, and/or medical transition; the self-identification itself is what validates the gender identity.


The management and care of a person to combat problems associated with alcohol and drugs. Treatment may include medicine, or medical intervention, therapy, or other modalities.


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 psychological or physical symptom recurrence and reinstatement of substance use disorder.

A trigger can be a person, place, smell, song, etc.  


Slang term for being under the influence of hallucinogens.  Tripping is used most commonly to describe having taken psilocybin mushrooms or LSD.

A bad trip is taking a hallucinogen and having a negative experience such as anxiety, nausea and other discomforts.


Term used within some American Indian and Alaska Native communities to refer to a person who identifies as having both a male and a female essence or spirit. The term encompasses sexual, cultural, gender, and spiritual identities, and provides unifying, positive, and encouraging language that emphasizes reconnecting to tribal traditions. Non-indigenous people should not use this term.

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Slang term used to describe drugs that are central nervous system stimulants. Examples include cocaine, caffeine, and methamphetamines.


Remaining still and concentrating on an urge rather than avoiding it.  Urges (cravings) typically last around 20 minutes.  In the ocean, one cannot escape the waves, rather people must learn to understand them and ride them. 

In urge surfing, one attempts to sit with the craving and try to understand what the urge really is.

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Valium is a benzodiazepine, classified as a sedative.  The generic name is diazepam.  (See benzodiazepines).


Vaping refers to the act of “smoking” an electronic device, a vape pen.  Sometimes called ENDS (electronic nictotine delivery system) or e-cigarette.

Originally developed for smoking cessation, with the idea they might be better than patches or gum since they allow the user to continue the act of “smoking”. 

There is a huge variety of vaping products and the quality of the chemicals used varies widely amongst the suppliers.  The American Cancer Society has requested more studies regarding their application as a smoking cessation aid.

The research into these products and their long-term effects is still new and very often split.


A semi-synthetic opioid used to treat pain.  Generic name is hydrocodone.  (See opioid).

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The co-occurrence of Wernicke’s Encephalopathy simultaneously with Korsakoff syndrome. Encephalopathy typically precedes Korsakoff’s Psychosis and can be prevented via administration of vitamin B-1 (Thiamin); if missed, onset results in permanent neurological damage.

Also known as wet-brain.


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.

The withdrawal process varies based both on the substance and individual circumstances.

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Xanax is a benzodiazepine, classified as a sedative.  The generic name is alprazolam.  (See benzodiazepines).

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(See ayahuasca).

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Usually refers to zero tolerance for drug use or relapse while in a treatment program. 

Also used in criminal justice and school sports.


Seeing animals (e.g. snakes, insects), typically as part of delirium tremens or other substance-induced or hallucinatory state.

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Web sources


1. American Psychological Association, Family Members of Adults with Substance Abuse Problems.  Retrieved from:

2. American Society of Addiction Medicine; Definition of Addiction.  Retrieved from:

3. Begley, S. (2018). Scientists are Starting to Test Claims about ‘Microdosing’.  Scientific American, online article.  Retrieved from:

4. Centers for Disease Control and Prevention, Alcohol and Public Health; Binge Drinking.  Retrieved from:

5. Frecska, E., Bokor, P., & Winkelman, M. (2016).  The Therapeutic Potentials of Ayahuasca: Possible Effects against Various Diseases of Civilization. Frontiers in Pharmacology, Volume 7. (Issue 35).  Retrieved from:

6. Lexicon of alcohol and drug terms published by the World Health Organization.  Retrieved from:

7. NCBI National Center for Biotechnology Information; Appendix C: Glossary of Terms.  Retrieved from:

8. PBS Newshour, What are Quaaludes and how do they work?  Retrieved from:

9. Recovery Research Institute, ADDICTIONARY®.  Retrieved from:

10. Sinclair, What is the Sinclair Method? Retrieved from:

11.Stanford University, Office of Alcohol Policy and Education; What is BAC? Retrieved from:

12. Substance Abuse and Mental Health Services Administration, Medication Assisted Treatment, Methadone.  Retrieved from:

13. Synthetic Opioid Overdose Date, CDC. Retrieved from:,opioids%2C%20like%20U%2D47700.

14. The Harm Reduction Therapy Center, Mission Statement; Retrieved from:

15.Trib Talk, A Publication of the Texas Tribune, Texas misses chance to prevent overdose deaths.  Retrieved from:


16.U.S. Department of Justice, Drug Enforcement Administration, Diversion Control Division; Controlled Substance Schedules.  Retrieved from:

17. PFLAG National Glossary of Terms.  Retrieved from:

Print Sources

1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author.

2. Denning, P., & Little, J. (2017). Over the Influence: The Harm Reduction Guide to Controlling Your Drug and Alcohol Use. The Guilford Press.


3.Kuhn, C., Swartzwelder, S., & Wilson, W. (2019). Buzzed: The Straight Facts about the Most Used and Abused Drugs from Alcohol to Ecstasy. W.W. Norton & Company.


4. Van Wormer, K. & Davis, D.R. (2013). Addiction Treatment, A Strength’s Perspective. 3rd. Ed. Brooks/Cole Cengage Learning, California.

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