Glossary

Abstinence is the absence of substance use. There are many different ways to practice abstinence.

Continuous abstinence: not consuming the drug of choice during a specified period of time

Essentially abstinent: not consuming more than a specified amount of the drug over a period of time

Minimal abstinence: achieving a minimal period of recovery during a period of time

Point-in-time abstinence: not consuming the drug of choice at a single point in time (e.g., the past 30 days)

Complete abstinence: continuous abstinence from all alcohol and other drugs

Involuntary abstinence: enforced abstinence due to hospitalization or incarceration

Analgesics are pain relieving medications including over-the-counter medications like acetaminophen (Tylenol®) or ibuprofen (Advil®) and prescription opioids.

Analogs are drugs that are similar in chemical structure or pharmacologic effect to another drug, but are not identical.

Behavioral Health focuses on how a person’s behavior affects their overall well-being. This includes, but is not limited to, substance use disorder.

Benzodiazepines commonly referred to as “Benzos” are a class of drugs primarily used for treating anxiety but are also used for treating insomnia, seizure disorders, alcohol withdrawal, or as muscle relaxers. Combining benzodiazepines with opioids increases a person’s risk of drug overdose and death

Approved by the FDA in 2002 as a medication treatment for opioid dependence, Buprenorphine 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. See also Suboxone.

Co-occuring, coexisting, or comorbid conditions refers simply to the fact that an individual is experiencing more than one condition or illness at the same time such as substance-use disorder and another mental health disorder.

Drug misuse is using prescriptions drugs in a manner other than as directed by a doctor, such as use in greater amounts, more often, or longer than told. This includes the use of illicit drugs as well as illicitly using someone else’s prescription drugs.

Drug courts are problem-solving courts that operate under a specialized model in which the judiciary, prosecution, defense bar, probation, law enforcement, mental health, social service, and treatment communities work together to help non-violent offenders find restoration in recovery and become productive citizens. Also referred to as recovery courts.

Pharmaceutical fentanyl is a synthetic opioid, approved for treating severe pain, typically advanced cancer pain. It is 50 to 100 times more potent than morphine. However, illegally made fentanyl is sold through illicit drug markets for its heroin-like effect, and it is often mixed with heroin or other drugs, such as cocaine, or pressed into counterfeit prescription pills.

A substance that induces hallucinations (i.e. visions, sounds, smells, tastes, or sensations) that do not actually exist. Common examples include LSD (“acid”) and psilocybin (“magic mushrooms”). Cannabis/marijuana in high doses also can act as a hallucinogen.

Harm reduction is a set of practical strategies and ideas aimed at reducing negative consequences associated with drug or alcohol 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. The defining features include a focus on the prevention of harm, rather than on the prevention of substance use itself, with attention and focus on the individual’s active substance use (e.g., a syringe exchange program can reduce rates of transmission of hepatitis C, HIV, or other infectious disease for individuals suffering from heroin use disorder).

Heroin is an illegal, highly addictive opioid drug processed from morphine and extracted from certain poppy plants.

Illicit drugs are the nonmedical use of a variety of drugs that are prohibited by law. These drugs can include: amphetamine- type stimulants, marijuana/cannabis, cocaine, heroin, other opioids, and synthetic drugs, such as illicitly manufactured fentanyl (IMF) and ecstasy (MDMA).

Medication-assisted treatment (MAT), including opioid treatment programs (OTPs), combines behavioral therapy and medications to treat substance use disorders. New research has shown that medications are effective treatments for opioid use disorder with or without psychosocial support. Low-barrier-MAT refers to MAT without the behavioral therapy supports.

A synthetic opioid medication 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.

Naloxone is a drug that can reverse the effects of opioid overdose and can be life-saving if administered in time. The drug is sold under the brand name Narcan or Evzio. Naloxone cannot reverse non-opioid drug overdoses.

Originally, narcotic referred to psychoactive compounds with sleep inducing properties (typically opioids such as heroin). In moderate doses, narcotics will dull the senses, relieve pain, and induce sleep. In large doses, narcotics will cause stupor, coma, and death.

Neonatal Abstinence Syndrome is a post-natal withdrawal syndrome inherited by children exposed to substances, such as opioids, during pregnancy. Babies born with Neonatal Abstinence Syndrome are more likely to suffer from low birthweight, breathing problems, feeding problems, seizures, or birth defects.

Nonmedical use is the taking of prescribed or diverted prescription drugs (drugs not prescribed to the person using them) not in the way, for the reasons, in the amount, or during the time-period prescribed.

A natural opiate derived directly from the natural opium poppy plant (see opioids).

Opioid analgesics are commonly referred to as prescription opioids, medications that have been used to treat moderate to severe pain in some patients. Categories of opioids for mortality data include:

• Natural opioid analgesics, including morphine and codeine;
• Semi-synthetic opioid analgesics, including drugs such as oxycodone, hydrocodone, hydromorphone, and oxymorphone;
• Methadone, a synthetic opioid that can be prescribed for pain reduction or for use in MAT for opioid use disorder (OUD). For MAT, methadone is used under direct supervision of a healthcare provider;
• Synthetic opioid analgesics other than methadone, including drugs such as tramadol and fentanyl.

In Maine, Certified Opioid Treatment Programs work under medical supervision for Medically Assisted Treatment (MAT) maintenance and detoxification. OTPs administer opioid agonist medication (Methadone), monitor dosages, and provide counseling to people with a dependence on heroin or prescription opioid medications.

Opioid Use Disorder (OUD) occurs when attempts to cut down or control use are unsuccessful or when use results in social problems and a failure to fulfill obligations at work, school, and home. Opioid addiction often comes after the person has developed opioid tolerance and dependence, making it physically challenging to stop opioid use and increasing the risk of withdrawal. National studies have shown that greater than 75% of heroin users utilized prescription painkillers as their introduction to opioid use.

Opioids are natural, synthetic, or semi-synthetic chemicals that interact with opioid receptors on nerve cells in the body and brain, and reduce the intensity of pain signals and feelings of pain. This class of drugs includes the illegal drug heroin, synthetic opioids such as fentanyl, and pain medications available legally by prescription, such as oxycodone, hydrocodone, codeine, morphine, and many others. Prescription opioids are generally safe when taken for a short time and as directed by a doctor, but because they produce euphoria in addition to pain relief, they can be misused and have addiction potential.

Outpatient treatment services are located at an agency office and provide individual, group, and family sessions. Requires daily to weekly attendance at a clinic or facility usually for 60-90 minutes, and allows the patient to return home or to other living arrangements during non-treatment hours.

Overdose is injury to the body (poisoning) that happens when a drug is taken in excessive amounts. An overdose can be fatal or nonfatal.

Physical dependence is adaptation to a drug that produces symptoms of withdrawal when the drug is stopped.

Potency is the degree of concentration of the psychoactive ingredient in a substance

Prescription drug monitoring programs are state or territorial-run electronic databases that track controlled substance prescriptions. PDMPs help providers identify patients at risk of opioid misuse, opioid use disorder, and/or overdose due to overlapping prescriptions, high dosages, or co-prescribing of opioids with benzodiazepines.

A recovery coach is typically a non-clinical peer support specialist or “peer mentor” operating within a community organization (e.g., a Recovery Community Center) or a clinical organization (e.g., treatment program or hospital) and can therefore be a paid or volunteer position. Recovery coaches are most often in recovery themselves and therefore offer the lived experience of active addiction and successful recovery. They focus on helping individuals to set & achieve goals important to recovery. They do not offer primary treatment for addiction, do not diagnose, & generally, are not associated with any specific method or pathway to recovery, supporting instead an array of recovery pathways.

A Recovery Community Center is a center or hub that organizes recovery networks regionally and nationally to facilitate supportive relationships between individuals in recovery as well as family and friends of people in recovery. Centers may provide advocacy training, peer support organization meetings, social activities, job linkage, and other community-based services.

Drug courts are problem-solving courts that operate under a specialized model in which the judiciary, prosecution, defense bar, probation, law enforcement, mental health, social service, and treatment communities work together to help non-violent offenders find restoration in recovery and become productive citizens. Also referred to as drug courts.

Recovery Residence is a broad term that encompasses a wide range of recovery housing programs from democratically operated to clinically oriented extended care that offer sober, safe, and healthy living environment that promotes recovery from alcohol and other drug use and associated problems. Many recovery residences accept residents on Medication Assisted Treatment.  In Maine, the Maine Association of Recovery Residences, a 501c6 nonprofit organization, oversees the ethical and safety standards for certified recovery residences.

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. Informally referred to as “uppers” (e.g., cocaine, amphetamine/methamphetamine).

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. See also Buprenorphine.

Substance Use Disorder (SUD) and mental health affect people from all walks of life and all age groups. These illnesses are common, recurrent, and often serious, but they are treatable and many people achieve full recovery. Substance use disorders occur when the recurrent use of alcohol and/or drugs causes clinically significant impairment, including health problems, disability, and failure to meet major responsibilities at work, school, or home. Mental disorders involve changes in thinking, mood, and/or behavior. These disorders can affect how one relates to others and makes choices. Reaching a level that can be formally diagnosed often depends on a reduction in a person’s ability to function as a result of the disorder.

Made synthetically or entirely from chemicals, and not made as a derivative of the original substance or plant (e.g. the opium poppy, marijuana plant, etc.) Examples of synthetic drugs include: carfentanil/carfentanyl, sufentanil, fentanyl, spice, bath salts, & herbal incense.

Syringe access (SAPs) are community-based prevention programs that can provide a range of services, including linkage to substance use disorder treatment; access to and disposal of sterile syringes and injection equipment; and vaccination, testing, and linkage to care and treatment for infectious diseases. Also referred to as Syringe Exchange Programs (SEPs) and Syringe Service Programs (SSPs)

Syringe access (SEPs) are community-based prevention programs that can provide a range of services, including linkage to substance use disorder treatment; access to and disposal of sterile syringes and injection equipment; and vaccination, testing, and linkage to care and treatment for infectious diseases. Also referred to as Syringe Access Programs (SAPs) and Syringe Service Programs (SSPs)

Syringe access (SAPs) are community-based prevention programs that can provide a range of services, including linkage to substance use disorder treatment; access to and disposal of sterile syringes and injection equipment; and vaccination, testing, and linkage to care and treatment for infectious diseases. Also referred to as Syringe Access Programs (SAPs) and Syringe Exchange Programs (SEPs).

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

The management and care of a patient to combat a disease or disorder. Can take the form of medicines, procedures, or counseling and psychotherapy.

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.