Find definitions to commonly used words related to addiction treatment.
- Facility: The physical location where addiction treatment services are provided. Multiple treatment programs or types—such as residential or outpatient—can be provided at one facility.
- Parent Organization: An organization that oversees multiple treatment facilities. The organization may focus only on addiction or on healthcare in general.
- On-site Care: Patients can receive services at the treatment facility.
- Off-site Care: Staff at the treatment facility can connect individuals with healthcare services at a different location, such as at another facility or organization.
- Accreditation: Facilities may have accreditation from an impartial accrediting organization that assesses whether a treatment facility meets nationally accepted standards for safety and care. Facilities must pay for this accreditation process. When a facility is “accredited,” this means they have met the standards set by the organization. The following are examples of accrediting bodies: CARF (Commission on Accreditation of Rehabilitation Facilities) International; Council on Accreditation; and The Joint Commission.
- Level of Care or Treatment Type: The intensity of a treatment program, or different levels of care, involves different types of clinical services. The level of care should be based on the individual’s needs.
- Outpatient: A program that provides regular counseling or medication support (or both) while the patient lives on their own.
- Intensive Outpatient: A more intensive program than standard outpatient programs. Typically, these programs include 9 or more hours of services a week.
- Opioid Treatment Programs (or OTPs): Programs certified to offer methadone, an FDA-approved medication for addiction treatment, to people with opioid use disorder.
- Intensive Inpatient: Care that is provided 24/7 at a hospital that typically lasts for days. Treatment often includes withdrawal management, also known as “detox.”
- Residential: Care that is provided in a setting where the patient lives for an extended period of time. Typically, this can last for one month to a year or longer. The program may offer low-intensity or high-intensity treatment.
Considerations for Personalized Treatment and Evaluation
The American Society of Addiction Medicine (ASAM) identified six key factors to assess an individual and develop an addiction treatment plan that meets their needs:
- Intoxication and/or Withdrawal Potential: The examination of an individual’s past and current experience of substance use and withdrawal.
- General Health: The examination of an individual’s health history and current physical condition.
- Mental Health: The examination of an individual’s thoughts, emotions, and mental health.
- Readiness to Change: The examination of an individual’s readiness and interest in changing their behaviors.
- Potential to Relapse: The examination of an individual’s unique relationship with relapse, continued substance use, or substance use problems.
- Recovery and Living Environment: The examination of an individual’s recovery or living situation, and the surrounding people, places, and things.
Stages of Care
- Intake: Intake is a process that occurs when a person begins treatment and the care team collects information from them to help develop a treatment plan.
- Withdrawal Management: The care of individuals experiencing withdrawal symptoms that occur after long-term use of a substance is abruptly reduced or stopped. In many cases, withdrawal can be treated with medications to ease the symptoms, but treating withdrawal is not the same as treating addiction.
- Detoxification: A process by which the body rids itself of a substance. Medically assisted detoxification, known as withdrawal management, may be needed to help manage an individual’s withdrawal symptoms.
- Treatment: A process to address an individual’s biological, psychological, and social needs to manage their substance use. An individual’s treatment plan should be determined with their care team based on their goals. This might include treatment across different settings and using medications and behavioral therapies to best achieve these goals and help maintain recovery.
- Recovery: A process of change through which an individual with a substance use disorder improves their health and wellness, lives a self-directed life, and strives to reach their full potential. Learn more.
- Relapse: Relapse is the return to substance use after an attempt to stop. Relapse is a common occurrence in many chronic health disorders, including addiction, that requires frequent adjustments to a person’s care plan in order to be treated effectively. Learn more.
Behavioral therapies are therapies that treat mental health disorders and substance use disorders. They also are used to treat other health conditions. These types of therapies are focused on helping an individual identify and change their behaviors to improve how they’re feeling.
Certain behavioral therapies have been proven to help individuals manage and treat their addiction:
- Cognitive Behavioral Therapy (CBT): This therapy involves changing unhelpful ways of thinking and learning about better ways to deal with problems.
- Community Reinforcement Approach: This therapy focuses on making a lifestyle with no substance use more rewarding than one with substance use. This approach uses different recreational, family, social, and professional reinforcements and/or material incentives (such as stipends).
- Contingency Management/Motivational Incentives: This therapy involves giving rewards to strengthen positive behaviors, such as not using substances.
- Family Behavior Therapy: This therapy addresses substance misuse problems and other problems, such as behavioral disorders, child mistreatment, depression, family conflict, and unemployment.
- Matrix Model: With this therapy, individuals learn about issues that are important to addiction and relapse, get guidance and support from a trained therapist, and learn about self-help programs.
- Mindfulness-based Relapse Prevention: This therapy combines skill-building approaches with mindfulness practices that promote flexible rather than “autopilot” responses to physical and emotional triggers.
- Motivational Enhancement Therapy: This therapy helps individuals resolve their indecision about engaging in treatment and stopping their substance misuse.
- Twelve Step Facilitation Therapy: This therapy involves active participation in a 12-Step fellowship, such as Alcoholics Anonymous. The counselor assesses the individual and actively supports initial engagement and ongoing participation in the program. This includes regularly scheduled meetings that focus on the connection between members for support and an action plan of 12 progressive steps. Learn more.
Medications for Addiction Treatment (MAT)
- Medication for Addiction Treatment: The use of FDA-approved medications, prescribed by a physician certified in addiction medicine or addiction psychiatry, for alcohol and opioid use disorders as part of an individual’s addiction treatment plan. These medications help reduce cravings, prevent overdose, and block the effects of certain substances. Medications are an effective treatment for alcohol, opioid, and tobacco addiction. Experts consider MAT combined with psychosocial therapy to be the gold standard of addiction care, especially for opioid use disorders. Learn more.
- Acamprosate (brand name Campral®): A medication that may be used to reduce symptoms of extended withdrawal, such as insomnia, anxiety, and restlessness in individuals with severe dependence. Acamprosate has been shown to help individuals with alcohol use disorder maintain abstinence for several weeks to months.
- Buprenorphine (brand names Suboxone®, Subutex®, or Bunavail®): A newer treatment option approved by the FDA in 2002 for the treatment of opioid use disorder. It’s the first medication to treat opioid dependency that is permitted to be prescribed or dispensed in a general physician’s office, unlike methadone. Buprenorphine reduces the effects of withdrawal and produces less euphoria. Treatment happens in three phases: induction, stabilization, and maintenance. It can be administered as a film (placed on the cheek), implant, or tablet. Learn more.
- Disulfiram (brand name Antabuse®): A medication that produces a very unpleasant reaction that includes flushing, nausea, and palpitations if a person drinks alcohol. The usefulness and effectiveness of disulfiram are limited because individuals often do not consistently take this medication. However, among patients who are highly motivated, disulfiram can be effective. Some patients use it every so often for high-risk situations, such as social events where alcohol is present.
- Methadone: A medication used since the 1960s to treat opioid addiction. Extensive research shows that methadone treatment is directly related to reducing illicit opioid use, specifically heroin. It also has been shown to reduce death rates; reduce transmission of diseases associated with drug injection; and reduce cravings. Methadone is more often prescribed to patients who have greater dependence on opioids and requires patients to receive treatment in a specially licensed methadone clinic. It can be taken as an oral tablet, liquid, wafer, or injection. Learn more.
- Naltrexone (brand names ReVia®, Depade®, or Vivitrol®): A medication used to treat both opioid and alcohol use disorders. It works by attaching to drug receptors in the brain without activating them; essentially blocking them. As a result, opioids and alcohol cannot attach to the brain receptors and have no effect. Unlike other medications for opioid use disorder, Naltrexone does not curb cravings and cannot be used for withdrawal management. It can be taken as an oral tablet or a monthly injection. Learn more.
- Naloxone (brand names Narcan® or Evzio®): A safe, FDA-approved medication proven to reverse an opioid overdose in minutes. It comes in a nasal spray or as an injection. Naloxone is an opioid antagonist. That means it binds to the same receptors as the opioid, displacing the opioid in the process and temporarily undoing its harmful effects. For example, it can help someone start breathing again. Naloxone must be introduced to the body relatively quickly, and its effects wear off in 20 to 90 minutes. Learn more.
- Cash or Self-payment: The option for individuals to pay for treatment directly—for example, with cash, credit, or debit—rather than using health insurance.
- Payment Assistance: Some facilities provide grants, scholarships, or other resources to help patients cover some or all of the cost of treatment.
- Private Insurance: A health insurance plan purchased by an employer or an individual from a private insurance company—such as Kaiser Permanente, Humana, Aetna, Cigna, Blue Cross Blue Shield, etc.
- Public Insurance: A health insurance plan paid for with government funds—such as Medicare, Medicaid, Veterans Affairs, Children’s Health Insurance Plan, etc.
- Sliding Fee Scale: The amount owed for treatment is adjusted based on an individual’s ability to pay.
Other Commonly Used Words
- Abstinence-based Addiction Treatment: Addiction treatment that requires people to completely stop using substances. Treatment facilities that are abstinence-only do not provide Medication for Addiction Treatment (MAT).
- Care Coordination: The coordination of health services, patient needs, and information by various providers and information systems to help achieve the goals of treatment and care (SAMHSA). Care coordination may include the coordination of an individual’s primary care provider (PCP) with specialists, such as addiction treatment programs and counselors.
- Drug Test: Drug tests are designed to measure whether a substance has been used within a particular window of time. Drug testing should be used to monitor recent substance use in all addiction treatment types. Evidence suggests that drug testing assists with monitoring adherence and abstinence in treatment and can improve patient outcomes. Drug tests should not be used to remove or eject people from treatment programs.
- Harm Reduction: Policies, programs, and interventions proven to reduce the harmful effects of substance misuse. Research shows that harm reduction strategies can help reduce drug overdoses. Strategies include syringe access, naloxone to reverse overdoses, and Medication for Addiction Treatment (MAT).
- Lab Test: A procedure in which a healthcare provider takes a sample of an individual’s blood, urine, or other bodily fluid or tissue to get information about their health. Lab tests can help diagnose, screen, or monitor a specific health condition.
- Long-term Treatment: The continued outpatient treatment an individual receives after leaving an addiction treatment program. This may include medication; ongoing therapy and counseling; follow-up meetings with a healthcare professional; peer support; and/or additional education, such as anger management or job skills training. Learn more.
- Mental Health Care: Healthcare services that cover diagnosis and treatment of mental health conditions, such as depression and anxiety, to improve emotional, psychological, and social well-being.
- Personalized Treatment: Treatment tailored to meet the specific needs of an individual.
- Primary Health Care: Health services that help people prevent and treat common illnesses and promote general well-being.
- Recovery Support Services: Recovery support services help people with mental health and substance use disorders manage these conditions and maintain a healthy and fulfilling life. These services may include peer recovery support (such as mutual aid groups) and community services (such as housing, childcare assistance, transportation assistance, and more) that can provide continuing emotional and practical support for recovery.
- Specialty Care: Healthcare services provided by physicians with specialized training that focuses on a specific group of individuals or area of medicine, such as addiction, pediatrics, cardiology, or surgery.
- Waiting Lists: Waiting lists are not a best practice since this process does not promote immediate, alternative treatment. There is evidence that individuals will continue to use substances while on waitlists. For someone struggling with addiction, waiting for treatment can be the difference between life and death.