Glossary
Navigating the world of addiction and opioid treatment can be a complex and often confusing journey. To help shed light on this challenging subject, let’s explore a comprehensive glossary of common terms related to opioid use and treatment. This glossary aims to provide clarity and understanding for individuals, healthcare professionals, and anyone seeking knowledge in this field.
Addiction is a complex and chronic brain disorder characterized by the compulsive use of a substance or engaging in a behavior despite harmful consequences. It often involves a loss of control over use, cravings, and a preoccupation with the substance or behavior. Addiction can lead to significant personal, social, and health problems. It is important to distinguish addiction from dependence, as dependence refers to the physical adaptation to a substance, often resulting in withdrawal symptoms when the substance is discontinued. Dependence can occur in the absence of addiction.
Agonist medications are substances that activate specific receptors in the brain and body. In the context of opioid addiction treatment, agonist medications like methadone and buprenorphine activate opioid receptors, reducing withdrawal symptoms and cravings. This helps individuals in recovery stabilize their lives without experiencing the intense euphoria associated with full opioid agonists like heroin. Agonists differ from antagonist medications, which block the opioid receptors, and partial agonist medications, which activate receptors with less intensity.
The Brief Assessment of Recovery Capital (BARC-10) is a valuable tool used to assess a person’s recovery resources and strengths. This assessment evaluates various aspects of a person’s life, such as physical health, psychological well-being, social connections, and community support. It helps treatment providers and individuals in recovery identify areas that may need additional attention and support to enhance their recovery from addiction.
Belbuca is a medication used in the management of chronic pain. It contains buprenorphine and is available in a buccal film formulation. Belbuca is prescribed to provide continuous pain relief for individuals with persistent pain conditions. It offers an alternative to traditional opioid pain medications and has a lower risk of misuse due to its unique delivery method, which makes it less attractive for recreational use.
Bupe is a colloquial term used to refer to the medication buprenorphine. Buprenorphine is a partial opioid agonist used in the treatment of opioid addiction. Unlike full opioid agonists, buprenorphine has a ceiling effect, meaning that its opioid effects plateau at a certain dose. This feature makes it less likely to be abused and reduces the risk of overdose, making it a valuable tool in addiction treatment.
Buprenorphine is a partial opioid agonist used in the treatment of opioid addiction. It activates the same receptors as other opioids but with less intensity, which helps reduce cravings and withdrawal symptoms while minimizing the risk of overdose. Buprenorphine is available in various formulations, including sublingual tablets and films, and can be prescribed by specially trained healthcare providers in an office-based setting, increasing access to addiction treatment.
Carfentanil is an extremely potent synthetic opioid developed as a tranquilizer for large animals, such as elephants. It is not approved for human use and is not prescribed medically. However, it has been found as a dangerous adulterant in street drugs like heroin, contributing to a significant increase in opioid overdoses due to its potency.
The ceiling effect is a crucial concept in opioid addiction treatment, particularly regarding medications like buprenorphine. It refers to the point at which increasing the dose of a medication no longer produces a greater effect. In the case of buprenorphine, it means that taking more of the drug does not lead to stronger opioid effects, reducing the risk of overdose and misuse.
Codeine is a naturally occurring opiate derived from the opium poppy plant and is commonly used to treat mild to moderate pain and as a cough suppressant. It is less potent than morphine and is available in various formulations, including over-the-counter cough syrups and prescription pain medications. However, it can still be habit-forming and has the potential for misuse.
Cravings are intense, overwhelming urges or desires to use a substance, often triggered by cues associated with the substance, such as specific environments, people, or emotions. Cravings can be a significant challenge in addiction recovery, as they can lead to relapse if not managed effectively. Treatment strategies often focus on helping individuals cope with and overcome cravings as part of their recovery journey.
The DEA (Drug Enforcement Administration) is a United States federal law enforcement agency responsible for enforcing controlled substance laws and regulations. The DEA combats drug trafficking, illegal drug manufacturing, and the diversion of prescription medications to the illicit market. It plays a crucial role in addressing the opioid epidemic and ensuring the safe and legal use of medications for addiction treatment.
Dependence, in the context of opioids, refers to a physical adaptation in which the body becomes reliant on the presence of the substance to function normally. When someone is dependent on opioids, they may experience withdrawal symptoms when they try to reduce or stop their opioid use. Dependence can occur with both therapeutic use of opioids and misuse, but it is distinct from addiction, which involves psychological and behavioral aspects.
Detox, short for detoxification, is the process of removing a substance, such as opioids, and its associated toxins from the body. It is often the first step in the treatment of substance use disorders. Medical detox is supervised by healthcare professionals and aims to safely manage withdrawal symptoms while preparing individuals for ongoing addiction treatment.
The FDA (Food and Drug Administration) is a U.S. government agency responsible for regulating and overseeing the safety and efficacy of medications used in medication-assisted treatment (MAT) for opioid use disorder (OUD). The FDA plays a crucial role in evaluating and approving medications used in addiction treatment and ensuring they meet rigorous standards for quality and safety.
Fentanyl is a synthetic opioid that is 50 to 100 times more potent than morphine. It is used medically for severe pain management, chronic pain control, and anesthesia during surgery. Due to its high potency, fentanyl carries a significant risk of overdose, especially when used illicitly or when mixed with other substances. The illicit use of fentanyl has contributed to the opioid overdose crisis.
Fentanyl test strips are a harm reduction tool used to detect the presence of fentanyl in drugs. They provide a quick and accessible way for individuals to check if their substances have been contaminated with fentanyl, which can help prevent accidental overdose deaths. These test strips are an essential tool in harm reduction efforts aimed at reducing the risks associated with fentanyl-adulterated street drugs.
Goofball is a colloquial term used to describe the dangerous combination of methamphetamine and opioids, such as heroin or fentanyl. This drug mixture can have unpredictable and potentially life-threatening effects on the user. The term highlights the risks associated with polysubstance use and its impact on drug culture and addiction.
Half-life, in pharmacology, refers to the time it takes for the concentration of a substance in the body to decrease by half. In the context of opioid medications, understanding their half-lives is crucial for dosing and managing withdrawal symptoms. Medications with longer half-lives, like methadone, provide more sustained relief from cravings and withdrawal compared to shorter-acting opioids.
Harm reduction is a public health approach that aims to minimize the negative consequences of substance use without requiring abstinence. It focuses on reducing the harms associated with drug use, such as overdose, disease transmission, and other health risks, through evidence-based strategies like naloxone distribution, syringe exchange programs, and education. Harm reduction recognizes that people will continue to use substances, and its goal is to keep them safe and offer pathways to treatment when they are ready.
Heroin is an illegal and highly addictive semi-synthetic opioid derived from morphine. It is known for its powerful euphoric effects and is commonly abused recreationally. Heroin use can lead to severe health problems, addiction, and legal issues. The opioid epidemic has been fueled, in part, by the misuse of prescription opioids, which can sometimes serve as a gateway to heroin use.
Hydrocodone is a semi-synthetic opioid derived from codeine and is used to treat moderate to severe pain as well as cough suppression. It is available in various formulations, often combined with other medications like acetaminophen. Hydrocodone carries a risk of dependence and misuse, and its prescription is closely regulated to prevent misuse and diversion.
Hydromorphone is a semi-synthetic opioid derived from morphine and is used to treat moderate to severe pain. It is more potent than morphine but has a shorter duration of action. Hydromorphone is prescribed in various forms, including tablets and injections, and is carefully monitored due to its potential for abuse and dependence.
IOP stands for Intensive Outpatient Program, and it plays a crucial role in the treatment of substance use disorders, including opioid use disorder (OUD). IOPs offer a flexible and less restrictive approach to care compared to residential treatment programs. They involve group therapy, individual counseling, and educational sessions to support individuals in their recovery journey while allowing them to continue their daily activities and responsibilities.
IVDU, or Intravenous Drug Use, refers to the practice of injecting drugs directly into the bloodstream using a needle and syringe. This method of drug administration carries significant risks, including the transmission of bloodborne diseases like HIV and hepatitis C. Harm reduction strategies for IVDU aim to minimize these risks through the provision of sterile injection equipment and education.
Induction is the initial phase of opioid addiction treatment where a person is transitioned from their current opioid use (often illicit or misused opioids) to a medication-assisted treatment (MAT) medication, such as buprenorphine or methadone. The induction process is carefully managed to ensure a safe and smooth transition, as starting MAT too soon or without sufficient withdrawal can lead to precipitated withdrawal, a highly uncomfortable and distressing experience.
Lofexidine is a non-opioid medication used to manage opioid withdrawal symptoms. It works by reducing the release of norepinephrine, a neurotransmitter associated with the stress response. Lofexidine is FDA-approved for the treatment of opioid withdrawal and can help individuals in recovery manage the discomfort and distress commonly associated with withdrawal.
Lucemyra is a brand name for the medication lofexidine. It is used in the management of opioid withdrawal symptoms. Lucemyra helps individuals in recovery by reducing the severity of symptoms like anxiety, agitation, muscle aches, and sweating, making the detoxification process more manageable.
MAT, or Medications for Addiction Treatment, is an approach to treating substance use disorders that involves the use of medications, such as buprenorphine, methadone, and naltrexone, in conjunction with counseling and behavioral therapies. MAT addresses the physical, psychological, and social aspects of addiction, providing a comprehensive approach to recovery.
MOUD, or Medications for Opioid Use Disorder, refers specifically to medications approved for the treatment of opioid use disorder (OUD). These medications, including buprenorphine, methadone, and naltrexone, help individuals with OUD stabilize their lives, reduce cravings, and prevent overdose, facilitating their journey to recovery.
Meperidine is a synthetic opioid that is structurally distinct from other opioids like morphine and codeine. It is used to treat moderate to severe pain but has seen a decrease in use over time due to concerns about its potential for toxicity and side effects. Safer and more effective opioid medications are often preferred for pain management.
Methadone is a synthetic opioid primarily used in the treatment of opioid addiction. It helps alleviate withdrawal symptoms and cravings, allowing individuals in recovery to stabilize their lives. Methadone maintenance treatment is highly regulated and provided through specialized clinics. It is considered an evidence-based approach to opioid addiction treatment.
Morphine is a naturally occurring opiate alkaloid extracted from the opium poppy plant. It is one of the most potent and commonly prescribed opioids for the treatment of moderate to severe pain. Morphine is used in various medical settings, such as post-surgery pain management and palliative care, but it is also associated with a risk of tolerance, dependence, and misuse.
Naloxone is an opioid antagonist used to rapidly reverse the effects of an opioid overdose. It works by binding to the same receptors in the brain as opioids but does not activate them. Naloxone is available in various forms, including nasal spray and injectable formulations, and is a critical emergency medication in overdose situations, potentially saving lives.
Naltrexone is an opioid antagonist that blocks the effects of opioids. It is used in the treatment of opioid use disorder (OUD) to prevent relapse after detoxification. Naltrexone, available in oral and injectable forms (Vivitrol), helps individuals maintain abstinence by reducing the rewarding effects of opioids.
Narcan is a brand name for the opioid medication naloxone. It is used interchangeably with naloxone and has gained recognition for its role in reversing opioid overdoses. Narcan can be administered via nasal spray or intramuscular injection and is accessible to first responders, healthcare providers, and individuals at risk of overdose.
OUD, or Opioid Use Disorder, is a medical condition characterized by a problematic pattern of opioid use that leads to significant impairment or distress. It is diagnosed based on specific criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). OUD can have serious health, social, and legal consequences and often requires specialized treatment.
The opioid epidemic refers to a public health crisis characterized by the widespread misuse and abuse of opioids, including prescription pain medications, heroin, and synthetic opioids like fentanyl. This epidemic has led to a significant increase in opioid-related overdose deaths, with devastating consequences for individuals, families, and communities. Efforts to address the epidemic include increased access to treatment, harm reduction initiatives, and improved prescriber practices.
Opioids are a class of drugs that include both natural and synthetic substances derived from opium, a substance found in the opium poppy plant. Opioids are known for their pain-relieving properties and include medications like morphine, oxycodone, hydrocodone, and fentanyl, as well as illegal substances like heroin. Opioids can be highly addictive, and their misuse can lead to physical and psychological dependence.
Oranges is a slang term used to refer to opioid addiction treatment medications containing buprenorphine. These medications are often administered sublingually, where they dissolve under the tongue, and some come in orange-colored tablets or film strips. Buprenorphine-containing medications, sometimes colloquially called “oranges,” play a critical role in opioid addiction treatment and recovery.
An overdose occurs when an individual consumes a toxic or lethal amount of a substance, leading to severe adverse effects or death Overdoses can result from various substances, including opioids, stimulants, sedatives, and more. In the context of opioids, overdoses are a particularly pressing concern due to the high potency of certain opioids like fentanyl. Recognizing the signs of an overdose and administering the opioid antagonist naloxone (commonly known as Narcan) promptly can be life-saving.
Oxycodone is a semi-synthetic opioid derived from thebaine, an opium alkaloid. It is used to treat moderate to severe pain and is available in various formulations, often combined with acetaminophen or other analgesics. Oxycodone is a potent opioid and carries a risk of tolerance, dependence, and misuse, making it subject to strict regulation.
Oxymorphone is a semi-synthetic opioid derived from thebaine, similar to oxycodone. It is used to treat moderate to severe pain and is available in various forms, including extended-release formulations. Oxymorphone is more potent than morphine but has a shorter duration of action. It is used cautiously due to its potential for abuse and misuse.
PWID, an abbreviation for People Who Inject Drugs, is a term used to humanize and destigmatize individuals who engage in the practice of injecting drugs. This language shift emphasizes the need for empathy, respect, and nonjudgmental support when addressing issues related to drug use. Stigmatizing language can be a barrier to effective healthcare and addiction treatment.
Using respectful language, such as PWUD (People Who Use Drugs), is essential to destigmatize and humanize individuals who use drugs. The term acknowledges that drug use does not define a person’s entire identity and emphasizes the importance of providing support and compassionate care to individuals dealing with substance use issues.
A partial agonist, in the context of opioid addiction treatment, is a medication that activates opioid receptors but with less intensity than full agonists like heroin or morphine. Partial agonists, such as buprenorphine, can reduce withdrawal symptoms and cravings without producing the same intense euphoria. They have a lower risk of overdose and misuse, making them valuable in addiction treatment.
Physical dependence is a physiological state in which the body has adapted to the presence of a substance and requires it to function normally. When the substance is reduced or discontinued, withdrawal symptoms can occur. Physical dependence can develop with various substances, including opioids, and is distinct from addiction, which involves psychological and behavioral aspects.
Polysubstance use refers to the concurrent use of multiple substances, often different classes of drugs, by an individual. This practice can complicate addiction treatment as it poses unique challenges in managing withdrawal symptoms, cravings, and potential drug interactions. Addressing polysubstance use is essential to ensure effective and comprehensive care for individuals with substance use disorders.
Precipitated withdrawal is a sudden and intense onset of withdrawal symptoms triggered by the administration of certain medications, particularly opioids. It occurs when a person takes an opioid antagonist, such as naloxone or naltrexone, or a partial agonist like buprenorphine too soon after using a full opioid agonist. Precipitated withdrawal can be highly uncomfortable and distressing.
Probuphine is a subdermal implant that delivers a continuous low dose of buprenorphine over a six-month period. It is used for the maintenance treatment of opioid use disorder (OUD). Probuphine offers a long-acting and convenient option for individuals in recovery, helping them manage cravings and withdrawal symptoms without the need for daily medication.
Psychological dependence can develop independently of physical dependence and is an important component of substance use disorders. It involves a strong psychological craving or compulsion to use a substance despite adverse consequences. Psychological dependence can drive addictive behaviors, and addressing it is a key aspect of addiction treatment.
Recovery in the context of opioid addiction treatment refers to the process of achieving and maintaining a healthy and fulfilling life without the compulsive use of opioids. Recovery is a personal journey and can involve various pathways, including abstinence, medication-assisted treatment (MAT), counseling, and support from peers and loved ones. It encompasses physical, psychological, and social well-being.
Rehab, short for rehabilitation, plays a significant role in treating substance use disorders, including opioid addiction. Rehab programs vary in their approaches, settings, and levels of care, but they all aim to help individuals achieve and sustain recovery. Rehab may involve medical detoxification, residential treatment, intensive outpatient programs (IOPs), and outpatient counseling.
Relapse occurs when an individual returns to active substance use after a period of abstinence or reduced use. It is a common challenge in the recovery process and does not signify failure. Instead, relapse can be viewed as an opportunity for learning and growth. Addiction treatment often includes strategies to prevent and address relapse effectively.
SAMHSA, or the Substance Abuse and Mental Health Services Administration, is a U.S. government agency within the Department of Health and Human Services. SAMHSA leads public health efforts to advance behavioral health and improve the well-being of individuals with mental and substance use disorders. It plays a vital role in supporting addiction treatment and recovery initiatives.
SSP, or Syringe Service Program, is an essential harm reduction initiative aimed at reducing the transmission of bloodborne diseases among people who inject drugs (PWID). SSPs provide sterile syringes and other injection equipment, as well as education and access to healthcare services. These programs promote health and safety for PWID while connecting them to resources for addiction treatment and support.
Speedball is a street term used to describe the dangerous practice of mixing cocaine (a stimulant) and opioids (such as heroin or fentanyl, a depressant). This combination can have unpredictable effects on the body and is associated with a higher risk of overdose, as the stimulant properties of cocaine can mask the depressant effects of opioids, leading to excessive opioid use.
Stigma refers to negative attitudes, beliefs, and stereotypes associated with individuals who have substance use disorders or addiction. Stigma can be a significant barrier to seeking treatment and support, as it can lead to discrimination, shame, and social isolation. It is crucial to combat stigma by using respectful and non-stigmatizing language and promoting empathy and understanding.
Sublocade is an extended-release injectable form of buprenorphine used in the treatment of opioid use disorder (OUD). It provides a continuous and stable dose of buprenorphine over an extended period, typically once a month. Sublocade helps individuals in recovery manage cravings and withdrawal symptoms while minimizing the need for daily medication.
Suboxone is a combination medication containing buprenorphine and naloxone. It is used as a medication for addiction treatment (MAT) for opioid use disorder (OUD). Buprenorphine reduces cravings and withdrawal symptoms, while naloxone helps deter misuse by precipitating withdrawal if the medication is injected. Suboxone is available in sublingual film or tablet formulations.
Subs is a common street name used to refer to the medication Suboxone, which contains buprenorphine and naloxone. Suboxone is a vital tool in opioid addiction treatment, helping individuals stabilize their lives, reduce cravings, and prevent overdose. However, it is essential to use such medications under medical supervision as part of a comprehensive treatment plan.
Subutex is a brand name for the medication buprenorphine, which is a partial opioid agonist used in the treatment of opioid use disorder (OUD). Subutex contains only buprenorphine and does not include naloxone, which is present in medications like Suboxone to deter misuse. Subutex can be used to manage OUD and chronic pain.
Tapentadol is a centrally acting atypical opioid analgesic with dual mechanisms of action. It acts as a mu-opioid receptor agonist and also inhibits the reuptake of norepinephrine. Tapentadol is used to treat moderate to severe pain and offers an alternative to traditional opioids. It has a lower risk of respiratory depression and constipation but can still lead to dependence and misuse.
Tapering involves gradually reducing the dose of an opioid medication as part of the treatment plan for opioid addiction. Tapering is done under medical supervision to help individuals safely and comfortably reduce their opioid use, manage withdrawal symptoms, and eventually achieve abstinence. It is a critical step in the recovery process.
Tolerance is a phenomenon in which the body becomes less responsive to the effects of a substance with regular use. Individuals who develop tolerance to opioids may require higher doses to achieve the same level of pain relief or euphoria. Tolerance is a significant factor in the development of substance use disorders, as it can lead to escalating drug use.
Tramadol is a synthetic atypical opioid used to treat moderate to severe pain. It has a unique mechanism of action, involving both opioid receptor activity and the inhibition of serotonin and norepinephrine reuptake. Tramadol is considered to have a lower risk of dependence compared to some other opioids, but it can still lead to misuse and should be used cautiously.
Vivitrol is an injectable, extended-release formulation of naltrexone used to treat opioid use disorder (OUD). It works as an opioid antagonist, blocking the effects of opioids and preventing relapse after detoxification. Vivitrol offers the advantage of monthly administration, reducing the need for daily medication and enhancing medication adherence.
Withdrawal refers to a set of physical and psychological symptoms that occur when a person with physical dependence on a substance, such as opioids, reduces or discontinues their use. Withdrawal symptoms can vary in intensity and duration and may include anxiety, irritability, sweating, muscle aches, nausea, vomiting, and more. Medical management and support are often needed to help individuals cope with withdrawal during addiction treatment.
Xylazine is a veterinary drug used as a sedative and muscle relaxant in animals, particularly horses and large animals. However, it has gained notoriety for its illicit use among humans, particularly in the context of substance misuse. The illicit use of xylazine can be dangerous and unpredictable, as it is not intended for human consumption and can lead to severe health consequences.
Zubsolv is a combination medication containing buprenorphine and naloxone. It is used as a medication for addiction treatment (MAT) for opioid use disorder (OUD). Zubsolv provides the benefits of buprenorphine, reducing cravings and withdrawal symptoms, while naloxone helps deter misuse. It is available in sublingual tablet form and is an important tool in OUD treatment and recovery.