XIV Glossary

Addiction: Severe substance use disorders are commonly referred to as addiction. Addiction is a chronic brain disease that has the potential for both recurrence (relapse) and recovery.^[1]

Binge drinking: Consuming several standard drinks on one occasion in the past 30 days, defined for males as drinking five or more standard alcoholic drinks on one occasion, and for females as drinking four or more standard drinks on one occasion.^[2]

Brief interventions: Therapeutic techniques used to initiate change in individuals with unhealthy behaviors.

Controlled substances: Substances regulated by the U.S. Drug Enforcement Agency into one of five categories called schedules. This placement is based on the substance’s medical use, its potential for abuse or dependency, and related safety issues.

Delirium tremens (DTs): A rapid-onset, fluctuating disturbance of attention and cognition, sometimes associated with hallucinations, due to alcohol withdrawal. In its most severe manifestation, DTs are accompanied by agitation and signs of extreme autonomic hyperactivity, including fever, severe tachycardia, hypertension, and drenching sweats. DTs typically begin between 72 and 96 hours after the client’s last drink.

Dependence: A condition that develops with chronic uses of a substance that causes a person to experience withdrawal symptoms if the substance is suddenly stopped.

Drug diversion: The act of redirecting medication from its intended destination for personal use, sale, or distribution to others. It includes drug theft, use, or tampering (adulteration or substitution). Drug diversion is a felony that can result in a nurse’s criminal prosecution and loss of license.^[3]

Heavy drinking: Excessive drinking defined as a female consuming 8 or more drinks per week and a male consuming 15 or more standard drinks per week, or either gender binge drinking on 5 or more days in the past 30 days.

Intoxication: A disturbance in behavior or mental function during or after the consumption of a substance.

Neuroadaptations: Progressive changes in the structure and function of the brain as a result of substance misuse. These neuroadaptations compromise brain function and also drive the transition from controlled, occasional substance use to chronic misuse that can be difficult to control.

Nonsubstance related disorders: Excessive behaviors such as gambling, viewing pornography, engaging in compulsive sexual activity, Internet gaming, overeating, shopping, overexercising, and overusing mobile phone technologies. These behaviors are thought to stimulate the same addiction centers of the brain as addictive substances. However, gambling disorder is the only nonsubstance use disorder with diagnostic criteria listed in the DSM-5.

Protective factors: Factors that help prevent substance use disorders from developing despite the risk factors that are present.

Recovery: A process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential. Although abstinence from all substance misuse is a primary feature of a recovery lifestyle, it is not the only healthy feature.^[4]

Relapse: The return to substance use after a significant period of abstinence.

Remission: The status of individuals with severe substance use disorders who overcome their disorder with effective treatment and regain health and social function.

Standard drink: 14 grams (0.6 ounces) of pure alcohol. Examples of a standard drink are one 12-ounce beer, 8 – 9 ounces of malt liquor, 5 ounces of wine, or 1.5 ounces distilled spirits.

Substance: A psychoactive compound with the potential to cause health and social problems, including substance use disorders. Substances can be divided into four major categories: alcohol, illicit drugs (including nonmedical use of prescription drugs), tobacco products, and over-the-counter drugs.

Substance misuse: The use of alcohol or drugs in a manner, situation, amount, or frequency that could cause harm to the user or to those around them.^[5]

Substance use: The use (even one time) of any psychoactive substance.

Substance use disorder (SUD): A chronic illness caused by repeated misuse of psychoactive substances (e.g., alcohol, caffeine, cannabis, hallucinogens, inhalants, opioids, sedatives, hypnotics, anxiolytics, stimulants, and tobacco) that have a common effect of directly activating the brain’s reward system.

Tolerance: A need for progressively increased amounts of a substance to achieve the desired effect or a diminished effect with continued use of the same amount of a substance.

Withdrawal: A group of physical and mental symptoms that can range from mild to life-threatening when a person suddenly stops using a substance.

Withdrawal management: Interventions that manage the physical and emotional symptoms that occur after a person stops using a psychoactive substance, also referred to as detoxification. Withdrawal symptoms vary in intensity and duration based on the substance(s) used, the duration and amount of use, and the overall health of the individual.