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Center for Substance Abuse Treatment. Detoxification From Alcohol and Other Drugs. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 1995. (Treatment Improvement Protocol (TIP) Series, No. 19.)

  • This publication is provided for historical reference only and the information may be out of date.

This publication is provided for historical reference only and the information may be out of date.

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Detoxification From Alcohol and Other Drugs.

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Appendix B—Glossary

Abstinence facilitation:: An outpatient treatment strategy designed to help persons who are addicted to drugs stop using them. Commonly used in association with the medical treatment of cocaine abuse.

Acute abstinence syndrome:: The aggregate of withdrawal signs and symptoms that occur shortly after a person who is physically dependent on a drug stops taking it. The adjective "acute" distinguishes this variant from the "protracted" or "chronic" drug withdrawal or abstinence syndrome.

Acute psychosis:: A disturbance in thinking that is often accompanied by delusions and visual or auditory hallucinations. An acute psychosis may be caused by alcohol or other drug (AOD) withdrawal, drug toxicity (most commonly in conjunction with abuse of cocaine, methamphetamine, or psychedelic agents), or schizophrenia.

Analgesia:: Relief from pain.

Anhedonia:: Absence of pleasure from acts that would ordinarily be enjoyable.

Anorexia:: Diminished appetite; aversion to food.

Arthralgia:: Joint pain.

Ataxia:: Unsteady walking or staggering, caused by an inability to coordinate the muscles.

Authorizing order:: An order issued by a court that permits an AOD abuse treatment program to make a disclosure about a patient that would otherwise be forbidden.

Cellulitis:: Inflammation of the cellular or connective tissues.

Chronic obstructive pulmonary disease:: A combination of chronic bronchitis and emphysema. Characterized by persistent disruption of the flow of air in and out of the lungs.

Clouded sensorium:: Confusion.

"Cold turkey":: Popular term used to describe the process of opiate withdrawal that is not treated with medication. During withdrawal, the person's skin is covered with goose bumps and resembles that of a turkey.

Decisional capacity:: The ability of a patient to make an informed choice.

Delirium:: A state of mental confusion characterized by difficulty in responding to stimuli and an absence of orientation to place and time. May be accompanied by auditory, visual, or tactile hallucinations. May be caused by drug withdrawal or severe intoxication with phencyclidine.

Delirium tremens:: A severe form of alcohol withdrawal characterized by confusion, auditory or visual hallucinations, and severe shakiness. Commonly called "DTs."

Delusions:: Fixed, irrational ideas not shared by others and not responding to a logical argument.

Diaphoresis:: Profuse sweating that is not in response to high temperature or exercise. A common symptom of opiate or sedative-hypnotic withdrawal.

Disclosure:: A "communication of patient-identifying information, the affirmative verification of another person's communication of patient-identifying information, or the communication of any information from the record of a patient who has been identified" (42 C.F.R. '2.11).

Drug receptors:: Specialized areas on the surface of brain cells to which drugs attach and through which they produce their effects.

Drug tolerance:: The body's ability to endure increasing quantities of a drug. As the brain cells adapt to the presence of a drug, more of the drug is required to produce the same effect.

Dual diagnosis:: The presence of both an AOD abuse problem and a psychiatric disorder.

Duty to warn:: The legal obligation of a health care provider to notify law-enforcement officials or the potential victim when a patient presents a serious danger of violence to an identifiable individual.

Dysphoria:: An unpleasant mood.

Electrolytes:: Compounds in the blood that conduct electricity and can be decomposed by it. They include, for example, sodium, potassium, and chloride ions. Electrolyte imbalance can be caused by protracted vomiting, diarrhea, or dehydration. It also may result from failure to administer the correct type or quantity of intravenous fluids.

Encephalopathy:: Any disease or disorder that affects the brain.

Grand mal seizures:: A type of seizure in which a person falls to the ground unconscious and suffers generalized muscle contractions. The person usually remains unconscious for a time and may have no recall of the episode on awakening. Petit mal seizures, by contrast, are characterized by a momentary loss of awareness; an observer may think the person experiencing the seizure is simply daydreaming.

Hyperpyrexia:: Extremely high fever.

Hyperreflexia:: An exaggerated response of muscle reflexes that indicates that the nervous system is in a pathologically excited state. May occur during withdrawal from sedative-hypnotic agents or alcohol.

Hypertension:: Abnormally high blood pressure. Usually defined as a resting blood pressure greater than 140 mm hg (systolic) and 90 mm hg (diastolic).

Involuntary commitment:: Process by which patients who have not committed any crime are brought into treatment against their wishes by relatives or the police or through a court proceeding. Involuntary commitment is also known as "protective custody" or "emergency commitment."

Medical comorbidity:: Presence of two serious illnesses at once; for example, drug addiction and acquired immunodeficiency syndrome.

Medical emergency:: A condition that poses an immediate threat to the health of any individual and that requires immediate medical intervention (42 C.F.R.).

Medically debilitated:: Term used to describe an individual who is both AOD-dependent and who has a chronic or severe medical disease such as emphysema.

Medication discontinuation:: The process through which therapeutic doses of a prescribed medication are tapered or withdrawn. Detoxification, by contrast, refers to discontinuation of the use of an illicit drug or a self-administered prescription medication.

Myalgia:: Muscle pain. A common complaint during opiate withdrawal.

Narcotic-dependent:: (Federal methadone guidelines): Term used to describe an individual who physiologically needs heroin or a morphine-like drug to prevent the onset of signs of withdrawal.

Narcotic treatment program:: According to Federal methadone guidelines, an organization (or a person, including a private physician) that administers or dispenses a narcotic drug to an addict for maintenance or detoxification treatment; provides, when appropriate or necessary, a comprehensive range of medical and rehabilitative services; is approved by the State authority and the Food and Drug Administration; and is registered with the Drug Enforcement Administration to use a narcotic drug for the treatment of narcotic addiction.

Network treatment:: "An approach to rehabilitation in which specific family members and friends are enlisted to provide ongoing support and to promote attitude change. Network members are part of the therapist's working 'team' and not subjects of treatment themselves" (Galanter, 1994).

Neuroadaptation:: The process by which the function of the brain cells changes in response to exposure to drugs. These adaptive changes may include increases in the number of receptor sites, alterations in the shape of the receptors, or changes in the chemical functioning of the cell.

Nonmalignant pain:: Chronic pain that is not caused by cancer. Also called "chronic benign pain."

Nystagmus:: A jerky movement of the eyes. May be seen in persons who are intoxicated as a result of ingestion of alcohol, sedative-hypnotic agents, or phencyclidine.

Orthostatic hypotension:: A rapid drop in blood pressure (usually defined as 10 mm hg or greater) that occurs when a person stands up. Such an individual may become dizzy or even faint. May be a sign of sedative-hypnotic withdrawal or opiate intoxication. Also called "postural hypotension."

Pancreatitis:: Inflammation of the pancreas. Alcohol abuse is the most common cause of chronic pancreatitis and a principal cause of acute pancreatitis.

Paresthesia:: An abnormal burning, pricking, tickling, or tingling sensation.

Patient-identifying information:: The "name, address, social security number, fingerprints, photograph, or similar information by which the identity of a patient can be determined with reasonable accuracy and speed, either directly or by reference to other publicly available information . . . " (42 C.F.R. '2.11).

Pentobarbital challenge:: A method of assessing physical dependence on alcohol or other sedative-hypnotic agents. The challenge consists of administering standard doses of pentobarbital to a patient and observing the effects. Patients who become intoxicated on 200 mg or less of pentobarbital do not have substantial tolerance to sedatives and are presumed not to be physically dependent on these substances.

Physical dependence:: A condition in which the brain cells have adapted as a result of repeated exposure to a drug and consequently require the drug in order to function. If the drug is suddenly made unavailable, the cells become hyperactive. The hyperactive cells produce the signs and symptoms of drug withdrawal.

Protracted abstinence syndrome:: The aggregate of signs and symptoms of drug withdrawal. These signs and symptoms may continue for weeks or months after cessation of drug use. (Also see "acute abstinence syndrome.")

Record:: "Any information, whether recorded or not, relating to a patient received or acquired by a Federally assisted alcohol or drug program" (42 C.F.R. '2.11).

Recrudescence:: Reappearance of symptoms after a period of remission.

Relapse prevention:: In common usage, any strategy or activity designed to assist a drug user who has become abstinent from returning to drug use. Relapse prevention also refers to specific cognitive-behavioral treatment "that combines behavioral skill-training procedures with cognitive intervention techniques to assist individuals in maintaining desired behavioral changes." It draws from both health psychology and social-cognitive therapy and uses a "psychoeducational self-management approach to substance abuse designed to teach patients new coping responses (e.g., alternatives to addictive behavior), to modify maladaptive beliefs and expectancies concerning substance abuse, and to change personal habits and lifestyles" (Marlatt and Barrett, 1994).

Signs:: Observable or measurable changes in a patient's physiology; for example, increased blood pressure or dilated pupils. Such changes may not be perceived by the patient.

Somnolence:: Sleepiness, drowsiness.

Symptom rebound:: Transient, intensified return of symptoms following termination of therapeutic doses of a benzodiazepine. The most common withdrawal consequence of prolonged benzodiazepine use.

Symptoms:: Subjective changes in mood, feelings, or bodily sensations.

Tachycardia:: Rapid heartbeat (generally more than 100 beats per minute).

Therapeutic dosage:: The amount of a drug required to produce a beneficial effect.

Triage:: Process by which patients are assessed to determine the type of services and level of care they will require.

Up-regulation:: An increase in the number of receptors on the brain cells that is caused by continuous contact with drugs.

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