Addiction Recovery Glossary: Plain-Language Definitions

Recovery has a vocabulary, and a lot of it gets thrown at families in the worst week of their lives. Discharge planners say "step down to IOP," a coach mentions "recovery capital," a doctor asks about "standard drinks," and nobody stops to explain. This glossary defines the terms we use most often with members and families, in plain language, with links to the source wherever a definition or a number comes from somewhere specific. Terms are grouped by letter. Where one term depends on another, we say so.

A

Abstinence

Not using a substance at all. For many people abstinence is the goal of recovery, though some programs and clinicians work toward reduced use instead.

Accountability

A structure that makes your recovery visible to someone else. It can be as simple as a standing weekly call with someone who will notice if you skip it, or as concrete as breathalyzer and toxicology results shared with a coach or family member. We wrote a full guide on accountability for sobriety.

Alcohol use disorder (AUD)

The clinical diagnosis for a problematic pattern of drinking that causes distress or impairment, ranging from mild to severe. It is defined by loss of control and consequences rather than by how much someone drinks. Only a licensed clinician can diagnose it. NIAAA's Rethinking Drinking site offers a self-assessment for people who are unsure (NIAAA Rethinking Drinking).

ASAM levels of care

The system most treatment programs use to match a person to the right intensity of care, published by the American Society of Addiction Medicine. In the fourth edition, Level 1.0 is ongoing monitoring for people in stable remission, Level 1.5 outpatient is fewer than 9 hours of clinical services a week, Level 2.1 intensive outpatient is 9 to 19 hours, and Level 2.5 high-intensity outpatient is 20 or more (ASAM Criteria Fourth Edition summary, PDF; ASAM overview). Residential and inpatient levels sit above these.

B

Binge drinking

NIAAA defines binge drinking as five or more drinks for men, or four or more for women, in about two hours (NIAAA Rethinking Drinking). A person can binge without having alcohol use disorder, and regular binges are one of the patterns clinicians ask about.

Breathalyzer and BAC

A breathalyzer estimates blood alcohol concentration (BAC), the amount of alcohol in the bloodstream, from a breath sample. At-home Bluetooth breathalyzers pair with a phone and log each reading. In our program, members test on a schedule and the readings go to the coach and to anyone the member has chosen to share them with. See how sobriety monitoring works.

C

Care coordination

Keeping the people involved in someone's recovery on the same page: the therapist, the prescriber, the treatment program, the family, and the coach. In practice it means sharing updates, with the member's consent, so that a positive screen or a missed appointment reaches the people who can do something about it.

Continuing care

The support that follows an initial course of treatment. NIAAA describes recovery as "more a marathon than a sprint" and recommends making a continuing care plan alongside the initial treatment plan, especially for moderate to severe alcohol use disorder (NIAAA). Therapy, medication, mutual-help meetings, and recovery coaching are all forms of continuing care.

Co-occurring disorder

A mental health condition, such as depression, anxiety, PTSD, or bipolar disorder, that exists alongside a substance use disorder. The two often feed each other, and treating only one tends not to work. This is the main reason many people need a therapist as well as a coach.

CPRS and NCPRSS

The two most common credentials for peer recovery coaches. A Certified Peer Recovery Specialist (CPRS) is certified by a state board, and requirements vary by state. The National Certified Peer Recovery Support Specialist (NCPRSS) is a national credential issued by NAADAC's National Certification Commission for Addiction Professionals (NAADAC).

CRAFT

Community Reinforcement and Family Training, an approach that teaches family members to change how they respond to a loved one's drinking or drug use so that sober behavior gets rewarded and use does not. In a 1999 randomized trial of 130 concerned family members, CRAFT engaged 64 percent of drinkers in treatment within six months, compared with 30 percent for a confrontational intervention and 13 percent for Al-Anon facilitation (Miller, Meyers and Tonigan, 1999, summarized in Meyers et al., 2005, PDF). SMART Recovery's Family & Friends program is built on it (SMART Recovery).

Craving

A strong urge to use, often triggered by a place, a feeling, a time of day, or a person. Cravings are normal in recovery and tend to be intense but short. Learning to ride one out is a core skill, and it is what a coach's between-session messaging is for.

Crisis lines

Free, confidential phone and text services for emergencies. The 988 Suicide & Crisis Lifeline can be reached by calling or texting 988 (988lifeline.org). The SAMHSA National Helpline at 1-800-662-4357 provides treatment referrals (SAMHSA).

D

Dependence

The body's adaptation to a substance, so that stopping produces withdrawal symptoms. Dependence and addiction overlap but are not identical. A patient on prescribed opioids can be dependent without being addicted.

Detox and withdrawal management

Medically supervised care for the period when a person stops using and the body adjusts. NIAAA warns that someone who has been drinking heavily for a long time and stops abruptly "can go into a painful or even potentially life-threatening process of withdrawal" (NIAAA). Detox is a beginning rather than a treatment.

E

Enabling

Absorbing the consequences of someone's substance use so they never feel them: calling in sick for them, paying the fine, covering the story. Stopping it does not mean withdrawing support. See our page for families.

F

Family support groups

Meetings for the people around someone with a substance use disorder, separate from any meeting the person themselves attends. Al-Anon is the longest-running (Al-Anon Family Groups), and SMART Recovery Family & Friends offers a CRAFT-based alternative (SMART Recovery). Accountable runs a weekly family Zoom group for families of enrolled members.

H

Harm reduction

Practices that reduce the damage from substance use without requiring the person to stop first: naloxone for overdose, clean supplies, medication for opioid use disorder, safer drinking limits. Most clinicians use tools from both harm reduction and abstinence-based recovery.

I

IOP (intensive outpatient program)

A structured treatment program, ASAM Level 2.1, that provides 9 to 19 hours a week of clinical services, mostly group counseling and psychoeducation, while the person lives at home (ASAM Criteria Fourth Edition summary, PDF). We compare it with coaching in recovery coaching vs IOP.

L

Lapse vs relapse

A lapse is a single use or a brief episode followed by a return to recovery. A relapse is a return to the old pattern. The difference is mostly in what happens next: whether the person tells someone and adjusts, or hides it and gives up. NIDA notes that a return to use "can be part of the process" and signals a need to resume or adjust treatment (NIDA). We treat both as information.

M

Medication for alcohol use disorder

NIAAA lists three FDA-approved medications for alcohol use disorder: naltrexone, acamprosate, and disulfiram (NIAAA). They work in different ways and are prescribed by a physician or other licensed prescriber, usually alongside counseling or other support. A recovery coach cannot prescribe them and should never advise stopping them.

Medication for opioid use disorder

Medications used to treat opioid addiction, including buprenorphine, methadone, and naltrexone. They reduce cravings and withdrawal and are prescribed and monitored by licensed clinicians. Taking one of these medications as prescribed is fully compatible with being in recovery, and a coach's role is to support the member in staying on it.

Motivational interviewing

A counseling style that helps a person find their own reasons for change instead of being told what to do. The clinician or coach asks open questions and reflects back what they hear. It is widely used in both treatment and peer coaching.

Mutual-help groups

Free peer-led meetings where people in recovery support each other. Alcoholics Anonymous and Narcotics Anonymous are the best known and follow the twelve steps. SMART Recovery is a secular, skills-based alternative (SMART Recovery). We compare meetings with coaching in recovery coaching vs AA.

P

Peer recovery coach (peer support specialist)

SAMHSA defines peer support workers as "people who have been successful in the recovery process who help others experiencing similar situations" (SAMHSA). SAMHSA's core competencies for the role include building a collaborative relationship, sharing lived experience, supporting recovery planning, and linking people to resources, with diagnosis and treatment not among them (SAMHSA core competencies, PDF). The titles peer recovery coach, peer support specialist, and recovery coach are used interchangeably. See what a recovery coach is.

R

Recovery capital

The sum of resources a person can draw on to start and sustain recovery: a stable place to live, a job, supportive relationships, physical health, a sense of purpose, and access to care. Coaches spend much of their time helping members build it.

Recovery management checkups (long-term remission monitoring)

Scheduled check-ins after treatment ends, designed to catch early signs of a return to use and reconnect the person to care quickly. The ASAM Criteria's fourth edition formalizes this as Level 1.0, ongoing monitoring for patients in stable remission (ASAM Criteria Fourth Edition summary, PDF). Accountable's program is aligned to this level.

Relapse prevention

The set of skills and plans that reduce the chance of a return to use: knowing your triggers, having a response ready for cravings, keeping a routine, and having people to call. NIDA puts relapse rates for substance use disorders at 40 to 60 percent, comparable to other chronic conditions (NIDA), which is why prevention is planned rather than hoped for. See how to stay sober after rehab.

Remission

A period during which a person no longer meets the criteria for a substance use disorder. Clinicians describe it as early or sustained depending on how long it has lasted. Remission is a clinical status, while recovery is the broader life around it.

S

Sober companion

A person hired to be physically present with someone in early recovery, sometimes around the clock, to keep them away from substances during a high-risk period such as the days after discharge or a business trip. Sober companions are typically private-pay and short-term. A recovery coach works on a weekly cadence over months instead. See what a sober coach is.

Sobriety

The state of not being under the influence and, in common use, of not using at all. Sobriety is the daily fact; recovery is the longer project.

Sponsor

A volunteer within a twelve-step fellowship who has worked the steps and guides a newer member through them. A sponsor is unpaid, holds no credential, and works within one program's tradition. A coach is certified and works across approaches. Many people have both. We covered this in our unofficial FAQ on 12-step programs.

Standard drink

In the United States, a standard drink contains about 0.6 ounces of pure alcohol. That is roughly a 12-ounce beer at 5 percent alcohol, a 5-ounce glass of wine at 12 percent, or a 1.5-ounce shot of spirits at 40 percent (NIAAA Rethinking Drinking). A pour at home is usually bigger than a standard drink.

Substance use disorder (SUD)

The umbrella clinical diagnosis for a problematic pattern of using any substance, alcohol included, that causes distress or impairment. It is rated mild, moderate, or severe based on the number of criteria met, and it is diagnosed by a licensed clinician. NIDA treats it as a chronic condition comparable to hypertension or asthma (NIDA).

T

Telehealth

Health care delivered by video, phone, or messaging instead of in person. A 2019 systematic review of 12 studies on telemedicine-delivered treatment for substance use disorders found high patient satisfaction and called it "an effective alternative, especially when access to treatment is otherwise limited," while noting substantial methodological limits (Lin et al., Journal of Substance Abuse Treatment, 2019).

Tolerance

Needing more of a substance to get the same effect. Tolerance builds with regular use and is one of the criteria clinicians look at. It fades during abstinence, which is one reason a return to old amounts after a period of sobriety can be dangerous.

Toxicology screening

Testing a sample of saliva, urine, blood, or hair for drugs or alcohol. Saliva screening can be done at home on camera and is well suited to frequent, random testing. In our program, screening is scheduled daily and at random; members do not control whether they are tested, but they control who sees the results. See how sobriety monitoring works.

Trigger

Anything that sets off a craving or the thought of using: a bar on the drive home, a paycheck, a fight, boredom, a Friday. Identifying them is early work in both treatment and coaching.

Twelve-step facilitation (TSF)

A structured, manualized approach in which a clinician actively helps a patient engage with Alcoholics Anonymous or a similar fellowship. A 2020 Cochrane review found that manualized AA and TSF produced higher rates of continuous abstinence at 12 months than other established treatments such as CBT, with the effect holding at 24 and 36 months (Kelly, Humphreys and Ferri, Cochrane, 2020).

V

Virtual recovery support

Ongoing, non-clinical recovery support delivered remotely: video sessions with a peer coach, messaging between sessions, at-home breathalyzer and saliva screening, and online peer and family groups. It is not treatment and does not replace a clinical level of care when one is needed. This is what Accountable provides. Our guide does virtual recovery support work covers the evidence, and you can check your coverage or call (646) 450-7641 to ask about the program.

W

Withdrawal

The physical and psychological symptoms that appear when a dependent person stops or cuts back. Alcohol withdrawal in particular can be medically dangerous, and stopping heavy daily drinking should be done with medical advice (NIAAA). See detox and withdrawal management above.

Sources

• National Institute on Alcohol Abuse and Alcoholism. Rethinking Drinking.

• Colorado Department of Health Care Policy and Financing. The ASAM Criteria, Fourth Edition: Summary (PDF). See also the ASAM overview of the Criteria.

• National Institute on Alcohol Abuse and Alcoholism. Support Recovery: It's a Marathon, Not a Sprint.

• National Institute on Alcohol Abuse and Alcoholism. Treatment for Alcohol Problems: Finding and Getting Help.

• National Institute on Drug Abuse. Drugs, Brains, and Behavior: The Science of Addiction, Treatment and Recovery.

• Substance Abuse and Mental Health Services Administration. Peer Support Workers for Those in Recovery.

• SAMHSA, Bringing Recovery Supports to Scale Technical Assistance Center Strategy. Core Competencies for Peer Workers in Behavioral Health Services (2015).

• NAADAC, the Association for Addiction Professionals. National Certified Peer Recovery Support Specialist (NCPRSS).

• Miller WR, Meyers RJ, Tonigan JS. Engaging the unmotivated in treatment for alcohol problems: a comparison of three strategies for intervention through family members. Journal of Consulting and Clinical Psychology. 1999;67(5):688-697. Summarized in Meyers RJ, Smith JE, Lash DN (2005), International Journal of Behavioral Consultation and Therapy 1(2):90-100 (PDF).

• Kelly JF, Humphreys K, Ferri M. Alcoholics Anonymous and other 12-step programs for alcohol use disorder. Cochrane Database of Systematic Reviews 2020, CD012880.

• Lin LA, et al. Telemedicine-delivered treatment interventions for substance use disorders: A systematic review. Journal of Substance Abuse Treatment. 2019;101:38-49.

• Al-Anon Family Groups. al-anon.org. SMART Recovery. smartrecovery.org and Family & Friends.

• 988 Suicide & Crisis Lifeline. 988lifeline.org. SAMHSA National Helpline. 1-800-662-4357.