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Glossary

Acetylcholine: The first neurotransmitter discovered. It is found in both the peripheral nervous system and the central nervous system. In the peripheral nervous system, it is involved in both muscle contraction as well as that part of the involuntary nervous system involved with "rest and restoration." In the central nervous system, it is involved with memory function.

ACTH: Adrenocorticotropic Hormone. A hormone released by the pituitary gland, which stimulates the adrenal glands to release adrenalin. Adrenalin is a stress response hormone that has a multitude of metabolic effects including alterations in blood pressure, heart rate, and muscle metabolism involved in the "fight or flight" response in the involuntary or autonomic nervous system. It also reverses inflammatory reactions.

Agonist: A drug capable of combining with a receptor on a cell and initiating a reaction or activity. The drug may produce the same biological effect as the neurotransmitter itself.

Alcohol: an organic chemical that consists of carbon, oxygen, and hydrogen.

Alcohol dehydrogenase: An enzyme that is a biological catalyst that accelerates the breakdown of alcohol into aldehyde, responsible for many of the negative effects of alcohol.

Alcohol-related neurodevelopmental disorder (ARND): A disorder in the development of the nervous system in a fetus. It is related to the exposure of the fetus to alcohol.

Alcohol withdrawal delirium: A syndrome that occurs after the amount of alcohol that is usually consumed has decreased, or upon abstinence, after prolonged and heavy use of alcohol which leads to the following: changes in the individual's vital signs and adverse gastrointestinal and central nervous system symptoms. Aldehyde dehydrogenase: An enzyme that accelerates the breakdown of aldehyde into acetic acid, a nontoxic chemical that is easily eliminated from the body.

ALT (Alanine Aminotransferase): See AST. The ratio of AST to ALT (AST: ALT) can sometimes help to determine whether the liver or another organ has been damaged. Both ALT and AST levels are reliable indicators of liver damage.

American Board of Psychiatry and Neurology: The governing body that oversees clinical standards for both psychiatrists and neurologists and the various subspecialty fellowships such as child and adolescent psychiatry and addiction psychiatry.

American Disabilities Act: Title I of the Americans with Disabilities Act of 1990 took effect July 26, 1992. It prohibits private employers, state and local governments, employment agencies, and labor unions from discriminating against people who have physical or mental disabilities in job application procedures, hiring, firing, advancement, compensation, job training, and other terms, conditions, and privileges of employment. Although alcoholism is included as a disability, the law does not shield employees who drink on the job or employees who cannot perform the job up to the required standards.

American Hospital Association: Founded in 1898 to represent and serve all types of hospitals, health care networks, and their patients and communities. The American Hospital Association provides education for health care leaders and is a source of information on health care issues and trends. Close to 5,000 hospitals, health care systems, networks, and other providers of care and 37,000 individual health care professionals form the American Hospital Association, which is located in Chicago.

American Nurses Association: The American Nurses Association is a professional organization of nurses to advance the profession of nursing. Its mission includes public education, establishing standards for nursing practice and guidelines for ethical health care practices, lobbying state and federal lawmakers to advance the practice of nursing. The American Nurses Association keeps their members informed of current issues regarding health care economics and the general public's health.

American Society of Addiction Medicine (ASAM): Established in 1989 and was the first American medical society to focus on drugs and alcohol. Its mission is to train medical students, faculty, and residents to provide better treatment and rehabilitation and to develop strategies for prevention of alcoholism. The organization has established a uniform credentialing process for psychiatrists and other physicians who demonstrate their expertise by examination in substance-use disorders and other behavioral health issues.

Amygdala: Attached to the tail of the caudate structure of the brain that is considered a part of the limbic system.

Anemia: A deficiency of red blood cells.

Antabuse: A drug given to alcoholics that produces nausea, vomiting, dizziness, flushing, and tachycardia (a fast heart rate) if alcohol is consumed, thus it is a deterrent to drinking and acts as a negative reinforcer.

Antagonism: The mechanism that causes the blocking of the biological responses at a given receptor site, due to a drug or other chemical.

Anterograde amnesia: Loss of memory where new events are unable to be transferred to long-term memory. Amnesia refers generically to memory loss and usually refers to memory loss for previously remembered events.

Antibodies: Occur in response to an antigen as larger numbers of proteins that have high molecular weights. Antibodies are a normal immune response to fight infection.

Anticonvulsant: A drug that prevents seizures from occurring.

Antiemetic: A drug known for its antinausea and antivomiting qualities.

Antisocial personality disorder (ASPD): An enduring pattern of inner experience and behavior that deviates markedly from the expectations of the culture is pervasive, inflexible, and most often has an onset in late adolescence. It may be preceded by the diagnosis of a childhood conduct disorder. The antisocial person exhibits a disregard for and violates the rights of others, lacks empathy for others, is unremorseful when hurting others, fails to conform to social norms, including participating in criminal and other high risk behaviors, lies or is deceitful, impulsive, and aggressive. The disorder is more prevalent in adolescents whose parents also have the disorder.

Aqua vitae: Latin for "the water of life."

AST (Aspartate Aminotransferase): See ALT. A liver enzyme present in liver cells but also in red blood cells, cardiac tissue, and pancreatic tissue. When there is acute liver disease, this enzyme is released into the blood stream leading to its elevation on laboratory testing. AST can help determine the cause of the liver damage. An AST:ALT ratio > 2.0, a value rarely seen in other liver diseases.

Atrophy: A decrease in the size of an organ or muscle, or a wasting away of a body part or tissue.

Attention deficit hyperactivity disorder (ADHD): A persistent pattern of inattention and/or hyperactivity and impulsivity that is seen more frequently in children with ADHD than in children at comparable developmental levels. Other features associated with ADHD are low frustration tolerance, temper outbursts, stubbornness, excessive and frequent insistence on their own requests, labile mood swings, dysphoria, rejection by peers, and poor self-esteem. Academic achievement is often impaired because the children are distractible. Conflicts with authority figures, both parents, and school personnel are common. Many of these children also have oppositional defiant disorders. These children may have been exposed to drugs or alcohol in utero. Many ADHD children exhibited low birth weights as newborns. Some teenagers who have ADHD selfmedicate with drugs or alcohol.

Aura: A subjective sensation of voices or colors prior to a seizure.

Axon: That part of the neuron or nerve cell that is a long tube conducting signals away from the cell body.

Barbiturates: A class of drugs that effect GABA to prevent seizures from occurring. They were used for anxiety disorders until the discovery of benzodiazepines, which were found to be much safer.

Beriberi: From Sri Lankan for "I cannot, I cannot." A condition caused by thiamine deficiency, leading to damage to the central nervous system and causing memory and emotional disturbances (Wernicke's encephalopathy), weakness and pain in the limbs, and periods of irregular heart beats. Swelling of bodily tissues is common. In advanced cases, the disease may cause heart failure and death.

Bipolar disorder: A mental illness defined by cyclic episodes of mania or hy- pomania, classically alternating with episodes of depression; however, the condition can take various forms, such as repeated episodes of mania only or only one episode of mania and repeated episodes of depression or rapid cycling between mania and severe depression.

Bupropion: Generic for Wellbutrin, marketed as an antidepressant, and Zyban, marketed as a smoking cessation medication.

Campral: A drug used to maintain alcohol abstinence. Its mechanism is not well understood but it is believed to restore the normal balance between neuronal excitement and inhibition.

Carbohydrate-deficient transferrin: A protein found in blood involved in transferring iron to cell tissues. It is elevated with heavy alcohol consumption. The performance of carbohydrate- deficient transferrin as a screen for alcoholic liver disease has a sensitivity of 80% and a specificity of 92%; however, carbohydrate-deficient transferrin is not routinely tested, is expensive, and is not reimbursed by Medicare.

Centers for Disease Control: A federally mandated program that was established in 1973 to monitor the nation's health. The overarching goal is to protect the health and safety of U.S. citizens.

Central pontine myelinolysis: Disintegration of the myelin sheath in the pons that is associated with rapid replacement of low sodium, most often due to alcoholism.

Cerebellar system: The part of the nervous system that has to do with coordination of muscles and the maintenance of equilibrium.

Cerebral edema: Swelling of the brain because of an abnormal accumulation of fluid.

Cirrhosis: A liver disease where there is widespread disruption of normal liver functions. It is a chronic progressive condition that may eventually leads to death.

Classical conditioning: A type of learning that results when a conditioned and unconditioned stimulus are paired together, resulting in a similar response to both stimuli. Pavlov, who paired a bell tone with the delivery of food to dogs, developed this learning model. The salivation in response to the food (unconditioned stimulus) became associated with the bell (conditioned stimulus) over time, such that the food was no long needed to cause salivation in the presence of the bell tone.

Clotting factors: A group of proteins specifically designed to interact together to cause blood to clot and stop bleeding.

Cocaethylene: A chemical produced by the liver when processing cocaine and alcohol (ethanol) simultaneously that has many pharmacological properties similar to cocaine except that it stays in the body longer and is potentially more toxic to the nervous and cardiac systems.

Co-dependence: A maladaptive coping pattern in family members who are closely related to a substance abuser or experience a prolonged exposure to the behaviors of the alcoholic- or drug-dependent person(s). It may also refer to people who are not associated with an alcoholic family but may come from families that are dysfunctional for whatever reason, including poverty or mental illness.

Cognitive behavior therapy: A therapeutic intervention that reinforces "positive thinking" and extinguishes "negative thinking" (i.e., changing undesirable cognitive functioning).

Concordance rates: The rate at which genetically related individuals share with one another a particular trait. For example, identical twins have 100% of their genes in common, whereas fraternal twins have only 50% of their genes in common.

Confabulation: Filling in the memory gaps through fabrication (i.e., making up stories to cover the loss of memory). This is opposed to lying, which is deliberate story telling to hide real (remembered) events from someone to achieve some other gain other than merely filling in memory gaps.

Congestive heart failure: The heart is unable to maintain adequate circulation of blood to the body's tissues and is unable to pump out blood via the circulation system.

Coronary artery disease: The build up of plaque in the coronary arteries constricting blood flow to the heart muscle, leading to chest pain (angina) and the potential for muscle death (myocardial infarction).

Cortisol: Also called hydrocortisone. It is derived from cortisone and is also used to treat inflammatory conditions, including arthritis.

Cystic fibrosis: An inherited disease found in Caucasians that appears early in childhood. It involves a functional disorder of the endocrine system. Symptoms include faulty digestion because of a lack of pancreatic enzymes, difficulty breathing because of the accumulation of mucus in the lungs, and excessive salt in the sweat. At one time, these children only lived to be 4 or 5 years old. Now they live to be adults.

Delirium tremens (DTs): An acute withdrawal syndrome from alcohol that frequently occurs in alcoholics who have a 10-year (or more) history of heavy drinking. Tachycardia, sweating, hypertension, tremors, and delusions characterize it. Vivid hallucinations that are usually visual in nature and wild agitated behavior, however, define it.

Dexedrine: A psychostimulant that is prescribed to treat ADHD.

Dipsomania: An uncontrollable urge or craving for alcohol. This is an old expression for an alcoholic.

Disulfiram: Generic name for Antabuse, which is the most widely used medication for alcoholism in this country. It inhibits aldehyde dehydrogenase, thereby preventing the metabolism of alcohol, which leads to a variety of unpleasant side effects if the person takes a drink. These effects include nausea, vomiting, flushing, palpitations, and overactivity of the sympathetic nerves; however, it is only effective if the person is motivated to stop drinking and continues to take the drug as a support for not drinking.

Dopamine: One of the brain's major neurotransmitters, it is responsible for attention, alertness, decision making, reward, pleasure, and mood.

Double-blind study: A drug study that consists of an experimental group of patients/volunteers who receive the experimental drug, medical device, or treatment and a control group who receives a placebo or the current and standard drug, medical device, or treatment. Neither the investigator nor the patient/volunteer knows who is getting the experimental drug, treatment, medical device, or placebo.

Downregulation: The process by which a cell decreases the number of receptors to a given hormone or neurotransmitter to decrease its sensitivity to this molecule. An increase of receptors is called upregulation.

Down's syndrome: A person with Down's syndrome is mentally delayed and has characteristic facial features. The risk factors for having Down's syndrome include family history of Alzheimer's disease, a family history of Down's syndrome, and advanced maternal age at the time of the pregnancy.

Drosophila: A type of fruit fly that is commonly used to test genetic influences to various physical and behavioral traits.

Drunken monkey hypothesis: An evolutionary theory as to why having a taste for alcohol may convey some survival advantage by allowing animals to choose fruit that is the ripest.

DWI: A legal acronym for driving while intoxicated. Some states use the term to mean driving while impaired, it is also known as driving under the influence or DUI. Some states define DUI as referring to drugs other than alcohol, whereas DWI refers specifically to alcohol and typically involves a moving violation. Other states define DUI as driving under the influence of any substance even when not intoxicated and not having made a moving violation. For example, a minor is caught behind the wheel of a car with alcohol on his breath, but his blood alcohol level is under the legal limit. States define these terms based on issues of burden of proof. For example, some states regard driving while intoxicated as requiring a greater burden of proof on the part of the state than driving under the influence or driving while impaired. Refer to your own state definitions for further information.

Dysphasia: The loss of the ability to use or understand language as a result of an injury to the brain or a disease.

Electrochemical: The means by which a nerve conducts signals through the body and axon. This causes a release of chemicals.

Eliciting stimuli: Plural for eliciting stimulus. It is a trigger that elicits an involuntary or automatic response. Traditionally, in Pavlovian conditioning, pairing a bell with the presence of food stimulated the dog to salivate. After repeated pairings, the bell alone would elicit salivation from the dog. The bell became the eliciting stimulus. Such repeated pairings occur frequently in an addict's pursuit and use of a drug. Therefore, a bar, a friend, even an innocent but frequently used word can act as an eliciting stimulus to prompt intense craving or even feelings of withdrawal.

Endogenously: Functional causes occur from internal factors in the mind or the body. An example may be depression if there was no external event that might have precipitated the depression.

Endogenous opiates: Opioids that develop or originate within the body.

Endorphins: Short for endogenous morphine. See enkephalin or endogenous opiate.

Enkephalins: Greek for cerebrum. An endogenous opioid made up of amino adds, the building blocks of proteins also known as peptides, which are produced in the brain that have an affinity for opiate receptor sites and act similarly to analgesics and opiates, providing pain relief and a feeling of wellbeing.

Enzyme: A biological molecule that catalyzes or accelerates a chemical reaction. Most enzymes are proteins.

Epidemiological: The basic science of public health, having to do with epidemiology, which is the study of patterns of disease distribution in time and space that focuses on the health status of population groups or aggregates, rather than on individuals, and involves quantitative analysis of the occurrence of diseases in population groups.

Epileptogenic: Causing epileptic attacks or seizures.

Epistemological: The study of the nature and grounds of knowledge especially with reference to its limits and validity.

Euphoric: A happy and elated mood.

Excitotoxicity: The pathological process by which neurons are damaged and killed by the overactivation of receptors for the excitatory neurotransmitter glutamate, such as the NMDA receptor. Exdtotoxins, such as NMDA, which bind to these receptors, as well as pathologically high levels of glutamate, can cause excitotoxicity by allowing high levels of calcium ions to enter the cell. These calcium ions lead to neuronal cell death also known as apoptosis.

Executive functions: Brain functions involving planning and dedsion making. Such functions require thinking and postponing of more immediate wants or needs thus suppressing impulsive action. Executive functions are located in the frontal lobes of the brain.

Extinction: Elimination of a dassically conditioned response by the repeated presentation of the conditioned stimulus 'without the unconditioned stimulus. It is also the elimination of an operantly conditioned response by no longer presenting the reward immediately after the response.

Family Medical Leave Act (FMLA): The U.S. Congress passed this act in 1993 with the goal of providing employees with a balanced life between family and work. The law only pertains to companies with 50 or more employees. The employee must have worked with the company for at least 1 year. The law mandates up to 12 weeks of leave for various medical emergendes, such as birth or adoption of a child or the illness of a family member. The old job or an equivalent position must be provided when the person returns to work.

Fetal alcohol syndrome disorder (FASD): A disorder that is found in infants whose mothers ingested alcohol during pregnancy, resulting in the infant being mentally retarded along with having other distinguishing features.

Flumazenil (Romazicon): A benzodiazepine antagonist that is used to reverse the sedative effects of benzodiazepines in the management of an overdose.

Fluoxetine: The generic name for Prozac, which is an SSRI. It is also effective with obsessive compulsive disorder, posttraumatic stress disorder and other anxiety disorders.

GABA: Gamma-amino butyric acid, the brains major inhibitory neurotransmitter. This neurotransmitter dampens all brain activity, essentially calming the brain down at every level.

Gabapentin (Neurontin): An anti convulsant medication that may be used as an adjunct treatment with other drugs for seizures for adults and children over 12 years old. The mechanism of action is unclear.

Gene: A specific sequence of nucleotides in the DNA and RNA, which is a unit of inheritance that controls the transmission and expression of specific traits in people and other living organisms. Scientists and clinicians believe that alcohol dependence and abuse is influenced by genetic factors.

GGT (Gamma Glutamyl Transpeptidase): A liver enzyme that when elevated is associated with alcoholic liver disease (among other diseases).

Glial: Cells that support and nourish the brain's neurons.

Glutamate: The brain's major excitatory neurotransmitter. This neurotransmitter activates all brain activity, essentially stimulating the brain and "lifting" it up at every level.

Gray matter: The part of the brain that contains the nerve cell bodies, including the cell nucleus and its metabolic machinery, as opposed to the axons, which are essentially the "transmission wires" of the nerve cell. The cerebral cortex contains the gray matter.

Growth hormone: Secreted by the pituitary gland and regulates growth.

Half-life: The time it takes for half of the blood concentration of a medication to be eliminated from the body. The half-life determines the time to achieve equilibrium of a drug in the blood and determines the frequency of dosing to maintain that equilibrium.

Hallucinogen: A classification of drugs that produces hallucinations, euphoria, an altered body image, distorted or sharpened visual and auditory perceptions, confusion, loss of motor coordination, and impaired judgment and memory.

Health Insurance Portability and Accountability Act (HIPAA): The American Health Insurance Portability and Accountability Act (HIPAA) was passed by the U.S. Congress in 1996 and was put into effect on April 14, 2003.

Hematocrit: Measures of the proportion of blood volume that is occupied by red blood cells — a measure of the amount of blood one has. When this is low, one is known to have anemia.

Hepatitis: A liver disease due to a viral infection. Drug users are at high risk for developing infectious diseases, such as hepatitis, because drug users share injection equipment with other users, are immunosuppressed, and have poor hygiene. There are several types of hepatitis viruses: A is usually transmitted by fecal-oral contact; B is often acquired through sexual contact, frequently among drug users; C is transmitted among drug users by injection; and D also is spread by drug users and their sexual contacts.

Hypertension: High blood pressure, which can appear without an apparent cause. Hypertension can damage other organs in the body and is frequently the cause of strokes.

Hypocalcemia: Low blood calcium.

Hypokalemia: Low blood potassium.

Hypomagnesemia: Low blood magnesium.

Hyponatremia: Low blood sodium.

Hypophosphatemia: Low blood phosphorous.

ICD (International Classification of Diseases): This is the World Health Organization's manual for classifying all diseases, including mental illness and substance abuse. It is very similar to DSM.

Immunosuppression: Involves an act that reduces the activation or effectiveness of the immune system. A person who is immunosuppressed is said to be immunocompromised — more susceptible to infections and cancer.

Intensive outpatient treatment program (IOP): A program usually run by inpatient personnel, as part of the discharge plan for continuing followup treatment for their inpatients, upon discharge. It may be at a hospital or in a community setting. It frequently includes any of the common treatment modalities, including cognitive behavioral therapy, motivational enhancement therapy, and the 12-step AA program. The interventions are usually group rather than individually oriented.

Intermittent reinforcement: The reinforcement of a behavior (the reward) that occurs some of the time as opposed to continuous reinforcement that occurs every time after the behavior occurs. The behavior tends to reoccur when followed by a positive reinforcer (e.g., a good grade for a written paper) or by eliminating the negative reinforcer (e.g., a spanking).

Kindling: An effect on the brain whereby repeated electrical or chemical stimulation of the brain eventually induces seizures. This may explain why cocaine and alcohol previously did not lead to seizures but after repeated use now do.

Kudzu (Pueraria lobata): A plant used in alternative medicine to reduce alcohol cravings.

Lamotrigine: Generic name for Lamictal, an anticonvulsant also approved for the treatment of bipolar depression, particularly with respect to relapse prevention.

Learning theories: Theories that have to do with the acquisition of knowledge and skills and modifying behavior to learn new behaviors through behavior modification interventions (positive and negative reinforcement, extinction) and cognitive behavior interventions.

Leukopenia: A condition in which the number of leukocytes (white blood cells) circulating in the blood stream is low, commonly due to a decrease in the production of new cells in conjunction with various infectious diseases, drug reactions, other chemical reactions, or radiation therapy.

Macrocytic: From "macro" for large and "cytic" for cell. Primarily in reference to large red blood cells from thiamine deficiency (pernicious anemia) that is common in chronic alcoholics whose nutrition is poor.

Malabsorption: Faulty absorption of nutrients from the alimentary canal.

Marchiafava-Bignami Syndrome: Named after the two Italian pathologists who first discovered the condition. A syndrome first identified in alcoholics of Italian origin who died after suffering from seizures resulting in a coma. Autopsy results demonstrated degeneration of the area of the brain known as the corpus callosum, the major pathway connecting the left and right hemispheres of the brain. It now appears that this very rare condition is not exclusive to alcoholics of Italian origin.

Mean corpuscular volume: A measure of the size of the red blood cells. When this number is high and the hematocrit is low, this is known a macrocytic anemia.

Mellanby effect: Impairment from alcohol is greater at a given blood alcohol level when the amount of alcohol in the blood is increasing as opposed to decreasing. This also explains the differences in feeling "hung over" as opposed to "buzzed" at the same alcohol level depending on a falling or rising level. This is why taking "the hair-of-the-dog" or another drink "cures" a hangover.

Mendelian: The central tenets of genetics developed by Gregor Mendel. They relate to the transmission of hereditary characteristics from parent organisms to their children; they underlie much of genetics.

Metaphysical: Relating to a reality not investigated by the natural sciences or perceptible to the normal senses.

Metronidazole: Generic name for Flagyl, an antibiotic medication that rarely can have an Antabuse-like effect for patients taking it and drinking alcohol.

Microcephaly: An abnormally small head with associated mental retardation.

Microvascular: The part of the circulatory system made up of minute vessels or capillaries measuring less than 0.3 millimeters in diameter.

Mitigate: To soften or become less harsh.

Modeling: Learning through pervasive imitation. One person tries to be like another person, who is a role model, who is admired. The second person identifies with the role model in order to imitate what they observed the role model doing. Modeling is a strategy used to form new behaviors, learn new skills, or enhance existing skills. The theory of modeling was also named by Bandura as "Social Learning Theory."

Moderation Management (MM): Founded in 1993 as an alternative alcoholic treatment program to the traditional AA 12-step program. MM requires each person to plan to limit their drinking rather than requiring complete abstinence. MM includes nine steps, which does include abstinence for the first 30 days. There must be the desire to moderate one's drinking behavior and to accept responsibility for one's own behavior. Attendance at MM meetings is also required. Its goal is prevention and its hopes to support persons at the onset of the disease of alcoholism.

Monoamine oxidase inhibitors: An ntidepressant that is not used as frequently as other antidepressants, namely because of the side effects, which include anticholinergic effects, such as a dry mouth. Additional side effects are adverse reactions, including a hypertensive (high blood pressure) crisis when eating certain foods, such as aged cheeses, casseroles made with cheese, pizza, dry sausage, pep- peroni, and alcoholic beverages (especially beer, including nonalcoholic beer and wine, especially red wine). Patients must adhere to low tyramine diets, which are sometimes difficult to follow. This diet should be adhered to even after the drug has been stopped for a period of 2 weeks. Mothers Against Drunk Driving (MADD): An advocacy group of women who have lost someone, usually a child, because of a drunk driver. The purpose of the group is to educate the public about the dangers of alcohol and driving while under the influence of an intoxicating substance and to lobby legislators at the federal, state, and local levels to pass laws that will get intoxicated drivers off the road. Motivational enhancement therapy: Cognitive interventions are used to enhance the substance abuser's desire to stop using. The therapy integrates a combination of humanistic treatment and enhanced cognitive- behavioral strategies. Motivational enhancement therapy was designed for the specific purpose of treating the substance abuser, particularly the opiate addict who uses euphoric enhancing drugs. The focus is on the negative implications of substance abuse, for each individual, encouraging the client to articulate his or her own need for change. It has been used with alcoholics but less effectively. Often, motivational enhancement therapy has been combined with biological interventions such a methadone. The underlying message is that drug misuse is a choice and it is the individual's choice to change his or her own behavior. It is an individually-oriented program conducted by a skilled therapist rather than a group program. Consequently, it is expensive.

Motivational interviewing: A brief treatment approach designed to produce rapid internally motivated change in addictive behavior and other problem behaviors. The core principles are (1) to express empathy, (2) develop discrepancy, (3) avoid augmentation, (4) roll with resistance, and (5) support self-efficacy. Motivational interviewing assumes that ambivalence and fluctuating motivation occur during substance abuse recovery. Motivational enhancement therapy and motivational interviewing are based on similar assumptions, especially the belief that change will not occur unless the individual is motivated to change.

Motor cortex: An area on the outer part of the brain that is responsible for voluntary motor control.

Muscular dystrophy: A group of heritable diseases characterized by the progressive wasting of muscles.

Myopathy: A disorder of the muscle tissue, typically causing wasting and weakness.

Naloxone: Generic for Narcan. It is an opioid antagonist and competes with opioids at the opiate receptor sites. It is used as an antidote when there is respiratory depression induced by opiate intoxication.

Naltrexone: Generic for ReVia. It is an opioid antagonist that competes with narcotics at opiate receptor sites, blocking the opioid analgesics. It is used primarily to treat various addictions.

Narcan: See Naloxone.

Narcotic analgesic: An opioid used to control pain.

National Organization of Fetal Alcohol Syndrome: An organization to educate young women about the dangers of drinking while pregnant, hopefully to prevent the incidence and prevalence of fetal alcohol syndrome. Neurochemical: A broader name for neurotransmitter. Any chemical that has effects on nerve cells.

Neuron: A nerve cell made up of a cell body with extensions called dendrites and the axon.

Neuroprotective: A protection of the nervous system against toxic substances.

Neurotoxic: Toxic or lethal to the nerve and/or nervous tissue.

Neurotransmitters: Chemicals released by nerves that communicate with other nerves causing electrochemical changes in those nerves to continue to propagate a signal.

NMDA (N-methyl-D-aspartic acid): An amino acid derivative acting as a specific agonist at the NMDA receptor and therefore mimics the action of glutamate at that receptor. In contrast to glutamate, NMDA binds to and opens the above receptor only, but not other glutamate receptors.

Nonsteroidal anti-inflammatory drugs (NSAIDs) : An extremely diverse group of anti-inflammatory and analgesic drugs that inhibit the enzyme cyclooxygenase and reduce the synthesis of prostaglandins. Aspirin and ibuprofen are examples.

Norepinephrine: A neurotransmitter in the brain as well as a stress hormone released by the adrenal glands, also known as noradrenaline or adrenaline. As a stress hormone, this compound affects the "fight or flight response," activating that part of the involuntary nervous system known as the sympathetic nervous system to increase heart rate, release energy from fat, and increase muscle readiness. As a neurotransmitter, it increases alertness and helps in elevating mood, but it can also increase anxiety and cause tremors.

Off-label: Prescribing of a medication for indications other than those indicated by the Food and Drug Administration.

Ondansetron: Generic name for Zofran, an antiemetic drug that acts on specific serotonin receptors.

Open-label: A term used to describe the type of study where both the researcher and the volunteer/subjects know the drug or treatment that the subjects are receiving. An open-label study is the opposite of the doubleblind study. In the double-blind study, neither the researcher nor the participant know whether the subject is receiving the experimental drug, device or treatment, or a placebo.

Operant conditioning: A type of learning that is concerned with the relationship between voluntary behavior and the environment. If behavior is followed by a reward, it will reoccur. It was developed by B. F. Skinner.

Opiate: A type of opioid. An opioid is any agent that binds to opioid receptors. Found principally in the central nervous system and gastrointestinal tract. There are four broad classes of opioids: endogenous opioid peptides, produced in the body; opium alkaloids, such as morphine (the prototypical opioid) and codeine; semisynthetic opioids such as heroin and oxycodone; and fully synthetic opioids such as pethidine and methadone that have structures unrelated to the opium alkaloids. Although the term "opiate" is often used as a synonym for opioid, it is more properly limited to the natural opium alkaloids and the semisynthetics derived from them. Opioids/ Opiates have addictive qualities.

Parathyroid hormone: A hormone produced by the parathyroid gland that is next to the thyroid. This hormone regulates calcium and phosphorus.

Partial agonist: A chemical (e.g., drug) that can both block and stimulate a receptor depending on the relative amount of neurotransmitter present in the synaptic cleft. If the amount of neurotransmitter is great, the chemical acts as an antagonist; if the amount of neurotransmitter is low, the chemical acts as an agonist.

Partial hospital program (PHP): A program usually run as part of the discharge plan for their inpatients. Patients attend 2 to 3 days per week. Partial hospital programs for alcoholics frequently include AA meetings and are based on the 12 steps of AA. The interventions are focused on group work rather than individual psychotherapy. It provides an opportunity to monitor the patient's progress and serves as a therapeutic bridge between the hospital and the community.

Peripheral neuropathy: Peripheral refers to the nerves outside of the central nervous system. Neuropathy is the degeneration of the nervous system. Peripheral neuropathy is the degeneration of the peripheral nerves.

Phénobarbital: A barbiturate currently used as an anticonvulsant.

Phenylketonuria: An inherited metabolic disease that causes mental retardation because of the inability to oxidize the metabolic product of phenylalanine.

Physician's Desk Reference: A compendium of all of the drugs available to legal prescribes (MDs, DOs, and NPs) in the United States and Canada, along with guidelines about their actions, how each drug is generally used, the drug interactions, side effects, and contraindications.

Placebo: A drug, medical device, or treatment that looks similar to the experimental drug, medical device, or treatment, but it is in fact an inactive drug, liquid, device, or treatment and will not affect the volunteer's health or illness.

Platelets: Also known as thrombocytes. A type of blood cell involved in the cellular mechanisms of the formation of blood clots. Low levels or dysfunction predisposes for bleeding, whereas high levels, although usually asymptomatic, may increase the risk of the development of a thrombus or clot.

Posttraumatic Stress Disorder (PTSD): A mental/emotional disorder that is characterized by persistent distressing symptoms lasting longer than 1 month after exposure to an extremely traumatic event.

Potable: Drinkable.

Potentiates: To make more active or effective, to augment, and to make more potent.

Prolactin: A hormone found in the anterior lobe of the pituitary that induces and maintains lactation during the postpartum period in a female.

Prophylaxis: Preventing the occurrence of something.

Proximate cause: In evolutionary theory, the initial cause that changes the behavior of a biological system. Pulling one's hand from a fire is caused by a reflex arc in the nervous system and would be an example of a proximate cause.

Prozac: See fluoxetine.

Pseudobulbar: A condition that simulates paralysis of certain cranial nerves caused by lesions in the medulla oblongata, a part of the brain.

Pseudobulbar palsy: Condition caused by damage to the cranial nerve pathways that can lead to unprovoked outbursts of laughing or crying along with other neurological deficits.

Psychosis: A state in which an individual experiences hallucinations, delusions, and disorganized thoughts, speech, and/or behaviors. An inability to distinguish reality from fantasy.

Psychosocial theory: A theoretic viewpoint that developed in the early 1900s that the cause of mental illness pertains to environmental circumstances that impact on one's psychological well-being. Mental disorders result from environmental and social factors, including social and environmental deprivation.

Psychostimulant: "Psycho" pertains to the brain and its cognitive functions. It is an agent or drug that increases the functional activity or efficiency of an organ. A psychostimulant enhances the functional capacity and efficiency of the brain and its cognitive functions temporarily during a brief span of time.

Psychotropic: A drug that has an effect on the psychic functions of the brain, behavior, or experience.

Rapid eye movement (REM): Rapid eye movements that occur during a stage of sleep that appears on EEG as if the subject is awake. During this time the subject is actively dreaming. Also known as dream sleep.

Receptors: Specific areas of protein on a neuron that are configured to respond only to specific neurotransmitters. Receptors act like locks, which can only be opened by specific keys that are the neurotransmitters.

Reinforcers: The stimuli that are coupled with a behavior in operant conditioning so that the reward is either applied or removed to elicit the desired response.

Reliability: The ability to reproduce the same outcomes upon repeated testing.

Reuptake: The process by which neurotransmitters return to the presynaptic cells after being released into the synaptic cleft and attaching receptors on the postsynaptic cells.

Reverse agonism: A chemical (drug) that has reverse activity on the receptor rather than just merely blocking the receptor.

Re Via: Trade name for naltrexone. A medication used for narcotic and alcohol addictions thought to control craving. It is an antagonist and blocks the effects of opioids.

Ritalin: The trade name for methylphenidate. It is used to treat ADHD.

Selective serotonin reuptake inhibitors (SSRI): A class of antidepressant/antianxiety medications that works by blocking the serotonin transporter, thereby increasing the amount of serotonin in the synaptic cleft. These medications include fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), fluvoxamine (Luvox), citalopram (Celexa), and escitalopram (Lexapro).

Self-medication: Taking medications that are not prescribed by a physician or nurse practitioner, including alcohol or other drugs, to cope with emotional distress (e.g., drinking alcohol or smoking marijuana to calm down when one is feeling anxious).

Sensitivity: Probability of a positive test among patients with a particular disease. The more sensitive the test the better it is at detecting the presence of disease.

Sensory cortex: An area on the outer part of the brain that is responsible for organizing sensory input into a coherent perception at the level of consciousness.

Serotonin: One of the brains major neurotransmitters. It is responsible for "vegetative functions," that is sleep, appetite, sex drive (libido), anxiety, and mood.

Sleep architecture: A predictable pattern during a night's sleep that includes the timing, amount, and distribution of rapid eye movement (REM) sleep and non REM. REM and NREM occur approximately in 90 to 110 minute cycles over the course of an 8-hour period during a person's night sleep. There are four stages in sleep architecture.

Slow-wave sleep: A state of deep sleep that occurs regularly during a normal period of sleep with intervening periods of rapid eye movement (REM) sleep. At this stage, there is a low rate of autonomic physiological activity.

Specificity: Probability of a negative test among patients without disease. A very specific test rules out disease.

Status epilepticus: A state in a person whereby seizures occur in rapid succession without recovery of consciousness.

St. John's Wort (Hypericum perforatum): A plant used in alternative medicine as an alternative to antidepressant medications.

Synaptic cleft: The gap between nerves where neurotransmitters are released that allow nerves to communicate with one another.

Teratogen: An agent, such as a virus, drugs or alcohol, or radiation, that causes malformations in a fetus or embryo.

Tetrahydrocannabinol: The psychoactive ingredient to marijuana that gives it its hallucinogenic and appetite effects. It is also pharmaceutically synthesized and released under the trade name Marinol and is prescribed as an appetite stimulant for cancer and AIDS patients.

Tetrahydroisoquinolone (THIQ): A chemical compound that can be formed by combining acetaldehyde (the toxic breakdown product of alcohol) and dopamine (the neurotransmitter). It is thought to be specific for alcoholics and has opioid-like activities causing euphoria, thereby explaining their increased propensity toward addiction when compared to the normal population.

Therapeutic communities: The environment on an inpatient unit that is developed to be a healthy milieu for staff and patients and that facilitates the development and implementation of treatment. A therapeutic community is described as a group of patients and professionals that adhere to cultural norms for behavior, value the individual, and provide activities for patients to teach them skills for healthy interpersonal relationships, as well as activities for daily living.

Thiamine: Vitamin B1. It plays an important role in converting carbohydrates and fat into energy. Deficiency can lead to conditions known as Beriberi and Wernicke/ Korsakoff's syndrome.

Thrombi: Plural for thrombus or blood clot. If the clot detaches and moves, it is known as an embolus.

Thrombocytopenia: The presence of relatively few platelets in blood.

Topamax: The trade name for topiramate. An anticonvulsant.

Topiramate: Off label, it may be used as an adjunctive mood stabilizer, especially in bipolar disorders.

Trade name: The name given to drugs by the company that has the patent rights to the drug, either through purchasing the patent rights from another company, or having discovered or designed them. The trade name is the company name.

Transporter: Also known as a transport pump. Transporters are made up of proteins that act as "vacuum cleaners," taking up leftover neurotransmitters from the synaptic cleft and transporting them back into the nerve cell that originally released them.

Transport pump: See transporter.

Ultimate cause: In evolutionary theory, the ultimate cause for why a particular behavior evolves to serve an evolutionary purpose that has survival value. A reflex arc is a more efficient system for conferring survival value than having the signal go to the level of consciousness before one pulls one's hand out of the fire would, as with the ultimate cause. Ultimate causes are often theoretical in nature because they are difficult to prove.

Upregulation: The process by which a cell increases the number of receptors to a given hormone or neurotransmitter to improve its sensitivity to this molecule. A decrease of receptors is called downregulation.

Valerian (Valeriana officinalis): An alternative medicine that is used in place of sedative drugs.

Validity: The accuracy of the outcome of a test or instrument (i.e., the extent to which a test or instrument measures what it intends to measure).

Valproic acid: An anticonvulsant medication that acts on GABA and is FDA approved for use in bipolar disorder (manic depression) and seizure disorders.

Vascular dementia: A cognitive disease with mental and emotional impairments, plus neurological signs and symptoms. The disease is the result of multiple vascular lesions. Vascular dementia may be seen with or without delirium, delusions, and depression and may be with or without behavioral disturbances. As in most dementias, there is memory loss and other cognitive impairments.

Vertigo: Dizziness, as in the room is spinning around. This is a brain effect as opposed to lightheadedness or feeling faint, which is often also described as dizziness but is due to low blood pressure.

Vivitrol: An injectable, long acting form of naltrexone.

White matter: Tracts in the brain that consist of sheaths (called myelin) covering long nerve fibers.

Zofran: Trade name for ondansetron. It is an antiemetic that prevents nausea and vomiting by blocking serotonin peripherally, centrally, and in the small intestine.

Zolpidem (Ambien), zaleplon (Sonata), and eszopiclone (Lunesta): These are all sleep-enhancing or sleep-inducing medications that are not benzodiazepines but do act on one of the GABA receptors in a manner similar to benzodiazepines.

Zyban: See bupropion.

 
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