CARN-AP key terms

A public health approach that screens every patient for risky substance use, delivers a brief intervention to those at moderate risk, and refers people with severe disorders to specialized treatment.

A 10-item World Health Organization questionnaire measuring drinking frequency, quantity, dependence symptoms, and alcohol-related problems over the past year; the 3-item AUDIT-C is a shorter version.

A four-question screen (Cut down, Annoyed, Guilty, Eye-opener) that flags possible alcohol problems; it is quick but misses low-level and binge drinking.

A 10-item scored scale rating alcohol withdrawal severity, including tremor, sweating, agitation, perceptual disturbance, and seizure risk, used to guide symptom-triggered benzodiazepine dosing.

An 11-item clinician-rated scale scoring opioid withdrawal signs and symptoms to confirm withdrawal and time buprenorphine induction so precipitated withdrawal is avoided.

The current diagnostic framework requiring at least 2 of 11 criteria within 12 months, graded mild, moderate, or severe; it replaced the older abuse and dependence categories.

Rapid immunoassay testing that detects drug classes; presumptive positives need confirmatory testing such as gas chromatography-mass spectrometry before clinical, employment, or legal conclusions are drawn.

A nine-item self-report scale scoring depressive symptom severity over the past two weeks; a score of 10 or more suggests clinically significant depression requiring further evaluation.

A standardized framework using six assessment dimensions to match patients to the appropriate intensity of addiction treatment, from early intervention through medically managed inpatient care.

An opioid antagonist given orally or as a monthly injection that blocks opioid reward and reduces heavy drinking; patients must be opioid-free first to avoid precipitated withdrawal.

A medication that reduces craving and supports abstinence in alcohol use disorder, usually started after detoxification and taken three times daily; adequate kidney function is required.

An aversive medication that blocks aldehyde dehydrogenase, producing flushing, nausea, and tachycardia if alcohol is consumed; it works only with supervised adherence and informed patient agreement.

A partial mu-opioid agonist used for opioid use disorder that relieves withdrawal and craving with a ceiling on respiratory depression; it is often combined with naloxone to deter injection misuse.

A full mu-opioid agonist dispensed through federally regulated opioid treatment programs, with a long half-life allowing once-daily dosing and requiring ECG monitoring for cardiac effects.

A short-acting opioid antagonist that reverses overdose-related respiratory depression; it is available as nasal spray or injection and can be given by anyone to a person with suspected overdose.

The plateau at which higher doses of a partial agonist such as buprenorphine add no further opioid effect, limiting respiratory depression and overdose risk.

Lengthening of the heart's repolarization interval that raises the risk of dangerous arrhythmias; it is monitored in patients taking methadone, certain antipsychotics, and other QT-prolonging drugs.

A gradual, planned dose reduction, often small decrements every one to two weeks, used to stop long-term benzodiazepines safely and prevent seizures, delirium, and rebound anxiety.

A collaborative, person-centered counseling style that draws out and strengthens a patient's own reasons for change using open questions, affirmations, reflections, and summaries.

A transtheoretical model describing movement through precontemplation, contemplation, preparation, action, and maintenance, used to match interventions to a person's current readiness.

A structured, skills-based therapy that helps patients identify and modify the thoughts, feelings, and behaviors that trigger and sustain substance use, often paired with coping-skills training.

An intervention giving tangible, often escalating rewards for objectively verified abstinence or treatment attendance; it is among the most effective treatments for stimulant use disorder.

A cognitive-behavioral maintenance strategy teaching patients to anticipate high-risk situations, manage cravings, and treat a lapse as a learning event rather than a personal failure.

A structured counseling and referral approach that encourages active involvement in mutual-help groups such as Alcoholics Anonymous as a complement to, not a substitute for, clinical care.

Community Reinforcement and Family Training: a program teaching concerned family members to change reinforcement patterns, increase the likelihood their relative enters treatment, and reduce their own distress.

An organizational and clinical approach that assumes widespread trauma exposure, prioritizes safety, trust, choice, and collaboration, and avoids practices that could re-traumatize patients.

A direct, in-person transfer of care between providers, often from an emergency department to treatment, made with the patient present so engagement does not depend on independent follow-up.

An integrated primary care design in which a care manager, primary clinician, and consulting psychiatrist use a patient registry and measurement-based treatment to reach defined targets.

A trained person with lived experience of substance use and recovery who offers nonclinical support, mentoring, and linkage to services as a member of the care team.

The total resources a person can draw on to start and sustain recovery, including social, physical, human, and cultural assets such as relationships, housing, health, skills, and community ties.

Policies and practices that lessen the negative consequences of drug use without requiring abstinence, such as naloxone distribution, sterile supplies, and nonjudgmental engagement in care.

Community programs supplying sterile syringes and disposal, naloxone, infection testing, and treatment referrals; they lower HIV and hepatitis transmission without increasing drug use.

A range of lifelong physical, cognitive, and behavioral effects caused by prenatal alcohol exposure; prevention depends on screening and abstinence counseling for people who may become pregnant.

A federal regulation giving heightened confidentiality protection to substance use disorder treatment records, generally requiring specific written consent before disclosure and barring re-disclosure.

Federal law protecting the privacy and security of health information; it allows disclosures for treatment, payment, and operations but generally requires patient authorization for other uses.

The ethical and legal requirement to explain a treatment's benefits, risks, and alternatives, confirm the patient understands, and obtain voluntary agreement before proceeding.

A legal obligation recognized in many jurisdictions to breach confidentiality in order to protect an identifiable person when a patient presents a serious threat of harm.

A state-run electronic database of controlled-substance prescriptions that clinicians check to spot duplicate prescribing, dangerous drug combinations, and possible misuse.

The legally defined activities a nurse or advanced practice nurse may perform, set by state law and licensure; authority to diagnose and prescribe varies widely across states.