FIND SUPPORT
Recovery Terms & Questions, Explained
Levels of Care (how intensive is the treatment?)
Levels of Care
The range of treatment intensities, from a single weekly appointment to 24-hour medical care. The industry uses a standard framework from the American Society of Addiction Medicine (the ASAM Criteria) to match a person to the right level. The goal isn’t the most intensive option — it’s the least intensive option that will actually work for your situation.
Assessment (or Intake Assessment)
The conversation that happens before treatment starts. A clinician asks about substance use history, physical health, mental health, living situation, family, work, and what you want to change. It usually takes 60–90 minutes. Its purpose is to recommend a level of care — not to judge you, and not to trap you into anything. You can ask questions during it, and you can decline recommendations.
Outpatient Treatment (OP)
The least intensive level. You live at home, keep working, and attend treatment for roughly 1 to 8 hours a week — typically individual therapy, a group session, or both. Good fit for someone with a stable living situation, low medical risk, and support around them.
Intensive Outpatient Program (IOP)
A structured program of 9 to 19 hours per week, usually three to five sessions a week, about three hours at a time, often scheduled in the evening so people can keep a job. Mostly group therapy, plus individual sessions and education. You go home at night. IOP is the most common starting point for people who need more than a weekly appointment but don’t need to leave their life to get help. In the ASAM framework this is Level 2.1.
Partial Hospitalization Program (PHP) / High-Intensity Outpatient (HIOP)
Sometimes called day treatment. You’re at the program 20 or more hours a week — typically five days a week, most of the day — but you sleep at home or in supportive housing. It’s close to residential intensity without the overnight stay. Suits someone who needs daily structure and clinical oversight but has a safe, stable place to sleep.
A naming note that will save you confusion: PHP and HIOP are the same level of care. In the 2023 update to the ASAM Criteria, Level 2.5 was renamed from “Partial Hospitalization” to “High-Intensity Outpatient” — because these programs aren’t actually delivered in a hospital, and the old name misled people into expecting one. Most programs, insurers, and search results still say “PHP.” Expect to see both.
Medically Managed Intensive Outpatient (ASAM 2.7)
An outpatient level with medical staff leading the treatment plan — used when someone needs intensive outpatient programming plus medical monitoring, including managed withdrawal, without a residential stay. This level absorbed what used to be called Level 2 withdrawal management.
Residential Treatment (also called "inpatient rehab")
You live at the facility, usually for 30 to 90 days, with treatment programming most of the day and staff on-site around the clock. Three tiers:
- Clinically managed low-intensity residential — a supportive, structured living environment with lighter clinical programming (ASAM 3.1). Often used as a step down.
- Clinically managed high-intensity residential — full-day therapeutic programming, 20+ hours a week, with 24-hour staffing (ASAM 3.5). This is what most people picture when they say “rehab.”
- Medically managed residential — the same, with 24-hour medical oversight for people with significant medical or withdrawal needs (ASAM 3.7).
Medically Managed Inpatient Treatment
The most intensive level: a hospital or hospital-like setting with 24-hour nursing and physician care. Used when someone has serious medical complications, a severe co-occurring psychiatric condition, or a withdrawal risk that needs medical monitoring. ASAM Level 4.0.
Detox / Withdrawal Management
The medically supervised process of getting a substance out of your system safely while symptoms are managed. Detox is not treatment — it’s the stabilization step that often comes before treatment. It typically lasts 3 to 10 days depending on the substance.
Two things worth knowing: withdrawal from alcohol and from benzodiazepines can be medically dangerous and occasionally fatal without supervision. Don’t attempt those alone. And detox by itself, with no treatment afterward, has a very high return-to-use rate — it’s a starting line, not a finish line.
Continuum of Care
The idea that treatment is a path, not an event. A common path: detox → residential → PHP → IOP → outpatient → ongoing support. Not everyone starts at the top or hits every stage, and moving back up a level isn’t failure — it’s the system doing what it’s designed to do.
Step-Down / Step-Up
Moving to a less intensive level (step-down) or a more intensive one (step-up) as needs change. A step-up isn’t a punishment. It’s a clinical adjustment.
Aftercare / Continuing Care
The plan for what happens after formal treatment ends: ongoing therapy, alumni groups, mutual-aid meetings, medication management, recovery coaching, sober housing. This is the part most people underestimate, and it’s the part most correlated with staying well.
Treatment Approaches & Medications
Evidence-Based Treatment
An approach that’s been tested in research and shown to work — not just something a program believes in. When you’re evaluating a program, it’s fair to ask which evidence-based practices they use and how they measure outcomes.
Cognitive Behavioral Therapy (CBT)
A widely used, well-researched therapy that focuses on the link between thoughts, feelings, and behavior — identifying the thinking patterns and situations that lead to use, and building different responses.
Dialectical Behavior Therapy (DBT)
A therapy originally developed for intense emotional swings and self-harm, now used widely in addiction treatment. Teaches four concrete skill sets: distress tolerance, emotion regulation, mindfulness, and interpersonal effectiveness.
Motivational Interviewing (MI)
A conversational approach where the clinician helps you find your own reasons to change rather than arguing you into it. Especially useful when someone is ambivalent — which is nearly everyone, at the start.
EMDR (Eye Movement Desensitization and Reprocessing)
A structured therapy for trauma. Relevant here because trauma and substance use overlap heavily, and untreated trauma is a common driver of return to use.
Medication-Assisted Treatment (MAT) / Medications for Opioid Use Disorder (MOUD)
FDA-approved medications used alongside counseling to treat substance use disorders. For opioids: buprenorphine (often as Suboxone), methadone, and naltrexone (Vivitrol). For alcohol: naltrexone, acamprosate, and disulfiram.
Worth saying plainly, because the stigma is persistent: taking these medications is not “still using.” They are among the most effective treatments available. Methadone and buprenorphine have the strongest evidence for reducing opioid overdose death — a large NIH-cited study found roughly 59% and 38% lower overdose mortality respectively. Naltrexone is FDA-approved for opioid use disorder, but the mortality evidence behind it is weaker, and the extended-release form requires completing withdrawal first.
The field increasingly prefers the term MOUD over “MAT,” because the medication is treatment, not an assist. Some mutual-aid groups and some sober housing have historically been unwelcoming toward people on these medications — worth asking about directly if it applies to you.
Naloxone (Narcan)
A medication that reverses an opioid overdose. The nasal spray is sold over the counter in the U.S. — no prescription needed — and it’s a reasonable thing to keep in a home, a car, or a backpack if opioids are anywhere in your life. (Injectable naloxone and some related products still require a prescription.) In Colorado, statewide standing orders and a state bulk-purchase fund make naloxone free or low-cost through many local channels.
Good Samaritan Law (Colorado)
Colorado law provides limited legal immunity to someone who calls 911 in good faith for an overdose — but the conditions are specific. You generally have to stay at the scene until help arrives, identify yourself, and cooperate with responders. The protection covers a defined list of offenses, mainly drug and paraphernalia possession and underage alcohol or marijuana. The person who overdosed is covered too, under the same conditions.
It is not blanket immunity. It doesn’t cover distribution above certain thresholds, outstanding warrants, weapons charges, or DUI. Still: the practical takeaway is that fear of arrest is a bad reason not to call, and calling is protected in the situation that most often stops someone.
Co-Occurring Disorders (also "dual diagnosis")
Having a substance use disorder and a mental health condition at the same time — depression, anxiety, PTSD, bipolar disorder, ADHD. This is common, not exceptional. Treating only one side tends to fail; look for programs that treat both together rather than sequencing them.
Substance Use Disorder (SUD)
The clinical term for what’s often called addiction. Diagnosed on a spectrum — mild, moderate, or severe — based on eleven criteria in the DSM-5, including loss of control, cravings, tolerance, withdrawal, and continued use despite consequences. The spectrum framing matters: you don’t have to be at the worst possible point to qualify for help, or to benefit from it.
Trauma-Informed Care
An approach that assumes trauma may be part of a person’s history and designs the whole environment around not re-traumatizing them — how staff communicate, how rules are enforced, how much control the client keeps. It’s a program-wide posture, not a single therapy.
Harm Reduction
A set of practices aimed at reducing the damage of substance use for people who aren’t stopping right now — naloxone distribution, fentanyl test strips, safer use education, syringe services. Harm reduction and abstinence-based recovery are often framed as opposites; in practice, keeping someone alive and connected is what makes later recovery possible.
Recovery, Support & Community
Recovery
There’s no single official definition, and that’s worth being honest about. SAMHSA describes it as a process of change through which a person improves their health and wellness, lives a self-directed life, and strives to reach their full potential. In practice, people mean different things by it — some mean total abstinence, some mean stability and improved functioning, some mean a whole rebuilt life. You get to define what it means for you, and it’s a fair question to ask any program how they define it.
Remission
The clinical term for symptoms of a substance use disorder no longer being present. Early remission is 3 to 12 months; sustained remission is 12 months or more. Clinicians use this language because it frames the condition the way other chronic conditions are framed.
One detail that matters to people living it: craving can still be present and you’re still counted as in remission. It’s the one criterion the definition explicitly allows. Wanting to use doesn’t mean you’re doing recovery wrong.
Abstinence
Not using a substance at all. Some programs require it, some don’t. It’s not synonymous with recovery, though for many people it’s central to theirs.
Sobriety
Commonly used to mean abstinence, though many people in recovery use it to mean something broader — a way of living, not just a behavior.
Relapse / Return to Use
Resuming substance use after a period of not using. Many clinicians now prefer “return to use” or “recurrence”, because “relapse” carries a load of moral failure that the evidence doesn’t support: substance use disorder is a chronic condition, and recurrence rates (roughly 40–60%, per NIDA) are comparable to those for asthma and hypertension (both 50–70%). It’s information about what the treatment plan needs, not a verdict on the person.
Recovery Capital
The total resources a person has to draw on — housing, income, health, relationships, skills, community, a sense of meaning. Two people with identical use histories can have wildly different outcomes based on this. It’s a useful frame because it points at what to build, not just what to stop.
12-Step Programs (AA, NA)
Alcoholics Anonymous, Narcotics Anonymous, and related fellowships: free, peer-led mutual-aid meetings built on a twelve-step framework, widely available almost everywhere. They are not treatment and not clinical care, but they’re the most accessible ongoing support in existence, and for many people they’re the backbone of long-term recovery.
SMART Recovery
A secular, science-based mutual-aid alternative to 12-step, built on CBT and motivational tools. Meets in person and online. Common choice for people who don’t connect with the spiritual framing of 12-step.
Refuge Recovery / Recovery Dharma
Mutual-aid approaches grounded in Buddhist practice and meditation. Another secular-friendly alternative.
Al-Anon / Nar-Anon
Mutual-aid groups for the families and friends of people with substance use disorders — not for the person using. Worth naming clearly, because families often don’t realize there’s support built specifically for them.
Peer Support Specialist / Recovery Coach
Someone with lived experience of recovery, trained and often certified, who works alongside clinical staff — helping with navigation, accountability, and the practical grind of rebuilding. Different from a therapist: peers work from experience, not clinical treatment.
Sober Living / Recovery Residence
Substance-free housing where residents live together with shared rules, usually after residential treatment. Typically not clinical treatment and usually not covered by insurance — residents generally pay rent. Quality varies enormously.
In Colorado, certification is required, not optional — state law mandates that recovery residences be certified against national NARR (National Alliance for Recovery Residences) standards through the Behavioral Health Administration’s approved certifying body. If a house isn’t certified, that’s a red flag worth asking about.
Alumni Program
Ongoing connection to a treatment program after you finish — events, groups, check-ins. A good indicator of whether a program is invested in outcomes past discharge.
Sponsor
In 12-step programs, a more experienced member who works the steps one-on-one with a newer member. Unpaid, informal, and not a clinician.