We talk a lot about community here at Workit Health because we believe—and the evidence supports this belief—that people recover better and feel more motivated to stay in treatment when they connect with other people who understand what they’re going through. There is one aspect of community that we don’t talk about very much, though, and that’s the kind of language we use.
There’s a very human tendency to have more positive feelings toward people we identify with. There’s a sense of belonging there. In a class I took once, the teacher called that the “in-group.” She pointed out that we often use word choice to reinforce that in-group. Without even thinking about it, we often know who is “one of us” by the things they talk about and the ways we phrase things. So it can be really uncomfortable when we come into a recovery group and find that we don’t understand the terms they’re using. These are supposed to be our people!
I can’t define the vocabulary for all in-groups you might be a part of, and I’m sure there are tons of terms I’ve never even encountered. But I can clarify some common phrases for two recovery circles: 12-step groups and clinical recovery programs like Workit Health. Here are a few of the words and phrases that often catch newcomers off-guard.
Common 12-step terms
- 12-step: This refers to all programs derived from Alcoholics Anonymous. AA suggests that members work through 12 steps of personal and spiritual action. The programs based on AA adapt these 12 steps to suit their own memberships (Cocaine Anonymous, Heroin Anonymous, Narcotics Anonymous, Crystal Meth Anonymous, etc.).
“The rehab downtown requires that everyone works a 12-step program.”
“I tried the 12 steps, but I didn’t buy into the Higher Power.” - Big Book: The book officially titled “Alcoholics Anonymous” is a thick, blue book that is commonly called “the Big Book.” The original book, as it was published in 1939, is the first 164 pages of the current version.
“Henry is always quoting from the Big Book; he’s such a Big Book-thumper.”
“Have you read the whole Big Book?” - Burning desire: A burning desire is an intense craving or urge to drink or use. Another common phrase for this is “up against a drink or drug.” Many 12-step meetings include a prompting for anyone with a burning desire to share about it out loud.
“I need to talk about this burning desire so I have some accountability.”
“Sami said they had a burning desire for days, so they reached out for help. - Coming in: This refers to either joining the 12-step program or getting into recovery/getting sober. It’s metaphorical and doesn’t necessarily have anything to do with physically entering any particular building or space.
“When I came in, I was sure I was only going to sober up for a few months, but I’m still here.”
“I’ve known John since the last time I came in, about 2 years ago.” - Counting days: This is the process of tracking how many days of sobriety or recovery a person has in a row, and often refers to someone in early recovery. Most 12-step meetings use chips or coins as symbols of certain milestones (i.e. 30 days, 60 days, 90 days, 6 months, etc.).
“Nigel has been sober for years, but the buddy he brought to the meeting was still counting days.”
“I’m counting days, and I’m so proud of getting a week of recovery under my belt.” - Dry drunk: “Dry” refers to not using drugs or alcohol, but also not working the 12 steps of the recovery program. This concept suggests that even when an individual is no longer under the influence of a substance, they are not yet “sober” if they aren’t addressing their personal problems or character defects. A “dry drunk” is when a person does not drink or use, but still behaves in the same ways they do when under the influence.
“Ruth always said that she got really mean when she was on a dry drunk.”
“I haven’t been to any meetings, but I’ve been dry for four days.” - Going out: The opposite of coming in, going out means resuming substance use (relapsing) and leaving the program. Again, this is metaphorical, and doesn’t have to involve physically going anywhere.
“I’ve been having dreams about drinking, and I’m afraid I’m about to go out.”
“I haven’t heard from Rita since she went out. - In the rooms/ in these rooms: These terms physically refer to any place where a 12-step meeting happen, and metaphorically refer to taking part in the 12-step program in general.
“When I came into these rooms, I was at a low point in my life.”
“I’ve met a lot of interesting people in the rooms.” - Normies: Normies are the people who don’t have the addiction that we do. It’s short for “normal.” Some people don’t like this term, because it implies that those of us with substance use disorders are abnormal.
“My husband is a normie. He can drink a single beer and not be at all bothered about whether he’ll ever have another one.”
“My brother and I both have addiction problems, but our parents are normies.” - ODAT: An acronym for the phrase “One day at a time,” meaning that members should focus on staying in recovery just for the current 24 hours. This is a hugely popular phrase in 12-step recovery and is also used a lot outside of 12-step circles. You’ll often see ODAT as a hashtag on social media posts about sobriety or recovery.
“So grateful to be free from drugs today! #ODAT”
“When I get overwhelmed by the thought of staying sober over Christmas, I remember it’s ODAT.” - Picking up: This means drinking or using.
“His family is a real trigger for Junior; he picks up every time he goes home.”
“I never thought I would pick up again, so I was shocked when I got drunk.” - Pink cloud: The pink cloud is the euphoric experience some people have when they first get into recovery and feel full of optimism and joy. Not everyone has a pink cloud phase, but many do.
“LaDelle is on such a pink cloud that she was singing on her way to work.”
“I was feeling so happy on my pink cloud, but now I’m starting to realize that life is still uncomfortable sometimes. - Sponsor: In 12-step recovery, it is common practice for individuals to seek out the guidance and support of a person with more time and experience in recovery. This guiding person is called their “sponsor.” Note that sponsorship isn’t just for newcomers; many folks with years of recovery still work with a sponsor.
“Tomas was freaking out, so I told him to call his sponsor.”
“I need a new sponsor; I just don’t connect with my old one anymore.”
Common Workit Health/clinical terms
- Abstinence: This means completely quitting the substance in question. If you’re abstinent from alcohol, you don’t drink at all. If you abstain from heroin, you’ve stopped using it. It is a common term across recovery programs.
“Chanelle knew that she couldn’t safely use fentanyl anymore, so she signed up for an abstinence program.”
“I stopped drinking cold turkey—complete abstinence.” - Ambassador: An Ambassador is a Workit Health member who has agreed to encourage and support their fellow members, and promote the program in the wider community. Our Ambassadors work with our Community Manager Max on ways to help others find and stay in recovery.
“If you have a question about how things work, asking an Ambassador is a great way to get an answer.”
“Tyler is an Ambassador, that’s why he shared his story.” - Compliant: When we say that a member is compliant with their program, it means they’re doing the things they’ve been asked to do. In particular, they’re attending appointments, taking their medication as prescribed, and completing urine drug screens.
“The research says that people who are compliant with their programs have a better chance of long-term recovery.”
“I need to take a drug screen this week; my social worker encouraged me to stay as compliant as possible.” - Drug screen: The common term for this is “drug test.” We prefer the term “screen” because we don’t want our members to think of them as a pass/fail situation. Drug screens are tools to help members and their care team get on the same page about what substances the member is using, to inform their treatment.
“Which do you prefer: video drug screening or automated drug screening?”
“I’m all out of drug screens. I better order more.” - Harm reduction: Harm reduction is an approach that seeks to reduce the damage related to substance use. Instead of focusing on an all-or-nothing approach, harm reduction supports all healthier actions that lessen the risks of substance use. Workit Health programs are grounded in harm reduction.
“I was afraid my provider would be mad that I had a drink this weekend, but she said that it’s a harm reduction program.”
“Using Narcan to reverse overdoses saves lives. It’s a harm reduction strategy.” - Induction: Induction refers to the process of starting on buprenorphine. During this process, the dose is incrementally increased a little at a time until the individual reaches their ideal maintenance dose.
“I’m ready to start induction onto Suboxone. My provider gave me a plan to follow.”
“Tia is off work for a couple of days while she inducts on buprenorphine.” - Moderation: Moderation is often considered in contrast to abstinence. Instead of strictly cutting off the substance, the goal of moderation is to use it in a more controlled manner.
“Kai wants to get better control over their marijuana use, so they’re starting a moderation program.”
“Medication-assisted treatment like naltrexone can help with alcohol moderation.” - Positive/negative: These are the preferred terms over the “dirty/clean” phrasing you may hear people use when talking about drug screens. Positive means the substance is present. Negative means the substance is not present. We do not believe that having a substance in your system makes you dirty. But it does mean that you’ll have a positive result on your urine drug screen.
“Don’t forget to confirm which substances you were positive for on your drug screen.”
“I knew I didn’t use this week, but I was still proud when my screen came up negative.” - Suboxone (buprenorphine/naloxone): Suboxone, Subs, Bupe … in general, it all refers to buprenorphine/naloxone. Buprenorphine is a partial opioid agonist that bonds to and partially activates the opioid receptors in the brain, and naloxone is an opioid antagonist that is included to discourage people from misusing the medication.
“Suboxone makes such a difference in my attempts to stop using Oxy.”
“I need to pick my Subs up at the pharmacy.”