| Accreditation: | The official authorization of a service by the public body legally entitled to confer that authorization by the laws of the country, based on a prescribed set of quality standards (WHO, 2003). |
| Acute care: | Intensive treatment for an immediate and urgent problem. |
| Addiction Counsellor: | An accredited lay counsellor (i.e. a non-health or social services professional) who has demonstrated proficiency in core addiction counselling competencies and has been dully accredited and registered by a recognized training and registration body. |
| Admission: | An administrative and clinical procedure by which a suitable applicant enters the centre. This occurs only after a pre-admission screening. |
| Administration: | The direct application of a prescribed drug, whether by injection, inhalation, ingestion or any other means. |
| Admission criteria: | Criteria that define those applicants suitable for admission to the centre. |
| Aftercare: | Follow-up care that offers ongoing support to maintain sobriety/abstinence, personal growth and assists with reintegration into the community/family. |
| Assessment / Evaluation: | The systematic identification of a patient’s/client’s condition and needs within a framework based on professionally accepted best-practice guidelines. |
| Barbiturate: | A sedative-hypnotic substance (minor tranquilizer), acts as a depressant on the central nervous system. |
| Benzodiazepines: | A sedative-hypnotic substance (minor tranquilizers) that acts as a depressant on the central nervous system. It is significantly dependence inducing (e.g. Valium, Rohypnol). |
| Centre: | Substance dependency treatment centre |
| Child: | Any person under the age of 18 years. |
| Clinical record: | An individual, permanent medico-legal document of the patient’s history, assessment and treatment progress. |
| Co-morbid condition: | A concurrent mental health condition that exists alongside substance-related disorders. The term “dual diagnosis” often applies here. |
| Counselling: | A therapeutic intervention that offers support and guidance and is undertaken by a relevantly trained accredited and professional staff member. |
| Critical incidents: | Any abnormal or unusual occurrence that threatens the safety or well being of patients/clients and staff. |
| Detoxification: | The medical management of physical withdrawal from a substance of dependence so that the associated risks are minimized. Medicated detoxification is the medically supervised process by which physical withdrawal from a substance is managed through the administration of individually prescribed medicines by a medical doctor or psychiatrist. These medicines (of a similar substance class to that used by the addict/alcoholic), are prescribed in doses that taper to zero (i.e. a safe substance weaning process). Frequent skilled 24-hour observations of the patient/clients, is the key aspect of treatment, as are emergency resuscitation equipment, necessary infrastructure and competent professional nursing staff. Voluntary withdrawal is a form of detoxification when a patient/client chooses to stop all mood-altering substances on admission to the treatment centre without the aid of prescribed medication. This should occur on a case-by-case basis with adequate available emergency resuscitation equipment and resources at the discretion of the supervising medical doctor. |
| Release criteria: | Criteria that define a patient’s/client’s suitability for release from the treatment centre. |
| Drug: | A substance that produces a psychoactive effect. This refers here to illicit/illegal drugs, including any psychoactive drug that is being misused or abused (e.g. prescribed medication). |
| Release planning: | A structured therapeutic intervention that assists patients/clients and their families/caregivers in preparing for patients’/clients’ release from the centre and subsequent integration into family life and other social networks (e.g. community and work). |
| Families and Caregivers: | Patients’/Clients’ families (including spouses, partners and dependents) and other significant non-family members who make up the support system (e.g. guardians, employees, friends). |
| Indicators: | Measures that summarize information about a specific aspect of service delivery. Indicators are usually quantifiable and can be used to measure change in a system (e.g. a staff/patient ratio). Norms can therefore be distinguished from indicators in the sense that indicators describe existing levels of care whereas norms recommend a level of care. |
| Individual counsellor: | An individual professional or accredited staff member especially assigned to patients/clients who is responsible for their assessment and ongoing management while at the centre. This could be any member of the interdisciplinary team, including a social worker, psychologist, and medical doctor. |
| Informed consent: | Consent for a procedure/treatment provided by a person who is deemed capable of making such a decision based on his/her mental state; intellectual, linguistic or educational abilities; freedom from coercion or age-related maturity and current relevant legislation. |
| Interdisciplinary team: | A therapeutic or multidisciplinary team of health and social development professional and accredited addiction counsellors (if members of the centre’s staffing body) who provide treatment at the centre. See section 2.17 for the minimum staff components of this team for type A and B facilities. |
| Mental health nurse: | A registered professional nurse (i.e. nursing sister) who has specialist mental health training accredited by the SA Nursing Council. |
| Mental health practitioner: | Professional staff member such as a psychiatrist or registered medical practitioner or a nurse, occupational therapist, psychologist or social worker who has been trained to provide prescribed mental health care, treatment and rehabilitation services. |
| Norms: | Recommended quantitative levels of service provision usually linked to indicators (e.g. recommended patient/staff ratio). |
| Opioids: | Substance derived from opium poppy or produced synthetically (e.g. Wellconal, heroin, Methadone, Pethidine, Morphine and Codeine). |
| Parents: | A person’s biological or adoptive parents, as well as legal guardians. |
| Patients/Clients: | People dependent on or addicted to a substance, who have been admitted to the centre. |
| Pharmacotherapy: | Individualized treatment and therapy using prescribed medicines. |
| Residential inpatient treatment: | Substance dependency/addiction treatment provided in a residential setting, i.e. patients/clients reside at the centre to obtain treatment. |
| Schedule drugs: | Medicines scheduled under the Pharmacy Act, No. 53 of 1974. These drugs require medical and pharmacy personnel and infrastructure for prescription, dispensing, monitoring, recording and storage (e.g. doctor, pharmacist, nurse and refrigeration). |
| Screening: | A brief assessment of the applicant’s suitability for admission to the centre based on the centre’s admission criteria and client need. |
| Social worker: | A person registered as such in terms of the Social Services Professions Act, 1978 (Act No. 110 of 1978) |
| Staff: | People employed by or contracted to the centre. This does not refer to volunteers. |
| Standards: | Qualitative statements that describe what constitutes acceptable or adequate performance or resources. |
| Structured daily Programme | An organized programme of activities and treatment offered by the centre, which occurs during daily “office hours” based on clear therapeutic aims and objectives. |
| Substance: | A chemical, psychoactive substance such as alcohol, tobacco and illicit/illegal, over-the-counter drugs and prescription drugs. |
| Substance dependency/addiction | A health condition that involves physical and/or psychological addiction to a psychoactive substance. The result of which is (1) a major disruption and distress in the person’s life (and usually that of his/her family/caregiver) and functioning; (2) a persistent desire or craving to take a substance (usually with unsuccessful efforts to reduce or stop); (3) a great deal of time spent in trying to acquire the substance (including often high-risk and illegal activities); (4) the continuation of the substance usage despite an awareness of the destruction and damages caused; (5) a marked increase in the amount of substance required to attain the desired intoxication effect (i.e. diminished effect of the substance and increased tolerance) (6); the presence of withdrawal symptoms if the substance is reduced or withdrawn. Substance dependency therefore affects a person’s emotional, psychological, physical, interpersonal and spiritual life and lifestyle. |
| Therapy: | Treatment provided by professional staff. |
| Treatment: | The clinical process by which the patients/clients are assisted in abstaining from their drug abuse/dependency and in participating in rehabilitation to achieve their optimal level of functioning. This process is based on best practice health care principles. Treatment should be holistic and, as far as possible, address all the patients’/clients’ (and their families’ and caregivers’) needs, i.e. physical, psychological, social, vocational, spiritual, interpersonal and lifestyle needs. |
| Treatment centre: | A public or private inpatient/residential facility that offers intensive treatment and rehabilitation for people with substance dependence (who meet the centre’s admission criteria). |
| Volunteer: | An individual offering services at the centre without formal employment or remuneration. |
| Withdrawal syndrome: | Symptoms with variable severity that occur on cessation or reduction of drug use after prolonged period of use and/or high doses. The syndrome may be accompanied by signs of both psychological and physiological disturbance (WHO, 1994). |
| Young people: | Children and young people under the age of 18 years, and young people who are in the Child and Youth Care System (CYC) when they turn 18 years old and who remain until 21 years. |
| At risk: | Young people who have their normal, healthy development placed at risk because their circumstances and/or behaviour make them susceptible to having to live away from their communities and/or families on the streets or under statutory care. OR they may be living under statutory care. |
| Service providers: | Personnel who interface directly with young people at risk within the child and youth care system as it pertains to welfare, justice, education, health, correctional services and the SAPS. Such service providers include teachers, social workers, child and youth care workers, probation officers, prosecutors, magistrates, police officers, youth workers and nurses. |
| Transitional care: | Residential or foster care for young people who are in need of care and protection and/or are in trouble with the law and are waiting for the finalization of the statutory process. This includes young people:
Transitional care may take place within a secure care facility, a place of safety, a correctional service facility, a school of industry or reform school, foster care, a shelter or a children’s home. |
Lists of Abbreviations
| AA: | Alcoholic Anonymous |
| ASAM: | American Society of Addiction Medicine |
| CDA: | Central Drug Authority |
| DSMIV: | Diagnostic and Statistical Manual of Mental Disorders, Volume IV. This is an internationally used standard diagnostic classification system produced by the American Psychiatric Association (1994). |
| HPCSA: | Health Professions Council of South Africa |
| ICD10: | International Classification of Diseases, Volume 10. An international disease classification system that includes physical and mental health conditions |
| N & S | Norms and standards |
| NA | Narcotics Anonymous |
| NADAC | National Association of Alcohol and Drug Addiction Counsellors (UK) |
| NDMP | The National Drug Master Plan |
| NGO | Non-governmental organization |
| NIDA | National Institute of Drug Abuse (USA) |
| NPO | Non-profit organization |
| OT | Occupational therapist |
| S & C | Standards and criteria |
| SACSSP | South African Council of Social Services Professionals |
| SACENDU | South African Community Epidemiology Network on Drug Use |
| TB | Tuberculosis |
| TC | Therapeutic community |
| USDHSS | United States Department of Health and Social Services |
| UNODP | United Nations Office for Drug and Crime |
| VCT | Voluntary counselling and testing for HIV/AIDS |
| WHO | World Health Organization |