Addiction & Substance Use Terminology for Medical Interpreters

I recently re-watched Dopesick, Hulu’s miniseries about the opioid crisis in the United States, told through the experiences of patients, families, and healthcare providers. More than once, I caught myself thinking about what it would feel like to interpret some of those scenes – the medical appointments, the painful family conversations, the interactions with treatment providers – and is often the case with medical encounters, with vocabulary that may not be part of everyday language.

As interpreters, we have a responsibility to educate ourselves on a wide range of medical topics, and I would argue this matters just as much when it comes to addiction, if not more. People with substance use disorders often come into healthcare encounters expecting to be judged, and too often, they are. When we interpret accurately, impartially, and without adding our own judgment, we help make sure the patient’s voice reaches the provider as it was meant, and that the provider’s care reaches the patient. The resources in this post will help you build the knowledge and vocabulary to do exactly that: understand what patients and providers are really talking about, recognize terminology (clinical and street) when you hear it, and step into these encounters with confidence and compassion. I hope you’ll come back to them whenever you’re preparing for an assignment, or simply want to keep learning.

This topic has been on my mind for another reason, too: I’m teaching a 7-hour CEU class titled Interpreting for Addiction Services over the next two weekends (October 17 and 24). [ Click 👉 here 👈to learn more and register!]

Below you’ll find a variety of sources for exploring this topic and learning related terminology: glossaries, slang references, as well as books, podcasts, films, and TV shows.

📖 Glossaries and terminology guides

Healthcare and addiction-treatment professionals have been moving toward person-first, non-stigmatizing language (“a person with a substance use disorder” rather than “an addict”). As interpreters, we don’t choose or soften what people say – if a patient calls himself an addict, that’s what we interpret. But knowing the current clinical terminology, and why it changed, helps us interpret accurately and recognize what providers mean when they use it. These are the resources I would bookmark:

Words Matter: Preferred Language for Talking About Addiction – from the National Institute on Drug Abuse (NIDA). A short, clear explanation of why stigmatizing terms are being replaced and what’s used instead.
Addictionary® by the Recovery Research Institute covers more than 200 terms, both clinical and conversational (“dope sick,” “dirty,” “dual diagnosis,” “craving”), and flags the ones considered stigmatizing. Very handy when a patient uses language you won’t find in a medical textbook.
The WHO Lexicon of Alcohol and Drug Terms – Provides concise definitions for some 230 terms frequently used by clinicians, researchers, teachers, and others working in the field of substance abuse. It’s a great foundation for building a bilingual glossary. Also available in Russian Spanish Greek
Facing Addiction in America: Glossary of Terms (navigate to page 335 of the pdf) – from the U.S. Surgeon General’s report on alcohol, drugs, and health. Good for the broader treatment, public health, and social services vocabulary: tolerance, withdrawal, wrap-around services, and more.
Pew Charitable Trusts: Substance Use Prevention and Treatment Glossary – public health focused.
And finally, to put all the terms into context and for when you want to go beyond a dictionary definition and understand what’s actually happening. NIDA: Drugs, Brains, and Behavior – The Science of Addiction – I especially recommend reading how NIDA distinguishes physical dependence from addiction – a distinction that comes up in clinical conversations all the time.

✴️ For tips on turning resources like these into your own working glossary, check out this blog post. ✴️

🗣️ Slang and street terms

Substance-related slang varies enormously by region, generation, and community, and it never stands still. New terms appear all the time and a list that was accurate two years ago may already be out of date. My advice: don’t try to memorize slang lists. Instead, know where to look things up when preparing, and know what to do when you hear a word you don’t recognize in the moment (which of course if to intervene transparently and to ask for clarification or to confirm your understanding).

These resources list street names alongside what they actually refer to:

Drugs of Abuse: A DEA Resource Guide (2024 Edition) – my top pick in this category. For each substance, it gives the street names along with a plain-language description of what the drug is, how it’s used, and its effects on the body and mind. It’s also available in Spanish, which makes it a handy bilingual reference. For example, the publication called Prescription for Disaster: How Teens Misuse Medicine (English/Spanish) gives examples of emojis codes used to advertise drugs on social media platforms.
NIDA: Commonly Used Drugs Charts – quick-reference charts listing commercial and street names, common forms, how each drug is taken, and possible health effects.
DEA: Drug Slang Code Words (2017) and 2018 Slang Terms and Code Words – longer lists of street names, organized by drug. Keep in mind they were written for law enforcement and haven’t been updated in years.
Your Room (NSW Health, Australia): A parents’ guide to drug slang – an A–Z list of street names grouped by substance, with links to plain-language drug profiles. It also explains why some terms describe how a drug is taken rather than which drug it is. “Lines,” for example, can mean any snorted powder. I’m including it partly because it’s Australian: compare it with the DEA lists and you’ll see how much slang changes from one English-speaking country to another, which says a lot about how much more it changes across languages.

What about slang in your working languages? This is where national English-language lists fall short. A few places to look:

Government and public health sources from the countries where your language is spoken. Many health ministries, national drug information services, and harm reduction organizations publish drug guides with local street names. Search in your working language using that language’s equivalent of “drug slang” or “street names for drugs.” You’ll often find far more relevant results than you would in English.
Local outreach and harm reduction organizations in your own community. Multilingual harm reduction coalitions and community health programs often know the terms actually in use in the communities you serve, in the languages they speak.
Your colleagues. Interpreters who work in addiction medicine, harm reduction, or criminal court have often already built these glossaries. Ask around, and consider workshops on drug terminology in your language pair.
Media in your working language. Films, TV series, documentaries, and news reporting on drug use in your language’s countries are a great way to hear current terminology in context.

🎙️ Podcasts

Podcasts are a wonderful way to learn without it feeling like studying. You hear the concepts explained and the terminology used naturally, by clinicians, researchers, and people sharing their own stories, so a lot of it sinks in through incidental learning. Best of all, you can do it on the go: on your commute, on a walk, at the gym, or while folding laundry. That turns the time you’d spend anyway into prep time! And if you want to push yourself, try shadowing a few minutes of an episode or using it for consecutive practice. Real, unscripted speech is excellent material!

Stories and lived experience

Last Day – host Stephanie Wittels Wachs created the show after losing her brother to an overdose. Season 1 focuses entirely on the opioid crisis, telling one person’s story at a time. Compassionate and trauma-informed. Start with Season 1, or the re-released “Last Day Revisited: The Opioid Crisis” episodes.
SMART Recovery Podcast – conversations with experts in science-based addiction treatment and with people in recovery, covering addictions of all kinds, not just substances.
The Fix: Treating New York’s Opioid Crisis (GroundTruth Project) – a five-episode series on how the crisis unfolded in the Bronx, Staten Island and Long Island, with voices of patients, families and providers.

Educational deep dives

The Curbsiders: Addiction Medicine series – this one is meant for clinicians, but if you want to hear how providers actually talk about addiction treatment, it’s gold. Each episode covers one topic: methadone, buprenorphine, alcohol withdrawal, medications for alcohol use disorder, stimulants, cannabis, sedatives, harm reduction, and even how to take a stigma-free substance use history. It’s one of the best ways I know to hear clinical terminology used in context.
Let’s Talk Addiction & Recovery – author and recovery advocate William C. Moyers interviews clinicians, researchers, policymakers, and people in recovery. Short episodes with a good mix of information and inspiration, and a large back catalog.
Trapped: Understanding Addiction – explores the medical science and social side of addiction: how substances affect the brain and body, how addiction affects different populations, and how treatment has evolved. Expert interviews are paired with first-hand accounts. Episode 1, with an addiction medicine fellowship director, is a great primer on what addiction is and how it differs from substance use.
Bonus recommendation: Huberman Lab Essentials: Understanding & Treating Addiction with Dr. Anna Lembke – a single, roughly 35-minute episode with the author of Dopamine Nation. It covers dopamine and the pleasure-pain balance, withdrawal, relapse and triggers, and the role of shame and truth-telling in recovery. A nice companion to the book.

✴️ For more podcast recommendations for medical interpreters, check out this blog post. ✴️

📚 Books

If you know me at all, you know that reading is one of my favorite ways to prepare for a specialty area. A good book lets you go deeper than any glossary can: you come away understanding basic concepts – in this case, how tolerance, withdrawal, and recovery actually play out in people’s lives, not just how they’re defined. And because you meet the terminology in context, the words tend to stick. You’ll hear how a doctor explains a taper, how a parent describes a relapse, and how someone in recovery talks about cravings. That mix of clinical language and everyday speech is exactly what we hear in real encounters. Audiobook versions double as great shadowing and consecutive practice material, too!

📌 A quick note: the book links in this post are Amazon affiliate links. As an Amazon Associate I earn from qualifying purchases. If you buy a book through one of these links, I may earn a small commission at no extra cost to you. It helps support the blog and keeps these resources free. I only recommend books I genuinely think are worth your time!

Memoirs

In Pain: A Bioethicist’s Personal Struggle with Opioids by Travis Rieder – after a motorcycle accident in 2015, Rieder was sent home on high doses of opioids. When he tried to taper off following his doctors’ instructions, he went into weeks of excruciating withdrawal. As a bioethicist, he weaves his story together with the history of opioids and how American medicine has handled pain. For interpreters, it’s a powerful reminder that dependence and addiction are not the same thing, and that many patients come to opioids through the front door of a clinic.
Beautiful Boy by David Sheff and Tweak by Nic Sheff – a father’s and a son’s memoirs of the same years of addiction. Reading them back to back is a powerful exercise in seeing one story from two sides of the room, not unlike what we do every day.
The Weight of Air: A Story of the Lies about Addiction and the Truth about Recovery by David Poses – Poses spent more than a decade hiding a double life of depression and heroin addiction, cycling through detox, rehab, and relapse. He finally found an evidence-based treatment that worked. It’s a candid look at how mental illness and addiction intertwine, and a critique of traditional recovery models.
Girl Walks Out of a Bar by Lisa F. Smith – a young lawyer at a prestigious New York firm in the 1990s whose drinking and cocaine use took over her life, told with dark humor and a lot of honesty. A good reminder that addiction often hides behind high achievement.
Blackout: Remembering the Things I Drank to Forget by Sarah Hepola – a journalist’s memoir of years of binge drinking and blackouts, waking up with no memory of the night before, and the slow process of getting sober. Funny, raw, and very readable.
The Recovering: Intoxication and Its Aftermath by Leslie Jamison – part memoir of her own alcoholism and recovery, part exploration of famous writers who drank. Jamison shows that the story of recovery can be just as gripping as the story of addiction.

Nonfiction for everyone

These books aren’t written for clinicians. They’re narrative nonfiction for general readers, which makes them great entry points if you’re new to the topic.

Dopamine Nation by Anna Lembke – the medical director of Stanford Addiction Medicine explains, through stories from her own practice, why constant access to pleasure, from drugs and alcohol to smartphones and shopping, leaves us in pain. Very accessible, and it widens the lens beyond substances.
Dopesick by Beth Macy – the book the Hulu series was based on, tracing the opioid epidemic from the boardroom to small towns in Appalachia.
Empire of Pain: The Secret History of the Sackler Dynasty by Patrick Radden Keefe – the story of the family behind Purdue Pharma and OxyContin, told across three generations. It reads like a thriller, and it’s a natural companion to Dopesick.
Dreamland: The True Tale of America’s Opiate Epidemic by Sam Quinones – how prescription painkillers and a new heroin distribution network from Mexico converged on small-town America. Quinones lived and reported in Mexico for years, which gives the book a cross-border perspective that’s especially interesting for those of us working with immigrant communities.
Unbroken Brain: A Revolutionary New Way of Understanding Addiction by Maia Szalavitz – a journalist who was once addicted herself combines her own story with the research. She argues that addiction is best understood as a learning disorder rather than a moral failing or a “broken brain.”
Chasing the Scream: The First and Last Days of the War on Drugs by Johann Hari – a history of the war on drugs told through people’s stories around the world, ending with countries that tried a very different approach. It’s the book behind his widely viewed TED talk arguing that the opposite of addiction is connection.
In the Realm of Hungry Ghosts by Gabor Maté – a physician’s look at addiction through the lens of trauma, drawn from his work with patients in Vancouver’s Downtown Eastside.

🔖 For more book recommendations for medical interpreters, check out this blog post. 🔖

🎬 Movies and documentaries

Beautiful Boy (2018) – the film adaptation of the Sheff memoirs recommended in the book section above.
Ben Is Back (2018) – a compassionate portrayal of relapse and what it does to a family over a single day.
Heroin(e) (Netflix) – a short documentary about three women fighting the opioid crisis in Huntington, West Virginia, told through a harm reduction lens.
The Anonymous People – a documentary about the recovery advocacy movement.

📺 TV shows

Dopesick (Hulu) – the systemic view: how the crisis was made, not just who it hurt. Not sensationalized.
Maid (Netflix) – gentle, trauma-informed storytelling, with alcohol use and relapse as part of the story.
Euphoria – selected episodes. Intense, but a realistic depiction of relapse cycles.
Intervention (A&E) – I’m including this one with a caveat: it’s documentary-style, but it can lean toward sensationalism. Worth watching with a critical eye.

✴️ For more TV recommendations, see TV shows for medical interpreters. ✴️

💛 Taking care of ourselves

Interpreting in substance use settings can mean hearing difficult stories of overdose, loss, family conflict, and sometimes trauma, and then rendering them in the first person, speaking as the patient/their loved one. Over time, that exposure adds up, and some interpreters experience vicarious trauma (also called secondary traumatic stress).

A few things that can help:

Have a plan for when you find yourself in a bad place. The University at Buffalo School of Social Work’s Self-Care Starter Kit walks you through creating both a “maintenance” self-care plan for everyday life and an emergency plan for when things get hard. Its worksheets are free for personal use.

Find ways to ground yourself in the present when your mind starts to feel overwhelmed. The 5-4-3-2-1 technique from the University of Rochester Medical Center is a simple one: a few slow breaths, then noticing five things you can see, four you can touch, three you can hear, two you can smell, and one you can taste. Some of it can be done quietly, even mid-session. Simply noticing your feet on the floor counts.

Find a way to process challenging encounters, whether that’s debriefing with a supervisor, talking to a trusted colleague, or journaling after a hard day.

Learn to recognize signs of distress in yourself. The Office for Victims of Crime’s What Is Vicarious Trauma? page is a clear, practical overview. It lists common reactions, from trouble sleeping, emotional numbness, and irritability to pulling away from friends, family, and activities you used to enjoy. It also covers risk factors that will sound familiar to many interpreters, such as limited training and supervision, and not having a supportive way to talk through difficult content. And it reminds us that this work can affect us in positive ways too, through what it calls vicarious resilience and compassion satisfaction.

You can read more about taking care of yourself in my posts on self-care for medical interpreters and what compassion means for medical interpreters.

🙌 I would love to hear from you! Have you interpreted in addiction medicine or harm reduction settings? What are your favorite books, podcasts, or resources about substance use? Share in the comments below or reach out to me using the Contact tab in the menu at the top of the page.