Despite remarkable progress in our understanding of the neurobiological bases of drug abuse, no novel pharmacotherapies have recently been approved to treat substance use disorders (SUDs). Thus, while reformulations of established treatments have either been approved or are currently in late stage development (e.g., sustained release formulations of naltrexone (Vivitrol®) and buprenorphine), the development of medications to treat SUDs has lagged well behind other areas of psychiatry. In this chapter, we review some of the factors that have contributed to this dearth of innovative pharmacotherapies. We also review evidence that supports clinical testing of late stage molecules (developed for other indications) acting at promising targets, as well as novel biological approaches to the treatment of SUDs.
