Substance Use Disorders

Over the past few years there has been an increased interest in the identification and treatment of substance use disorders, due at least in part to the widespread drug overdose epidemic. Clinicians and the lay public have gained a greater understanding of the need for treatment of substance use disorders and the consequences of avoiding treatment. In addition, there has been a growing understanding of substance use disorders as medical or mental health disorders, rather than as character flaws or merely illegal activities. This book builds on this nascent understanding and presents epidemiology, basic science, and treatment from the perspective of a clinician who wants to gain the knowledge and background needed to work with this patient population. The overall theme of the book is to discuss evidence-based rather than anecdotal or unproved treatments. Section I begins with the epidemiology, etiology, and neurobiology of substance use disorders, including preclinical data. Section II discusses pharmacotherapy for substance use disorders, focusing on medications approved by the US Food and Drug Administration (FDA). Section III focuses on other evidence-based treatments for substance use disorders, including behavioral therapies, and ends with potential future treatments.

Author(s):  
Amy Baker Dennis ◽  
Tamara Pryor

Eating disorders (ED) and substance use disorders (SUD) frequently co-occur but are rarely treated in a comprehensive integrated manner. This chapter elucidates the complex relationship between ED and SUD to help the treating professional create an integrated treatment plan that addresses both disorders and any other co-occurring conditions. Evidence-based treatments for each disorder are discussed, and recommendations on how to take “best practices” from both fields to formulate a treatment plan that addresses the specific needs of the patient are presented. The chapter includes case examples that demonstrate the importance of understanding the adaptive function of both disorders when developing an effective intervention.


Author(s):  
Dennis C. Daley ◽  
Antoine Douaihy

Medications can help clients safely and comfortably withdraw from substances such as alcohol, opiates, or sedatives if they have a physical addiction. The medicines used will depend on the drug or drugs on which they are dependent. Medication-assisted treatment is the use of medications approved by the US Food and Drug Administration, in combination with counseling and behavioral therapies, to provide a whole-client approach to the treatment of opioid, alcohol, or tobacco use disorders. The goals of this chapter are to learn about types of medication that aid recovery from a substance use disorder, to understand the reasons why some people may have problems with medication, to learn about withdrawal symptoms and medications that help, to understand the effects of drug and alcohol use on psychiatric medications, and to determine whether or not a client needs medication to help with his or her substance disorder.


Author(s):  
Adam W. Carrico ◽  
Walter Gómez ◽  
Cathy J. Reback

Although sexual and gender minority (SGM) populations remain at markedly elevated risk for developing alcohol and substance use disorders, relatively few substance use disorder treatment programs provide culturally tailored services. This chapter provides an overview of alcohol and substance use disparities as well as reviews evidence-based interventions in distinct SGM populations. In general, clinical research has focused on culturally tailoring evidence-based substance use disorder treatments such as cognitive–behavioral therapy and motivational interviewing with modest success. Further clinical research should develop and test novel substance use disorder intervention approaches that address minority stress processes as key triggers for unhealthy alcohol consumption and substance use. Clinical research is also needed to address the disparities in unhealthy drinking among sexual minority women as well as alcohol and substance use disparities in transgender individuals. Recommendations are provided to optimize the effectiveness and scalability of existing evidence-based treatments targeting alcohol and substance use disorders in SGM populations.


2020 ◽  
pp. 267-282
Author(s):  
Kathryn Polak ◽  
Sydney Kelpin ◽  
Jarrod Reisweber ◽  
Dace S. Svikis

A variety of pharmacological and psychosocial interventions have demonstrated efficacy in the treatment of substance use disorders (SUDs). This chapter focuses on evidence-based behavioral and psychosocial interventions for the treatment of alcohol use disorder and other SUDs. Among the interventions discussed are screening, brief intervention, and referral to treatment (SBIRT); motivational interviewing (MI); cognitive behavioral therapy (CBT); and contingency management (CM). Additionally, one promising intervention for SUD, Transcending Self Therapy (TST), is spotlighted. The importance of comprehensive care is noted by the authors, as is the importance of recognizing gender differences in the selection of therapies and the need to address barriers to care for specific populations.


2020 ◽  
pp. 245-266
Author(s):  
Jonathan J. K. Stoltman ◽  
Laura R. Lander

This chapter discusses the range of evidence for efficacy in evidence-based treatments for substance abuse disorders. The authors draw their information from both case reports and multisite randomized control trials, presenting both the controversies over evidence-based behavioral therapies and the reasons given for the utilization of less evidence-based behavioral treatments. The chapter also discusses the reasons for the lack of approval from the US Food and Drug Administration (FDA) for evidence-based pharmacotherapy treatments in substance use disorders and details the corresponding reasons for clinicians’ use of non-FDA-approved pharmacotherapies, all while stressing the importance of transparency and documentation.


2018 ◽  
Vol 15 (3) ◽  
pp. 61-63
Author(s):  
Lampros Samartzis

Addiction psychiatry is a relatively new field in Cyprus. This paper presents the advances in the treatment of substance use disorders in the country in the past three decades. These advances have included increased availability of services, increased accessibility, the development of a modern biopsychosocial harm-reduction approach and evidence-based pharmacological treatments.


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