scholarly journals The Profound Heterogeneity of Substance Use Disorders: Implications for Treatment Development

2021 ◽  
pp. 096372142110269
Author(s):  
Kathleen M. Carroll

A single treatment approach will never be sufficient to address the diversity of individuals with substance use disorders (SUDs). SUDs have historically defied definition through simple characterizations or models, and no single characterization has led to the development of broadly effective interventions. The range of dimensions of heterogeneity among individuals with SUDs, including severity of the disorder, type of substance, and issues that frequently co-occur, underscores the need for highly tailored approaches. Personalized medicine for individuals with SUDs will require two major developments. First, given the diversity of individuals with SUDs, multivariate phenotyping is needed to identify the particular features driving addictive processes in a given individual. Second, a wider range of interventions that directly target core mechanisms of addiction and the problems that co-occur with them is needed. As clinicians cannot be expected to master the full range of interventions that may target these core processes, developing interventions that can be delivered easily, flexibly, and systematically via technology will facilitate the ability to truly tailor them to this highly complex and challenging population. One such technology-delivered intervention, Computer-Based Training for Cognitive Behavioral Therapy (CBT4CBT), is used as an example to illustrate a vision for the future of highly tailored interventions for individuals with SUDs.

2019 ◽  
Vol 17 (2) ◽  
pp. 37-39
Author(s):  
Sidharth Arya ◽  
Mirjana Delic ◽  
Blanca Iciar Indave Ruiz ◽  
Jan Klimas ◽  
Duccio Papanti ◽  
...  

Substance use disorders pose a significant global social and economic burden. Although effective interventions exist, treatment coverage remains limited. The lack of an adequately trained workforce is one of the prominent reasons. Recent initiatives have been taken worldwide to improve training, but further efforts are required to build curricula that are internationally applicable. We believe that the training needs of professionals in the area have not yet been explored in sufficient detail. We propose that a peer-led survey to assess those needs, using a standardised structured tool, would help to overcome this deficiency. The findings from such a survey could be used to develop a core set of competencies which is sufficiently flexible in its implementation to address the specific needs of the wide range of professionals working in addiction medicine worldwide.


Author(s):  
Michael F. Weaver

In conjunction with chapters 16 and 17, which described non-pharmacological approaches to pain management, this chapter reviews the available non-pharmacological approaches to substance use disorders (SUD). Specific subtopics include 12-Step programs and facilitation, motivational enhancement therapy, cognitive behavioral therapy, individual and group psychotherapies, contingency management, community reinforcement, family therapy, relapse management, and the terminal consideration of all therapies, termination (what is the duration of treatment)? Each subtopic is addressed in abstract rather than in comprehensive format, to allow the primary care provider to identify her level of interest and present level of understanding, and to inform further reading. The chapter concludes with a text box providing additional resources.


2016 ◽  
Vol 33 (S1) ◽  
pp. S54-S54
Author(s):  
J.A. Ramos-Quiroga

Attention-deficit/hyperactivity disorder (ADHD) is a complex, and multifactorial and chronic neurodevelopmental disorder. Comorbid psychiatric disorders are highly prevalent in individuals with a diagnosis of ADHD. There is a solid overlap between ADHD and substance use disorders (SUD). Prevalence of SUD is high among patients with ADHD, so that SUD are approximately double as common among individuals with ADHD than in general population, and individuals with SUD have much higher rates than expected of a comorbid ADHD. Studies shown that treatment during childhood of attention-deficit/hyperactivity disorder with stimulant medication neither protects nor increases the risk of later substance use disorders. Nevertheless, recent studies found that patients with ADHD and SUD can reduce ADHD symptoms and SUD with stimulants and cognitive-behavioral therapy. Treatment of ADHD in patients with SUD requires a comprehensive diagnostic assessment. It is recommendable to stabilize the addiction prior to treating the ADHD. In this talk, the recent literature for the treatment of adults with co-occurring ADHD and SUD will be reviewed.Disclosure of interestThe author has not supplied his declaration of competing interest.


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