Treatment of Substance-Related Disorders: Introduction | Alcohol | Nicotine | Benzodiazepines and Other Sedatives | Cocaine | Methamphetamine | Opioids | Hallucinogens | Marijuana | Self-Help Groups | Conclusion | References
Drugs that produce substance use disorders all
activate the brain reward system, but each class of drugs activates the
system by a different pharmacological mechanism. Thus, this chapter
is organized according to pharmacological class. The emphasis is
on pharmacotherapy, but all treatment using medications should be
accompanied by counseling or psychotherapy according to the patient's needs.
Medication combines very well with psychotherapy, including self-help
groups such as Alcoholics Anonymous (AA). The majority of patients
also have an additional mental disorder (besides the addictive disorder) such
as depression, anxiety, or bipolar disorder. These comorbidities
require specific treatment including medication and psychotherapy.
The best treatments for addiction complicated by additional psychiatric
disorders are delivered in an integrated fashion, preferably from
the same therapist. All psychiatrists should be able to manage substance
use disorders, especially those that co-occur with other psychiatric