Chapter

Drugs used in the treatment of the addictions

Fergus D. Law and David J. Nutt

in New Oxford Textbook of Psychiatry

Second edition

Published on behalf of Oxford University Press

Published in print February 2012 | ISBN: 9780199696758
Published online October 2012 | e-ISBN: 9780191743221 | DOI: http://dx.doi.org/10.1093/med/9780199696758.003.0158
Drugs used in the treatment of the addictions

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Medical treatment of the addictions remains controversial, with addiction itself viewed as a lifestyle problem, a hijacking of brain systems by drugs, or as a medical illness. Many of these controversies may be avoided by taking a goal-oriented approach to treatment, in which clinical objectives are defined, and both medications and psychological interventions are used to facilitate progress towards these. The effectiveness of medications is maximized when they are used as one component of a comprehensive treatment plan. There are no ‘magic bullets’ in addiction treatment—the same pharmacological principles apply to these drug treatments as to any other. Drugs need to be given in effective doses, at appropriate intervals, allowed time to reach steady state, and also to dissipate when terminated on the basis of their half-life. Some drugs also have an abuse potential of their own (e.g. opiates, sedative-hypnotics) especially those with a rapid onset of action, and such drugs need to be particularly closely monitored and controlled, to minimize their diversion and misuse.

Chapter.  4324 words. 

Subjects: Psychiatry

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