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Pharmacological Treatment of Substance Use Disorders

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Tasman’s Psychiatry

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Abstract

Substance use disorders (SUDs) represent a significant public health challenge, with morbidity and mortality from overdoses and other use-related causes increasing substantially during the COVID-19 pandemic. Thus, a working knowledge of treatment of substance use disorders is prudent for any psychiatrist. The United States Food and Drug Administration (FDA) has approved medications for the treatment of opioid, alcohol, and tobacco use disorders; however, evidence-based pharmacotherapy exists for many of the major classes of substances. This chapter will detail mechanistic approaches to the treatment of SUDs, evidence for the use of pharmacotherapy for the treatment of SUDs including efficacy and safety, and important clinical caveats including optimal management of SUDs and co-occurring psychiatric disorders. Important nuances regarding the treatment of withdrawal, relapse prevention, harm reduction, and how different medications may be appropriate for a given purpose will be described. Additionally, avenues for medication development will be discussed, suggesting ways in which pharmacotherapy for SUDs can be improved.

This chapter is an update from the 4th edition. Previous edition authors were Wilfrid Noel Raby, John J. Mariani, Frances R. Levin and Edward V. Nunes

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Acknowledgments

The authors wish to acknowledge the support from the National Institute on Drug Abuse.

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Authors and Affiliations

  1. Department of Psychiatry, Columbia University College of Physicians and Surgeons/New York State Psychiatric Institute, New York, NY, USA

    A. Benjamin Srivastava, Frances R. Levin & Edward V. Nunes

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  1. A. Benjamin Srivastava
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  2. Frances R. Levin
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  3. Edward V. Nunes
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Correspondence to A. Benjamin Srivastava .

Editor information

Editors and Affiliations

  1. Department of Psychiatry, University of Louisville, Louisville, KY, USA

    Allan Tasman

  2. Department of Psychiatry, University of Michigan Rogel Cancer Cent, Ann Arbor, MI, USA

    Michelle B. Riba

  3. Mayo Clinic College of Medicine, Oakland, CA, USA

    Renato D. Alarcón

  4. Columbia University Medical Center, New York, USA

    César A. Alfonso

  5. Kyushu University, Fukuoka, Japan

    Shigenobu Kanba

  6. Department of Psychiatry, University of Nairobi, Nairobi, Kenya

    David M. Ndetei

  7. Malaysian Research Inst on Ageing, Universiti Putra Malaysia, Selangor, Malaysia

    Chee H. Ng

  8. Department of Psychiatry, University of Munich, München, Bayern, Germany

    Thomas G. Schulze

  9. Serbian Academy of Sciences and Arts, Belgrade, Serbia

    Dusica Lecic-Tosevski

Section Editor information

  1. No affiliation provided

    Shigenobu Kanba

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    Rif S. El-Mallakh

  3. No affiliation provided

    Joseph Zohar

  4. No affiliation provided

    Andrew D. Krystal

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Srivastava, A.B., Levin, F.R., Nunes, E.V. (2023). Pharmacological Treatment of Substance Use Disorders. In: Tasman, A., et al. Tasman’s Psychiatry. Springer, Cham. https://doi.org/10.1007/978-3-030-42825-9_140-1

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