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The Multidisciplinary Approach to the Management of Substance Abuse

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Substance Abuse

Abstract

The successful management of patients with substance abuse disorders requires addressing the patient’s substance abuse, medical, psychiatric, and psychosocial problems. Screening tools and algorithms for determining the most effective treatment paradigm are now available, as patients have distinct, individual needs. Treatment modalities include those that focus on medical, psychological, and sociocultural aspects. Therefore, a multidisciplinary model of care best addresses the complexities of substance abuse, as most patients will benefit from integrated pharmacological and psychosocial therapies.

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References

  1. Results from the 2012 National Survey on Drug Use and Health: Summary 2012; NSDUH Series H-46, HHS Publication No. (SMA) 13-4795.

    Google Scholar 

  2. Jemal A, Thun MJ, Ries LA, Howe HL, Weir HK, Center MM, et al. Annual report to the nation on the status of cancer, 1975-2005, featuring trends in lung cancer, tobacco use, and tobacco control. J Natl Cancer Inst. 2008;100(23):1672–94.

    Article  PubMed Central  PubMed  Google Scholar 

  3. Thun MJ, Peto R, Lopez AD, Monaco JH, Henley SJ, Heath Jr CW, et al. Alcohol consumption and mortality among middle-aged and elderly U.S. adults. N Engl J Med. 1997;337(24):1705–14.

    Article  CAS  PubMed  Google Scholar 

  4. Amon JJ, Garfein RS, Ahdieh-Grant L, Armstrong GL, Ouellet LJ, Latka MH, et al. Prevalence of hepatitis C virus infection among injection drug users in the United States, 1994-2004. Clin Infect Dis. 2008;46(12):1852–8.

    Article  PubMed  Google Scholar 

  5. Parikh N, Nonnemacher MR, Pirrone V, Block T, Mehta A, Wigdahl B. Substance abuse, HIV-1 and hepatitis. Curr HIV Res. 2012;10(7):557–71.

    CAS  PubMed Central  PubMed  Google Scholar 

  6. Substance Abuse and Mental Health Services Administration. Office of Applied Studies, National Survey on Drug Use and Health, 2008 and 2009.

    Google Scholar 

  7. Grant BF, Stinson FS, Hasin DS, Dawson DA, Chou SP, Ruan WJ, et al. Prevalence, correlates, and comorbidity of bipolar I disorder and axis I and II disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions. J Clin Psychiatry. 2005;66(10):1205–15.

    Article  PubMed  Google Scholar 

  8. Pettinati HM, O’Brien CP, Dundon WD. Current status of co-occurring mood and substance use disorders: a new therapeutic target. Am J Psychiatry. 2013;170(1):23–30.

    Article  PubMed Central  PubMed  Google Scholar 

  9. Ruiz P, Strain EC, Lowinson JH. Lowinson and Ruiz’s substance abuse: a comprehensive textbook. 5th ed. Philadelphia: Wolters Kluwer Health; 2011.

    Google Scholar 

  10. Nunes EV, Civic Research Institute. Substance dependence and co-occurring psychiatric disorders: best practices for diagnosis and clinical treatment. Kingston: Civic Research Institute; 2010.

    Google Scholar 

  11. Fleming MF, Mundt MP, French MT, Manwell LB, Stauffacher EA, Barry KL. Brief physician advice for problem drinkers: long-term efficacy and benefit-cost analysis. Alcohol Clin Exp Res. 2002;26(1):36–43.

    Article  PubMed  Google Scholar 

  12. Babor TF, Higgins-Biddle JC. http://whqlibdoc.who.int/hq/2001/who_msd_msb_01.6b.pdf. 2013.

  13. Miller WR, Rollnick S. Motivational interviewing: preparing people for change. 2nd ed. New York: Guilford Press; 2002.

    Google Scholar 

  14. Miller WR, Wilbourne PL. Mesa Grande: a methodological analysis of clinical trials of treatments for alcohol use disorders. Addiction. 2002;97(3):265–77.

    Article  PubMed  Google Scholar 

  15. Gentilello LM, Rivara FP, Donovan DM, Jurkovich GJ, Daranciang E, Dunn CW, et al. Alcohol interventions in a trauma center as a means of reducing the risk of injury recurrence. Ann Surg. 1999;230(4):473–80; discussion 480–3.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  16. Screening and behavioral counseling interventions in primary care to reduce alcohol misuse. http://www.uspreventiveservicestaskforce.org/uspstf/uspsdrin.htm. 2013.

  17. U.S. Preventive Services Task Force Screening for Illicit Drug Use. http://www.uspreventiveservicestaskforce.org/uspstf/uspsdrug.htm. 2013.

  18. Shapiro B, Coffa D, McCance-Katz EF. A primary care approach to substance misuse. Am Fam Physician. 2013;88(2):113–21.

    PubMed  Google Scholar 

  19. Nutt DJ, King LA, Phillips LD, Independent Scientific Committee on Drugs. Drug harms in the UK: a multicriteria decision analysis. Lancet. 2010;376(9752):1558–65.

    Article  PubMed  Google Scholar 

  20. A guide to substance abuse services for primary care clinicians center for substance abuse treatment. A guide to substance abuse services for primary care clinicians. http://www.ncbi.nlm.nih.gov/books/NBK64828/

  21. Merkx MJ, Schippers GM, Koeter MW, Vuijk PJ, Poch M, Kronemeijer H, et al. Predictive validity of treatment allocation guidelines on drinking outcome in alcohol-dependent patients. Addict Behav. 2013;38(3):1691–8.

    Article  PubMed  Google Scholar 

  22. Mee-Lee D, American Society of Addiction Medicine, Working Group on PPC-2. ASAM (American Society of Addiction Medicine) patient placement criteria for the treatment of substance-related disorders. 2nd ed. Chevy Chase: American Society of Addiction Medicine; 1996.

    Google Scholar 

  23. Sharon E, Krebs C, Turner W, Desai N, Binus G, Penk W, et al. Predictive validity of the ASAM patient placement criteria for hospital utilization. J Addict Dis. 2003;22 Suppl 1:79–93.

    PubMed  Google Scholar 

  24. Magura S, Staines G, Kosanke N, Rosenblum A, Foote J, DeLuca A, et al. Predictive validity of the ASAM Patient Placement Criteria for naturalistically matched vs. mismatched alcoholism patients. Am J Addict. 2003;12((5):386–97.

    Article  PubMed  Google Scholar 

  25. Rychtarik RG, Connors GJ, Whitney RB, McGillicuddy NB, Fitterling JM, Wirtz PW. Treatment settings for persons with alcoholism: evidence for matching clients to inpatient versus outpatient care. J Consult Clin Psychol. 2000;68(2):277–89.

    Article  CAS  PubMed  Google Scholar 

  26. Albanese AP. Management of alcohol abuse. Clin Liver Dis. 2012;16(4):737–62.

    Article  PubMed  Google Scholar 

  27. Wallace J. The new disease model of alcoholism. West J Med. 1990;152(5):502–5.

    CAS  PubMed Central  PubMed  Google Scholar 

  28. Mee-Lee D, Shulman G, Fishman M, Gastfriend D, Griffith J, editors. ASAM patient placement criteria for the treatment of substance—related disorders. 2nd ed. Revisited ed. Chevy Chase: American Society of Addiction Medicine; 2001.

    Google Scholar 

  29. Connors GJ, Tonigan JS, Miller WR, MATCH Research Group. A longitudinal model of intake symptomatology, AA participation and outcome: retrospective study of the project MATCH outpatient and aftercare samples. J Stud Alcohol. 2001;62(6):817–25.

    Article  CAS  PubMed  Google Scholar 

  30. Kelly JF, Stout R, Zywiak W, Schneider R. A 3-year study of addiction mutual-help group participation following intensive outpatient treatment. Alcohol Clin Exp Res. 2006;30(8):1381–92.

    Article  PubMed  Google Scholar 

  31. Kissin W, McLeod C, McKay J. The longitudinal relationship between self-help group attendance and course of recovery. Eval Program Plann. 2003;26(3):311–23.

    Article  Google Scholar 

  32. McLellan AT, Lewis DC, O’Brien CP, Kleber HD. Drug dependence, a chronic medical illness: implications for treatment, insurance, and outcomes evaluation. J Am Med Assoc. 2000;284(13):1689–95.

    Article  CAS  Google Scholar 

  33. Sofuoglu M, DeVito EE, Waters AJ, Carroll KM. Cognitive enhancement as a treatment for drug addictions. Neuropharmacology. 2013;64:452–63.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  34. Hettema J, Steele J, Miller WR. Motivational interviewing. Annu Rev Clin Psychol. 2005;1:91–111.

    Article  PubMed  Google Scholar 

  35. Matching alcoholism treatments to client heterogeneity: project MATCH posttreatment drinking outcomes. J Stud Alcohol 1997;58(1):7–29.

    Google Scholar 

  36. Matching alcoholism treatments to client heterogeneity: project MATCH three-year drinking outcomes. Alcohol Clin Exp Res 1998;22(6):1300–11.

    Google Scholar 

  37. Glazer SS, Galanter M, Megwinoff O, Dermatis H, Keller DS. The role of therapeutic alliance in network therapy: a family and peer support-based treatment for cocaine abuse. Subst Abus. 2003;24(2):93–100.

    PubMed  Google Scholar 

  38. Saitz R, Cheng DM, Winter M, Kim TW, Meli SM, Allensworth-Davies D, et al. Chronic care management for dependence on alcohol and other drugs: the AHEAD randomized trial. J Am Med Assoc. 2013;310(11):1156–67.

    Article  CAS  Google Scholar 

  39. Weisner C, Mertens J, Parthasarathy S, Moore C, Lu Y. Integrating primary medical care with addiction treatment: a randomized controlled trial. J Am Med Assoc. 2001;286(14):1715–23.

    Article  CAS  Google Scholar 

  40. Niccols A, Milligan K, Smith A, Sword W, Thabane L, Henderson J. Integrated programs for mothers with substance abuse issues and their children: a systematic review of studies reporting on child outcomes. Child Abuse Negl. 2012;36(4):308–22.

    Article  PubMed  Google Scholar 

  41. Drake RE, Mueser KT, Brunette MF, McHugo GJ. A review of treatments for people with severe mental illnesses and co-occurring substance use disorders. Psychiatr Rehabil J. 2004;27(4):360–74.

    Article  PubMed  Google Scholar 

  42. Jorgensen CH, Pedersen B, Tonnesen H. The efficacy of disulfiram for the treatment of alcohol use disorder. Alcohol Clin Exp Res. 2011;35(10):1749–58.

    Article  CAS  PubMed  Google Scholar 

  43. Pani PP, Trogu E, Vacca R, Amato L, Vecchi S, Davoli M. Disulfiram for the treatment of cocaine dependence. Cochrane Database Syst Rev 2010;(1):CD007024.

    Google Scholar 

  44. Miller PM, Book SW, Stewart SH. Medical treatment of alcohol dependence: a systematic review. Int J Psychiatry Med. 2011;42(3):227–66.

    Article  PubMed Central  PubMed  Google Scholar 

  45. Rosner S, Hackl-Herrwerth A, Leucht S, Lehert P, Vecchi S, Soyka M. Acamprosate for alcohol dependence. Cochrane Database Syst Rev 2010;(9):CD004332.

    Google Scholar 

  46. Cho SH, Whang WW. Acupuncture for alcohol dependence: a systematic review. Alcohol Clin Exp Res. 2009;33(8):1305–13.

    Article  PubMed  Google Scholar 

  47. Anton RF, O’Malley SS, Ciraulo DA, Cisler RA, Couper D, Donovan DM, et al. Combined pharmacotherapies and behavioral interventions for alcohol dependence: the COMBINE study: a randomized controlled trial. J Am Med Assoc. 2006;295(17):2003–17.

    Article  CAS  Google Scholar 

  48. Krystal JH, Cramer JA, Krol WF, Kirk GF, Rosenheck RA, Veterans Affairs Naltrexone Cooperative Study 425 Group. Naltrexone in the treatment of alcohol dependence. N Engl J Med. 2001;345(24):1734–9.

    Article  CAS  PubMed  Google Scholar 

  49. Witte J, Bentley K, Evins AE, Clain AJ, Baer L, Pedrelli P, et al. A randomized, controlled, pilot study of acamprosate added to escitalopram in adults with major depressive disorder and alcohol use disorder. J Clin Psychopharmacol. 2012;32(6):787–96.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  50. Pettinati HM, Oslin DW, Kampman KM, Dundon WD, Xie H, Gallis TL, et al. A double-blind, placebo-controlled trial combining sertraline and naltrexone for treating co-occurring depression and alcohol dependence. Am J Psychiatry. 2010;167(6):668–75.

    Article  PubMed Central  PubMed  Google Scholar 

  51. Mattick RP, Breen C, Kimber J, Davoli M. Methadone maintenance therapy versus no opioid replacement therapy for opioid dependence. Cochrane Database Syst Rev 2009;(3):CD002209.

    Google Scholar 

  52. Colson J, Helm S, Silverman SM. Office-based opioid dependence treatment. Pain Physician. 2012;15(3 Suppl):ES231–6.

    PubMed  Google Scholar 

  53. Minozzi S, Amato L, Vecchi S, Davoli M, Kirchmayer U, Verster A. Oral naltrexone maintenance treatment for opioid dependence. Cochrane Database Syst Rev 2011;(4):CD001333.

    Google Scholar 

  54. Rosner S, Hackl-Herrwerth A, Leucht S, Vecchi S, Srisurapanont M, Soyka M. Opioid antagonists for alcohol dependence. Cochrane Database Syst Rev 2010;(12):CD001867.

    Google Scholar 

  55. Chamorro AJ, Marcos M, Miron-Canelo JA, Pastor I, Gonzalez-Sarmiento R, Laso FJ. Association of micro-opioid receptor (OPRM1) gene polymorphism with response to naltrexone in alcohol dependence: a systematic review and meta-analysis. Addict Biol. 2012;17(3):505–12.

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Andrei D. Sdrulla M.D., Ph.D. .

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Sdrulla, A.D., Chen, G. (2015). The Multidisciplinary Approach to the Management of Substance Abuse. In: Kaye, A., Vadivelu, N., Urman, R. (eds) Substance Abuse. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1951-2_16

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  • DOI: https://doi.org/10.1007/978-1-4939-1951-2_16

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