DSM-5: Clinical and Financial Implications

Topics: DSM | Free Articles | Substance Abuse

The new DSM-5 will change the way clinicians diagnose substance use disorders (SUD) and could have far-reaching consequences for patients seeking treatment and clinicians and organizations offering that treatment. Various proposals for addiction were batted around during the DSM-5 revision process. The final version changed the diagnostic criteria for S

Addiction Through the Decades: From DSM-I to DSM-5

Topics: DSM | Substance Abuse

Addiction has been around seemingly forever. However, how we have conceptualized it, has changed considerably over time. The release of the fifth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in May 2013 marks yet another shift in how clinicians diagnose substance use disorders (SUDs

Substance Use Disorder in DSM-5

Topics: DSM | Substance Abuse

Suboxone: What’s New

Topics: Substance Abuse

In 2010, TCPR published an overview of Suboxone (buprenorphine/naloxone) (TCPR, May 2010). Lots has happened in the three years since then. For starters, the American Society of Addiction Medicine (ASAM) issued a consensus statement in December 2011 on the office-based use of buprenorphine for opioid addiction treatment (Kraus ML et al, J Addict Med

ADHD and Stimulant Abuse

Topics: Substance Abuse

Prescription medication abuse is the among the biggest health issues facing the United States, but prescription medications have an important place in responsible medical treatment. Psychostimulants are among the most commonly prescribed of all medications for children and adolescents (Zuvekas S et al, Am J Psychiatry 2012;169(2):160–166). Widespread

The Psychological Root of Addiction

Topics: Substance Abuse

TCPR: Dr. Dodes, you have written that addictions of all sorts have common psychological roots. Can you describe what you mean by that? Dr. Dodes: The object of any addiction—whether it is alcohol or narcotics or gambling—is not what is important in addiction. What really matters is what drives a person to compulsively seek that drug or that acti

New Drugs, Legal Highs, and Big Risks: A Review of Novel Intoxicants

Topics: Child Psychiatry | Substance Abuse

Get high with no hassles! Try our potent herbal blend! Relax with soothing bath salts! Safe and legal! Popular among individuals seeking to avoid social and legal consequences of drug use, a bewildering array of synthetic intoxicants and formerly obscure ethnobotanicals have surged to prominence in the past decade. A wider variety of intoxicants is avai

Pharmacotherapy for Substance Abuse

Topics: Child Psychiatry | Substance Abuse

Treating substance abuse is difficult whether the patient is young or old. Although one might hope that the shorter period of abuse seen in teens would make the disorder less entrenched, the data shows otherwise: addiction is a stubborn disorder with a long term, relapsing, and remitting course (Simkin DR and Grenoble S, Child Adolesc Psychiatric Clin N

Marijuana May Hurt Cognitive Function, Worse with Heavier Use

Topics: Research Updates | Substance Abuse

Subject: Substance Abuse Short Description: Marijuana May Hurt Cognitive Function, Worse with Heavier Use Background: Does marijuana affect cognitive function? There seems to be no shortage of opinions on this question, but no prospective, longitudinal study has ever been published. Until now, that is. Researchers in New Zealand followed more

Motivational Interviewing: A Tool to Help Treat Substance Abuse

Topics: Substance Abuse

Support Groups for Family Members of Alcoholics

Topics: Substance Abuse

Alcoholism doesn’t just affect the alcoholic. It can impact spouses, partners, children, other family members, and friends. Alcoholics Anonymous (AA) is there to help alcoholics stop drinking, but there are other fellowships to help those with a loved one who is an alcoholic. These groups welcome members whether their loved ones are actively drinking

Twelve Steps at the Heart of Recovery

Topics: Substance Abuse

The heart of the Alcoholic Anonymous (AA) recovery program is contained in 12 Steps. These guiding principles, accepted by AA members as ‘spiritual principles,’ outline a course of action for recovery from alcoholism. The method has since been adapted and become the foundation of other 12-step programs aimed at diverse addictions, compulsions, or

FDA-Approved Medications to Treat Addiction

Topics: Free Articles | Substance Abuse

For decades, the principal treatment for substance use disorders has been psychological therapies. Twelve-step facilitation therapy, modeled after Alcoholics Anonymous, and motivational enhancement therapy are currently the two most widely used. Although disulfiram (Antabuse) hit the U.S. market in 1951, addiction pharmacotherapy was underwhelming fo

Alcoholics Anonymous: A Helpful Adjunct for Some Clients

Topics: Free Articles | Substance Abuse

Alcoholics Anonymous (AA), the biggest self-help group for alcoholics not only in the United States but in the world, was founded in 1935 by Bill Wilson. Wilson—known as Bill W in keeping with the AA tradition of Anonymity—was a successful stockbroker who was also an alcoholic. He sought treatment in a New York City hospital twice. The secon

Mid-Teens Is Peak Age for Prescription Drug Abuse

Topics: Child Psychiatry | Research Updates | Substance Abuse

Is Frequency a Good Indicator of Problem Drinking in Adolescents?

Topics: Child Psychiatry | Research Updates | Substance Abuse

Does Counseling Add to Suboxone’s Efficacy?

Topics: Research Updates | Substance Abuse

Subject: SUBSTANCE ABUSE Short Description: Does Counseling Add to Suboxone’s Efficacy? Background: The combination of buprenorphine and naloxone (Suboxone) has become a popular replacement therapy for heroin dependence. However, it’s not yet clear how effective it is for prescription opioid dependence, or whether adjunctive counseling pr

Off-Label Use of Antipsychotics Effective for Some Indications

Topics: Antipsychotics | Dementia | OCD | PTSD | Substance Abuse

Drugs to Treat Alcoholism

Topics: Substance Abuse

Psychiatrists often take a “don’t ask, don’t treat” approach to alcohol use disorders, often because of the seeming futility of treatment. Why address addiction when many patients will continue to drink? Addiction, not surprisingly, behaves like other mental disorders. No one is too shocked when a patient with a history of major depression devel

Treating Anxiety in Alcoholics

Topics: Free Articles | Substance Abuse

Alcoholism and anxiety go hand in hand. The extent of this comorbidity is clear from the numbers: as many as 45% of patients with alcohol disorders meet diagnostic criteria for a co-occurring anxiety disorder. And alcoholic patients with a comorbid anxiety disorder—particularly panic disorder or social phobia—are three to seven times more likely to