Alcoholism in DSM-IV and DSM-5

Topics: Substance Abuse

Too Much “Screen Time” May Lead to Substance Use

Topics: Child Psychiatry | Substance Abuse

Suboxone Treatment Agreement

Topics: Substance Abuse

Suboxone: An Overview

Topics: Substance Abuse

Opioid drugs represent one of the great triumphs of medicine, because they are extremely effective at relieving pain. Since the 1960s, multiple forms of synthetic opioids have been introduced, including such wellknown drugs as hydrocodone (Vicodin) and oxycodone (Percocet, Oxycontin). Unfortunately, the array of opiate options has led to an exponential

A Primer on Drug Testing

Topics: Substance Abuse

If you are a typical psychiatrist practicing in a setting other than a substance abuse clinic, chances are good that you rarely order drug testing on most of your patients. But should you be doing this more? Possibly. Here are some reasons why you might want to order drug testing: To monitor the sobriety of patients who are acknowledged drug/alcoho

Motivational Interviewing

Topics: Substance Abuse

Five Questions for Effective Motivational Interviewing 1. Why would you want to make this change? (desire) 2. How could you do it in order to succeed? (ability) 3. What are the three best reasons to make this change? (reason) 4. On a scale from 0 to 10, where 0 is not at all important and 10 is most important, how important is it for you to make

Practical Advice on Treating Alcohol Problems

Topics: Substance Abuse

The NIAAA (National Institute on Alcohol Abuse and Alcoholism) has recently posted a practical guide for professionals interested in improving their skills in evaluating and treating patients with alcohol problems. The guide is free, is posted on the NIAAA website, and a CME activity based on the guide is available through Medscape (http://www.medscape.

Behavior Therapy for Substance Abuse

Topics: Substance Abuse

The current issue of the American Journal of Psychiatry carries a meta-analysis of different psychosocial interventions for the treatment of substance abuse (Dutra L et al., Am J Psychiatry 2008 165: 179-187). While the article may not qualify as pleasure-reading, it is an important scientific contribution, because it shows that the effect sizes for cer

Medications for Alcohol Dependence

Topics: Substance Abuse

Topiramate (Topamax) is somewhat effective for alcohol dependence, but heavy on side effects

Topics: Substance Abuse

Monitoring alcohol use may be enough for some

Topics: Substance Abuse

A Cure for Amphetamine Dependence?

Topics: Substance Abuse

Medications for Alcoholism

Topics: Substance Abuse

There are now four medications that are approved by the FDA for the treatment of alcohol dependence, so it is high time we take a fresh look at what our options are. Antabuse. The scientific evidence that Antabuse (disulfiram) actually works is old and not terribly impressive; nonetheless, with over 40 years of experience prescribing it, most addicti

Motivational Interviewing for Alcoholism

Topics: Psychotherapy | Substance Abuse

Motivational interviewing (MI) has taken the world of addiction therapy by storm. MI was first developed by William Miller, Ph.D., who says that the technique began in a barber shop in Norway that had been vacated to provide space for Miller, who was then a visiting professor from the U.S. at the Hjellestad Clinic. He developed the technique in a series

Suboxone: A Primer

Topics: Substance Abuse

Suboxone (buprenorphine/naloxone) was approved by the FDA on October 8, 2002 for the treatment of opioid addiction. This has been heralded as a landmark in psychiatry (see “Anecdotes from the Field” in this issue), which is difficult to fully comprehend for those of us who do not specialize in the treatment of addictions. So a little background o

Anecdotes from the Field: From Methadone to Suboxone

Topics: Substance Abuse

Anthony Raynes, M.D., a psychiatrist and director of Arbour Health Systems in Boston, MA, formerly ran a methadone clinic and is now is a certified prescriber of Suboxone. Note: The following anecdote is not a part of this month’s ACCME-accredited continuing medical education material. “I have found Suboxone to be a tremendous breakthrough in

Alcoholics Anonymous

Topics: Substance Abuse

Editor’s Note: For an elaboration of Dr. Chappel’s views on 12-step programs you can read “Twelve-step and mutual-help programs for addictive disorders” (Chappel JN - Psychiatr Clin North Am - 01-JUN-1999;22(2):425-46).