Pharmacotherapy for Clients Dependent on a Substance

2868 Words12 Pages
Medications approved by the FDA for treatment of alcohol and opioid dependence, including acamprosate, disulfiram, naltrexone, methadone, and buprenorphine, have not been widely studied in the dually diagnosed population. Often, study participation criteria exclude individuals with co-occurring substance use disorders and mental illness, and it is only in recent years that research specifically focused on this population has become more common. Pharmacotherapy has also been underutilized in practice. A survey of 955 bipolar individuals found that while 8% met criteria for a current alcohol use disorder and 5% met criteria for a current non-alcohol substance use disorder, only 0.4% received disulfiram, methadone, naltrexone, and/or buprenorphine (Simon et al., 2004). The high prevalence of comorbid substance abuse and mental illness, and the challenges associated with treatment, mean that underutilization and lack of research are likely to have a critical impact on client outcomes. This paper explores evidence for the safety and efficacy of pharmacotherapy for substance use disorders in clients with comorbid mental illness. It was hypothesized that use of such medications carries risks unique to this client group, and that pharmacotherapy nonetheless has a role in treating substance dependence for these clients. The MNCat and Google Scholar research databases were searched for publications addressing the use of FDA-approved medications for alcohol and opioid dependence in clients with comorbid psychiatric diagnoses. Controlled, double-blind, and large-scale studies were prioritized. When this information was unavailable, theoretical papers, literature reviews, and case histories were included. The paper finds that research on ... ... middle of paper ... ...issues. These beneficial effects were not anticipated. Specifically, the symptoms of psychotic spectrum disorders and PTSD seem to helped by a number of pharmacotherapeutic options. Above all, however, more research is needed. The large gaps in our current understandings of these medications are clear, but there is also room to review other evidence in this area. Further reviews would benefit from a broader range of topics. First, theoretical and neurological understandings of psychiatric disorders and the pharmaceuticals discussed in this paper could be explored in order to add context for case studies when larger research studies are not available. Second, the effect of psychiatric medications on substance use would be useful for prescribing clinicians. Third, further literature reviews would benefit from the inclusion of pharmacotherapy for nicotine dependence.

More about Pharmacotherapy for Clients Dependent on a Substance

Open Document